A randomized 4-arm multicenter study of interferon alfa-2b plus ribavirin in the treatment of patients with chronic hepatitis C not responding to interferon alone.

To determine whether a higher dosage of interferon (IFN) associated with ribavirin and/or prolonged time of administration may improve therapeutic efficacy, we conducted a 4-arm randomized trial on patients with chronic hepatitis C not responding to one or more previous treatment courses with IFN monotherapy. Group 1 (n = 139) received 3 million units (MU) IFN-alpha2b 3 times a week (t.i.w.) plus ribavirin 1,000 mg/d for 12 months; group 2 (n = 162) received 5 MU t.i.w. plus ribavirin for 12 months; group 3 (n = 142) received 3 MU t.i.w. plus ribavirin for 6 months; and group 4 (n = 151) received 5 MU t.i.w. plus ribavirin for 6 months. The primary end point was hepatitis C virus (HCV)-RNA clearance at the end of 6-month follow-up. HCV-RNA was negative in 15% of group 1, 23% of group 2, 11% of group 3, 16% of group 4 (group 2 vs. group 3, P =.04). Among patients with genotypes 1 and 4, sustained response was significantly higher in group 2 vs. group 3 (18% vs. 7%, P =.03; group 1 = 9%, group 4 = 12%, P = not significant [NS]). In patients with genotypes 2 and 3, sustained virologic response was not affected by the different regimens (group 1 = 32%, group 2 = 30%, group 3 = 30%, group 4 = 35%, P = NS). In conclusion, about 23% of nonresponders to IFN monotherapy may achieve a sustained response if re-treated by 5 MU t.i.w. IFN plus ribavirin 1,000 mg/d for 1 year. Patients with genotype 1 should receive a high dosage of IFN plus ribavirin for 12 months, whereas therapy for patients with genotype 2 or 3 should be less aggressive.

[Arthromyopathy caused by barbiturates. Description of a clinical case]. / Artromiopatia da barbiturici. Descrizione di un caso clinico.

The study describes a rare case of arthromyopathy from phenobarbital which affected the right hand of a patient. The case is particularly interesting since symptoms developed after the drug had been taken for only one month.

[Hymenolepis diminuta: a rare helminthiasis in humans. Description of a clinical case]. / Hymenolepis diminuta: un'elmintiasi rara nell'uomo. Descrizione di un caso clinico.

The paper describes a case of hymenolepis diminuta, a relatively uncommon helminthiasis in man. The patient examined displayed very particular aspects with regard to the course of the disease and its diagnosis.

[Protracted course hepatitis A]. / Epatite A a decorso protratto.

Two cases of protracted hepatitis A with normalisation of the transaminases and disappearance of the anti-HAV IgM over a year after onset are described.

[Epidemiological and clinical aspects of a survey of viral non-A, non-B hepatitis in the province of Alessandria]. / Rilievi epidemiologici e clinici su una casistica di epatiti virali non A-non B (NANB) nella provincia di Alessandria.

An epidemiological and clinical research on 48 cases of nonA-nonB hepatitis hospitalized in Alessandria, Infectious Diseases Department, from 1-1-1983 to 1-3-1984 is reported. NonA-nonB hepatitis formed 25% of full cases of viral hepatitis in the same period (192 cases); it was mainly related to hemotransfusion (33,3%) and drug addiction (29,2%); its chronic evolution was observed in the 37,5% of the cases.