Assuntos
Anticoagulantes/administração & dosagem , Fibrinolíticos/uso terapêutico , Heparina de Baixo Peso Molecular/uso terapêutico , Veia Porta , Trombose Venosa/tratamento farmacológico , Doença Aguda , Administração Oral , Adulto , Anticoagulantes/uso terapêutico , Feminino , Humanos , Resultado do TratamentoRESUMO
The initial clearance of hepatitis C virus (HCV) during interferon-alfa therapy is dose-dependent. Therefore, higher initial interferon doses (induction therapy) may improve treatment results. This concept was tested in a prospective, randomized controlled trial. Previously untreated patients with chronic hepatitis C were randomized to receive 3 different interferon doses during the first 14 weeks of therapy (Group A, n = 130: 10 MU IntronA [AESCA-Schering Plough, Traiskirchen, Austria]/day for 2 weeks, followed by 10 MU/2 days for 12 weeks; Group B, n = 124: 5 MU/day for 14 weeks; Group C, n = 119; 5 MU/2 days for 14 weeks) followed in all by 5 MU/2 days for 24 weeks. Throughout the whole study all patients received 1 to 1.2 g ribavirin/day. On treatment, no differences in viral clearance rates were observed. Sustained response rates were also not different among the groups (A: 48.5%, B and C: 41.3%, intent to treat). When data were analyzed according to genotypes, sustained response was almost twice as high in patients with genotype 1 receiving high-dose interferon induction therapy (A: 44.2%, B: 28.6%, C: 27%, P <.05). In contrast, results were not different in genotype 3a patients (A: 61.3%, B: 75.9%, C: 56.3%; P >.1). These data indicate that high-dose interferon induction therapy may improve the outcome of interferon/ribavirin combination therapy in genotype 1 patients.
Assuntos
Antivirais/uso terapêutico , Hepatite C Crônica/tratamento farmacológico , Indutores de Interferon/uso terapêutico , Ribavirina/uso terapêutico , Adulto , Antivirais/efeitos adversos , Quimioterapia Combinada , Feminino , Hepatite C Crônica/virologia , Humanos , Indutores de Interferon/efeitos adversos , Masculino , Pessoa de Meia-Idade , Pacientes Desistentes do Tratamento , Estudos Prospectivos , Ribavirina/efeitos adversos , Resultado do Tratamento , Carga ViralAssuntos
Antimetabólitos/efeitos adversos , Feto/efeitos dos fármacos , Resultado da Gravidez , Ribavirina/efeitos adversos , Adulto , Feminino , Fertilização , Hepatite C Crônica/tratamento farmacológico , Humanos , Interferon alfa-2 , Interferon-alfa/efeitos adversos , Masculino , Mutagênese , Exposição Paterna , Gravidez , Proteínas RecombinantesRESUMO
In this study, we compared serum hepatitis C virus (HCV) RNA concentrations with HCV RNA concentrations in whole blood collection tubes, including two different types of EDTA tubes and nucleic acid stabilization tubes (NASTs). We also investigated the impact of a processing delay on HCV RNA concentration in these tubes. In NASTs, the mean HCV RNA concentration was comparable to the mean serum HCV RNA concentration at "date zero." In EDTA tubes, mean baseline HCV RNA concentrations were higher. Storage at room temperature up to 96 h did not result in a decline of HCV RNA concentration in any of the whole blood collection tubes. In NASTs, HCV RNA concentrations remained stable during the whole study period, whereas a significant increase of HCV RNA was observed in both types of EDTA tubes at 96 h compared to date zero. We concluded that HCV RNA remains stable in NASTs at room temperature for at least 96 h, allowing greater flexibility in sample collection and transport.
Assuntos
Coleta de Amostras Sanguíneas , Sangue/virologia , Hepacivirus/isolamento & purificação , Hepatite C/virologia , RNA Viral/sangue , Adulto , Coleta de Amostras Sanguíneas/instrumentação , Coleta de Amostras Sanguíneas/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Diffuse hemangiomatoses are extremely rare in adults. The etiology and natural history of the disease are not well understood. A case of diffuse hemangiomatosis of the liver and spleen associated with progressive liver failure, thrombocytopenia, and disturbance of blood coagulation (comparable to Kasabach-Merritt syndrome) is presented in a 62-year-old male. We describe the histopathological and immunohistochemical findings and illustrate the morphological aspects of differential diagnosis, distinguishing the disease from other vascular proliferations.