RESUMO
BACKGROUND: Interferon monotherapy significantly reduces the chronicity rate of acute hepatitis C in nonuremic patients. In this clinical study, we evaluated the efficacy and tolerance of interferon-alpha therapy for acute hepatitis C in hemodialysis patients. METHODS: Patients with acute hepatitis C, established on the basis of seroconversion to anti-hepatitis C virus and the presence of hepatitis C virus RNA, received a low dose of interferon-alpha (3 MU three times per week) for 12 months or a high dose (5 MU three times per week, preceded by a daily induction dose) for 6 months. Response to treatment was defined as undetectable hepatitis C virus RNA at the end of treatment and sustained virological response was defined as persistent negative hepatitis C virus RNA 6 months after the end of treatment. RESULTS: Twenty-three patients were treated, 16 with a low dose of interferon-alpha and seven with a high dose. At the end of treatment, hepatitis C virus RNA was undetectable in 16/23 patients (70%). Of these, 6/23 patients (26%) relapsed and 10/23 (43%) maintained a sustained virological response (38% in lower doses vs. 57% in higher doses). Treatment was well tolerated and only three patients discontinued therapy (13%). CONCLUSION: Interferon-alpha within the first year after acute hepatitis C in hemodialysis patients was found to be safe and effective, inducing a sustained virological response in 43% of cases. This study supports the routine indication of acute hepatitis C treatment with interferon-alpha for hemodialysis patients, and higher doses administered for a shorter period of time should be tried according to the tolerance of the patients.
Assuntos
Antivirais/uso terapêutico , Hepatite C/tratamento farmacológico , Interferon-alfa/uso terapêutico , Falência Renal Crônica/complicações , Diálise Renal , Doença Aguda , Adulto , Antivirais/efeitos adversos , Esquema de Medicação , Feminino , Seguimentos , Hepacivirus/isolamento & purificação , Hepatite C/complicações , Hepatite C Crônica/prevenção & controle , Humanos , Interferon-alfa/efeitos adversos , Falência Renal Crônica/terapia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , RNA Viral/sangue , Resultado do TratamentoAssuntos
Biomarcadores/sangue , Infecções por HIV/complicações , Hepatite C/complicações , Cirrose Hepática/diagnóstico , Cirrose Hepática/etiologia , Índice de Gravidade de Doença , Fatores Etários , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Humanos , Cirrose Hepática/sangue , Cirrose Hepática/fisiopatologia , Contagem de Plaquetas , PrognósticoRESUMO
Relato de um caso de doença celíaca em asso»ciação com diabetes melito insulino-dependente, sarcoidose e doença auto-imune da tiróide. Exis»tem poucos relatos da associação destas quatro doenças, mas nenhum caso no Brasil. Neste caso, a dieta sem glúten foi seguida pela remissão de um nódulo sarcóide cutâneo e pelo desapareci»mento de auto-anticorpos relacionados a tiróide.
