RESUMO
BACKGROUND AND AIMS: We undertook this study to evaluate the virological response to and presence of adverse events to natural interferon α (nIFNα; Multiferon®) treatment in previously nonresponsive Mexican patients chronically infected with genotype 1 hepatitis C. METHODS: Thirty-nine patients received a 4-week induction of 5 days/week of 6 MU nIFNα plus weight-based ribavirin followed by 3 MU of nIFNα three times a week for 44 weeks. The relationship between viral response and incidence of adverse events was analyzed. RESULTS: Early viral response (EVR) was age- and sex-dependent, with older male patients being less responsive. Sustained viral response (SVR) was evaluated according to: a) intention to treat analysis, b) 48-week treatment and 24-week follow-up (16 patients), and c) patients with EVR (11 patients). None of the factors was significantly different in groups a) and b); however, in group c) there was a better response with a marked viral load decline in younger patients and in patients aged 50 years and older. Five of 39 (13%) patients who completed treatment presented with an SVR. The most common adverse effect was asthenia in 27% of patients. CONCLUSIONS: nIFNα could be a useful strategy for re-treatment in chronic hepatitis C, genotype 1, in previously nonresponsive patients. Confirmation of these data in a larger population is required.
Assuntos
Antivirais/administração & dosagem , Hepatite C Crônica/tratamento farmacológico , Hepatite C Crônica/genética , Interferon-alfa/administração & dosagem , Antivirais/efeitos adversos , Astenia/induzido quimicamente , Esquema de Medicação , Quimioterapia Combinada , Feminino , Genótipo , Hepacivirus/genética , Hepatite C Crônica/virologia , Humanos , Interferon-alfa/efeitos adversos , Cirrose Hepática/complicações , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Projetos Piloto , Estudos Prospectivos , Proteínas Recombinantes/efeitos adversos , Proteínas Recombinantes/genética , Proteínas Recombinantes/uso terapêutico , Retratamento , Ribavirina/administração & dosagem , Carga Viral/efeitos dos fármacosRESUMO
Algunas de las patologías que se presentan en el esófago son de tipo obstructivo, como las estenosis esofágica benignas o malignas, el diagnóstico se realiza mediante la endoscopia, además de otros estudios. Desde el punto de vista terapéutico el objeto es restablecer una vía adecuada para la alimentación, el cual puede ser por diversas técnicas endoscópicas como dilataciones, ablación térmica o química y prótesis esofágicas, entre otras. El presente reporte es un estudio retrospectivo descriptivo para establecer la prevalencia etiología y manejo en pacientes con estenosis esofágica atendidos en la Unidad de Endoscopia del Hospital regional. "Lic. Adolfo López Mateos del ISSSTE, durante un período de dos años. El total de pacientes fue de 28, que representó el 0.7 por ciento sobre el total de panendoscopias realizadas, la etiología benigna es de 61 por ciento y la maligna de 39 por ciento de los pacientes. El tratamiento utilizado fue por métodos de dilatación tradicional (Hurst y Savary-Gilliard), donde hubo alivio de la disfagia en 96.5 por ciento de los casos, con el inconveniente de requerir múltiples sesiones para alcanzar una luz esofágica adecuada. No hubo complicaciones inherentes a la técnica de dilatación