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
Se estudiaron 104 pacientes con eclampsia, de enero de 1984 a agosto de 1988. La edad de presentación media fue de 24.2 años, primigestas en su mayoría, con una media de 34.2 semanas de embarazo, la presión arterial media de ingreso fue de 132 mmHg, el gradiente alveolo arterial se encontró abierto en 80.36% y la presión coloidosmótica disminuida en 59.38%; no hubo correlación significativa entre las mismas. Se concluyó que la presión oncótica es un factor importante pués valores bajos favorecen edema pulmonar y cerebral. Las pacientes con eclampsia presentan vasoespasmo genralizado que favorece daño endotelial, aumento de la permeabilidad capilar, elevación de la presión oncótica, activación del sistema de coagulación fibrinolisis y gradiente alveolo arterial abierto por lo que a su vez requieren una evaluación integral de los factores alterados para así establecer el tratamiento adecuado.