References of "DELWAIDE, Jean"
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See detailTreatment of acute hepatitis C with interferon alpha-2b: early initiation of treatment is the most effective predictive factor of sustained viral response
Delwaide, Jean ULg; Bourgeois, N.; Gerard, Christiane ULg et al

in Alimentary Pharmacology & Therapeutics (2004), 20(1), 15-22

AIM: To evaluate the efficacy of early interferon alpha-2b in non-post-transfusion acute hepatitis C virus: a prospective study with historical comparison. PATIENTS: Group A: 28 patients prospectively ... [more ▼]

AIM: To evaluate the efficacy of early interferon alpha-2b in non-post-transfusion acute hepatitis C virus: a prospective study with historical comparison. PATIENTS: Group A: 28 patients prospectively treated for acute hepatitis C virus with daily regimen of interferon 5 million units for 2 months. Group B: historical series of 16 patients with untreated acute hepatitis C virus. RESULTS: There was no significant difference between the two groups with regard to gender, age, icterus, alanine aminotransferase, or genotypes. In group B, hepatitis spontaneously resolved in three of 16 (19%) patients (follow-up 1-7 years). In group A, 21 of 25 patients became sustained viral responders (75%; P = 0.0003 vs. group B). Factors include not predictive of sustained viral response: age, gender, sources of infection, presence of icterus, alanine aminotransferase peak, bilirubin peak, incubation period, presence of hepatitis C virus antibodies at presentation, or genotypes. The time from presentation to the start of therapy was, however, significantly shorter in sustained viral responders (43 +/- 31 days) than in relapsers or non-responders (88 +/- 52 days) (P = 0.016). CONCLUSIONS: Early treatment of acute hepatitis C virus with interferon prevents chronicity. A short waiting time from presentation to treatment appears as the most relevant predictive factor for sustained response. [less ▲]

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See detailLiving related liver transplantation in adults: First year experience at the University of Liege
Detry, Olivier ULg; De Roover, Arnaud ULg; Delwaide, Jean ULg et al

in Acta Chirurgica Belgica (2004), 104(2, MAR-APR), 166-171

Living related liver transplantation (LRLT) in adult recipients has been recently developed to overcome the organ donor shortage, but LRLT leaves the healthy donors at risk of serious post-operative ... [more ▼]

Living related liver transplantation (LRLT) in adult recipients has been recently developed to overcome the organ donor shortage, but LRLT leaves the healthy donors at risk of serious post-operative complications, or even death. The aim of this paper is to report the prospective evaluation of the initial experience of adult LRLT at the University of Liege. From March 2002 till March 2003, in a consecutive series of 35 adult liver transplantations, five recipients (mean age : 51 years) underwent LRLT, including one retransplantation. Indications for transplantation were autoimmune hepatitis, hepatitis B virus related cirrhosis with hepatocarcinoma (two cases), hepatitis C virus related cirrhosis with hepatocarcinoma, and ischemic intrahepatic bile duct necrosis 10 years after primary liver transplantation. Mean age of the donors was 34 years (range : 21-53 years). All donation cases were intra familial at first degree. The right lobe was used as a graft in four cases and the left lobe in one case. All right lobe donors developed transient hyperbilirubinemia and hypocoagulation for 4 to 6 days. No severe complication (transfusion, bile duct fistula, reintervention, rehospitalization) nor significant long-term sequelae were observed in the donors. In the recipients, graft function was immediate, and there was no small-for-size syndrome. One recipient developed biliary fistula treated by reoperation. One recipient died from invasive aspergillosis 11 days after the procedure. The four other recipients were alive without recurrence of the disease at follow-up. This report confirmed that LRLT may be a valuable alternative to cadaveric liver transplantation in the era of organ donor shortage. However, even if there was no severe complication for the donors in our preliminary experience, LRLT puts healthy living donors at risk of significant morbidity and even death. [less ▲]

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See detailLe cas clinique du mois. Cirrhose autoimmune traitee par transplantation hepatique 'a partir d'un lobe hepatique droit preleve chez un donneur vivant
Detry, Olivier ULg; De Roover, Arnaud ULg; Coimbra Marques, Carla ULg et al

in Revue Médicale de Liège (2004), 59(2), 69-74

The authors describe the case of a 17-year-old girl who suffered from end-stage liver failure due to chronic autoimmune hepatitis. Liver failure was complicated by severe portal hypertension ... [more ▼]

The authors describe the case of a 17-year-old girl who suffered from end-stage liver failure due to chronic autoimmune hepatitis. Liver failure was complicated by severe portal hypertension, hypersplenism and refractory ascites. Liver transplantation was indicated. She was listed for cadaveric whole liver transplantation, but her infrequent blood group (B) increased waiting time. Her condition deteriorated to Child C liver failure and living related liver transplant was considered. Her father was compatible and proposed himself for donation. Right lobe procurement was decided in order to provide sufficient liver mass. No transfusion of red cells, platelets, or fresh frozen plasma was used either in the donor or the recipient. Both recipient and donor left the ward at postoperative day 14, without complication. They were both asymptomatic and with normal liver tests at one year follow-up. Living related liver transplantation using the right lobe may offer an alternative to liver transplant candidates in this period of organ donor shortage. [less ▲]

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See detailLiving related liver transplantation in adults: First year experience at the University of Liege
DETRY, Olivier ULg; DE ROOVER, Arnaud ULg; DELWAIDE, Jean ULg et al

in Acta Gastro-Enterologica Belgica (2004), 67

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See detailHpatitis C infection: eligibility for antiviral therapies
El souda, R; DELWAIDE, Jean ULg; GERARD, Christiane ULg et al

in Acta Gastro-Enterologica Belgica (2004), 67

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See detailHCV genotype 5: an easy to treat population
REENAERS, Catherine ULg; DELWAIDE, Jean ULg; GERARD, Christiane ULg et al

in Acta Gastro-Enterologica Belgica (2004), 67

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See detailHCV genotype 4 in Belgium: epidemiological characteristics
REENAERS, Catherine ULg; DELWAIDE, Jean ULg; GERARD, Christiane ULg et al

in Acta Gastro-Enterologica Belgica (2004), (67), 03

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See detailLiver transplantation in Jehovah's witnesses
DETRY, Olivier ULg; DE ROOVER, Arnaud ULg; DELWAIDE, Jean ULg et al

in Acta Gastro-Enterologica Belgica (2004), 67

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See detailParadoxe: lorsqu'un etat prothrombotique est responsable d'une hemorragie digestive. Observation d'un cas de sclerose hepatoportale
Croes, F.; Servais, B.; Delwaide, Jean ULg et al

in Revue Médicale de Liège (2004), 59(1), 32-34

Variceal bleeding is frequently the initial presentation of a previously unknown cirrhosis. Portal hypertension and its complications without liver cirrhosis should raise the possibility of presinusoidal ... [more ▼]

Variceal bleeding is frequently the initial presentation of a previously unknown cirrhosis. Portal hypertension and its complications without liver cirrhosis should raise the possibility of presinusoidal portal hypertension, and the diagnosis of hepatoportal sclerosis. These patients need to be investigated for coagulation disorders. A hypercoagulable state is often associated. Risks and benefits of anticoagulation should be further investigated in these patients. [less ▲]

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See detailReduction of relapse rates by 18-month treatment in chronic hepatitis C. A Benelux randomized trial in 300 patients.
Brouwer, Johannes T; Nevens, Frederik; Bekkering, Frank C et al

in Journal of Hepatology (2004), 40(4), 689-695

BACKGROUND/AIMS: Treatment of chronic hepatitis C with interferon can be ineffective due to relapse. We aimed to reduce the 40% relapse rate of 6 months interferon-ribavirin combination therapy by ... [more ▼]

BACKGROUND/AIMS: Treatment of chronic hepatitis C with interferon can be ineffective due to relapse. We aimed to reduce the 40% relapse rate of 6 months interferon-ribavirin combination therapy by prolonging treatment to 18 months. METHODS: Three hundred patients with treatment-naive hepatitis C, were randomized to 18 months combination therapy with interferon (3MU tiw) and ribavirin (1000-1200 mg/day), 18 months interferon combined with placebo, or 6 months combination therapy with interferon and ribavirin, in a double blinded manner. All 295 patients who received at least one dose of treatment were included in the intention to treat analysis. RESULTS: At the end of treatment, HCV RNA was undetectable in 55 and 49% of those on 6 and 18 months combination therapy, respectively, versus 26% of those on monotherapy (P<0.001). The relapse rate was 38% for 6 months combination therapy, 38% for 18 months monotherapy, and only 13% for 18 months combination treatment (P=0.002). The sustained response rates were 34% for 6 months combination therapy, 16% for 18 months monotherapy and 43% for 18 months combination therapy (P<0.05). CONCLUSIONS: Reduction of relapse rates to 15% or less is feasible by prolongation of interferon-ribavirin treatment to 18 months. [less ▲]

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See detailBASL guidelines for the surveillance, diagnosis and treatment of hepatocellular carcinoma
Van Vlierberghe, Hans; Borbath, Ivan; Delwaide, Jean ULg et al

in Acta Gastro-Enterologica Belgica (2004), 67(1), 14-25

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See detailL'image du mois. Une varice duodenale compliquant une hypertension portale
Detry, Olivier ULg; Delwaide, Jean ULg; De Roover, Arnaud ULg et al

in Revue Médicale de Liège (2003), 58(11), 657-8

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See detailThe use of mycophenolate mofetil in liver transplant recipients
Detry, Olivier ULg; De Roover, Arnaud ULg; Delwaide, Jean ULg et al

in Expert Opinion on Pharmacotherapy (2003), 4(11), 1949-1957

Mycophenolate mofetil is an important drug in the modern immunosuppressive arsenal. Mycophenolate mofetil is the semisynthetic morpholinoethyl ester of mycophenolate acid. Mycophenolate acid prevents T ... [more ▼]

Mycophenolate mofetil is an important drug in the modern immunosuppressive arsenal. Mycophenolate mofetil is the semisynthetic morpholinoethyl ester of mycophenolate acid. Mycophenolate acid prevents T and B cell proliferation by specifically inhibiting a purine pathway required for lymphocyte division. This paper extensively reviews the experience of mycophenolate mofetil use in liver transplant recipients. In randomised trials, mycophenolate mofetil decreased the rate of acute rejection after liver transplantation, without a significant increase of septic complications. However, so far, there are no data indicating that mycophenolate mofetil increases liver transplant patient or graft survivals. Mycophenolate mofetil is interesting because of its particular side effects profile, which is very different from the other immunosuppressants. The absence of mycophenolate mofetil nephrotoxicity is of specific interest in liver recipients with impairment of renal function. The monitoring of mycophenolate acid area under the concentration time curve might be interesting to limit side effects and provide better clinical efficacy but the exact role of mycophenolate acid monitoring in liver recipients has yet to be further evaluated in large series. [less ▲]

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See detailLe cas clinique du mois. La maladie de still de l'adulte: une cause rare d'hepatite aigue febrile
Michels, V.; Delwaide, Jean ULg; Vermeulen, P. et al

in Revue Médicale de Liège (2003), 58(12), 729-733

A 63-year-old woman was hospitalized for the third time in one year for asthenia, fever and chills, jaundice, cytolysis and cholestasis. An adult onset Still's disease was diagnosed. Hepatic ... [more ▼]

A 63-year-old woman was hospitalized for the third time in one year for asthenia, fever and chills, jaundice, cytolysis and cholestasis. An adult onset Still's disease was diagnosed. Hepatic manifestations, diagnostic criteria and efficient therapy of AOSD will be reviewed. [less ▲]

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See detailPostexposure management of hepatitis A, B or C: treatment, postexposure prophylaxis and recommendations
Delwaide, Jean ULg

in Acta Gastro-Enterologica Belgica (2003), 66(3), 250-254

Although there is no consensus on the best management of acute hepatitis C or on optimal strategy of follow-up after potential contamination, certain guidelines can nevertheless be proposed for the care ... [more ▼]

Although there is no consensus on the best management of acute hepatitis C or on optimal strategy of follow-up after potential contamination, certain guidelines can nevertheless be proposed for the care of these patients in practice. It is now recommended that acute hepatitis C be treated by interferon monotherapy in the presence of a C viremia, detectable by polymerase chain reaction, and an elevation of the transaminases. The earlier the treatment is started after appearance of symptoms, the more effective it is. Management of a potentially contaminated individuals consists of screening for the C virus as early as the fifteenth day after the potentially contaminating act and, in the case of virus transmission, starting interferon treatment as soon as elevation of the transaminases appears. No special precautions are to be taken by the person potentially contaminated for avoiding possible secondary C virus transmission during the follow-up period. In the case of acute hepatitis B, antiviral treatment should not be started, in view of the high percentage of spontaneous recoveries and the potentially negative effect of treatment on the chances of spontaneous recovery. Post-exposure prophylaxis by anti-hepatitis B immunoglobin injections and/or vaccination should be considered after evaluation of the hepatitis B surface antigen status of the source and of the vaccination and vaccine-response status of the exposed person. The classic scheme for selecting the most appropriate postexposure prophylaxis is reminded. In post-exposure prophylaxis for hepatitis A virus, although there have been no studies comparing the effectiveness of vaccination with that of immunoglobin injections, it is at present proposed to provide only vaccination. The target groups eligible for post-exposure prophylaxis are evoked. [less ▲]

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See detailHépatite C: dépistage, traitement et prévention. Recommandations pratiques-résumé
Brenard, R.; Michielsen, P.; Bourgeois, N. et al

in La Revue de la Medicine Generale (2003), 205

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See detailRetreatment of hepatitis C non-responsive to interferon. A placebo controlled randomized trial of ribavirin monotherapy versus combination therapy with Ribavirin and Interferon in 121 patients in the Benelux [ISRCTN53821378]
Veldt, Bart J; Brouwer, Johannes T; Adler, Michael et al

in BMC Gastroenterology (2003), 3(1), 24

BACKGROUND: Evidence based medicine depends on unbiased selection of completed randomized controlled trials. For completeness it is important to publish all trials. This report describes the first large ... [more ▼]

BACKGROUND: Evidence based medicine depends on unbiased selection of completed randomized controlled trials. For completeness it is important to publish all trials. This report describes the first large randomised controlled trial where combination therapy was compared to placebo therapy and to ribavirin monotherapy, which has not been published until now. METHODS: One hundred and twenty one patients with chronic hepatitis C and elevated transaminases who did not respond to previous treatment with standard interferon monotherapy, were included from 16 centers in Belgium, the Netherlands and Luxembourg between 1992 and 1996. Patient poor-response characteristics were: genotype 1 (69%), HCV RNA above 2 x 10(6) copies/ml (55%) and cirrhosis (38%). Patients were randomized to 6 months combination therapy with interferon alpha-2b (3 MU tiw) and ribavirin (1000-1200 mg/day), 6 months ribavirin monotherapy (1000-1200 mg/day) or 6 months ribavirin placebo. The study was double blinded for the ribavirin/placebo component. One patient did not fit the entry criteria, and 3 did not start. All 117 patients who received at least one dose of treatment were included in the intention to treat analysis. RESULTS: At the end of treatment, HCV RNA was undetectable in 35% of patients on combination therapy and in none of the patients treated with ribavirin monotherapy or placebo. The sustained virological response rate at 6 months after therapy was 15% for patients treated with interferon and ribavirin.During the 6 months treatment period 13% of patients on interferon ribavirin combination therapy, 13% of patients on ribavirin monotherapy and 11% of patients on placebo withdrew due to side effects or noncompliance. At 24 weeks of treatment the mean Hb level was 85% of the baseline value, which means a mean decrease from 9.1 mmol/l to 7.8 mmol/l. The Hb levels at the end of treatment were not significantly different from patients treated with ribavirin monotherapy (p = 0.76). End of treatment WBC was significantly lower in patients treated with combination therapy, compared to ribavirin (p < 0.01) as well as for patients treated with ribavirin monotherapy compared to placebo (p < 0.01). DISCUSSION: This belated report on the only placebo controlled study of interferon ribavirin combination therapy in non responders to standard doses of interferon monotherapy documents the effectiveness, be it limited, of this approach as well as the dynamics of the effects on blood counts. [less ▲]

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See detailDaily induction combination treatment with alpha 2b interferon and ribavirin or standard combination treatment in naive chronic hepatitis C patients. A multicentre randomized controlled trial
Van Vlierberghe, H.; Leroux-Roels, G.; Adler, M. et al

in Journal of Viral Hepatitis (2003), 10(6), 460-466

The standard treatment for patients with chronic hepatitis C is a 6-12-month combination therapy with interferon alpha and ribavirin. Induction treatment could result in a faster early decline of the ... [more ▼]

The standard treatment for patients with chronic hepatitis C is a 6-12-month combination therapy with interferon alpha and ribavirin. Induction treatment could result in a faster early decline of the hepatitis C virus (HCV) load and a better response rate. Naive chronically infected HCV patients (n = 454) were randomized into two arms to receive either induction treatment with interferon alpha 2b 5 million units (MU) subcutaneously (s.c.) daily during a period of 8 weeks (arm A); or treatment with interferon alpha 2b 5 MU s.c. three times a week (TIW) for a period of 8 weeks (arm B). After week 8, interferon treatment in both arms was 3 MU s.c. TIW for a total period of 12 months. In both arms, ribavirin (1000-1200 mg orally per day) was added at week 4. Induction treatment resulted in a higher virological response at week 8 of treatment (66%vs 47%; P < 0.01). However, response at the end of treatment and at 6 months follow-up was not different (53%vs 50%, 41%vs 33%). The occurrence of adverse events and the drop-out rate were similar in both arms. Although an early virological response is observed more frequently in the induction treatment, end of treatment response and sustained responses did not differ. [less ▲]

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See detailHepatitis C: screening, treatment and prevention practical guidelines
Michielsen, P.; Brenard, R.; Bourgeois, N. et al

in Acta Gastro-Enterologica Belgica (2003), 66(1), 15-19

The standard treatment for patients with chronic hepatitis C is a 6-12-month combination therapy with interferon alpha and ribavirin. Induction treatment could result in a faster early decline of the ... [more ▼]

The standard treatment for patients with chronic hepatitis C is a 6-12-month combination therapy with interferon alpha and ribavirin. Induction treatment could result in a faster early decline of the hepatitis C virus (HCV) load and a better response rate. Naive chronically infected HCV patients (n = 454) were randomized into two arms to receive either induction treatment with interferon alpha 2b 5 million units (MU) subcutaneously (s.c.) daily during a period of 8 weeks (arm A); or treatment with interferon alpha 2b 5 MU s.c. three times a week (TIW) for a period of 8 weeks (arm B). After week 8, interferon treatment in both arms was 3 MU s.c. TIW for a total period of 12 months. In both arms, ribavirin (1000-1200 mg orally per day) was added at week 4. Induction treatment resulted in a higher virological response at week 8 of treatment (66%vs 47%; P < 0.01). However, response at the end of treatment and at 6 months follow-up was not different (53%vs 50%, 41%vs 33%). The occurrence of adverse events and the drop-out rate were similar in both arms. Although an early virological response is observed more frequently in the induction treatment, end of treatment response and sustained responses did not differ [less ▲]

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