Guidelines for the management of chronic hepatitis C in patients infected after substance use

in Acta Gastro-Enterologica Belgica (2005), 68(1), 38-45

Hépatite C: dépistage, traitement et prévention. Recommandations pratiques-résumé

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

Hepatitis C: screening, treatment and prevention practical guidelines

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 ▲]

Factors inftuencing ribavirin-induced hemolysis

in Journal of Hepatology (2001), 34

BackgroundlAims: One of the major side eft'ects of the combination therapy for chronic hepatitis C is ribavirininduced hemolytic anemia. Little is known about variables inftuencing tbis anemia. Our study ... [more ▼]

BackgroundlAims: One of the major side eft'ects of the combination therapy for chronic hepatitis C is ribavirininduced hemolytic anemia. Little is known about variables inftuencing tbis anemia. Our study tried to search for these variables in a large group of patients with hepatitis C treated with the combination therapy. Methods: Two hundred and forty-four patients chronically infected with the hepatitis C virus were treated either with induction treatment (daily dose ofinterferon) or with a standard treatment (interferon thrice weekly). Both groups received 1000-1200 mg of ribavirin from week 4 until the end of the treatment. The drop in hemoglobin level was defined as the dift'erence between the pretreatment hemoglobin level and the hemoglobin level at week 8. Seventeen variables which could possibly influencê'this drop in hemoglobin level were examined. Results: After multivariate analysis, the drop in hemoglobin level was only significant influenced by pretreatment platelet level, treatment and haptoglobin phenotype. The ribavirin dose did not influence the drop in hemoglobin level or the early virological response. Conclusions: Ribavirin-induced hemolysis is inftuenced by the pretreatment platelet level, the administered amount of a-interferon and the haptoglobin phenotype. A careful search for the minimal dose of ribavirin needed in combination treatment is necessary. [less ▲]

The presence of a type IV collagen skeleton associated with periductal elastosis in breast cancer

in Journal of Histochemistry and Cytochemistry : Official Journal of the Histochemistry Society (1990), 38

Using serial sections of frozen and AFA-fixed tissues from 34 breast cancers, we studied the presence of basement membrane material in the areas of elastosis. Various amounts of type IV collagen but not ... [more ▼]

Using serial sections of frozen and AFA-fixed tissues from 34 breast cancers, we studied the presence of basement membrane material in the areas of elastosis. Various amounts of type IV collagen but not of laminin were demonstrated in areas of periductal elastosis. In some tumors, type IV collagen accumulated beneath the basement membrane. Periductal elastosis in areas of extensive fibrosis showed focal type IV collagen immunoreactivity, indicating remnants of ducts. Interstitial elastosis corresponded with weak type IV collagen reactivity. Each tumor showed type IV collagen immunostaining of the elastotic areas, with various degrees of intensity. Negative crossreactivity of the type IV collagen antibody with elastin was verified in skin biopsies with solar elastosis. Pre-incubation of the antibody with large amounts of elastin demonstrated an identical immunoreactivity. The specificity of the antibody was confirmed by ELISA and by Western blot analysis. To explain the periductal elastosis, we propose the following hypothesis. Excessive production of basement membrane material by the epithelial cells of the ducts leads to formation of a type IV collagen skeleton. This skeleton can act as the matrix for a secondary deposition of elastic material. [less ▲]