HBV infection in Belgium: results of the BASL observatory of 1456 HBsAg carriers.

in Acta Gastro-Enterologica Belgica (2012), 75(1), 35-41

Introduction : Nationwide studies are mandatory to assess changes in the epidemiology of HBV infection in Europe. Aim : To describe epidemiological characteristics of HBsAgpositive patients, especially ... [more ▼]

Introduction : Nationwide studies are mandatory to assess changes in the epidemiology of HBV infection in Europe. Aim : To describe epidemiological characteristics of HBsAgpositive patients, especially inactive carriers, and to evaluate how practitioners manage HBV patients in real life. Methods : Belgian physicians were asked to report all chronically infected HBV patients during a one-year period. Results : Among 1,456 patients included, 1,035 (71%) were classified into one of four phases of chronic infection : immune tolerance (n = 10), HBeAg-positive hepatitis (n = 248), HBeAgnegative hepatitis (n = 420) and inactive carrier state (n = 357 HBeAg-negative patients with ALT < upper limit of normal (ULN) and HBV DNA < 2,000 IU/mL). Using less restrictive criteria for ALT (1-2 ULN) or HBV DNA (2,000-20,000 IU/mL), 93 unclassified patients were added to the group of inactive carriers. These 93 additional inactive carriers were younger, more frequently males, with similar risk factors for HBV infection and histological features compared to inactive carriers according to recent guidelines. Recent guidelines on management of HBV patients were generally followed, but systematic HBV DNA measurements and HDV coinfection screening should be reinforced. Conclusion : In Belgium, an inactive carrier state was a common form of chronic HBV infection. Using less restrictive criteria for classification of inactive carriers did not modify their main characteristics and seemed better adapted to clinical practice. Recent guidelines on management of HBV patients should be reinforced. [less ▲]

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 ▲]