فهرست مطالب

Hepatitis Monthly
Volume:6 Issue: 1, Spring 2006

  • تاریخ انتشار: 1386/05/20
  • تعداد عناوین: 8
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  • Khan H., Zarif M. Page 7
    Background And Aims
    To determine the risk factors, complications and prognosis of cirrhosis in a hospital based study at Peshawar.
    Methods
    A descriptive Cross sectional study, in medical department, Khyber teaching hospital Peshawar, from April 2005 to march 2006.Relevant informations were recorded from patients and treatment chart of the patients, on a questionnaire designed in accordance with the objectives of the study.
    Results
    A total of 61 patients, 41(67.21%) males and 20(32.78%) females were included. The age range of the patients was from 36 to 75 years with mean age of 57.5 years. Forty-four patients (72.33%) had family history of chronic liver diseases. The risk factors distribution was: Chronic hepatitis "B" infection (13.11%), chronic hepatitis "C" infection (59.01%), chronic hepatitis "B" and "C" co-infection (8.19%), Biliary cirrhosis (3.27%), Wilson disease (1.63%) and No risk factors recorded were recorded in (14.75%) patients. Complications of liver cirrhosis recorded were: Ascites (27.86%), Variceal hemorrhage (18.03%), Hepatorenal syndrome (3.27%), Encephalopathies (1.63%), Hepatocellular carcinoma (1.63%) and no complications were recorded in (47.54%) patients. Prognosis of patients with cirrhosis based on modified child''s Pugh classification was studied in only 30(49.18%) of patients. Out of thirty patients 25(83.33%) had child''s ''A'' grade of prognosis, 4(13.33%) Child''s ''B'' grade and 1(3.33%) Child''s ''C'' grade.
    Conclusions
    Chronic hepatitis B and C infections were the major risk factors for cirrhosis. Ascites and variceal bleeding were recorded as major complications of cirrhosis and majority of our patients fit in child''s a grade of prognosis with 45% chances of 5 years survival.
  • Alavian Sm, Ahmadzad Asl M., Keshvari M., Behnava B., Hajibeigi B. Page 11
    Background And Aims
    There are different treatment regimens for chronic HCV (CHC). The regimen that combines interferon |α| (IFN α) and ribavirin (RIBA) is one of the best known effective regimens.
    Aim
    to assess the therapeutic efficacy (as end treatment and sustained response) and safety of a particular brand of IFN α (PDferon B®) in combination with RIBA on Iranian patients with CHC considering genotype characteristics of subjects.
    Methods
    A quasi-experimental study of 176 adult patients with chronic hepatitis C, regardless of previous IFN α treatment carried out between December 2002 and February 2006 in Tehran Hepatitis Center and then divided in two comparison groups: group 1 with genotype (1a, 1b, non-typable) treated for 48 weeks and group 2 with genotype 2,3 (2a,3a,3b) treated for 24 weeks. Treatments consisted of 48 or 24 weeks of 3 million units subcutaneous PDferon B® three times weekly plus 1000-1200 mg oral RIBA twice daily depending on body mass index (BMI). The Main outcomes were the end treatment virologic response (EVR), biochemical response (EBR) and sustained virologic response (SVR)
    Results
    115 patient with genotype 1 (male/female: 91/24) and 61 patients with genotype 2,3 (male/female: 50/11) were included and matched for age, BMI and cirrhosis. The rate of EVR, EBR and SVR for all patients were 76.1%, 83.5% and 68.2% respectively and EVR and SVR were significantly higher in group 2 than group 1 (71.3% and 61.7% for group 1 and 85.2% and 80.3% for group 2 respectively; P<0.05). In 5.7% and 9.1% of patients adverse drug reactions
    Conclusions
    The genotype and age of patients are the only two independent factors influencing efficacy of treatment either as end treatment or sustained response. The particular brand of IFN in this study (PDferon B®) in combination with RIBA had comparable adverse effects with other reports and a somewhat higher rate end treatment and sustained
  • Khadem Ansari Mh, Omrani Page 19
    Background And Aims
    Since hepatitis C Virus has contaminated approximately 170 millions people over the world. Applying serological screening methods using EIA has led to decline the risk of transmission. However, in chronic renal disease and hemodialysis patients, the EIA method is not sufficient for diagnosis of HCV. Therefore, PCR method is suggested for rapid diagnosis of the disease in this group of patients.
    Methods
    Of 50 collected blood specimens from hemodialysis patients serum separated and stored at -20º C. Then they were examined by the methods of EIA and PCR.
    Results
    Using EIA method, 19 cases were positive (38%) and 31 cases were found negative (62%). In PCR method, 12 cases were found positive (24%) and 38 (76%) were negative. In this method, 12 cases were found real positive and 38 cases were found real negative. While, using EIA method, 5 cases were real positive and 24 cases were real negative and 14 cases were found false positive and 7 cases false negative.
    Conclusions
    Considering the obtained results and their comparison, it is observed that the PCR method is accredited as a specific and reliable method suitable for public screening and that the PCR method is recommended as an exact and final diagnosis method of these patients.
  • Page 25
    HBV infection in chronic renal failure (CRF) becomes chronic in 30 to 60% compared with less than 10% in nonuremic patients.Immunological dysfunction in patients on hemodialysis may be related to imbalanced cytokine systems, such as tumor necrosis factor (TNF-|α|) and interleukin (IL) 6,1 by retention of renal metabolite in uremia and chronic inflammation and have a poor immunological reaction to T-cell-dependent antigens, like hepatitis B vaccination. Immunocompromised patients who are unresponsive to hepatitis B vaccination seem to be unable to enhance IL-10 synthesis for control of monokine overproduction.Moreover, human leukocyte antigen (HLA) genes, which play a major role in the antigen presentation to immunocompetent cells, have also been shown to modulate this immune response.Unfortunately, seroconversion to anti-HBS has been reported to occur in only 40 to 50% of the vaccine, a significantly lower rate than that observed in healthy adults. Various methods including adjutants such as zinc, gamma interferon, thymopentine, GM-CSF and Levamisol for improving immune responses have been advised. Experience with Pres1/s2, third-generation vaccines is limited and they have not been proven more effective than intradermally (ID) administered second-generation S antigen vaccines.Both intramuscular (IM) and intradermal (ID) vaccinations against hepatitis B have variable efficiency in hemodialysis and non-responders should be retreated by ID route.
  • Jalali Mv, Alavian Sm Page 31