Introduction: Liver represents the main place of drug metabolisation. Drugs and toxic substances reach the level of liver after absorption at gastro-intestinal level. Drug hepatotoxicity represents an important chapter of iatrogenic pathology, because the hepatic lesions induced by drugs include extremely diverse clinical, biological and histological expressions that can take the aspect of any form of acute or chronic hepatobiliary disease. Hepatic lesions induced by drugs (LHIM) represent a histological and/or biochemical alteration caused and attributed to the consumption of a drug. Hepatic elastography (Fibroscan) represents a noninvasive method of quantification of hepatic fibrosis. Material and method: We carried out a retrospective study and longitudinally prospective study that included a set of patients under treatment with Methotrexate, amounting to 76, divided into 2 subsets: a subset consisting of patients with hepatitis to Methotrexate, subset 1, of 23 patients, a subset of patients under treatment with Methotrexate but with normal hepatic samples, subset b, of 53 patients. Results: We carried out fibroscan a t a ll t he patients treated with Methotrexate, obtaining a medium score of fibrosis of 6.23 for the subset a with hepatitis at Methotrexate and of 5.33 for the subset b with normal hepatic samples. We made a correlation between the cumulated dose of Methotrexate and the

Introduction: Direct-acting antiviral agents (DAA) have a direct action in chronic hepatitis C, their addition to the standard therapy with interferon alfa2 (IFN) and ribavirin (RBV) significantly improving the sustained virologic response (SVR) in this disease. Objective: The study analyses the results of triple therapy inclduign DAA in terms of tolerability and efficiency. Material and method: We selected a lot of 24 patients who concluded the DAA administration period, being in the period of finalization of standard therapy at the time of the study. In all the patients clinical and paraclinical assesment was performed including laboratory tests, fibroscan, echography, etc. Results: The duration of the therapy consisting in association of DAA to the standard treatment was 3 months and led to a remarkable result represented by a high rate of negativation of viremia (83.3%). Among the adverse reactions recorded, the most important were: anemia 17 patients (70.8%), leucopenia 10 patients (41.6%), thrombocitopenia 14 patients (58.3%), hyperbilirubinemia 3 patients (12,5%); hyperuricemia 8 patients (33,3%), hypocalcemia 4 patients (16.6%), loss of weight 4 patients (16,6%), anal pruritus (16,6%); among the 24 patients, 2% did not exhibit any adverse reactions. Conclusions: Despite of the various adverse reactions recorded, the triple therapy consisting in DAA added to the standard treatment proves its utility, and the high rates of sustained viral reaction justifies its utilization. It is necessary to increase the number of patients who benefit from the advantages of triple therapy, which, after becoming larger available, could become a new standard therapy in patients with viral chronic hepatitis.

Introduction. The infection with hepatitis C (HCV) is a major cause of chronic liver diseases, with approximately 71,000.000 chronically infected persons worldwide. Material and methods. This study includes the results of the evaluation of the quality of life of patients with chronic hepatic diseases, on a group of 122 patients divided into two lots. The study period was January 2020 - december 2022. Our aim was to study the impact of the antiviral therapy on the patients quality of life before and after the interferon free antiviral therapy, as well as to study the quality of life of the patients with chronic viral hepatitis C who did not receive interferon free antiviral therapy because they did not meet the eligibility criteria, but accepted to participate in the study. Results. Following the analysis and the interpretation of the questionnaire used, we found that the patients who did not receive the treatment presented more frequently a psychosocial unbalance (social activities), psychoemotional and loss of interest for the sexual activity. In the case of patients treated with interferon free regimens we found an improvement of the quality of the whole duration of the therapy, this being correlated, especially, with drug interaction that were limited or easily manageable and had minimal adverse effects, increasing psychoemotional, balance, and the sexual activity was not influenced. Conclusions. The results of our study indicate that the patients who were treated with the antiviral interferon free therapy become aware the fact that the problems related to the chronic hepatic disease are solvable, which influences the quality of life in a positive way.

Hepatic lesions induced by drugs include extremely diverse various clinical, biological and histological manifestations that can determine acute or chronic hepatobiliary disease. The term of hepatitis is recommended to be used when there is a histological confirmation. In the last decades a 11 time increase of the hepatic lesions induced by drugs is reported, due both to the increase of the number of used drugs but also by their more frequent recognition. We carried out a combined retrospective study and longitudinally prospective study that included patients with drug hepatitis. In our study there were 83 cases of drug hepatitis at AINS, which represents 33.46 % of the total number of 248 patients with drug hepatitis. In our study the highest drug hepatitis at AINS were Nimesulid (24 cases), followed by Diclofenac (21 cases), and the fewest at Piroxicam (9 cases). All the cases from the study were symptomatic, showing the increase of the cytolysis enzymes and sometimes cholestasis enzymes (mainly GGT).

Hepatitis C virus (HCV) infection affects approximately 180 million people worldwide, which accounts for roughly 2% -3% of the world's population. Complications arising from chronic HCV infection include the development of cirrhosis, end stage liver disease, and hepatocellular carcinoma (HCV). Objective: The study analyses management of anemia with patients in administrating DAA treatment (Telaprevir for 12 weeks). Material and method: We conducted a study on 24 patients who have concluded the DAA administration period, being now in the period of finalization of standard therapy.Results: Anemia was the most common adverse reaction,17 patients ( 70.8% ),mild anemia 5 patients (20.8%),medium anemia 8 patients( 47% ),severe anemia 4 patients (24% ). Hemoglobin levels were recorded during therapy, mild Hgb (10.0-10.9g/dl),medium Hgb (9.99-9.9 g/dl),severe Hgb (7.0-8.9 g/dl ), and analyzed the management of anemia in these patients. In the first 3 months of therapy ( DAA+PegINF and RBV ), doses of DAA not changed. Any doses of RBV were not modified in patients with mild anemia, in patients with moderate anemia patients received lower doses of RBV, while those with severe anemia patients received lower doses of RBV and red blood cells mass.