Few studies have been conducted in the Eastern Mediterranean region on chronic hepatitis C virus (HCV) infection with reference to genotypes. We investigated the response to standard combination therapy (pegylated interferon/ribavirin) of different genotypes of HCV in Kuwaiti patients and factors that could be associated with sustained virological response (SVR). The records of all Kuwaiti patients treated for chronic HCV between January 2003 and May 2009 were retrospectively identified and reviewed. Of 108 patients studied, 27.8% were infected with genotype 1, 25.0% with genotype 3 and 47.2% with genotype 4. Overall, 64.8% of patients achieved SVR, 25.9%, were non-responders and 9.3% were relapsers. Baseline viral load and alanine aminotransferase level in addition to early virological response to pegylated interferon-based therapy may serve as a decision tool for clinicians to identify patients who are unlikely to achieve SVR. Traitement par peginterféron alfa-2b et ribavirine chez des patients koweïtiens atteints d'infection chronique par le virus de l'hépatite CRÉSUMÉ Peu d'études ont été conduites dans la région de la Méditerranée orientale sur l'infection chronique par le virus de l'hépatite C rapportée aux différents génotypes. Nous avons étudié la réponse à une association médicamenteuse classique (interféron pégylé/ribavirine), de différents génotypes du virus de l'hépatite C chez des patients koweïtiens, et les facteurs qui pourraient être associés à une réponse virologique prolongée. Les dossiers de tous les patients koweïtiens traités pour une infection par le virus de l'hépatite C entre janvier 2003 et mai 2009 ont été recherchés et examinés. Parmi 108 patients étudiés sur dossier, 27,8 % d'entre eux étaient infectés par le génotype 1, 25,0 % par le génotype 3, et 47,2 % par le génotype 4. Globalement, 64,8 % des patients ont présenté une réponse virologique prolongée, 25,9 % étaient non-répondeurs et 9,3 % ont rechuté. La charge virale de référence et le taux d'alanine aminotransférase, associés à une réponse virologique précoce au traitement à base d'interféron pégylé sont des critères qui pourraient servir d'aide à la décision pour les cliniciens afin d'identifier les patients qui ne sont pas susceptibles de présenter une réponse virologique prolongée.

Aim of the work: this study aimed to report a case of a bandage contact lens (BCL) retained for two years and six months in its primary position, which was associated with distinct clinical appearance over the patient's only Seeing Eye. Patient and methods: a 70-year-old one-eyed female patient with a history of systemic hypertension and poor vision in the left eye due to an old trauma was presented with right eye spontaneous corneal perforation and leak. The patient was treated with cyanoacrylate corneal glue along with a bandage contact lens (BCL). For the unknown reasons, the patient did not come for a follow-up medical care and presented after two years and six months with the retention of the BCL in its original position. Results: the retained BCL developed an atypical clinical appearance in the form of granular deposits along the edges made of mixed epithelium and mucous deposition. We hypothesize that this deposition occurred as an adaptive mechanism and aided in BCL stabilization and prevention of serious contact lens-related complications. Conclusions and Importance: to our knowledge, long-term in-place retention of BCL with distinct clinical appearance has not been characterized before. Despite the long period of retention, the lens did not migrate to the local vicinity and presented any serious complications. This report highlights the importance of appropriate patient education and counselling to ensure their compliance, thereby preventing any unfavourable future complications.

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