No abstract

Absence or a low level of HBcAg expression may predict the end of treatment response to current therapies, especially in HBeAg (-) patients. The PCNA determination does not predict treatment response.

Background Our aim was to determine the short-term natural course of viraemia and the response to lamivudine treatment in HBeAg-negative chronic hepatitis B patients with a persistently low hepatitis B virus (HBV)-DNA level. Methods A total of 55 patients were included. Group 1 consisted of 37 patients with low-level viraemia and high serum alanine aminotransferase (ALT) levels and further randomized to two groups: group 1a ( n=19) patients received 1 year of lamivudine therapy and group 1b ( n=18) patients were untreated controls. Group 2 consisted of 18 inactive carriers who were followed as controls of untreated low viraemic chronic hepatitis B patients. HBV DNA was longitudinally determined by real-time polymerase chain reaction assay. Results A female predominance in group 2 was observed while males were predominant in group 1. Mean age and baseline HBV-DNA levels did not differ between group 1 and 2 patients while group 1 patients had a higher histological score ( P<0.01). Of group 1a patients, 44% had complete ALT normalization at end of treatment, whereas 21% untreated group 1b patients had normal ALT at the end of the follow-up. No change in histological activity was observed in group 1a patients at the end of treatment. HBV-DNA levels did not significantly change from baseline to end-of-treatment/observation period in patient groups. The viraemia course was not different across the groups. Conclusions Low viraemic HBeAg-negative patients with high ALT present with minimal/mild histological activity. Inactive carriers cannot be differentiated from low viraemic patients with high ALT based on HBV DNA determination. Although lamivudine treatment can be effective in some cases, observation rather than a prompt treatment attempt seems to be more logical because of mild histological changes and low response rate to treatment in these patients.

Introduction: Crimean-Congo haemorrhagic fever (CCHF) is a lethal zoonotic disease caused by an RNA virus that is a member of the Nairovirus genus in the Bunyaviridae family from the arbovirus group. CCHF is transmitted by Hyalomma ticks through direct contact with the blood and other bodily fluids of patients or infected animals. Case description: A 65-year-old man was admitted to the emergency unit with dry cough, myalgia and fever. He was treated with favipiravir. He had disseminated intravascular coagulopathy with thrombocytopenia in the setting of COVID-19 infection. He tested positive for both COVID-19 and CCHF. By the end of the fifth day of treatment, his laboratory parameters and clinical symptoms had normalized. Conclusion: Favipiravir is currently on the market for treating COVID-19 infection worldwide. It has also been used to treat CCHF in laboratory animals. To the best of our knowledge this is the first report of CCHF successfully treated with favipiravir, which could be a key drug for treating human CCHF.

No abstract