The sustained virologic response of nonresponder hepatitis C virus patients with retreatment

Akhan, Sıla; Gurel, Erdem; Sayan, Murat

doi:10.4103/0377-4929.77330

Cited by 7 publications

(5 citation statements)

References 2 publications

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“…Hepatit C virusu ile infekte hastaların, fibrozise ilerleyişi henüz tam olarak anlaşılmış değildir. Tc (CD8+) hücrelerinin erken cevabı viral klirenste önemli olabilir (8). TNF-alfa, TGF-beta, IL-10 gibi bazı sitokin ve kemokinler antiviral mekanizmada rol oynar.…”

Section: İrdelemeunclassified

“…Bizim çalışmamızda, karaciğer enflamasyonu ve fibrozise etkili olabilecek sitokinlerden TNF-alfa, IL-10 ve TGF-beta araştırıldı. İnfeksiyöz patojenlerin neden olduğu akut inflamatuar cevabın ana mediyatörü olan TNF-alfa, antiviral defans mekanizmasını tetikleyerek enflamasyonun progresyonunu sağlamaktadır (11,12); antikor üretimini tetikleyerek infeksiyonun şiddetlenmesine de sebep olabilir (8). Karaciğerde lokal inflamatuar alanlarda infiltrasyon yapan mononükleer hücrelerde üretilip sekrete edilir ve bu TNF-alfa'nın kronik karaciğer hastalığında inflamatuar aktivitede rol oynayabileceğini düşündürmektedir (13).…”

Section: İrdelemeunclassified

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Evaluation of the Correlation Between Serum Tumor Necrosis Factor Alpha, Transforming Growth Factor-Beta, Interleukin-10 and Alanine Aminotransferase Levels and Liver Histological Activity in Naive Chronic Hepatitis C Patients

BALASAR¹,

Erayman²,

Turk-Aribas³

2023

Klimik Derg

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Objective: In this study serum tumor necrosis factor alpha (TNF-alpha), transforming growth factor beta (TGF- beta), interleukin-10 (IL–10) and alanine transferase (ALT) levels were measured in naive chronic hepatitis C patients and healthy control group. The relationship between the values and the histological activity of the liver was evaluated to make predictions about liver histology without the need for biopsy. Methods: A total of 86 individuals including 43 patients and 43 controls participated in the study. Serum AST, ALT, TNF-alpha, TGF- beta and IL–10 values were analyzed in patient and control groups. The correlation between liver fibrosis degree (stage) and histological activity index (HAI) scores and the IL–10, TNF-alpha, IL-10, TGF-BETA values of the case and control group was evaluated. Results: A very strong correlation was found between HAI and TNF-alpha (rho=0965). A significant relation was found between HAI and TGF-beta (rho=0.446) and statistical correlation was not found between HAI and IL-10. A significant relation was found between HAI and serum ALT values in the patient group. Conclusion: Liver biopsy is an invasive procedure with complications which may have severe results. There is a need for biochemical or radiological markers which extrapolate to liver biopsy. In our study, measurement of serum cytokine and ALT values was observed as a noninvasive method which can help to meet this need.

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Section: İrdelemeunclassified

Evaluation of the Correlation Between Serum Tumor Necrosis Factor Alpha, Transforming Growth Factor-Beta, Interleukin-10 and Alanine Aminotransferase Levels and Liver Histological Activity in Naive Chronic Hepatitis C Patients

BALASAR¹,

Erayman²,

Turk-Aribas³

2023

Klimik Derg

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“…Puoti ve arkadaşları (6), ALT düzeyi normal olan ve karaciğer biyopsisi yapılan 159 hastanın %44'ünde hafif, %34'ünde minimal, %4'ünde orta-şiddetli kronik hepatit bulgularının olduğunu ve %1 oranında ise siroz tanısı konulduğunu bildirmişlerdir. Martinot-Peignoux ve arkadaşları (17) (28)(29)(30)(31)(32)(33). Günümüzde kabul gören standard tedavi protokolü pegile interferon-a ve ribavirin kombinasyonudur (30,34,35).…”

Section: İrdelemeunclassified

Liver Histology of Patients with Hepatitis C Virus Infection and Normal Alanine Aminotransferase Levels

Aygen¹,

Denız²,

Akhan³

et al. 2012

Klimik Dergisi

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ÖzetAmaç: Bu çalışmada alanin aminotransferaz (ALT) düzeyi normal kronik hepatit C (KHC)'li hastalarda karaciğerdeki histolojik değişikliklerin değerlendirilmesi amaçlanmıştır. Yöntemler: Çok merkezli retrospektif çalışmamızda >16 yaş, ALT düzeyi normal, KHC'li 72 hasta değerlendirildi. ALT'nin en az 6 ay süresince ve en az birer ay arayla 2 veya 3 kez normal sınırlar içinde olması "normal ALT düzeyi" kabul edildi. Demografik veriler, tanı konulan yıl, 6 ay içindeki en az 2 ALT değeri, hepatit göstergeleri, hepatit C virusu (HCV) RNA ve karaciğer biyopsisi sonuçları kaydedildi. Hepatit göstergeleri farklı kitlerle test edildi. HCV RNA, ölçüm aralığı ve duyarlılığı farklı polimeraz zincir reaksiyonu kitleriyle çalışıldı. Biyopsi preparatları aynı patologca tekrar değerlendirildi. Bulgular: Hastaların yaş ortalaması 44±13 yıldı ve %61.1'i kadındı. HCV RNA değerleri 1.53x10 2 -1.13x10 8 İÜ/ml arasındaydı. ALT değerleri ortalaması 30.3±9.6 İÜ/lt bulundu. Histopatolojik olarak ortalama nekroinflamasyon derecesi 4.67±1.96 ve ortalama fibroz evresi 1.03±1.13 idi. Biyopsilerin %48.6'sında minimal aktivite, %45.8'inde hafif aktivite ve %2.8'inde orta aktivite saptandı. Portal-periportal fibroz oranı %51.4, köprüleşen fibroz oranı %6.9 ve inkomplet-komplet siroz oranı %1.4 idi. Sonuçlar: KHC'li hastalarda ALT düzeyleri hastalığın aktivitesini belirlemede zayıf bir göstergedir. Tedavi indikasyonu olan hastalar karaciğer biyopsisi açısından değerlendirilmelidir. AbstractObjective: In this study, our objective is to evaluate histological changes in livers of hepatitis C virus (HCV)-infected patients with normal alanine aminotransferase (ALT) levels. Methods: 72 patients over 16 years old, with chronic hepatitis C (CHC) and normal ALT levels were evaluated in this multicenter retrospective study. Persistently normal ALT level was defined as 2 or 3 normal ALT levels at intervals of at least 1 month during 6 months. Demographic data, year of diagnosis, at least 2 ALT values within 6 months, hepatitis markers, results of HCV RNA and the liver biopsy were all evaluated. Serological markers have been tested with different kits. HCV RNA has been studied by RT-PCR with dynamic range and sensitivity of different kits. All biopsies were evaluated again by the same pathologist. Results: The mean age was 44±13 years and 61.1% were female. HCV RNA levels were between 1.53x10 2 -1.13x10 8 IU/ml. The mean ALT levels were 30.3±9.6 IU/lt. The mean grade of necroinflammation was 4.67±1.96 and mean staging of fibrosis was 1.03±1.13. The ratios of minimal, mild and moderate activity in the liver biopsies were 48.6%, 45.3% and, 2.8%, respectively. Rate of portal-periportal fibrosis, bridging fibrosis and incomplete cirrhosis were 51.4%, 6.9%, and 1.4%, respectively. Conclusions: ALT level is a poor indicator of liver disease activity in patients with CHC. Patients with indication for treatment should be evaluated for liver biopsy.

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“…Tedavide ön-celeri interferon (IFN) tek başına kullanılmaktayken daha sonra ribavirin (RBV) ile kombinasyonu ve IFN'nin pegilasyonuyla da pegile IFN (PegIFN) kullanıma girdi. Yakın zamana kadar PegIFN ve RBV kombinasyonu KHC infeksiyonunda ilk basamak tedavi olarak kullanılmaktaydı (3). Günümüzde ise, genotip 1'e bağlı KHC tedavisi, PegIFN ve RBV kombinasyonuna proteaz inhibitörleri (telaprevir veya boseprevir) eklenerek yönetilmektedir (1).…”

Section: Introductionunclassified

“…Günümüzde ise, genotip 1'e bağlı KHC tedavisi, PegIFN ve RBV kombinasyonuna proteaz inhibitörleri (telaprevir veya boseprevir) eklenerek yönetilmektedir (1). Bu tedavi rejimleri için iki çe-şit PegIFN molekülü bulunmaktadır: PegIFN α-2a ve PegIFN α-2b (3,4). Bu iki molekülün, farmakokinetik ve farmakodinamik özelliklerinde, kalıcı viral yanıt (KVY) oranlarında ve yan etkilerinde değişikliklere neden olabilecek yapısal farklılıkları vardır (5).…”

Section: Introductionunclassified

Comparison of Haematologic Side Effects of Different Pegylated Interferon-α Molecules Combined With Ribavirin

Aydın¹,

Aksöz²,

Korkut³

et al. 2015

Klimik Dergisi

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Objective: Treatment of chronic hepatitis C virus (HCV) infection with pegylated interferon (PegIFN) and ribavirin causes haematological side effects such as anemia, neutropenia and trombocytopenia. This study aimed to evaluate and compare the haematological side effects of PegIFN α-2a and PegIFN α-2b with ribavirin in the treatment of chronic HCV infection. Methods: 103 patients treated with PegIFN α-2b plus ribavirin and 70 patients treated with PegIFN α-2a plus ribavirin were included in this retrospective study. Patients' haematological parameters in first and third month's visits were compared with pretreatment test results. Results: In all patients, 21.2% had anemia (haemoglobin <10 g/dL), 3.8% had neutropenia (<750/mm 3 ) and 6.2% had thrombocytopenia (<75x10 9 /L) at the end of the third month. When compared with initial levels, significant decreases in haemoglobin, neutrophil and thrombocyte counts were observed at first and third months in both groups. There wasn't a significant decrease in thrombocyte counts in the first month between two groups, however, a more significant decrease in thrombocyte counts were observed in patients who received PegIFN α-2a plus ribavirin than the patients receiving PegIFN α-2b plus ribavirin during the third month. Conclusions: PegIFN α-2b seems to have similar haematologic side effects, compared with PegIFN α-2a except the effects on the thrombocyte counts during the third month. Klimik Dergisi 2014; 27(3): 99-102.

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The sustained virologic response of nonresponder hepatitis C virus patients with retreatment

Cited by 7 publications

References 2 publications

Evaluation of the Correlation Between Serum Tumor Necrosis Factor Alpha, Transforming Growth Factor-Beta, Interleukin-10 and Alanine Aminotransferase Levels and Liver Histological Activity in Naive Chronic Hepatitis C Patients

Evaluation of the Correlation Between Serum Tumor Necrosis Factor Alpha, Transforming Growth Factor-Beta, Interleukin-10 and Alanine Aminotransferase Levels and Liver Histological Activity in Naive Chronic Hepatitis C Patients

Liver Histology of Patients with Hepatitis C Virus Infection and Normal Alanine Aminotransferase Levels

Comparison of Haematologic Side Effects of Different Pegylated Interferon-α Molecules Combined With Ribavirin

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