0000000000157103
AUTHOR
Ricard Solà
Evolutionary dynamics of the E1-E2 viral populations during combination therapy in non-responder patients chronically infected with hepatitis C virus subtype 1b.
Abstract Half of the patients chronically infected with hepatitis C virus (HCV) genotype 1 fail to respond to pegylated interferon alpha (PEG-IFN) and ribavirin (RBV) therapy. This study assesses the effects of treatment on the evolution of the E1–E2 viral region in non-responder patients infected with HCV-1b. Twenty-three HCV-1b chronically infected patients were studied retrospectively, including 19 non-responders to PEG-IFN/RBV therapy (11 null-responders and 8 relapsers) in the study group, and 4 untreated patients in the control group. Genetic and phylogenetic analyses of the E1–E2 viral populations were performed at baseline and at the time of treatment failure to assess changes in ge…
Tratamiento de la hepatitis C en grupos de pacientes especiales
Resumen El plan de tratamiento de la hepatitis cronica C en las poblaciones especiales varia en funcion de la comorbilidad y las evidencias de tratamiento existentes. En los pacientes con coinfeccion por virus de la hepatitis C y virus de la inmunodeficiencia humana, los resultados del tratamiento con biterapia (interferon pegilado mas ribavirina) son pobres. En los pacientes infectados por virus de genotipo 1, la terapia triple (biterapia mas boceprevir o telaprevir) ha duplicado la tasa de respuesta, pero los inhibidores de la proteasa pueden interactuar con algunos farmacos antirretrovirales y provocan mas efectos adversos. Estos inconvenientes no los presentan los nuevos antivirales dir…
Serum and ascitic fluid bacterial DNA: a new independent prognostic factor in noninfected patients with cirrhosis.
We tested the hypothesis that the presence of bacterial DNA (bactDNA) in ascitic fluid and serum is associated with decreased survival in patients with cirrhosis. In a prospective, multicenter study, we analyzed the clinical evolution of 156 patients with cirrhosis and ascites (first or recurrence) with lower than 250 polymorphonuclear cells (PMN)/L, negative ascites bacteriological culture, and absence of other bacterial infections being admitted for evaluation of largevolume paracentesis, according to the presence of bactDNA at admission. Survival, causes of death, and successive hospital admissions were determined during a 12-month follow-up period. BactDNA was detected in 48 patients. T…