Search results for " hepatitis"

Pegylated interferon α plus ribavirin for the treatment of chronic hepatitis C: A multicentre independent study supported by the Italian Drug Agency

2014

a b s t r a c t Background: Data on the efficacy of Peg-interferon/ribavirin therapy for chronic hepatitis C are mostly derived from treatment of selected patients enrolled in clinical trials. This study aimed to assess the effectiveness of Peg-interferon/ribavirin therapy in “real world” chronic hepatitis C patients in Italy. Methods: Independent observational multicentre study including consecutive patients receiving Peginterferon/ribavirin in the 18 months before (retrospective phase) and after (prospective phase) the start of the study. Results: 4176 patients were eligible. The final study population consisted of 2051 patients in the retrospective and 2073 in the prospective phase. Sust…

Oral immunization with HCV-NS3-transformed Salmonella: induction of HCV-specific CTL in a transgenic mouse model.

2001

Abstract Background & Aims: The ability to induce cytotoxic T cells is considered an important feature of a candidate hepatitis C virus (HCV) vaccine. We used an oral immunization strategy with attenuated HCV-NS3–transformed Salmonella typhimurium to deliver DNA directly to the gut-associated lymphoid tissue. Methods: HLA-A2.1 transgenic mice were immunized once with transformed attenuated Salmonella . HCV-specific CD8 + T cells were analyzed in vitro as well as in vivo by challenge of mice with recombinant HCV-NS3 vaccinia virus. Results: Salmonella (10 8 colony-forming units; 20 μg plasmid DNA) induced cytotoxic and IFN-γ–producing CD8 + T cells specific for the immunodominant epitope NS3…

Correlation between the single nucleotide polymorphism (SNP) rs4374383 in MERTK gene with the risk of development and progression of liver disease

[Access to hepatitis C treatment: a lesson for the future.]

2018

L’immissione in commercio dei farmaci antivirali ad azione diretta (DAA) di nuova generazione per la terapia dell’infezione cronica da virus dell’epatite C ha rivoluzionato lo scenario precedente e ha messo a dura prova le istituzioni, a causa del prezzo elevato delle terapie. Un’analisi di quanto accaduto negli ultimi tre anni, specialmente in Italia, ci aiuta a comprendere come è stata gestita la contrattazione dei prezzi e soprattutto con quali criteri si è scelto, in una prima fase, di consentire un accesso ristretto in base al bisogno di cura dei pazienti. Ciò consente di mettere a fuoco alcuni temi importanti e di individuare le sfide che ci attendono nel prossimo futuro. The new gene…

EFFETTI DELLA TERAPIA CON DIRECT ACTING ANTIVIRALS (DAAS) SUI PARAMETRI ECOGRAFICI DI IPERTENSIONE PORTALE

2017

Obiettivi dello studio: Tra gli end point della terapia antivirale con DAAs nella cirrosi HCV (LCHCV) oltre all' eradicazione del virus vi sono: la regressione della fibrosi e dell’ipertensione portale. Abbiamo valutato in pazienti LCHCV e risposta sostenuta (SVR) alla terapia con DAAs il comportamento dell’AST to Platelet Ratio Index (APRI) (marker indiretto di fibrosi) e di due segni ecografici di ipertensione portale: calibro della vena porta (cVP) e diametro longitudinale della milza (DLM). Materiali: 98 pazienti con LCHCV,al Baseline (BL) a fine terapia (FT) e tre mesi (PostT3) e 9 mesi dopo la fine della terapia (PostT9) eseguivano i test di funzionalità epatica e la conta piastrinica…

HCV genotypes in western Sicily: any evidence for a shift?

2008

Background: The relative prevalence of each HCV strain in a specific country is characterized by a predominant genotype and a number of other sub-prevalent types. Over the last decade a shift away from the prevalent HCV G1 towards G3 and G4 has been reported in some countries, and might affect the global management of HCV disease. Aim: In order to assess any possible variation in the prevalence of HCV genotypes in Sicily, we surveyed an hospital based cohort of subjects with chronic HCV infection observed over the last ten years. Patient and methods: 3209 Italian patients resident in Western Sicily, 1842/1367 M/F, between 1 and 89 years of age, presented at our tertiary referral Laboratory …

Antimitochondrial antibody -M2 positive autoimmune hepatitis during standard of care for chronic hepatitis C.

2012

The current standard of care (SoC) for chronic hepatitis C, i.e. the combination of a pegylated-interferon (PEG-IFN) with ribavirin (RBV), may activate underlying autoimmune conditions. Particularly, interferon (IFN) has been known to induce or exacerbate autoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC) in hepatitis C virus patients. We describe a severe, acute-onset antimitochondrial antibody (AMA)-M2 positive AIH appearing during the last weeks of SoC in a woman with chronic hepatitis C and no previous history of autoimmunity, and resolving on protracted steroids. In this context, the relevance of the characterization of the immunoglobulin isotype of portal plasma cells for …

Cost-effectiveness of sofosbuvir-based triple therapy for untreated patients with genotype 1 chronic hepatitis C

2013

We assessed the cost-effectiveness of sofosbuvir (SOF)-based triple therapy (TT) compared with boceprevir (BOC)- and telaprevir (TVR)-based TT in untreated genotype 1 (G1) chronic hepatitis C (CHC) patients discriminated according to IL28B genotype, severity of liver fibrosis, and G1 subtype. The available published literature provided the data source. The target population was made up of untreated Caucasian patients, aged 50 years, with G1CHC and these were evaluated over a lifetime horizon by Markov model. The study was carried out from the perspective of the Italian National Health Service. Outcomes included discounted costs (in euros at 2013 value), life-years gained (LYG), quality-adju…

Simeprevir with pegylated interferon alfa 2a plus ribavirin in treatment-naive patients with chronic hepatitis C virus genotype 1 infection (QUEST-1)…

2014

Although the addition of the HCV NS3/4A protease inhibitors boceprevir and telaprevir to pegylated interferon (peginterferon) alfa plus ribavirin has improved sustained virological response (SVR) in treatment-naive and treatment-experienced patients infected with hepatitis C virus (HCV) genotype 1, the regimens have a high pill burden and are associated with increased rates and severity of adverse events, such as anaemia and rash. The efficacy and safety of the combination of simeprevir, a one pill, once-daily, oral HCV NS3/4A protease inhibitor, plus peginterferon alfa 2a plus ribavirin were assessed in treatment-naive patients with HCV genotype 1 infection.In QUEST-1, a phase 3, randomise…

Incidence of DAA failure and the clinical impact of retreatment in real-life patients treated in the advanced stage of liver disease: Interim evaluat…

2017

Background: Few data are available on the virological and clinical outcomes of advanced liver disease patients retreated after first-line DAA failure. Aim: To evaluate DAA failure incidence and the retreatment clinical impact in patients treated in the advanced liver disease stage. Methods: Data on HCV genotype, liver disease severity, and first and second line DAA regimens were prospectively collected in consecutive patients who reached the 12-week post-treatment and retreatment evaluations from January 2015 to December 2016 in 23 of the PITER network centers. Results: Among 3,830 patients with advanced fibrosis (F3) or cirrhosis, 139 (3.6%) failed to achieve SVR. Genotype 3, bilirubin lev…