conclusions: absence of the c allele was significantly associated with failure of response. the presence of c allele was associated with a favorable outcome. afp is a strong baseline predictor of hcv treatment response. a decision tree model is useful for predicting the probability of response to therapy. patients and methods: the study included 263 chronic hcv egyptian patients receiving peg-i...

Hepatitis C virus (HCV) management in the transplant setting is still an open issue. The therapeutic strategies being addressed include: (a) pre-transplant prophylaxis (to prevent the infection of the transplanted organ); (b) post-transplant prophylaxis (to reduce the possibility of developing acute hepatitis); (c) management once the chronic disease has already set in and stabilized. Combinati...

Chronic hepatitis C might lead to several immunological dysfunctions. Studies have shown a positive association between hepatitis C virus (HCV) infection and psoriasis. These results suggest that the infection may be one of the triggering factors for the development or exacerbation of psoriasis. Here, we present a case of chronic HCV infection with psoriasis who developed exacerbation of skin l...

Although no randomized controlled trials have addressed this question, I recommend a 3to 6-month course of peginterferon-based therapy (with or without ribavirin) in those patients who have failed to clear acute infection. Success rates in this setting (ie, rates of sustained viral clearance) approach 90%. The importance of early treatment is clear: these success rates vastly eclipse those seen...

n engl j med 355;23 www.nejm.org december 7, 2006 2444 This Journal feature begins with a case vignette that includes a therapeutic recommendation. A discussion of the clinical problem and the mechanism of benefit of this form of therapy follows. Major clinical studies, the clinical use of this therapy, and potential adverse effects are reviewed. Relevant formal guidelines, if they exist, are p...

Methods Patients were treated with telaprevir in combination with peginterferon alfa and ribavirin (PR) for 12 weeks, followed by PR for 12 or 36 weeks. Severe fibrosis/cirrhosis was defined by liver biopsy (Metavir F3-4 or Ishak 3-6) or noninvasive tests. Platelet count >90,000/cmm was required at entry. HCV RNA was evaluated at baseline and Weeks 4 and 12 of treatment. Virological response wa...

PJP Based on my clinical experience with telaprevir (Incivek, Vertex), I would say that anorectal symptoms occur 25–30% of the time. The package insert for telaprevir cites a similar figure, reporting anorectal symptoms in 29% of telaprevir-treated patients compared to only 7% of patients treated with peginterferon and ribavirin. Overall, approximately one fourth of patients seem to experience ...