Search

Background: In the period 2000 – 2011, chronic hepatitis C virus infection (HCV infection) was primarily treated with a combination of pegylated interferon and ribavirin. New antiviral drugs, which are effective but very expensive, are in the process of replacing this regimen. We have investigated the results pegylated interferon and ribavirin have yielded in ordinary clinical practice and examined the part this treatment may play in the near future., Material and Method: We included in this retrospective study HCV-RNA-positive, treatment-naive patients at Stavanger University Hospital, Akershus University Hospital and Østfold Hospital who received at least one dose of pegylated interferon in combination with ribavirin in the period 2000 – 2011. The primary endpoint was sustained virologic response (SVR). Predictors for SVR were identified by means of logistic regression analysis., Results: Of 588 included patients, 69.6% (409/588) achieved SVR, 14.3% (84/588) suffered relapse and 16.1% (95/588) showed non-response. In a multivariate analysis, genotypes 2 or 3 and low age at treatment start were independent predictors of SVR. A total of 85.4% of patients aged ≤ 40 years with genotype 2 or 3 had SVR., Interpretation: We found good results for treatment of young patients with genotype 2 or 3 with pegylated interferon and ribavirin. Low age and viral genotype were predictors of sustained virologic response (SVR).

Background: Hepatitis C virus (HCV) infection is common among injecting drug users. The aims of this study were to assess the prevalence of risk behaviour and its association with HCV infection., Material and Methods: All users of the needle exchange program in Oslo, within a given time period, were eligible for inclusion in this cross-sectional study; 327 chose to participate. The users were asked about type of drug use and risk behaviour for HCV exposure in a structured interview. Sera were drawn and tested for anti HCV (EIA-3) and HCV RNA (in- house PCR)., Results: The prevalence of HCV RNA was 51 % and 81 % had anti-HCV. A multivariate analysis revealed positive associations between anti-HCV positive status and age < 20 years at first injection, > 5 years of drug use, age > 34 years, sharing of syringes, injecting drug use while imprisoned, back-loading and use of heroin. One in five users with anti-HCV reported to never have shared syringes. However, sharing of drug paraphernalia other than needles was not associated with anti-HCV. Sharing of needles the last four weeks before the interview was more common among those living with a partner than those who lived alone., Interpretation: Most injecting drug users in Oslo have been exposed to HCV (anti HCV+) and half of them have developed chronic infection (HCV RNA+). HCV was associated with back-loading and sharing of syringes - especially during incarceration. Sharing of injection paraphernalia was not associated with being anti HCV positive.

Background: Hepatitis C is a large global health problem; approximately 20 - 30 000 are infected in Norway. Hepatitis C-infection is often chronic and can progress into chronic liver disease, liver cirrhosis and hepatocellular carcinoma. The most important transmission route is through percutaneous exposure to infected blood. The aim of this article is to describe the clinical course, microbiological diagnostic approaches, therapy, prophylaxis and public health aspects of Hepatitis C infection., Material and Methods: The paper is based on results from annual health examinations (conducted since 2001) of persons who abuse drugs intravenously in Oslo, from diagnostic work in a national reference laboratory for Hepatitis C and studies of literature (retrieved from Pubmed)., Results and Interpretation: The prevalence of Hepatitis C varies by country and subgroup of patients. In Norway the prevalence is 0.13 % among new blood donors, 0.7 % among pregnant women, 0.55 % in the general adult population and approximately 70 % among persons who abuse drugs intravenously. Treatment with pegylated interferon and ribavirin induces sustained virological response in 80 % of patients with genotypes 2 and 3 and in 30 - 40 % of those with genotype 1.

Invasive infections caused by bacteria and fungi are common complications of intravenous drug abuse. Various vital organs and structures may be affected, e.g. the cardiac valves, the larger arteries, the bones, the joints and the central nervous system. However, due to the high frequency of low-virulent microbes of skin and oral origin, the clinical picture may be atypical with subacute course and few focal signs and symptoms. The complexity of this problem is illustrated by eight cases of serious bacterial and fungal infections recently diagnosed at our hospitals. All patients were HIV negative intravenous heroin addicts. The clinical spectrum was wide and included skin abscesses, pyomyositis, spondylodiscitis, septic arthritis, costal osteomyelitis, infective endocarditis, recurrent bacteraemia, and multiple brain abscesses.

All residents aged 40-42 in Akershus county were invited to screening for cardiovascular risk factors in 1990-91 as part of a prevention programme. Of the 13,607 attendants, 8,960 answered an anonymous questionnaire about social network, drinking habits, and injuries due to violence. Compared with data from the Central Bureau of Statistics, our material included a high percentage of persons with a higher education, a high percentage of married persons, and a low percentage of persons living alone. Results in respect of social network and drinking habits roughly agreed with those of other studies. Of the males, 15.7% had been injured at least once as a result of violence, most often assault and robbery. Of the females, the corresponding percentage was 18.1. Here the dominating forms of violence were maltreatment, threats and sexual assault. Females were more often exposed than males to repeated violence and more often suffered persisting problems as a result of maltreatment. Compared with other studies, we found a high prevalence of injuries from violence among females, suggesting underreporting of experiences of violence by females in studies based on personal interview or the hospitals' injury register.