Search

Different types of interferon are widely used to treat hepatitis C virus (HCV) infection. Results obtained in vitro suggest that interferon inhibits internal ribosome entry site (IRES)-mediated translation of the HCV genome. To elucidate the possible effect of the nucleotide sequence of IRES on therapy outcome, we compared HCV isolates from patients with sustained response and non-response to interferon/ribavirin combination therapy. In 56 analyzed HCV isolates, nucleotide changes appeared strictly in the stem-loop IIIb region, the stem part from 243 nt to 248 nt, and the polypyrimidine-II region. The natural sequence variability of IRES in isolates of genotype 3a was significantly higher than in isolates of genotype 1b (p < 0.05). The average number of nucleotide changes in genotype 3a correlated with response to therapy (p < 0.05).

Introduction: Progression from acute to chronic HCV infection occurs in 50% to 84% of cases. Even the latest approach - combination therapy with pegilated interferon alfa 2-a or 2b and ribavirin - eliminates the virus in only 54% to 56 % of cases with chronic infection. The aim of this study is to determine whether treatment during the acute phase prevents the development of chronic infection. Material and methods: Between 2001 and 2004, 27 patients with diagnosis of acute hepatitis C were treated at the hepatology Department of Institute of Infectious and Tropical Diseases. Among them, 19 were treated with recombinant interferon alfa 2-a. Acute hepatitis C was defined by clinical and laboratory test results and by exclusion of other causes of acute liver disease. Results: The mean age of our patients was 32.7 years, whereas the mean incubation time was 61.7 days. The mean serum aminotransferase levels were 1119 U/I and the mean total bilirubin levels were 106 mmol/l. At the end of therapy, 81.8% of patients had undetectable levels of HCV RNA, but 94.7% of patients had normal serum alanine aminotransferase levels. At the end of follow up, 84.6% of patients had normal alanine aminotransferase levels and 83.3% of patients had undetectable levels of HCV RNA. One patient had undetectable antibody to HCV at the end of follow-up. Conclusions: The results reported here demonstrate that in the acute phase of HCV infection, interferon treatment is associated with a high rate of virological and biochemical response. We concluded that early treatment of acute hepatitis C may prevent chronic hepatitis C. [ABSTRACT FROM AUTHOR]

Total of 153 patients with chronic Hepatitis C Virus infection was investigated. Patients were classified into three groups: with histologic confirmed liver cirrhosis, clinical advanced cirrhosis, and chronic hepatitis without fibrosis. Acitivity of aminotransferases (AST, ALT), value of INR and platelet counts were analyzed by SPSS for Windows (version 10.0). Probability of cirrhosis was calculated by HALT-C formula and expressed in percent (http://www.haltctrial.org). Thrombocytopenia was the most important predictive factor for progression/exclusion of cirrhosis. Probability of cirrhosis in patients with histologic cirrhosis, clinical cirrhosis and chronic hepatitis without fibrosis was from 23-93%, 41-98% and 4-65%, respectively. Probability equal/more than 50% had 60%, 90% and 14% of patients from the same groups. In conclusion, liver cirrhosis can be predicted based on standard laboratory parameters in more than half of patients with chronic hepatitis C virus infection. [ABSTRACT FROM AUTHOR]