Prevalence of Helicobacter pylori infection among new outpatients with dyspepsia in Kuwait

<p>Abstract</p> <p>Background</p> <p>Testing and treatment for <it>Helicobacter pylori </it>has become widely accepted as the approach of choice for patients with chronic dyspepsia but no alarming features. We evaluated <it>H. pylori </it>status among outpatients with uninvestigated dyspepsia in Kuwait.</p> <p>Methods</p> <p>A prospectively collected database for 1035 patients who had undergone ¹³C-urea breath tests (UBT) for various indications was reviewed for the period from October 2007 to July 2009. The status of <it>H. pylori </it>in dyspeptic patients was determined by UBT.</p> <p>Results</p> <p>Among the 362 patients who had undergone UBT for uninvestigated dyspepsia, 49.7% were positive for <it>H. pylori </it>(95% CI = 44%-55%) and the percentage increased with age (35.8% at 20-29 years, 95% CI = 25.4% - 47.2%; 59.3% at 30-39 years, 95% CI = 48.5% - 69.5%) (P = 0.013). The prevalence of <it>H. pylori </it>was 42.6% among Kuwaitis (95% CI = 35%-50%) and 57.6% (95% CI = 49.8%-65%) among expatriates (p = 0.004). The prevalence among males was 51.3%, while in females it was 48.6%.</p> <p>Conclusions</p> <p>Almost half of the patients with dyspeptic symptoms in Kuwait were positive for <it>H. pylori</it>, though the prevalence varied with age and was higher among expatriates. The American Gastroenterology Association guidelines recommending testing and treatment for <it>H. pylori </it>for patients with uninvestigated dyspepsia should be endorsed in Kuwait.</p

Peginterferon Alpha-2B plus Ribavirin with or without Amantidine for the Treatment of Non-Responders to Standard Interferon and Ribavirin

Background A significant proportion of hepatitis C patients treated with unmodified interferon plus ribavirin fail to respond. The optimal therapy for these patients has not been established yet. The objective of this study was to assess the efficacy and safety of peginterferon plus ribavirin with or without amantidine in such patients. Methods In this open-label, prospective controlled trial, a total of 63 patients were randomly divided into groups A and B with a ratio of 1:2. Group A (21 patients) received weekly peginterferon alpha-2b, 1.5 μg/kg concomitantly with ribavirin 1000–1200 mg per day. Group B (42 patients) received peginterferon and ribavirin as in group A, plus amantidine 200 mg per day. Results At the completion of treatment, serum levels of hepatitis C virus RNA were undetectable in 14% and 12% of patients in groups A and B, respectively ( P=NS). Hepatitis C virus RNA remained undetectable 24 weeks after the end of treatment in one patient (5%) in group A and three patients (7%) in group B ( P=NS). Sustained viral clearance was associated with sustained normalization of serum alanine aminotransferase level. Both drug regimens had similar side effect profiles. Conclusion Peginterferon plus ribavirin therapy with or without amantidine is associated with a low sustained virological response in patients who failed interferon and ribavirin combination therapy. </jats:sec