The impact of hepatitis C viremia status on lung functions in chronic hepatitis c patients

Background: Previous trials have investigated the effect of hepatitis C on lung functions; however, the role of viral load levels is unclear. The aim of this study was to investigate the effect of HCV viremia status on lung functions.Methods: This study was in 60 patients with chronic hepatitis C (CHC). Patients were classified into three groups (non-viremic, low-viremic and high-viremic) based on serum HCV RNA levels. Spirometric parameters (FEV1, FVC, FEV1/FVC) and the proportion of patients with spirometric abnormalities were compared between three groups.Results: High-viremic and low-viremic patients showed a significantly higher prevalance of spirometric abnormality than observed in non-viremic patients (p=0.02). Moreover, there was a significant moderate correlation between viremia level and the percentage of spirometric abnormalities (Cramer’s U value=0.452, p=0.002). High-viremic patients were 14.2 times more likely to exhibiting pulmonary dysfunction than non-viremic patients. Additionally, spirometric parameters FEV1 and FVC were significantly reduced in high-viremic and low-viremic patients compared to those in non-viremic patients (p=0.013 and p<0.001respectively).Conclusion: These results indicate that persistent HCV infection may be associated with reduced pulmonary functions, especially in patients with high viremia levels. Therefore, these patients should be carefully monitored for lung function.Keywords: Chronic hepatitis C infection, viremia, lung function tests

The impact of hepatitis C viremia status on lung functions in chronic hepatitis c patients

Background: Previous trials have investigated the effect of hepatitis C on lung functions; however, the role of viral load levels is unclear. The aim of this study was to investigate the effect of HCV viremia status on lung functions. Methods: This study was in 60 patients with chronic hepatitis C (CHC). Patients were classified into three groups (non-viremic, low-viremic and high-viremic) based on serum HCV RNA levels. Spirometric parameters (FEV1, FVC, FEV1/FVC) and the proportion of patients with spirometric abnormalities were compared between three groups. Results: High-viremic and low-viremic patients showed a significantly higher prevalance of spirometric abnormality than observed in non-viremic patients (p=0.02). Moreover, there was a significant moderate correlation between viremia level and the percentage of spirometric abnormalities (Cramer\u2019s U value=0.452, p=0.002). High-viremic patients were 14.2 times more likely to exhibiting pulmonary dysfunction than non-viremic patients. Additionally, spirometric parameters FEV1 and FVC were significantly reduced in high-viremic and low-viremic patients compared to those in non-viremic patients (p=0.013 and p<0.001 respectively). Conclusion: These results indicate that persistent HCV infection may be associated with reduced pulmonary functions, especially in patients with high viremia levels. Therefore, these patients should be carefully monitored for lung function. DOI: https://dx.doi.org/10.4314/ahs.v19i2.21 Cite as: Bal T, Onlen Y, Babayigit C, Yumer Y, Sahin SI. The impact of hepatitis C viremia status on lung functions in hronic hepatitis C patients. Afri Health Sci.2019;19(2): 1988-1992. https://dx.doi.org/10.4314/ahs.v19i2.2

In a real-life setting, direct-acting antivirals to people who inject drugs with chronic hepatitis c in Turkey

Background: People who inject drugs (PWID) should be treated in order to eliminate hepatitis C virus in the world. The aim of this study was to compare direct-acting antivirals treatment of hepatitis C virus for PWID and non-PWID in a real-life setting. Methods: We performed a prospective, non-randomized, observational multicenter cohort study in 37 centers. All patients treated with direct-acting antivirals between April 1, 2017, and February 28, 2019, were included. In total, 2713 patients were included in the study among which 250 were PWID and 2463 were non-PWID. Besides patient characteristics, treatment response, follow-up, and side effects of treatment were also analyzed. Results: Genotype 1a and 3 were more prevalent in PWID-infected patients (20.4% vs 9.9% and 46.8% vs 5.3%). The number of naïve patients was higher in PWID (90.7% vs 60.0%), while the number of patients with cirrhosis was higher in non-PWID (14.1% vs 3.7%). The loss of follow-up was higher in PWID (29.6% vs 13.6%). There was no difference in the sustained virologic response at 12 weeks after treatment (98.3% vs 98.4%), but the end of treatment response was lower in PWID (96.2% vs 99.0%). In addition, the rate of treatment completion was lower in PWID (74% vs 94.4%). Conclusion: Direct-acting antivirals were safe and effective in PWID. Primary measures should be taken to prevent the loss of follow-up and poor adherence in PWID patients in order to achieve World Health Organization’s objective of eliminating viral hepatitis

Incidence and predictors of direct-acting antiviral treatment failure in Turkish patients with chronic hepatitis C genotype 1b infection

Evaluation of the incidence and predictors of failure of direct-acting antiviral treatment for hepatitis C virus genotype 1b patients is important. Our retrospective cohort study assessed 172 Turkish patients who had received a full course of such treatment and could be checked for sustained virologic response. The overall treatment failure rate was 2.9% (5/172), all of whom relapsed. In three of these cases with sequencing data available, all had NS5A resistance-associated substitution. Multivariate analysis revealed that a 1 mg/dL increase in pre-treatment total bilirubin level was associated with a sevenfold increased likelihood of treatment failure. The baseline level of total bilirubin was the only significant independent predictor of direct-acting antiviral treatment failure. </jats:p

Probable montelukast-induced hepatotoxicity in a pediatric patient: case report

WOS: 000252921000015

Inducible nitric oxide synthase and histopathological correlation in chronic viral hepatitis

SummaryBackgroundChronic liver disorders represent a serious health problem. Nitric oxide (NO) synthesized by inducible nitric oxide synthase (iNOS) can function as an antimicrobial agent able to kill or reduce replication of microorganisms, and plays an important role in immune regulation. This study was undertaken to evaluate the expression of iNOS in chronic viral hepatitis and its relation to histopathology.MethodsThis study included 56 patients with chronic viral hepatitis (38 hepatitis B, 18 hepatitis C). There were 35 men and 21 women with a mean age of 38.6±21.731 years. A modified form of the histology activity index (HAI) designed by Ishak and colleagues was used to assess grading and staging of chronic viral hepatitis. The needle biopsy specimens were fixed in 10% formalin and routinely processed. Routine hematoxylin–eosin, periodic acid–Schiff, and reticulin staining, and iNOS immunoperoxidase technique were performed on paraffin-embedded tissues.ResultsWe demonstrated that all liver samples had a marked iNOS expression, with a diffuse distribution pattern. iNOS consistently labeled mononuclear cells infiltrating portal tracts in all samples. Statistical evaluation of data showed that the iNOS expression correlated with the HAI and fibrosis. Furthermore a correlation between iNOS and severity of disease was detected (r=0.772, p=0.000).ConclusionsFurther investigations are required to determine whether iNOS-related treatment protocols could be useful in reducing disease severity