Browsing by Author "Švirtlih, Neda (6603664119)"

Introduction: Chronic hepatitis C virus (HCV) infection can progress to liver cirrhosis that causes bleeding from the gastrointestinal tract, liver failure and primary hepatocellular carcinoma. Use of standard therapeutic option consists of recombinant pegylated interferon alpha 2a/b with ribavirin in order to eradicate virus and prevent complications. Objective: The aim of investigation was to evaluate efficiency of combination therapy (pegylated interferon alpha 2a/b plus ribavirin) in patients with chronic HCV infection and to estimate predictive factors for successful treatment. Methods: A total of 387 patients with confirmed diagnosis of hepatitis C were evaluated (aged 18-65 years of both genders). Patients were treated with pegylated interferon alpha 2a/b and ribavirin according to a standard regimen lasting 24 or 48 weeks, dependent on virus genotype. Results: Negative HCV RNA (PCR assay) was recorded in 79.7% of patients at the end of treatment. Six months after completed therapy, negative HCV RNA, i.e. stained virologic response (SVR) was assessed in 70.5% of patients. Statistical summary of our results concerning SVR confirmed better efficiency of combination therapy for the following parameters compared to other investigated variables: age ≤40 (843% vs. 59.1%; p<0.0005), absence of cirrhosis (75.6% vs. 58.3%; p=0.003), lack of genotype 1 (86.6% vs. 61.8%; p<0.0005), and in patients who received full doses of pegylated interferon alpha 2a (78.3% vs. 633%; p=0.002). Conclusion: Combination therapy of recombinant pegylated interferon alpha 2a with ribavirin leads to SVR in the majority of treated patients (70.5%). Successful treatment depends on a variety of host and virus factors.

Background: Primary hepatocellular carcinoma (HCC) is the most common liver malignancy. Aim: To identify the clinical characteristics of patients with HCC and the factors for its occurrence. Methods: A total of 110 hospitalized patients with HCC was investigated. Histological diagnosis of underlying liver disease was done in 93 patients. Biochemical and hematological parameters were obtained by routine biochemical and hematological techniques. Serum markers for hepatitis B and C viruses and autoantibodies were determined. SPSS version 17.0 was used for statistical analyses and p<0.05 was considered significant. Results: Patients were aged from 48 to 82 years (65,8 ± 7). Males dominated (74 pts). Solitary HCC pattern was observed in 87 patients. Viral etiology was proven in 61 patients while alcoholic liver disease was detected in 21 patients. Increased AFP values (≥ 20 ng/ml) were obtained in 88 pts; values ≥200 ng/ml in 71 pts, and values ≥400 ng/ ml in 57 pts. The clinical presentation was dominated by fatigue, gynecomastia, and bone aches. The most common comorbidities were diabetes mellitus type 2 (53 pts), chronic cardiomyopathy/arterial hypertension (48 pts), and obesity (29 pts). Comparison of patients with and without cirrhosis (66/110) showed no difference in age, gender, tumor pattern, and AFP values ≥20 ng/ml. Those from the first group had higher AFP, larger solitary tumors, greater liver damage and more pronounced clinical symptoms. Conclusions: HCC is mostly detected in liver cirrhosis. Other risk factors include hepatitis B and C viruses, heavy alcohol abuse, older age, male gender, metabolic and chronic cardiovascular diseases. © 2024 by Acta Medica Saliniana.

Introduction Pronounced symptoms of depression and disorders of cognitive functions can be observed in patients with chronic hepatitis B. Objective The objective of the study was evaluation of the severity of symptoms and predictive factors for depression and the existence of cognitive disorders in patients with chronic hepatitis B. Methods A total of 150 respondents were included in this prospective study (50 patients with chronic hepatitis B, 50 patients with other chronic liver diseases and 50 healthy persons). The patients with chronic hepatitis B were homogeneous by age compared to healthy subjects (p=0.566) and patients with other chronic liver diseases (p=0.528). Assessment of intensity of depression was determined by the Hamilton Depression Rating Scale (HAMD). A Mini Mental State Examination (MMSE) test was used to investigate the presence of cognitive disorders. Results Significantly expressed depression was observed in patients with chronic hepatitis B compared with healthy persons as well as the occurrence of cognitive dysfunction (p=0.00), while in comparison with the patients with chronic nonviral liver diseases, depression was statistically significantly less markedly expressed (p=0.003). Depression and cognitive dysfunction were more noticeable in patients with chronic hepatitis B in the stage of liver cirrhosis in relation to the early stage of the disease. Multivariate analysis of variables related to the sociodemographic characteristics showed that the most significant positive predictor of depression was more expressed in older age (over 50 years) (B=0.276; SE=0.092; p=0.004). Conclusion Patients with chronic hepatitis B have a higher intensity of depression compared to healthy people, which is intensified with the progression of the disease. The highest expression of depression is expected in the elderly. Patients with chronic hepatitis B have a lower intensity of depression and fewer disorders of cognitive functions than patients with other chronic liver diseases. © 2015 Serbia Medical Society. All rightsreserved.