Adverse effects of peg-Interferon and Ribavirin combined antiviral treatment in a Romanian hepatitis C virus infected cohort

Vol. 53 No. 3 Suppl., 2012
This supplement was not sponsored by Outside Organizations.

ROMANIAN JOURNAL of MORPHOLOGY and EMBRYOLOGY

O. Predescu, Letitia Adela-Maria Streba, Eugenia Irimia, Liliana Streba, L. Mogoanta

Introduction: Adverse effects appearing during combined peg-Interferon and Ribavirin antiviral treatment against chronic infection with the_x000D_ hepatitis C virus are a major cause for treatment failures and abrupt interruption. In the prospect of the imminent introduction of new direct_x000D_ acting antiviral agents, with demonstrated higher rates of adverse effects, our study aimed to assess the severity and incidence of several_x000D_ types of adverse effects in a cohort of genotype 1 infected Romanian patients. Materials and Methods: We prospectively included a total of_x000D_ 150 patients (45 men), aged 25 to 64 years, who received combined peg-Interferon and Ribavirin antiviral treatment for chronic hepatitis C._x000D_ Out of these, 145 patients also had liver biopsies prior to treatment initiation. We recorded their viral loads, hemoglobin values and_x000D_ thrombocyte counts, as well as any dermatological, psychiatric or constitutional adverse effect after twelve doses, eight and twelve months_x000D_ of treatment, with two follow-up examinations at three and six months after treatment completion. Results: Viral loads significantly_x000D_ decreased after 12 doses of treatment, in the end a total of six patients (two men and four women) being declared non-responders._x000D_ Hemoglobin values and thrombocyte counts significantly decreased during treatment (p<0.0001), with their values being restored to pretreatment_x000D_ levels during the follow-up period. We did not find significant differences between the 12-doses, 8 and 12 months values during_x000D_ treatment (p>0.05). We recorded 43 cases (11 men and 32 women) presenting with rashes, drug eruptions and erythema. We only_x000D_ encountered grade 1 and 2 dermatological adverse effects. Psychiatric effects were present in 34 cases (10 men and 24 women, 22.6% of_x000D_ the group) and manifested as mild depressions, which did not require specific medication or antiviral dose adjustment. Patients also_x000D_ presented headaches (80.6%), fatigue (71.3%), nausea (47.3%), arthralgias (35.3%) and fever (30%). Conclusions: We did not encounter_x000D_ severe hematological adverse effects that would require Ribavirin dosage adjustments. Cutaneous and psychiatric adverse effects were_x000D_ also present in a significant number of patients; however, their severity did not influence the continuity or outcome of the antiviral_x000D_ treatment. Other constitutional effects were also present with no direct consequence on the course of treatment. Future agents employed_x000D_ in antiviral therapy shall require extensive monitoring of all adverse effects already acknowledged during dual combination therapy.

Corresponding author: Laurentiu Mogoanta, laurentiu_mogoanta@yahoo.com

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ROMANIAN JOURNAL of MORPHOLOGY and EMBRYOLOGY

O. Caraivan, H. Manolea, Dorina Corlan Puscu, A. Fronie, Adina Bunget, L. Mogoanta

Chronic periodontitis is one of the most frequent and severe diseases involving the tooth. Untreated, they can lead to tooth loss. Our study involved 67 patients with chronic marginal periodontitis who underwent tooth extraction, of which 29 had moderate periodontal lesions and 38 severe periodontal lesions. The microscopic study of the dental pulp revealed significant changes in all patients. In patients with moderate periodontitis the pulp tissue was found to be the site of an enhanced process of collagenous fibrosis associated with a moderate inflammatory infiltrate, dystrophic mineralization, reduced blood vascularization and arteriolosclerosis. The dental pulp of patients with severe periodontitis showed an abundant chronic inflammatory infiltrate associated with pulpal necrosis, vascular congestion, microhemorrhages, dentin demineralization and odontoblast impairment.

Corresponding author: Laurentiu Mogoanta, Professor, MD, PhD; e-mail: laurentiu_mogoanta@yahoo.com

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