Symptomatic Acute Hepatitis C in Egypt: Diagnosis, Spontaneous Viral Clearance, and Delayed Treatment with 12 Weeks of Pegylated Interferon Alfa-2a

The aim of this study was to estimate the proportion of spontaneous viral clearance (SVC) after symptomatic acute hepatitis C and to evaluate the efficacy of 12 weeks of pegylated interferon alfa-2a in patients who did not clear the virus spontaneously.Patients with symptomatic acute hepatitis C were recruited from two "fever hospitals" in Cairo, Egypt. Patients still viremic three months after the onset of symptoms were considered for treatment with 12 weeks of pegylated interferon alfa-2a (180 microg/week).Between May 2002 and February 2006, 2243 adult patients with acute hepatitis were enrolled in the study. The SVC rate among 117 patients with acute hepatitis C was 33.8% (95%CI [25.9%-43.2%]) at three months and 41.5% (95%CI [33.0%-51.2%]) at six months. The sustained virological response (SVR) rate among the 17 patients who started treatment 4-6 months after onset of symptoms was 15/17 = 88.2% (95%CI [63.6%-98.5%]).Spontaneous viral clearance was high (41.5% six months after the onset of symptoms) in this population with symptomatic acute hepatitis C. Allowing time for spontaneous clearance should be considered before treatment is initiated for symptomatic acute hepatitis C

Screening for preclinical chloroquine maculopathy using microperimetry and spectral domain optical coherence tomography

Objective The aim of this study was to evaluate the role of microperimetry and spectral domain optical coherence tomography (SD-OCT) in screening of preclinical chloroquine maculopathy in rheumatoid arthritis (RA) patients. Study design This is a cross-sectional comparative study. Patients and methods The study included 20 eyes of RA patients treated with chloroquine for more than 1 year (Group A), and 20 eyes of RA patients not treated by chloroquine (Group B). All patients were subjected to full ophthalmological examination, imaging with SD-OCT, and microperimetry. The study group ranged in age from 40 to 65 years with normal fundus. Results The mean central foveal thickness was found to be thin both in Group A (178.25±33.27 μm) and Group B (180.15±36.56 μm), with a statistically nonsignificant difference between the two groups (P=0.864). The mean parafoveal thickness was thinner than normal in both groups in all quadrants (P0.05) in all quadrants. The mean test score perimetry and the mean foveal sensitivity were decreased in Group A (11.12±4.11 and 11.73±3.92, respectively) compared with Group B (12.86±2.14 and 13.10±2.48, respectively), but the difference was not statistically significant (P=0.104 and 0.194, respectively). Conclusion Retinal thinning in the form of foveal and parafoveal thinning was detected by SD-OCT in patients of both groups, whereas decreased macular sensitivity was detected in the chloroquine group only with normal macular sensitivity in the nonchloroquine group as detected by microperimetry

Kaplan-Meier estimate of the SVC rate among 117 patients with acute hepatitis C, 2002–6, Cairo.

<p>Kaplan-Meier estimate of the SVC rate among 117 patients with acute hepatitis C, 2002–6, Cairo.</p

Diagnosis and follow-up of acute hepatitis C among 2243 patients with acute hepatitis, 2002–6, Cairo.

<p>Diagnosis and follow-up of acute hepatitis C among 2243 patients with acute hepatitis, 2002–6, Cairo.</p

Characteristics of the 17 patients who underwent treatment with pegylated interferon

<p>Characteristics of the 17 patients who underwent treatment with pegylated interferon</p

Factors associated with spontaneous viral clearance in acute hepatitis C patients (n = 117).

1<p>Median ALT was 684 IU/L; median bilirubin was 7.2 mg/dl (two missing values for bilirubin).</p>2<p>Medical procedures included surgery, blood transfusion, hemodialysis, biopsy, endoscopy, Caesarean section, episiotomy, uterine curettage, injection, infusion, catheter, sclerotherapy of varicose veins. Low risk exposures included acupuncture, shaving at barber, tattooing, pedicure, manicure, and circumcision.</p