Hepatic adverse events during highly active antiretroviral therapy containing nevirapine: a case report

BACKGROUND: Hepatotoxicity is one of the most serious complications of highly active antiretroviral therapy (HAART). The aim of this report is to analyse an HIV infected patient on HAART including nevirapine and taking antidepressive agents, with acute toxic hepatitis. CASE PRESENTATION: A 39 year old patient diagnosed as HIV positive one month ago administered to the clinical ward of the Department of Infectious Diseases and Clinical Microbiology in Ege University Medical School with high fever, malaise, nausea, diarrheae and elevated liver enzymes (ALT 1558 U/L, AST 4288 U/L). He has been using HAART including zidovudine+lamivudine (2 × 1/day) and nevirapine (2 × 200 mg/day, following dose escalation) for 22 days, sertralin and diazepam for 12 days and lithium for 10 days. The patient was hospitalized. Antiretroviral and antidepressant treatments were stopped. The day after admission, his fever dropped and his symptoms improved. Clinical improvement continued on the following days. The patient was discharged upon his request on the 14(th) day of hospitalization. The liver function tests returned to normal levels in two weeks following discharge. CONCLUSION: Close monitoring of liver enzymes during the first 12 weeks of nevirapine therapy is critical to prevent life threatening events

The Advocate - June 8, 1961

Original title (1951-1987)--The Advocate: official publication of the Archdiocese of Newark (N.J.)

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

EDITORIAL

WOS: 00045445090000

Detection of Adenovirus, Respiratory Syncytial Virus and Parainfluenza Virus Infections in Our Region in the 1995-96 Winter Season by Cell Culture Method

The frequency and distribution of respiratory syncytial virus (RSV), adenovirus and parainfluenza virus, the important causes of respiratory tract infections in our region were investigated in this study. For this reason, nasopharyngeal swab specimens were collected from 187 patients (131 children and 56 adults) who suffered from influenza-like illness in the winter of 1995-96. Specimens were inoculated on Hep-2 cells for RSV and adenovirus, and on MDBK cells for parainfluenza virus isolation. The tubes were examined for the cytopathic effect every other day for 15 days and hemagglutination test was performed for parainfluenza virus identification. Cytopathic effect and/or hemagglutination test positive specimens were stained using fluorescein-conjugated monoclonal antibodies and examined under fluorescent microscope. RSV was isolated from 6 children, adenovirus from 7 patients, five of them were adults, and human parainfluenza viruses type 1 and 2 each from one child patient. As a result: A respiratory tract pathogen was isolated from 15 of all 187 (%8) nasopharyngeal swab specimens

1995-1996 kış mevsiminde, hücre kültürü yöntemi ile bölgemizde saptanan adenovirüs, solunum sinsityal virüsü ve parainfluenza virüsü infeksiyonları

The frequency and distribution of respiratory syncytial virus (RSV), adenovirus and Para influenza virus, the important causes of respiratory tract infections in our region were investigated in this study. For this reason, nasopharyngeal swab specimens were collected from 187 patients (131 children and 56 adults) who suffered from influenza-like illness in the winter of 1995-96. Specimens were inoculated on Hep-2 cells for RSV and adenovirus, and on MDBK cells for Para influenza virus isolation. the cubes were examined for the cytopathic effect every other day for 15 days and hemagglutination test was performed for parainfluenza virus identification.-Cytopathic effect and/or hemagglutination test positive specimens were stained using fluorescein-conjugated monoclonal antibodies and examined under fluorescent microscope. RSV was isolated from 6 children, adenovirus from 7 patients; five of them were adults, and human Para influenza viruses' type l and 2 each from one child patient. As a result: A respiratory tract pathogen was isolated from 15 of all 187 (%8) nasopharyngeal swab specimens.Bu çalışmada, solunum sistemi hastalıklarının önemli etkenlerinden olan solunum sinsityal virüsü, adenovirüs ve parainfluenza virüslerinin bölgemizdeki dağılımı ve sıklığı araştırılmıştır. Bu amaçla 1995-96 kış mevsiminde influenza benzeri hastalık tablosu gösteren, 131'i çocuk ve 56'sı erişkin olmak üzere toplam 187 hastanın nazofaringeal sürüntü örnekleri alınmıştır. Alınan örnekler, solunum sinsityal virüsü (SSV) ve adenovirüs izolasyonu için Hep-2 hücrelerine, parainfluenza virüsü izolasyonu için ise Madine-Darby Bovine Kidney (MDBK) hücreleri üzerine inoküle edilmiştir. Tüpler 15 gün boyunca günaşırı, sitopatik etki yönünden araştırılmış, ayrıca parainfluenza virüslerinin tanısı için yine günaşırı olmak üzere hemaglütinasyon testi yapılmıştır. Sitopatik etki gözlenen ve/veya hemaglütinasyon olumlu olan örnekler, floresein ile işaretli monoklonal antikorlar kullanılarak boyanmış ve floresein mikroskopta incelenmiştir. Yapılan çalışma sonucunda, 6 çocuk hastadan SSV, beşi erişkin olmak üzere 7 hastadan adenovirüs, 2 çocuk hastadan ise parainfluenza virüsü tip 1 ve tip 2 izole edilmiştir. Sonuç olarak toplam 187 örneğin 15'inde (%8) viral bir solunum yolu patojeni saptanmıştır