- Email: [email protected]
HBV co-infection: Week 24 analysis
21ST ANNUAL CONFERENCE —2013
ABSTRACTS
Results: Overall, sustained virological response was achieved in 75/177 (42.4%) of the cohort without a significant difference between the two ethnic groups [Greek: 44/ 101 (43.6%); Egyptian 31/76 (40.8%), P =0.7598]. In multivariate analysis, it was found that ethnicity was not associated with an impaired response but age $45 years [odds ratio (OR): 0.4225, 95% confidence interval (CI): 0.21350.8133; P =0.0134], diabetes (OR: 0.2346, 95% CI: 0.08160.0674; P =0.0071), advanced liver fibrosis (OR: 0.3964, 95% CI: 0.1933-0.8133; P =0.0116), and treatment suspension (OR: 0.1738, 95% CI: 0.0482-0.6262; P =0.0075) showed an independent negative association with response to antiviral treatment. Conclusion: In contrast to previous European data suggesting Egyptian ethnicity to be a positive predictor for a sustained virological response, there was no influence of Greek versus Egyptian ethnicity on treatment outcomes. Higher age, advanced liver fibrosis, and diabetes have been shown to reduce significantly response rates in patients infected with HCV-4. Corresponding author. Dimitrios Dimitroulopoulos. E-mail: [email protected]
Viral Hepatitis
HEPATITIS VIRUS INFECTION IN CHILDREN WITH CHRONIC LIVER DISEASE
were reactive for HBsAg including 4 patients with HAV co-infection (anti HAV IgM reactive). Seventeen patients (6.29%) of CLD had HCV infection including one with HAV co-infection. 16 patients (5.92%) of CLD had HAV infection whilst 3 patients (1.11%) of CLD were suffering from HEV infection. Conclusion: Approximately 27% children with chronic liver disease were having hepatitis B infection followed by 6.29% children with HCV infection. Approximately 6% children of CLD had Hepatitis A infection and 1.1% children had acquired Hepatitis E infection through feco-oral route. Prophylactic vaccination against HBV and HAV infection needs to be intensified in children with chronic liver disease. Corresponding author. A.K. Sharma. E-mail: [email protected]
STUDIES ON ANTIVIRAL THERAPY WITH 3TC/TDF COMPARED TO 3TC/ADV TREATMENT NAIVE PATIENTS WITH HIV/ HBV CO-INFECTION: WEEK 24 ANALYSIS Jayeeta Sarkar,1 Debraj Saha,2 Runu Chakrabarty,2 Subhasish Kamal Guha1 1
School of Tropical Medicine, Kolkata ICMR Virus Unit, Kolkata, India, ICMR Virus Unit, Kolkata School of Tropical Medicine, Kolkata, India
A. K. Sharma, R. Goyal, U. Debi, B. R. Thapa, K. Singh
2
Department of Superspeciality of Gastroenterology, PGIMER, Chandigarh, India
To compare the effectiveness of Tenofovir (TDF) vs. Adefovir (ADV) in HBV treatment outcome (virologic and biochemical response) as well as tolerability among treatment naïve HIV/HBV co-infected patients, a randomized trial of Adefovir + Lamivudine + Zidovudine + Efavirenz vs. Tenofovir + Lamivudine + Efavirenz combination has been started. HBe-antigen positivity was observed in 54% on TDF arm (n=13) and in 60% on ADV arm (n=10). There was no significant change in creatinine level for both the arm and none of the study subjects had proteinuria at the end of 6 months. After 6 month of treatment, Serum ALT level decreased 5.6 U/L for TDF arm and 13 U/L for ADV arm, whereas, CD4 count increased upto 144 cells/mm3 for TDF arm and 117 cells/mm3 for ADV arm. Mean decreases in serum HBV DNA concentrations from baseline were 3log copies/mL for Tenofovir arm and 2.36 log copies/mL for Adefovir arm at week 24. Hepatitis genotype D (13), A (4), C (3) were distributed among the patients. Both Adefovir and Tenofovir were well tolerated and had similar HBV virologic and biochemical response rate at 6 months. Further follow up is needed to ascertain if there is difference in long term response between the two regimens.
Background: Hepatitis B and Hepatitis C viral infections are important causes of chronic liver disease (CLD) in patients. Prevalence of hepatitis virus infections among children with chronic liver disease is not known from this region. Objectives: To know the prevalence of HBV,HCV,HAV and HEV infection among children of CLD attending Nehru Hospital, PGIMER, Chandigarh. Methods: Two hundred and seventy children (174 males and 96 females, mean age SD: 6.38 yrs 3.92) of CLD between July 2008 to December 2012 were included in the study. Patient features, routine investigations including abdominal USG were recorded. 2 ml blood was collected and serum samples were stored at -20 C.These were tested for HBsAg, anti HCV, anti HAV IgM and anti HEV IgM by ELISA. All samples were uniformly tested for these four parameters using same standards. Results: One hundred and sixty five patients (61.1%) out of 270 children with CLD were non-reactive for HBsAg, anti HCV, anti HAV IgM and anti HEV IgM. These patients were of EHPVO with or without ascites, auto-immune hepatitis and Wilson's disease.73 patients (27.03%) of CLD S70
Corresponding author. Jayeeta Sarkar. E-mail: [email protected]
© 2013, INASL
ABSTRACTS
Results: Overall, sustained virological response was achieved in 75/177 (42.4%) of the cohort without a significant difference between the two ethnic groups [Greek: 44/ 101 (43.6%); Egyptian 31/76 (40.8%), P =0.7598]. In multivariate analysis, it was found that ethnicity was not associated with an impaired response but age $45 years [odds ratio (OR): 0.4225, 95% confidence interval (CI): 0.21350.8133; P =0.0134], diabetes (OR: 0.2346, 95% CI: 0.08160.0674; P =0.0071), advanced liver fibrosis (OR: 0.3964, 95% CI: 0.1933-0.8133; P =0.0116), and treatment suspension (OR: 0.1738, 95% CI: 0.0482-0.6262; P =0.0075) showed an independent negative association with response to antiviral treatment. Conclusion: In contrast to previous European data suggesting Egyptian ethnicity to be a positive predictor for a sustained virological response, there was no influence of Greek versus Egyptian ethnicity on treatment outcomes. Higher age, advanced liver fibrosis, and diabetes have been shown to reduce significantly response rates in patients infected with HCV-4. Corresponding author. Dimitrios Dimitroulopoulos. E-mail: [email protected]
Viral Hepatitis
HEPATITIS VIRUS INFECTION IN CHILDREN WITH CHRONIC LIVER DISEASE
were reactive for HBsAg including 4 patients with HAV co-infection (anti HAV IgM reactive). Seventeen patients (6.29%) of CLD had HCV infection including one with HAV co-infection. 16 patients (5.92%) of CLD had HAV infection whilst 3 patients (1.11%) of CLD were suffering from HEV infection. Conclusion: Approximately 27% children with chronic liver disease were having hepatitis B infection followed by 6.29% children with HCV infection. Approximately 6% children of CLD had Hepatitis A infection and 1.1% children had acquired Hepatitis E infection through feco-oral route. Prophylactic vaccination against HBV and HAV infection needs to be intensified in children with chronic liver disease. Corresponding author. A.K. Sharma. E-mail: [email protected]
STUDIES ON ANTIVIRAL THERAPY WITH 3TC/TDF COMPARED TO 3TC/ADV TREATMENT NAIVE PATIENTS WITH HIV/ HBV CO-INFECTION: WEEK 24 ANALYSIS Jayeeta Sarkar,1 Debraj Saha,2 Runu Chakrabarty,2 Subhasish Kamal Guha1 1
School of Tropical Medicine, Kolkata ICMR Virus Unit, Kolkata, India, ICMR Virus Unit, Kolkata School of Tropical Medicine, Kolkata, India
A. K. Sharma, R. Goyal, U. Debi, B. R. Thapa, K. Singh
2
Department of Superspeciality of Gastroenterology, PGIMER, Chandigarh, India
To compare the effectiveness of Tenofovir (TDF) vs. Adefovir (ADV) in HBV treatment outcome (virologic and biochemical response) as well as tolerability among treatment naïve HIV/HBV co-infected patients, a randomized trial of Adefovir + Lamivudine + Zidovudine + Efavirenz vs. Tenofovir + Lamivudine + Efavirenz combination has been started. HBe-antigen positivity was observed in 54% on TDF arm (n=13) and in 60% on ADV arm (n=10). There was no significant change in creatinine level for both the arm and none of the study subjects had proteinuria at the end of 6 months. After 6 month of treatment, Serum ALT level decreased 5.6 U/L for TDF arm and 13 U/L for ADV arm, whereas, CD4 count increased upto 144 cells/mm3 for TDF arm and 117 cells/mm3 for ADV arm. Mean decreases in serum HBV DNA concentrations from baseline were 3log copies/mL for Tenofovir arm and 2.36 log copies/mL for Adefovir arm at week 24. Hepatitis genotype D (13), A (4), C (3) were distributed among the patients. Both Adefovir and Tenofovir were well tolerated and had similar HBV virologic and biochemical response rate at 6 months. Further follow up is needed to ascertain if there is difference in long term response between the two regimens.
Background: Hepatitis B and Hepatitis C viral infections are important causes of chronic liver disease (CLD) in patients. Prevalence of hepatitis virus infections among children with chronic liver disease is not known from this region. Objectives: To know the prevalence of HBV,HCV,HAV and HEV infection among children of CLD attending Nehru Hospital, PGIMER, Chandigarh. Methods: Two hundred and seventy children (174 males and 96 females, mean age SD: 6.38 yrs 3.92) of CLD between July 2008 to December 2012 were included in the study. Patient features, routine investigations including abdominal USG were recorded. 2 ml blood was collected and serum samples were stored at -20 C.These were tested for HBsAg, anti HCV, anti HAV IgM and anti HEV IgM by ELISA. All samples were uniformly tested for these four parameters using same standards. Results: One hundred and sixty five patients (61.1%) out of 270 children with CLD were non-reactive for HBsAg, anti HCV, anti HAV IgM and anti HEV IgM. These patients were of EHPVO with or without ascites, auto-immune hepatitis and Wilson's disease.73 patients (27.03%) of CLD S70
Corresponding author. Jayeeta Sarkar. E-mail: [email protected]
© 2013, INASL