Recently several cases of hyper-attenuating nodules on CT during arterial portography (CTAP) have been reported as the chance of meticulous examination has been increasing. For the study reported here, seven cases of hyper-attenuating nodules on CTAP were analyzed by means of single-level dynamic CTAP (sCTAP). Peak values of the time-density curve from the 7 cases were 110, 106, 71, 75, 65, 45, 246 HU for the ROIs (regions of interest) placed on the nodule, and 63, 73, 41, 35, 20, 28, 22 HU for those placed on the surrounding liver parenchyma, respectively. Average peak value in another set of 46 cases as a control, including chronic hepatitis, liver cirrhosis and normal liver, was 55.3±17.6 HU. These results seem to indicate that portal flow shows an absolute increase in some cases of hyper-attenuating nodules on CTAP and that a decreased portal flow in the sorrounding parencyma may cause the visual effect of hyper-attenuation on CTAP in some cases.
Patients with chronic hepatitis C who do not respond rapidly to therapy have a low chance of acquiring sustained virological response (SVR). We tried a new regimen of treatment with peginterferon α2b plus ribavirin, arranged to continue it for 44 weeks after HCV RNA has disappeared in the patient's circulation. Subjects were 17 consecutive patients with chronic hepatitis C (50.8 [21-68] years of age, 10 females and 7 males, HCV genotype 1, HCV RNA>100KIU/ml) whose serum HCV RNA remained positive at week 4 but became undetectable between weeks 5 and 24 of treatment. SVR rate for all patients enrolled in this study was 76.5%. Among patients with HCV clearance between weeks 5 and 12 (n=13), SVR rate was 76.9% (10/13), and among those with HCV clearance between weeks 13 and 24 (n=4), SVR rate was 75.0% (3/4). These data suggest that this prolonged therapy (i.e., 5∼24+44=49∼68 weeks in total) will be of use in patients who first cleared HCV RNA between weeks 5 and 24, though a larger number of patients should be examined to clarify whether this therapy is really superior to the current standard 48-week treatment.
COBAS AmpliPrep/COBAS Taq Man HCV Test is a new method to detect HCV RNA with higher sensitivity and broader range of quantitation (0.015∼69000 KIU/ml) than conventional methods (e.g., 0.05 KIU/mlfor Amplicore HCV v2.0 and 5∼5000 KIU/ml for COBAS Amplicor HCV Monitor v2.0). Using this new method, we re-evaluated 76 interferon/ribavirin-treated chronic hepatitis C patients who had shown an end-of-treatment response (ETR) when HCV RNA was measured previously by Amplicore HCV v2.0 Test. As a result, 8 patients (10.5%) were newly identified to be positive for HCV RNA. Thus, our present results suggest that COBAS AmpliPrep/COBAS Taq Man HCV Test is more preferable than conventional methods to determine ETR and of prognostic values as well.