We investigated the efficacy of peginterferon alfa-2a plus ribavirin (α-2a therapy) for chronic hepatitis C patients who relapsed or did not respond to peginterferon alfa-2b plus ribavirin (α-2b therapy). Eleven patients with relapse and 5 non-responders to α-2b therapy received α-2a therapy for 48 to 72 weeks. In those with relapse, the rate of RVR, complete EVR and SVR were 54.5%, 72.7% and 72.7%, respectively. In non-responders, the rate of RVR, complete EVR and SVR were all 0%. Three of 5 LVR patients on α-2b therapy achieved SVR on α-2a therapy. Our findings suggest that patients showing relapse on α-2b therapy could achieve an early viral response and high SVR rate on α-2a therapy, non-responders could not.
Clearance of HBsAg is considered the ultimate goal in the treatment for chronic hepatitis B. We analyzed clinical factors associated with HBsAg clearance during long-term nucleot(s)ide analogue treatment. By univariate analysis, HBV genotype, family history of HBV infection, previous IFN therapy, HBeAg clearance at 6 months, and undetectable HBV DNA at 6 months were significant predictive factors. By multivariate analysis, HBV genotype, previous IFN therapy, HBeAg clearance at 6 months, and undetectable HBV DNA at 6 months were independent and significant predictive factors of HBsAg clearance. We conclude that patients with genotype A have high probability of HBsAg clearance, and it seems that not only the antiviral potential of nucleot(s)ide analogue but host immune response is needed to achieve HBsAg clearance.
The purposes of this study were comparison of accuracy for the detection of esophageal varices (EV) obtained by liver stiffness (LS) and spleen stiffness (SS) measurement using Virtual Touch Tissue Quantification (VTTQ). LS and SS were measured in 95 patients with LC and 16 healthy volunteers. The mean SS and LS were significantly higher in the patients with LC than in the volunteers (p<0.001 and p<0.001, respectively). In pairwise comparison analysis of the areas under the receiver operating characteristic curve (AUROC) for the detection of EV, the accuracy of SS (AUROC=0.963) was better than that of LS (AUROC=0.646) (p<0.001). SS measurement via VTTQ is a useful method for predicting the presence of EV in LC patients.