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Challenging clinical cases in HCV infection

We present clinical cases, which underline some difficulties in diagnosis and treatment of hepatitis C virus (HCV) infection. Case report #1 shows a patient who avoided clinical follow-up for HCV until the development of hepatocellular carcinoma. In this patient, non-invasive procedures did not allo...

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Detalles Bibliográficos
Autores principales: Strazzulla, Alessio, Matera, Giovanni, Mammone, Selma Valerie, Vaccaro, Vittoria, Pisani, Vincenzo, Costa, Chiara, Manti, Francesco, Doldo, Patrizia, Cosco, Lucio, Quintieri, Francesco, Cesario, Francesco, Liberto, Maria Carla, Giancotti, Aida, Torti, Carlo, Focà, Alfredo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4160901/
https://www.ncbi.nlm.nih.gov/pubmed/25236848
http://dx.doi.org/10.1186/1471-2334-14-S5-S7
Descripción
Sumario:We present clinical cases, which underline some difficulties in diagnosis and treatment of hepatitis C virus (HCV) infection. Case report #1 shows a patient who avoided clinical follow-up for HCV until the development of hepatocellular carcinoma. In this patient, non-invasive procedures did not allow to make a differential diagnosis between hydatidosis and hepatocellular carcinoma but diagnosis was only made with liver biopsy. In the case report #2, 24-week treatment with peg-interferon α2 and ribavirin was successfully administered to a HCV genotype-1b infected patient. Shortening HCV treatment did not impair sustained virological response, probably because HCV RNA was low (< 200,000 IU/l) at baseline. Lastly, a case series of patients (#3-6) with hemoglobinopathies is described. Sustained virological response after peg-interferon α2 and ribavirin was achieved in 2 out of 4 patients. While no severe treatment limiting hematological effects were encountered, patients needed more frequent blood transfusions. Thus, new anti-HCV schemes without peg-interferon and ribavirin are urgently needed.