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D Quintero

Publications and source records attributed to D Quintero.

13 recordsLinked to original sources
PubMed2002

Genomic and antigenomic chains of hepatitis C virus and hepatitis G virus in serum, liver and peripheral blood mononuclear cells.

OBJECTIVE: To determine HCV and HGV replication sites in patients with chronic hepatitis C and to study interaction between these two viruses. PATIENTS: HGV RNA was studied in 272 patients with chronic hepatitis C. Of these, 35 were positive (group I). Twenty-three patients with chronic hepatitis C not co-infected with HGV were selected (group II). RESULTS: Genomic and antigenomic chains of HCV were studied in both groups and those of HGV in group I in serum samples, peripheral blood mononuclear cells and liver tissue. In group I genomic chains of HCV and HGV were observed in 86 and 100%, respectively (ns), in serum samples (n = 35), and antigenomic chains in 17 and 23%, respectively (ns). In mononuclear cell samples (n = 15) 100% presented the genomic chain of HCV and 60% presented that of HGV (p < 0.05). Antigenomic chains were detected in 13 and 33%, respectively (ns). In liver tissue (n = 25) genomic chains were observed in 100 and 12%, respectively (p < 0.001); the antigenomic chain of HCV was detected in 76% while that of HGV was not present (p < 0.001). In group II genomic chains of HCV were found to be present in a very high percentage in all samples, while antigenomic chains appeared in 13% of serum and mononuclear cell samples and 89% of liver samples. CONCLUSIONS: HCV and HGV have different sites of replication: whereas HCV replicates mainly in the liver, HGV is not hepatotropic. Mononuclear cells could represent a replication site for HGV but they are less important for HCV. Lastly, HGV does not modify the viral replication of HCV.

Adult↗
PubMed2000

[Coinfection with hepatitis G virus in chronic hepatitis C. Response to treatment with interferon alpha].

BACKGROUND: It is thought that the cytopathic effect of HGV is not important. Nevertheless, the cytopathic effect on liver is less known in the cases of co-infection with HCV. The aim was to study the prevalence of co-infection in patients with chronic hepatitis C (CHC) and to analyse the clinical-epidemiological and histological data and the interferon (IFN) response. PATIENTS AND METHODS: We included 180 patients with CHC and the HGV-RNA was determined. RESULTS: The prevalence of co-infection was 12.2% (n = 22). No statistical differences were observed between the non co-infected and co-infected groups with regard to the age, sex, mechanism of transmission and alcohol abuse. Also, there were no differences in the hepatic biochemical, no organ-specific antibodies, histological lesions and Knodell index. The HCV biochemical response (BR) and virological response (VR) after 6 months post-IFN were the same in both groups (HGV negative: BR = 29%, VR = 12%; HGV positive: BR = 22%, VR = 18%). HGV was determined after 6 months posttreatment in the co-infected group (first cycle of IFN, n = 22; second cycle of IFN, n = 9): 12 (55%) were HGV-RNA negative and 5 (23%) HCV-RNA negative, (p = 0.021). When we compared the BR vs VR in this group, there were 12 HGV-RNA negative but only two had BR (NS). On the contrary, the BR was related to HCV-RNA negative (p = 0.023). CONCLUSION: The prevalence of HGV co-infection is important in our area (12.8%). The HGV does not increase the pathogenicity of HCV and does not change the IFN response, although the HGV is more IFN sensible than HCV. The determination of HGV is not necessary in patients with HCV.

Adolescent↗
PubMed2000

Multicenter retrospective study of response to interferon in chronic hepatitis B.

AIM: The only agent known to have a lasting beneficial effect in chronic hepatitis B is interferon alpha, which achieves long-term remission in 25-40% of the patients. The goals of treatment are to induce clearance of HBV DNA from serum, to return serum aminotransferases to normal, and to improve histological findings in the liver. The most important factors predictive of response to treatment are high serum aminotranferases levels, low serum HBV DNA concentrations, and active histologic changes on liver biopsy. The aim of this study was to assess the response to interferon alpha in patients with chronic hepatitis B and to analyze the factors predictive of response. METHODS: We conducted a multicenter retrospective study to investigate the effect of interferon treatment in 132 patients with chronic hepatitis B in overall terms and based on HBeAg, and factors predictive of response. RESULTS: A overall sustained response was noted in 59 of 132 interferon-treated patients (45%) and 61 patients were nonresponders (46%). 12 patients relapsed (9%). None of the patients had negative HBsAg. No difference was observed in the response rate between the two treatment groups (HBeAg-positive and HBeAg-negative patients). Overall, high initial levels of serum AST and ALT predicted a good response. Age and liver biopsy findings were factors predictive of response in HBeAg-positive and HBeAg-negative patients respectively. Sex, epidemiological factors, treatment and type of virus did not correlate with the response to interferon. CONCLUSIONS: A sustained response to interferon alpha was observed in 45% of the patients with chronic hepatitis B. HBeAg seroconversion was found in up to 50% of HBeAg-positive patients. None of the patients had negative HBsAg. Overall, the response rate was higher in patients with high pretreatment serum aminotransferase levels. Age was the predictive factor in HBeAg-positive patients, and histological features were predictive in the HBeAg-negative group. However, further studies in a larger patient population are necessary to obtain well-substantiated conclusions.

Adolescent↗
PubMed1999

Interferon versus ribavirin plus interferon in chronic hepatitis C previously resistant to interferon: a randomized trial.

BACKGROUND: More than 70% of patients with chronic hepatitis C are resistant to interferon therapy. Ribavirin, in association with interferon, has been demonstrated as effective, at a dose of 800-1200 mg/day, but the efficacy of a lower dose has not been established. METHODS: We assessed the effectiveness of the combination of 600 mg/day of ribavirin plus 3 MU of interferon over a period of 6 months, in a group of patients previously resistant to interferon. Sixty-two patients with chronic hepatitis C with serum and hepatic HCV RNA relapsers or non-responders to interferon, were randomly divided into two groups: group A received 3 MU of interferon alpha-2b, three times a week for 6 months; group B was given the same dose plus 600 mg per day of ribavirin for 6 months. Two patients from each group dropped from therapy. One patient from group A and two from group B withdrew from treatment because of adverse effects. RESULTS: Mean alanine aminotransferase levels were similar in both groups throughout the study. A sustained response was observed in 7% and 7.4% of groups A and B with short-term response in 39% and 59%, and no response in 54% and 34% from both groups respectively (non-significant). At 12 months, 4 and 7 patients from groups A and B respectively, cleared serum HCV RNA however, only one sustained responder from each group cleared HCV RNA from peripheral blood mononuclear cells. At 18 months, 3 patients remained serum HCV RNA negative. Adverse effects were similar. Only haemoglobin values were lower in group B in the first month of therapy (p<0.05). CONCLUSION: In conclusion, the combination of 3 MU of interferon plus 600 mg of ribavirin is not effective in chronic hepatitis C resistant to interferon.

Adult↗
PubMed1998

Epidemiology and prevalence of seropositivity for hepatitis C virus in pregnant women in Granada.

OBJECTIVES: To study personal and familial antecedents of risk and prevalence of infection by HCV in pregnant women in the south area of Granada. PATIENTS AND METHODS: We included in the study 3003 pregnant women of the south area of Granada during the period from January 1993 to December 1995. Anti-HCV was detected in the third trimester of pregnancy by second and third generation ELISA, and positive results were confirmed by RIBA 3. We also determined HCV-RNA and genotype. Finally, we analyzed ALT levels in 1171 (39%) pregnant women. We carried out an epidemiological survey of all pregnant women, which included the following personal antecedents: transfusion, intravenous drug use, liver diseases, risk profession and sexually transmitted diseases. We studied the same antecedents in the parents, husbands and other relatives. RESULTS: Prevalence of anti-HCV was 0.63% (19 cases) with ELISA and 0.53% with RIBA. HCV-RNA was positive in 14 (74%) genotype 1b (57%) being the most frequent. ALT was increased in 52 (4.4%) pregnant women, 7 (13.5%) of whom were anti-HCV positive, versus 12 women (1%) in the normal ALT group (p < 0.001). In the epidemiological study we observed statistically significant differences in: a) housing characteristics [2125 (71%) anti-HCV negative pregnant women living in occupant-owned housing versus 7 (36%) in anti-HCV-positive group, p < 0.001]; b) personal antecedents of transfusion, chronic or acute hepatitis, or intravenous drug use (p < 0.001) (these factors were confirmed in the multivariable analysis), and c) familial antecedents of the husband (p < 0.05). CONCLUSIONS: In this study we demonstrated that 0.53% of the pregnant women were infected by HCV; most of them were HCV-RNA positive and was genotype 1b was the most frequent. The risk factors most frequently associated with infection were antecedents of transfusion, intravenous drug use and acute or chronic hepatitis.

Female↗
PubMed1997

Response of chronic hepatitis C to interferon-alpha treatment and relationship with iron metabolism.

AIM: to prospectively analyze the influence of iron metabolism of the response to interferon-alpha therapy in chronic hepatitis C. METHODS: ninety-two patients with chronic hepatitis C treated with recombinant alpha-interferon were included. Basal serum levels of iron, ferritin and transferrin saturation were compared in responding and nonresponding patients. Additional epidemiologic, histologic and biochemical variables were studied as predictors of response to interferon-alpha therapy. RESULTS: we studied 57 men (62%) and 35 women (35%) with a mean age of 40 years. Biopsy specimens were classified as having chronic active hepatitis (63%), chronic persistent hepatitis (33.8%) or cirrhosis (3.2%). The basal serum levels of iron and ferritin were significantly higher in non responders (126 +/- 9.1 mu/dL and 222.7 +/- 31.9 eta g/dL respectively; p < 0.05) than in responders (101 +/- 5.7 micrograms/dL and 136 +/- 24.1 eta g/dL). Mean transferrin saturation was also higher in nonresponders (29.7% +/- 2.7% vs 26% +/- 2.02%) although this difference was not significant. Younger age, absence of cirrhosis and parenteral transmission were associated with an improved response to interferon therapy. No relationship was found between the presence of iron in the hepatic parenchyma and response to interferon treatment. CONCLUSIONS: elevated serum levels of iron, ferritin, or both may be associated with a worse response to interferon-alpha therapy.

Adult↗
PubMed1996

[Retrospective multicenter study of the efficacy of interferon alpha in chronic hepatitis C].

BACKGROUND: Until very recently, interferon (INF) in Spain was authorized in chronic hepatitis C (C-HCV) at a dosis of 3 megaunits (mu) for 6 months. Nonetheless, the rate of maintained complete response is lower than that obtained with more prolonged treatments. The first aim of this study was to retrospectively know the effectiveness of alpha INF in patients treated for 6 or 12 months with a dosis of 3 or 5-6 MU. The second was to analyze the characteristics of the patients who achieved a maintained complete response. PATIENTS AND METHODS: Patients with C-HCV treated in 9 hospitals in Andalucía, Spain who fulfilled the following conditions were retrospectively analyzed: liver biopsy prior to treatment, positive test for anti HCV and a follow up of at least 6 months after alpha INF treatment. A total of 344 patients were studied: 267 treated with alpha INF-2b, 51 with alpha INF-2a and 26 with lymphoblastoid INF. One hundred ninety-five patients were treated for 6 months and 149 for 12 months. RESULTS: Seventy-seven (22%) of the patients presented maintained complete response, 170 (50%) did not respond and 97 (28%) relapsed. On comparing the three types of interferon used over 6 months, no significant differences were observed. Neither were differences found on comparing the dosis of 3 mu versus 5 or 6 mu. On analyzing the treatments of 6 and 12 months, the following was observed, respectively: maintained complete response 15% vs 32%, relapse 29% vs 30% and non responders 57% vs 38% (p < 0.001). Multivariate analysis demonstrated that the patients who responded the best to INF were those who presented the following characteristics: female sex, age under 40 years last, history of transfusion or IVDA, basal GPT level higher than 145 IU/I, GGT less than 55 IU/I, less evolved histologic lesions and duration of treatment over 12 months. CONCLUSIONS: Of the different treatments analyzed with alpha interferon in chronic hepatitis C, the best was found to be that with 3 mu during 12 months.

Adult↗
PubMed1996

[Thyroid dysfunction in patients with chronic hepatitis C pre and post treatment with interferon].

OBJECTIVE: The aim of this study was to evaluate the thyroid function and the dysfunction after interferon therapy in patients with chronic hepatitis C. MATERIAL AND METHODS: Between 1988 and 1994, 119 patients with chronic hepatitis C treated with interferon were reviewed 92 patients received interferon alfa for six or twelve months. 27 patients were treated with interferon beta for six months. Before, during and after interferon therapy, free thyroxine, thyroid-stimulating hormone, antimicrosomal antibodies and antithyroglobulin antibodies were measured in 51 patients. None of the patients had abnormal thyroid function or autoimmune disease before treatment. RESULTS: Among the interferon-treated patients, 6% developed biochemical evidence of thyroid dysfunction during or after therapy. Most cases had hypothyroidism. Thyroid dysfunction was statistically more frequent in the female sex, older patients and in patients who received greater total dose of interferon. In one patient the titters of antimicrosomal thyroid antibodies increased from 1/10 to 1/40 and another patient was positive in a dilution of 1/80 by the time of onset of thyroid disease. Thyroid disease (hypothyroidism) developed in (3.5%) of untreated patients with chronic hepatitis C. CONCLUSIONS: Interferon therapy can development autoimmune thyroid fenomena. Thyroid dysfunction and the presence of antithyroid antibodies before therapy can be a contraindication to the use of interferon in these patients. It is important that patients undergoing interferon therapy be tested for antithyroid antibodies and thyroid function before treatment and be monitored during the course of therapy. Also, it is important to evaluate the factors related with the development of thyroid dysfunction (age, sex, interferon dose...).

Adult↗
PubMed1995

[Emergency laparoscopy. A 20-year experience].

We revised 7988 laparoscopies over twenty years. Three hundred and ninety three were urgent laparoscopies: 325 patients with acute spontaneous abdomen and 68 acute traumatic abdomen. Emergency laparoscopy is made in patients with, both spontaneous and traumatic acute abdomen, when diagnosis is not made in 8 hours with the usual clinical and imaging methods. Acute diffuse peritonitis was the commonest finding in the first group (21%) and splenic rupture in the traumatic group (34%). There were two severe complications (0.5%): pulmonary oedema in a patient with myocardial disease and a respiratory failure in a old patient, which were resolved. We had two deaths related to laparoscopic diagnosis: massive mesenteric thrombosis and fecal peritonitis. There are few contraindications and tolerance is very good. This study shows a sensitivity of 98%, a specificity of 90%, a predictive positive value greater than 98% and a negative predictive value of 100%. In summary, the present study demonstrates that emergency laparoscopy is a effective diagnostic method in acute abdominal pain of uncertain aetiology.

Abdomen, Acute↗
PubMed1995

[Laparoscopic diagnosis of hepatic angiomas after erroneous imaging techniques].

Hemangiomas are de most frequent benign liver tumours. Their clinical relevance is small but they can cause to the patient and/or the physician a great worry because can be indistinguishable from hepatic malignances. From 1991 to 1994 five patients with liver hemangiomas were diagnosed by laparoscopy after a erroneous and/or contradictory interpretation by various imaging techniques. In four cases hemangiomas resembled metastatic carcinoma of the liver, and in the other patient hemangioma was interpreted as focal nodular hyperplasia. Diagnosis and treatment are discussed.

Carcinoma↗