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Biomedical subjects

Jacques Belaïche

Publications and source records attributed to Jacques Belaïche.

5 recordsLinked to original sources
PubMed2006

HCV genotype 4 in Belgium: three distinct patterns among patients from European and African origin.

BACKGROUND: Considered uncommon in western countries some years ago, hepatitis C virus of genotype 4 is now spreading in some areas of Europe. This is assumed to be due to immigration from a region of high prevalence for this genotype and to propagation among drug users. In the south of Belgium, genotype 4 currently accounts for 10% of hepatitis C virus patients and its prevalence is increasing with time. OBJECTIVE: To better define the genotype 4 carriers' characteristics. METHODS: In a database comprising 1726 viraemic hepatitis C virus patients, the files of 85 genotype 4 carriers were reviewed. RESULTS: Beside the African (58%) and European drug user (15%) subgroups classically described, a third subgroup consisting of European nondrug users (26%) was identified as peculiar: these patients were older, had been mostly contaminated sporadically, presented a great diversity of subtypes, and were mainly of Italian origin. In this subgroup, contamination was supposed to be ancient, having occurred probably in Italy before immigration into Belgium. By contrast, European drug users were infected with only two subtypes (4c/4d and 4), an observation in favour of recent spread. Africans had a great diversity of subtypes, were young, and were mostly contaminated sporadically in their home countries. Despite their epidemiological differences, the clinical management, and in particular the rates of eligibility for treatment, were similar for these three groups. CONCLUSIONS: Three different patterns of genotype 4 carriers were observed, corresponding to three different spreading profiles. They did not induce, however, different clinical management.

Adult↗
PubMed2005

Evolution over a 10 year period of the epidemiological profile of 1,726 newly diagnosed HCV patients in Belgium.

In order to evaluate the future burden of hepatitis C, there is a need to quantify the evolution with time of some crucial parameters such as disease frequency and age, modes of infection and infecting genotypes of patients presenting for the first time at consultation. The yearly evolution of these parameters was analyzed retrospectively in a cohort of 1,726 patients living in Belgium, who were diagnosed as hepatitis C virus (HCV) carriers by polymerase chain reaction (PCR) between 1992 and 2002. The epidemiological profile of HCV patients showed significant changes during this period. The number of new patients increased with time. The proportion of patients under 50 increased linearly at a rate of 3% per year. The rate of newly presenting patients infected by transfusion before 1990 decreased, but only by 2.7% per year. The proportion of intravenous (IV) drug users increased by 2.5% per year. Patients presenting "undefined" risk factors increased by 2.1% per year. Nosocomial acquisition of HCV infection exhibited a disturbing relative stability in time whereas dialysis tended to disappear as a cause of infection. There was a significant linear annual decrease of 2.3% in the frequency of genotype 1b, which was counterbalanced by a significant increase of 0.7% for genotype 1a and 1.1% for genotype 4. Genotypes 2 and 3 did not vary significantly with time. Such figures are useful for evaluating the epidemiological changes of C virus infection and for anticipating the future economical cost of hepatitis C treatment in the next few years.

Adult↗
PubMed2005

Hepatitis C infection: eligibility for antiviral therapies.

BACKGROUND: Current treatments of chronic hepatitis C virus (HCV) are effective, but expensive and susceptible to induce significant side effects. OBJECTIVES: To evaluate the proportion of HCV patients who are eligible for a treatment. METHODS: In a database comprising 1726 viraemic HCV patients, the files of 299 patients who presented to the same hepatologist for an initial appointment between 1996 and 2003 were reviewed. RESULTS: Patients' characteristics were age 43.1 +/- 15.6 years, 53% male and 92% Caucasian. The main risk factors were transfusion (43%) and drug use (22%). Genotypes were mostly genotype 1 (66%), genotype 3 (12%) and genotype 2 (10%). These characteristics were not different from those of the whole series of 1726 patients. A total of 176 patients (59%) were not treated, the reasons for non-treatment being medical contraindications (34%), non-compliance (25%) and normal transaminases (24%). In addition, 17% of patients declined therapy despite being considered as eligible, mainly due to fear of adverse events. Medical contraindications were psychiatric (27%), age (22%), end-stage liver disease (15%), willingness for pregnancy (13%), cardiac contraindication (7%) and others (16%). Only 123 patients (41%) were treated. A sustained viral response was observed in 41%. The treatment was interrupted in 16% for adverse events. CONCLUSIONS: The majority of HCV patients are not eligible for treatment. This implies that, with current therapies, only 17% of patients referred for chronic HCV become sustained responders. Some modifications of guidelines could extend the rate of treatment (patients with normal transaminases), but an important barrier remains the patients' and the doctors' fear of adverse events.

Adult↗
PubMed2002

Gastric collision between a papillotubular adenocarcinoma and a gastrinoma in a patient with Zollinger-Ellison syndrome.

We report a unique case of a gastric collision tumor composed of an intramural gastrin-secreting tumor and a papillotubular adenocarcinoma of the intestinal type discovered at autopsy in a patient with Zollinger-Ellison syndrome. There was extensive metastatic dissemination of the neuroendocrine component to regional lymph nodes and to the liver. The unusual macroscopical, histological, and immunohistochemical features of this case and its specific clinical setting are discussed.

Adenocarcinoma↗