Association of Warfarin Therapy Duration After Bioprosthetic Aortic Valve Replacement With Risk of Mortality, Thromboembolic Complications, and Bleeding
Charlotte Mérie, MD; Lars Køber, MD, DMSc; Peter Skov Olsen, MD, DMSc; Charlotte Andersson, MD, PhD; Gunnar Gislason, MD, PhD; Jan Skov Jensen, MD, PhD, DMSc; Christian Torp-Pedersen, MD, DMSc
Significance of a Reduction in HCV RNA Levels at 4 and 12 Weeks in Patients Infected with HCV Genotype 1b for the Prediction of the Outcome of Combination Therapy with Peginterferon and Ribavirin
Toyoda H, Kumada T, Shimada N, Takaguchi K, Ide T, Sata M, Ginba H, Matsuyama K, Izumi N
ABSTRACT:
BACKGROUND: The importance of the reduction in hepatitis C virus (HCV) RNA levels 4 and 12 weeks after starting peginterferon (PEG-IFN) and ribavirin combination therapy has been reported to predict a sustained virologic response (SVR) in patients infected with HCV genotype 1. We conducted a multicenter study to validate this importance along with baseline predictive factors in this patient subpopulation.
METHODS: A total of 516 patients with HCV genotype 1 and pretreatment HCV RNA levels>=5.0 log10 IU/mL who completed response-guided therapy according to the AASLD guidelines were enrolled. The reduction in serum HCV RNA levels 4 and 12 weeks after starting therapy was measured using real-time PCR, and its value in predicting the likelihood of SVR was evaluated.
RESULTS: The area under the receiver operating characteristics (ROC) curve was 0.852 for 4-week reduction and 0.826 for 12-week reduction of HCV RNA levels, respectively. When the cut-off is fixed at a 2.8-log10 reduction at 4 weeks and a 4.9-log10 reduction at 12 weeks on the basis of ROC analysis, the sensitivity and specificity for SVR were 80.9% and 77.9% at 4 weeks and were 89.0% and 67.2% at 12 weeks, respectively. These variables were independent factors associated with SVR in multivariate analysis. Among 99 patients who showed a delayed virologic response and completed 72-week extended regimen, the area under ROC curve was low: 0.516 for 4-week reduction and 0.482 for 12-week reduction of HCV RNA levels, respectively.
CONCLUSIONS: The reduction in HCV RNA levels 4 and 12 weeks after starting combination therapy is a strong independent predictor for SVR overall. These variables were not useful for predicting SVR in patients who showed a slow virologic response and experienced 72-week extended regimen.
Comorbidity in Patients with Branch Retinal Vein Occlusion: Case-control Study
Mette Bertelsen, medical doctor, clinical research fellow, Allan Linneberg, senior researcher and head of department, Thomas Rosenberg, consultant ophthalmologist, Nynne Christoffersen, consultant ophthalmologist, Henrik Vorum, professor of ophthalmology, Else Gade, ophthalmologist, Michael Larsen, professor of ophthalmology
Association of Childhood Pertussis With Receipt of 5 Doses of Pertussis Vaccine by Time Since Last Vaccine Dose, California, 2010
Lara K. Misegades, PhD, MS; Kathleen Winter, MPH; Kathleen Harriman, PhD, MPH, RN; John Talarico, DO, MPH; Nancy E. Messonnier, MD; Thomas A. Clark, MD, MPH; Stacey W. Martin, MSc
Autoimmune Pancreatitis: An Illustrated Guide to Diagnosis
Proctor RD, Rofe CJ, Bryant TJ, Hacking CN, Stedman B
Cardiovascular Mortality After Pre-eclampsia in One Child Mothers: Prospective, Population Based Cohort Study
Rolv Skjaerven, professor, Allen J Wilcox, senior investigator, Kari Klungsøyr, associate professor, Lorentz M Irgens, professor, Bjørn Egil Vikse, associate professor, Lars J Vatten, professor, Rolv Terje Lie, professor
A 57-Year-Old Man With a History of Podagra, Hyperuricemia, and Mild Renal Insufficiency
Robert H. Shmerling, MD, Discussant
An Allergic Phenotype and the Use of Steroid Inhalers Predict Eosinophilic Oesophagitis in Patients with Asthma
Harer KN, Enders FT, Lim KG, Alexander JA, Katzka DA
Prevalence of Cervical Ribs and Elongated Transverse Processes in Saudi Arabia
Author: Rakan F Bokharie, Mohammad J.os Al-Sayyad, Saleh S Baeesae
Hamilton Moses, MD; E. Ray Dorsey, MD, MBA
