الفهرس 
Material and methodsOnly 14 pages are availabe for public view
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Abstract
This study was performed to assess the effect of different drug regimens for chronic HCV and to study the effect and safety of oral enzyme therapy as a treatment for patients with chronic HCV.
All patient studied were subjected to thorough history taking, full clinical examination and investigations in the form of CBC, biochemical liver profile, protein electrophoresis, immunoglobulins (IgG, IgA and IgM ),serum electrolytes , serum creatinine and blood glucose level. These investigations were performed every month to the last month of therapy (3 month). Abdominal ultrasonography, liver biopsy and qualitative HCV RNA were done at the start of the study to all patients. Quantitative PCR were done to all patient of group I at the start of the study and to 20 patients after the end of the work. The patients classified into 4 groups; group I (50 patient) and 3groups each of 20 patient, receiving oral enzyme, interferon, ribavirin and placebo (control) respectively.
At the beginning of the study 96 patients (87%) did not gave a history of acute hepatitis and 22 (20%) gave a history of parentral exposure. Fatigue was the main complaint and present in 28 patients (25%),while in 57 of patients (52%)the disease discovered accidentally. Schistosomiasis were present in 30 patients (27 %), most patients in this study showed normal value of bilirubin and alkaline phosphatase while GGT was elevated in 40 patients (36%).
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After end of the study, 30 patients of group I (60% ) respond to treatment with enzyme therapy with normalization of transaminases while 4 (20%)of group II and 3 patients (15%)in group III respond to treatment with interferon and ribavirin respectively. The response to treatment was related to GGT, immunoglobulins, and pretreatment histopathological findings but no relation found between response and clinical or other biochemical tests. Clearance of vireamia occur in one patient and decease (no clearance) in 5 patients associated biochemical response, while in 6 patient HCV RNA titer remain within the pretreatment level or slightly elevated associated with response, the last 8 patients showed elevation in viral level more than before the study. All the responders to treatment and some of non responder of group I have improved the general condition with disappearance of symptoms especially fatigue, anorexia and weight loss with no appearance of any side effects to either responders or non responders. Some patients in group II and III showed development of side effects mainly on hematological tests. No patient in control group shown return in transaminases to normal level and two of them deteriorate with development of decompansated liver disease.
117 SUMMARY
CONCLUSIONS
The response to treatment were related to pretreatment histopathological finding, GGT and immunoglobulins and measurement of this parameter may improve the response to treatment
No correlation were found between either transaminases or HCV RNA with histopathological findings.
The short course of interferon therapy (3 months) to patients with chronic HCV has gave biochemical response in 20 %, and only 15% of patients responsded to ribavirin at the same course of therapy.
Oral enzyme therapy a drug tried in the management of chronic HCV. It showed a hopeful promising result as 60% of patients treated with this drug responded to it and improved the general condition with amelioration of the disease. On other hand, the virus disappear in one patient, decreased in another 5 and remained within the pretreatment level in 6 patients, while in 8 patients the viral titer increased than the level at the start of therapy. No relations were found between biochemical and virological response. No side effects were observed to any patient treated with oral enzyme, while mild to moderate side effects to some patients under interferon and ribavirin were observed especially blood picture.
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oral enzyme in chronic
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tried in non responder to either one.
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therapy of interferon and oral enzyme could be
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be tried to maintain the response and prevent relapse.
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that respond to therapy.
Prolonged course of therapy or increase the dose of the oral
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Large scale meta-analysis of the effect of oral enzyme therapy