Erectile dysfunction in patients with chronic viral hepatitis: a systematic review of the literature.

Introduction: This article reviews the literature on epidemiology and pathogenetic factors of erectile dysfunction in patients with chronic viral hepatic (CVH) diseases in men and the potential implications for diagnosis and treatment.

Areas Covered: A search to identify original articles, reviews and any other article suitable for the purposes of this review was conducted by combining the following terms: erectile dysfunction and/or sexual dysfunction, chronic viral hepatitis, hepatitis B virus infection and hepatitis C virus infection.

Expert Opinion: The results of this review have led to the following main observations: i) there is scarce documentation on the association between CVH and sexual dysfunction; ii) hormonal impairment seems to be a major component in the development of erectile dysfunction in CVH; however, published evidence concerning the contribution of other pathogenetic factors is rare and inconclusive and iii) available treatment options for CVH potentially contribute to the development of sexual dysfunction in these patients.

In vivo antiviral activity of telbivudine against HIV-1: a case report.

The treatment of HBV infection in patients with HIV co-infection presents several peculiar features: some drugs active against HBV are also active against HIV. This precludes their use in monotherapy in HIV-HBV co-infected patients due to the potential risk of selecting HIV-resistant strains. Telbivudine seemed to be a candidate for exclusive anti-HBV therapy because it exerts no significant in vitro activity against HIV.

A Simple Noninvasive Score Based on Routine Parameters can Predict Liver Cirrhosis in Patients With Chronic Hepatitis C.

Background: Liver biopsy has remained the gold standard for the diagnosis of chronic hepatitis C; even though, it has a low but non-negligible rate of both false negative and complications. Several authors have proposed noninvasive tools to diagnose cirrhosis. But none of them showed complete concordance with liver biopsy.

Efficacy and Safety of Sofosbuvir in the Treatment of Chronic Hepatitis C: The Dawn of a New Era.

Hepatitis C virus (HCV) infection affects about 160 million people worldwide. Currently, it is treated with pegylated interferon (PEG-IFN) plus ribavirin, associated with a protease inhibitor in case of genotype 1 infection. However, this combination is often contraindicated and associated with severe adverse events that limit its use in clinical practice.

Concomitant interferon-alpha and chemotherapy in hepatitis C and colorectal cancer: a case report.

Hepatitis C virus (HCV) infection is one of the main causes of liver disease worldwide. Patients undergoing surgery are at risk of acquiring acute HCV infection and those undergoing surgical eradication of a neoplasia may be indicated for adjuvant treatment. Therefore, unlike chronic infection, these patients may simultaneously need antiviral therapy with interferon for acute hepatitis C and cytotoxic chemotherapy.

Antibiotic prophylaxis and risk of infections in thyroid surgery: results from a national study (UEC-Italian Endocrine Surgery Units Association).

Thyroid surgery is considered a clean procedure, and therefore antibiotic prophylaxis is not recommended. However, antibiotic prophylaxis is often used in clinical practice. Aim of the present study is to show the rate of infections in thyroid surgery and whether antibiotic prophylaxis, among other factors, is associated with a lower infection rate in 2,926 patients (constituting the cohort of UEC-Italian Endocrine Surgery Units Association) who had a thyroid surgical operation between the years 2009 and 2011.

Sustained virological response: a milestone in the treatment of chronic hepatitis C.

Aim: To evaluate the long-term eradication of hepatitis C virus (HCV) infection and liver-related complications in chronically infected patients that have achieved sustained virological response.

Methods: One hundred and fifty subjects with chronic hepatitis C (CHC) or cirrhosis and sustained virological response (SVR) between the years of 1989 and 2008 were enrolled in a long-term clinical follow-up study at the Gastrointestinal and Liver Unit of the University Hospital of Naples "Federico II". At the beginning of the study, the diagnosis of HCV infection was made on the basis of serum positivity for antibodies to HCV and detection of HCV RNA transcripts, while a diagnosis of chronic hepatitis was formulated using imaging techniques and/or a liver biopsy.

Etiopathogenesis of autism spectrum disorders: fitting the pieces of the puzzle together.

Autism spectrum disorders (ASD) are disorders of the central nervous system characterized by impairments in communication and social reciprocity. Despite thousands of studies on this topic, the etiopathogenesis of these disorders remains unclear, apart from a general belief that they derive from an interaction between several genes and the environment. Given the mystery surrounding the etiopathogenesis of ASD it is impossible to plan effective preventive and treatment measures.

Response to measles-mumps-rubella vaccine in children with autism spectrum disorders.

Background/aim: The etiology of autism spectrum disorders (ASD) is unknown. The measles-mumps-rubella (MMR) vaccination has been in the past implicated in ASD pathogenesis. The aim of our study was to evaluate the rate of seropositivity and the levels of antibodies against MMR antigens in a cohort of children with ASD compared to control children.

Do Italian surgeons use antibiotic prophylaxis in thyroid surgery? Results from a national study (UEC--Italian Endocrine Surgery Units Association).

Thyroid surgery is a clean procedure and therefore antibiotic prophylaxis is not routinely recommended by most international guidelines. However, antibiotics are often used in clinical practice. We enrolled 2926 patients who performed a thyroid surgical operation between the years 2009 and 2011 in the 38 centers of endocrine surgery that joined the UEC--Italian Endocrine Surgery Units Association.

Resolution of autoimmune thrombocytopenia associated with raltegravir use in an HIV-positive patient.

About 10% of the human immunodeficiency virus (HIV) patients show thrombocytopenia. We describe the case of an HIV/HCV-positive patient whose autoimmune thrombocytopenia resolved with the addition of raltegravir to previous highly active antiretroviral therapy (HAART). It is noteworthy that the effect on platelet count appeared to be independent of viral load suppression, which was achieved with previous antiretroviral regimens.

Hepatitis B in pregnancy.

Chronic hepatitis B virus (HBV) infection affects about 350 million individuals worldwide. Management of HBV infection in pregnancy is difficult because of several peculiar and somewhat controversial aspects. The aim of the present review is to provide a tool that may help physicians to correctly manage HBV infection in pregnancy.

Development and progression of gastroesophageal varices in patients with chronic hepatitis C.

Hepatitis C virus infection is the leading cause of chronic liver disease in the western world. Chronic liver diseases may cause, through portal hypertension, the development of gastroesophageal varices, which can then bleed. We assess the findings of a study aimed at identifying the incidence of de novo varix development and their progression in patients with chronic hepatitis C and advanced fibrosis.

Is the drug-induced hypersensitivity syndrome (DIHS) due to human herpesvirus 6 infection or to allergy-mediated viral reactivation? Report of a case and literature review.

Background: Drug-Induced Hypersensitivity Syndrome (DIHS) is a severe and rare systemic reaction triggered by a drug (usually an antiepileptic drug). We present a case of DISH and we review studies on the clinical features and treatment of DIHS, and on its pathogenesis in which two elements (Herpesvirus infection and the drug) interact with the immune system to trigger such a syndrome that can lead to death in about 20% of cases.

Case Presentation: We report the case of a 26-year old woman with fever, systemic maculopapular rash, lymphadenopathy, hepatitis and eosinophilic leukocytosis.

The efficacy and safety of telaprevir - a new protease inhibitor against hepatitis C virus.

Importance Of The Field: Hepatitis C virus (HCV) is the main agent of chronic hepatitis, liver cirrhosis and hepatocellular carcinoma in the western world. It affects more than 170 million people worldwide. HCV treatment, based on the combination of Peg-interferon and ribavirin, is effective in about 50% of treated patients.

Iron depletion before HCV antiviral therapy: a pilot, randomized, controlled trial.

It is not known whether iron depletion before pegylated IFN or combination treatment improves sustained virological response (SVR) rate in patients with chronic hepatitis C, despite its use in clinical practice in this setting. We aimed to investigate whether blood letting improves the efficacy (SVR) and tolerability of PEG-IFNalpha2b + Ribavirin in chronic hepatitis C patients. Patients with chronic hepatitis C and ferritin >100 ng/mL were randomized to: (1) repeated phlebotomies to obtain a ferritin level <50 ng/mL followed by pegylated-Interferon alpha2b + ribavirin (active arm); or (2) pegylated-Interferon alpha2b + ribavirin (control arm).

Homocysteine levels and sustained virological response to pegylated-interferon alpha2b plus ribavirin therapy for chronic hepatitis C: a prospective study.

Background: Chronic hepatitis C affects about 3% of the world's population. Pegylated interferon (IFN) alpha plus ribavirin is the gold standard treatment. Methylenetetrahydrofolate reductase(MTHFR) is a key enzyme in the metabolism of homocysteine.

A simple noninvasive score predicts gastroesophageal varices in patients with chronic viral hepatitis.

Background: Guidelines recommend upper endoscopic screening of cirrhotic patients for gastroesophageal varices. Cirrhosis is not always distinguishable from chronic hepatitis.

Goals: To identify low-risk patients who can be spared upper endoscopy irrespective of a diagnosis of cirrhosis.

Multiple sclerosis and hepatitis C virus infection are associated with single nucleotide polymorphisms in interferon pathway genes.

We have studied 35 single nucleotide polymorphisms (SNPs) in the interferon (IFN) pathway to determine their contribution to multiple sclerosis (MS) and hepatitis C virus (HCV) infection. A total of 182 patients with MS, 103 patients with chronic hepatitis C, and 118 control subjects were enrolled in the study. Of the 35 SNPs studied, 3 were in IFN-alpha receptor (IFNAR-1), 10 in IFN-alpha/beta receptor (IFNAR-2), 9 in Stat1, 5 in Stat2, and 8 in IFN regulatory factor-1 (IRF-1).

A rare case of brainstem encephalitis by Listeria monocytogenes with isolated mesencephalic localization. Case report and review.

We describe a case of brainstem infection by Listeria monocytogenes with right oculomotor palsy and lip drop, facial hypoesthesia, left arm paresthesia, positive blood culture, and sterile liquor in a 63-year-old man. Magnetic resonance imaging revealed an isolated mesencephalic lesion. Localization of this kind accounted for 3% of 111 cases reviewed.

Hemolytic anemia during pegylated IFN-alpha2b plus ribavirin treatment for chronic hepatitis C: ribavirin is not always the culprit.

A 53-year-old woman admitted to our department for histologically proven chronic hepatitis C had previously been treated with pegylated interferon-alpha2b (PEG-IFN) plus ribavirin. Combination therapy had been withdrawn after 5 weeks because of severe anemia (hemoglobin 8.2 g/dl) despite a reduction in ribavirin dose.

Pernicious anemia during IFN-alpha treatment for chronic hepatitis C.

Some latent diseases, such as immune disorders, can appear during interferon-alpha (IFN-alpha) therapy. These disorders are difficult to predict because of their low prevalence in the general population. We describe a case of pernicious anemia (PA) in a patient affected by chronic hepatitis C and macrocytosis during IFN-alpha therapy.