Objectives: The combination of pegylated interferon-α and ribavirin is a standard-of-care (SOC) treatment for chronic hepatitis C (CHC), and it achieves a sustained virological response (SVR) in 41-52% of genotype 1 and in 73-79% of genotype 3 patients. In a few clinical trials, the combination of fluvastatin and SOC increased the SVR in genotype 1 patients. Methods: This prospective study enrolled 179 naïve CHC patients. In the fluvastatin group patients received the combination of SOC and fluvastatin 80 mg daily; historical controls matching the study group in genotype, age and gender were treated with the SOC treatment only. Results: On-treatment viral responses as well as the SVR did not differ significantly between the two groups, except for the genotype 1 patients with a high viral load presenting a significantly higher SVR rate in the fluvastatin group (75%) compared to the control group (41%; p = 0.024). Multivariate logistic regression identified hepatitis C virus (HCV) genotype 3 infection (p < 0.001), age ≤40 years (p < 0.001), liver steatosis <5% (p < 0.01) and low viral load (p < 0.001) as independent predictors of an SVR. Conclusion: A combination of fluvastatin and SOC significantly improved the SVR in naïve CHC patients infected with HCV genotype 1 and high viral load, but it did not improve the SVR in patients infected with HCV genotype 3.
Background: Hepatitis B virus (HBV) genotypes have been shown to have virological, clinical, and therapeutic implications. Knowledge about HBV genotype distribution in Slovenia is scarce. This study was the first to determine various characteristics of patients with chronic HBV infection with regard to HBV genotypes at the national level. Methods: HBV genotype determination was performed on randomly selected patients out of 1,729 patients from all Slovenian regions who tested positive for HBV surface antigen (HBsAg) at the national reference laboratory for viral hepatitis between January 1997 and December 2010. Demographic, epidemiological, virological, and clinical data were extracted from the medical records and statistically analyzed with regard to HBV genotypes. Results: A total of 186 HBsAg positive patients with the mean age of 40.1 years were identified from whom, 65.1% were male. 157 (84.4%) cases presented with genotype D, 23 (12.4%) with genotype A, and 6 (3.2%) with other HBV genotypes. Sexual transmission was more significantly associated with lower odds for HBV genotype D infection compared to blood-related risk factors (P = 0.023). Genotype A was significantly more common in men who had sex with men (P = 0.043). Compared to females with genotype D, genotype A positive women presented unknown risk factors more significantly (P = 0.002). Conclusions: HBV genotype D is the most prevalent genotype in Slovenia. However, future changes might be expected due to recent massive immigrations to Europe. Routine HBV genotyping is recommended in patients with certain risk factors prior to initiation of hepatitis B treatment.
We report here on the identification of the first meningococcal meningitis case in Slovenia caused by Neisseria meningitidis serogroup Z' in December 2010. The 19-year-old patient had not left the country during the incubation period. The patient was hospitalised and given the antibiotic treatment with cefotaxime very early in the course of the disease. The patient did not develop any complications during hospitalisation and was discharged on 5 January 2011.
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