3 research outputs found
From infection to autoimmunity: can COVID-19 spark new auto-immune conditions?
No full textBackground: Some studies have described a probable relationship between SARS-CoV-2 infection and autoimmunity. Aim: to present a case series of autoimmune manifestations (AIM) following COVID-19 infection. Methods: A consecutive series of patients from January 2020 to December 2023 was collected from the various departments of Fattouma Bourguiba University Hospital, Monastir, where all clinical assessments were performed. Anti-nuclear antibody (ANA) screening was performed using indirect immunofluorescence on HEp-2 cells (Euroimmun, Germany) with a positivity titer of ≥1/180. Typing was performed using ELISA (Biosystems, Spain) or line blot (Euroimmun, Germany). The assessment of other autoantibodies was performed using various techniques (indirect immunofluorescence, ELISA, and line blot). Results: Sixteen patients presented with AIM after the COVID-19 infection. Their ages ranged from 12 to 67 years (44.6 ± 15.5 years). The sex ratio was 1 (eight men to eight women). Clinical manifestations began between one week and three months after infection. The clinical presentation was polymorphic (general, cutaneous, neurological, ophthalmic, muscular, articular, and abdominal features). Biological, radiological, and histopathological investigations revealed principal abnormalities in endocrine, articular, muscular, or neurological functions in the presence of ANA and/or specific autoantibodies. Fiveteen patients were diagnosed with autoimmune diseases (AID) and treated with specific treatments. The diagnosis retained for the other case was non-specific autoimmune stimulation with spontaneous recovery. Conclusion: These cases suggest that AID or AIM can be triggered or unmasked by SARS-CoV-2 infection
Treatment of Helicobacter pylori infection 14‐day concomitant quadruple therapy versus triple therapy: A parallel double‐blind randomized controlled trial
No full textAbstract Background and Aims Successful Helicobacter pylori (Hp) eradication with the traditional 7‐day course of proton pump inhibitor triple therapy is declining. Prolonging therapy to 14 days is associated with better eradication rates. Most learned societies recommend concomitant quadruple therapy (QC) as a first‐line alternative therapy for this bacterial infection. The aim of this study is to compare the efficacy and safety of triple therapy (TT) and QC for the eradication of Hp infection. Methods A parallel double‐blind randomized controlled trial was conducted. The diagnosis of Hp infection was made by pathological examination of gastric biopsies. Patients were randomly assigned to two treatment groups: either QC (esomeprazole 80 mg, amoxicillin 2000 mg, clarithromycin 1000 mg, and metronidazole 1000 mg daily) or triple therapy (esomeprazole 80 mg, amoxicillin 2000 mg, and clarithromycin 1000 mg daily in divided doses) for 14 days. The efficacy of the treatment is defined by Hp eradication attested by a negative breath test performed 6 weeks after the completion of treatment. Treatment outcomes were compared using the chi‐square test, while binary logistic regression identified predictors of treatment failure. Results Ninety‐two patients were included. Forty‐two patients belonged to the QC group and 50 to the TT group. No significant difference was noted between the two groups concerning the rate of Hp eradication either by intention to treat (81% vs. 72% respectively, p = 0.31) or per protocol (81.6% vs. 76.1% respectively, p = 0.54). Likewise, there was no difference between the two groups in terms of tolerance to treatment (59.5% for QC vs. 58% for TT, p = 0.88). No factor has been associated with treatment failure. Conclusion There was no significant difference in the rate of HP eradication between the QC and the 14‐day triple therapy. Neither regimen should be used topically because of their low eradication rates
Response to Pegylated Interferon in Chronic Hepatitis B, Effect of with and without Precore Mutant Stain: A Multicenter Tunisian Study
No full textBackground and Study Aims: To evaluate the effectiveness of pegylated interferon in patients with chronic hepatitis B infection in a real life setting.Patients and Methods: Fifteen hospitals in Tunisia were included in this study. Data from consecutively treated chronic hepatitis B (CHB) patients, who received pegylated interferon, were collected retrospectively. Baseline demographic and clinical data, on-treatment virological and serological responses and adverse events (AE) were recorded. Sustained virologic response (SVR) is defined as an hepatitis B virus (HBV) DNA concentration of less than 2,000 IU/mL six months after the completion of therapy.Results: A total of 351 CHBÂ patients under peg interferon alfa-2a treatment were included in this multicenter, open label, non-interventional study.Thirty five HBeAg positive patients were identified (62% male, 23% advanced fibrosis). Six months after therapy, 24% had viral loads < 2000 IU/mL, 20% achieved HBeAg seroconversion and 5, 7% achieved HBs Ag loss.Three hundreds sixteen HBeAg negative patients were treated (72, 5% male, 24% advanced fibrosis). Six months post-treatment, 14 % had viral loads < 2000 IU/mL and 1, 2% achieved HBs Ag loss.Treatment was well tolerated in 92% of cases and was stopped in 5.2% of patients.In multivariate analysis, predictors of response to pegylated interferon were: age less than 50 years (P=0,04 IC [0,169-0,737]), precore mutant stain infection (p=0,04 IC [0,60-0,69]), a body mass index < 30kg/m2 (P=0,05 IC [0,225-0,320]), and a pre-treatment serum HBV DNA level <20000IU/ml (P=0,03 IC [1,316-2,225]).Conclusion: PEG-IFN therapy in chronic hepatitis B (CHB) is well tolerated and can achieve a good response especially if we select good responders
