肛肠腔内导入复合能治疗仪治疗溃疡性结肠炎30例

目的:探讨肛肠腔内导入复合能治疗仪治疗慢性溃疡性结肠炎(UC)的临床疗效.方法:60例UC患者随机分为2组,治疗组30例,使用肛肠腔内导入复合能治疗仪治疗.对照组30例,用常规药物治疗,分别于3 mo和维持治疗12 mo比较.结果:治疗组3 mo临床治愈(完全缓解)25例,显效3例,有效2例,无效0例,总有效率100%,治愈率83.3%.对照组3 mo临床治愈9例,显效10例,有效5例,无效6例,总有效率76.6%,治愈率30%.两组有效率、治愈率有显著性差异(P<0.05,P<0.01),12 mo两组总有效率和治愈率比较也均有显著性差异(P<0.01).治疗组25例患者治愈,1年之内无复发.结论:肛肠腔内导入复合能治疗仪对溃疡性结肠炎的缓解治疗和维持缓解状态的疗效明显优于药物治疗,是治疗溃疡性结肠炎较好的方法.     

建中清肠汤联合孟鲁司特治疗溃疡性结肠炎疗效观察

目的观察建中清肠汤联合孟鲁司特治疗溃疡性结肠炎疗效。方法将患者按随机抽取方式分为观察组(109例)与比较组(108例),比较组:给予孟鲁司特片口服,观察组:给予建中清肠汤联合孟鲁司特治疗。观察2组患者的疗效与不良反应。结果观察组与比较组的总有效率分别为(93.58%)、(77.77%),观察组高于比较组,表明建中清肠汤联合孟鲁司特治疗溃疡性结肠炎疗效显著,2组之间差异具显著性(P0.05);2组患者经相关治疗后,胃肠道不适等不良反应均得到控制,无其他严重不良反应发生,之间差异无显著性(P0.05)。结论建中清肠汤联合孟鲁司特治疗溃疡性结肠炎疗效较为显著,患者的临床不适感可快速缓解,同时提升患者机体免疫力,值得临床应用推广。     

中药灌肠治疗中重度溃疡性结肠炎的疗效观察

目的 观察在西药治疗基础上中药保留灌肠治疗溃疡性结肠炎的疗效.方法 将60例溃疡性结肠炎患者随机分为两组,各30例,治疗组采用规范性西药治疗加中药保留灌肠,对照组采用西医规范治疗,治疗3个月后观察疗效.结果 治疗组总有效率为90%,对照组总有效率为70%.两组比较差异有显著性.结论 增加中药保留灌肠组疗效明显优于单纯西医常规治疗.     

参附注射液治疗溃疡性结肠炎38例疗效观察

目的 :观察参附注射液对溃疡性结肠炎的疗效与副作用。方法 :70例溃疡性结肠炎患者随机分为参附治疗组 38例和激素对照组 32例。治疗组用参附注射液 30ml静滴 ,每天 1次 ,共 15d ;对照组用氢化考的松 10 0mg静滴 ,每天 1次 ,共 7d ;后改为强的松 10mg ,每天 1次 ,口服 8d。两组同样应用小剂量柳氮磺吡啶 1g ,每天 3次。 结果 :参附组治愈率 2 3 .7% ,有效率 6 5 .8% ,总有效率 89.5 %。激素组治愈率 15 .6 % ,有效率 5 9.4% ,总有效率 75 %。两组比较有显著差异性 (P <0 .0 5 ) ,两组均未发现严重副作用。结论 :参附注射液用于治疗溃疡性结肠炎是安全有效的药物。     

中西医结合治疗溃疡性结肠炎的疗效观察

目的分析中西医结合治疗溃疡性结肠炎的疗效。方法选取我院2014年1月~2015年6月收治的溃疡性结肠炎患者185例作为研究对象,将其随机分为研究组93例与对照组92例。所有患者均给予营养支持、纠正电解质及酸碱平衡等常规治疗,并给予柳氮磺胺吡啶+黄连素片进行西药治疗;研究组加用于中药汤剂进行中西医结合治疗。比较两组疗效、治疗前后血浆C-反应蛋白(CRP)、不良反应及复发情况。结果研究组总有效率为94.6%,对照组总有效率为68.5%,两组比较,差异有统计学意义(P0.05);治疗前治疗组与对照组血浆CRP比较,差异无统计学意义(P0.05);治疗后两组血浆CRP,差异有统计学意义(P0.05);治疗1年后两组复发率比较,差异有统计学意义(P0.05);两组腹胀、恶心等胃肠道不良反应发生率比较,差异有统计学意义(P0.05)。结论与单一西药相比,中西医结合治疗治疗溃疡性结肠炎的疗效较明显,可有效改善患者的临床症状,降低不良反应发生率及复发率,值得临床推广与使用。     

类固醇激素治疗溃疡性结肠炎长期疗效及因素分析

目的分析类固醇激素(简称激素)治疗溃疡性结肠炎(ulcerative colitis,UC)的长期疗效及影响因素。方法回顾性分析确诊的UC患者59例,且均有完整的确诊和随诊临床资料。分析激素治疗1年的临床疗效及相关影响因素,以及撤减激素至10mg/d时临床复发率及影响因素。结果①入组59例UC患者,激素减至10 mg/d时缓解率为88.1%(52/59),1年缓解率为50.8%(30/59)。②维持1年临床缓解组与复发组比较,在性别、发病年龄、体质量、吸烟史、病程、病情严重程度及病变范围、治疗前血WBC、PLT、ALB、ESR、CRP、p-ANCA水平等方面结果显示没有显著差异;③缓解组和复发组比较,激素起始量、激素减量速度、激素累积量也未显示有统计学差异(P0.05)。结论延长激素使用时间及增加激素累积量对于维持患者长期缓解无明显意义。     

美沙拉嗪联合双歧三联活菌治疗重度溃疡性结肠炎患者临床分析

目的探讨美沙拉嗪联合双歧三联活菌治疗重度溃疡性结肠炎患者的临床效果。方法选择重度溃疡性结肠炎患者60例,根据随机数字法分为观察组与对照组各30例。对照组患者单纯用美沙拉嗪进行治疗,观察组患者在此基础上联合应用双歧三联活菌进行治疗,比较两组患者的临床治疗效果及复发情况。结果治疗2个月,观察组患者治疗总有效率为90.0%,对照组为86.7%,两组比较差异无统计学意义(P0.05)。秩和检验结果显示,两组患者临床疗效比较差异无统计学意义(P0.05)。治疗后随访6个月,观察组患者无复发病例(0%);对照组患者4例复发(13.3%),两组患者复发率比较差异无统计学意义(P0.05)。结论美沙拉嗪联合双歧三联活菌治疗重度溃疡性结肠炎患者,可能对提高临床治愈率、改善症状体征、减少复发有一定的帮助。     

溃结汤治疗溃疡性结肠炎合并糖尿病25例疗效观察

目的观察溃结汤治疗溃疡性结肠炎合并糖尿病的临床疗效。方法将该院2009年1月—2014年5月收治的溃疡性结肠炎合并糖尿病患者45例,随机分为观察组25例,给予患者溃结汤进行治疗;对照组20例,给予口服柳氮磺吡啶片进行治疗,观察两组的治疗效果。结果通过治疗,观察组治愈12例,显效6例,有效5例,无效2例,总有效率92.00%;对照组治愈2例,显效3例,有效10例,无效5例,总有效率75.00%。两组差异有统计学意义。结论溃结汤治疗溃疡性结肠炎,安全性高效果满意。     

核黄素烟酸与非溃疡性消化不良的相关性探讨

目的探讨核黄素烟酸与非溃疡性消化不良的关系.方法回顾性、单盲法分析113例伴有舌尖口角炎症状的非溃疡性消化不良的患者.随机分为二组.A组57例,男35例,女22例,年龄41.3岁±5.1岁.B组56例,男37例,女19例,年龄43.7岁±4.2岁,分两轮治疗.第一轮两组均按第九届世界胃肠病会议推荐的三联二周治疗方案治疗(CBS120mg,4次/d,甲硝唑0.4,3次/d,四环素0.5,3次/d).于wk2开始A组加服核黄素30mg/d,烟酸150mg/d,分三次口服.2wk治疗完成后B组未达治愈标准的病例进入第二轮治疗,同量口服核黄素烟酸1wk.两组病例于第一、第二轮治疗完成后分别进行比较分析.结果第一轮治疗结束后A组和B组治愈,有效,无效分别为49例(85.1%)和23例(41%),5例(8.77%)和28例(49.5%),3例(6.13%)和5例(9.5%).总有效率分别为93.87%和90.5%.两组对比提示总有效率差异无显著性(P>0.05).但两组治愈率有非常显著性差异(P<0.01).B组未达治愈标准的共33例,其中4例因症状无改善未再来院.完成第二轮治疗的29例.治愈,有效,无效分别是24例(87.2%),2例(6.9%)和3例(10.4%).该组在第一、第二轮治疗完成后分别治愈23例和24例共47例(82%).与A组比较差异无显著性(P>0.05),但组内第一轮治疗后未达治愈标准的29例在第二轮治疗后有24例治愈,两轮治疗结果比较差异有非常显著性(P<0.01).结论核黄素烟酸是非溃疡性消化不良的病因之一.     

致康胶囊治疗溃疡性结肠炎的疗效观察

目的为探讨致康胶囊治疗溃疡性结肠炎临床疗效,将活动期溃疡性直肠、乙状结肠炎患者55例,分别给予致康胶囊或柳氮磺胺吡治疗。疗程结束后,致康胶囊治疗组完全缓解率和总有效率分别为86.7%和100%,柳氨磺胺吡啶组分别为48%和96.8%,两组完全缓解率有非常显著性差异(P<0.05)。致康胶囊组无明显不良反应,柳氮磺胺组出现恶心4例。结果显示,致康胶囊治疗溃疡性结肠炎有较好疗效,较传统的抗生素疗法治愈率高,不良反应小。     

CCNU (lomustine), idarubicin and dexamethasone (CIDEX): an effective oral regimen for the treatment of refractory or relapsed myeloma

We report the results of a non-randomized pilot study of an oral regimen comprising CCNU (lomustine; 25 or 50 mg/m2 on day 1), idarubicin (4-demethoxydaunorubicin) (10 mg/m2 on days 1-3) and dexamethasone (10 mg b.d. on days 1-4) in patients with relapsed or refractory myeloma. Treatment was given every 28 d for a maximum of six courses. Sixty patients were entered of whom 57 were evaluable. Overall response rate (partial or minor response) was 49% with 30% of patients achieving a partial response (50% tumour reduction). Response rates were higher in patients with untested relapse than in those with refractory disease (overall response rates 56% vs. 31%). The major toxicity was neutropenia and the regimen was otherwise well tolerated. The median survival from entry of all patients was 15 months, with 30% of patients alive at 2 years. This regimen represents a useful addition to available treatment options.     

Infliximab treatment and prognostic factors for response in patients with Crohn's disease.

OBJECTIVE: The aim of this study is to report our experience with infliximab and analyse prognostic factors for response in Crohn's disease (CD). MATERIAL AND METHODS: Consecutive patients were prospectively enrolled in the study when referred for infliximab infusion. Data collected included indication for infusion, patient epidemiological characteristics, Vienna classification, previous surgery, previous medications and extra-intestinal manifestations. Adverse events and clinical response were tabulated separately for patients with luminal or fistulous Crohn's disease. RESULTS: 28 patients were treated (7 with inflammatory and 21 with fistulizing disease). Patients received a total of 116 infusions of infliximab: 57.1% (4 of 7) of patients with luminal disease had complete response within a median of 17.5 days (range 15-28 days), and 62% (13 of 21) of patients with fistulizing disease had complete response within a median of 9 days (range 6-51 days). All patients (5) without relapse received concomitant treatment with immune modifiers. The group of patients with previous resection or perianal fistula repair had complete response more frequently p = 0.03 (OR = 30; IC 95% = 1.47-119.8). CONCLUSIONS: Infliximab is safe and beneficial in clinical practice for Crohn's disease. The re-treatment regimen of infliximab is effective in maintaining clinical response. Immunosuppressant therapy may have a role in the duration of maintained clinical remission in patients with fistulizing disease. In patients with perianal fistulizing disease infliximab treatment is more effective when previous resection or fistula repair is present.     

Cytomegalovirus pneumonia in adult autologous blood and marrow transplant recipients

CMV pneumonia is a major cause of morbidity and mortality among allogeneic BMT recipients. To assess the frequency, timing, risk factors and response to therapy of CMV pneumonia among autologous BMT recipients, we reviewed our experience with 795 patients. Sixteen (2%) patients were diagnosed with CMV pneumonia. The frequency was higher among patients who were seropositive than those who were seronegative (3.3% vs 0%, P = 0.008). Among seropositive patients, the frequency was higher among patients with hematological malignancies than patients with solid tumors (5.0 % vs 1.0%, P = 0.019). Eleven cases occurred <30 days, and five cases occurred >100 days post transplant. The overall CMV pneumonia-related mortality rate was 31%. Seven (78%) of nine patients treated with ganciclovir and IVIG prior to respiratory failure survived; neither of two patients treated after respiratory failure survived. Four of five (80%) untreated patients survived. In conclusion, CMV is a not infrequent cause of pneumonia among autologous BMT recipients. Risk factors include CMV seropositivity and an underlying hematological malignancy. A favorable response hinges on the prompt initiation of therapy. The survival of 25% of the patients without antiviral therapy suggests that the isolation of CMV from a BAL specimen occasionally reflects oropharyngeal contamination or that CMV pneumonia may sometimes be self-limited in more immunocompetent autologous BMT recipients.     

Results of fludarabine and prednisone therapy in 264 patients with chronic lymphocytic leukemia with multivariate analysis-derived prognostic model for response to treatment [see comments]

Two hundred sixty-four patients with chronic lymphocytic leukemia were treated with fludarabine 30 mg/m2 intravenously for 30 minutes each day for 5 days and with prednisone 30 mg/m2 orally each day for 5 days. Courses were repeated monthly. Of the 264 patients. 125 patients (47%) had Rai stage III-IV disease; 169 patients (64%) were previously treated with a median of 3 prior regimens; and 138 of them (82%) were refractory to therapy with alkylating agents. The overall response (OR) and complete response (CR) rates in the 169 previously-treated patients were 52% and 37%; these were 74% and 63%, respectively, in Rai stage O- II patients and declined to 64% and 46%, respectively, in Rai III-IV disease. Among the previously untreated patients, the OR and CR rates were 79% and 63%, these being 85% and 70%, respectively, in Rai O-II patients, and declining to 64% and 46%, respectively, in Rai III-IV disease. The incidence of minor infections or fever of unknown origin was similar in all patient groups and occurred in 22% of courses. The incidence of sepsis and/or pneumonia was significantly correlated with the extent of prior therapy and with Rai stage, and ranged from 3% of courses in the previously untreated Rai O-II patients, to 13% of courses in the previously treated Rai III-IV patients. Listeria sepsis or Pneumocystis carinii pneumonia was noted in 14 patients. With therapy, CD4 levels were uniformly depressed from a median 1,015/microL pretreatment to a median 159/microL after 3 months of fludarabine therapy. Median time to progression in previously treated patients was 22 months. In previously untreated patients, median time to progression was 30 months for patients who achieved a partial remission and has not been reached in patients who achieved a CR with a median follow-up of 2 years. The median survival was 18 months for previously treated patients and has not been reached for previously untreated patients. Response rates in previously treated and untreated patients, as well as infection rates, were identical to those seen in 110 patients treated with the same dose schedule of fludarabine alone. Logistic regression analysis selected 4 factors to be significantly associated with worse response: Rai III-IV stage disease, prior therapy, older age, and low albumin levels. The regression equation was used to derive a probability of response based on the 4 characteristics. When the model was applied to the same population, patients could be divided into 4 prognostic groups with different outcomes.     

Risk factors of septic shock in patients with hematologic malignancies and Pseudomonas infections

Pseudomonas is a clinically significant and opportunist pathogen, usually associated in causing high mortality nosocomial infections. The aim of this study was to determine the risk factors associated with septic shock in patients diagnosed with hematologic malignancies and Pseudomonas infections. A total of 80 Pseudomonas isolates (77 Pseudomonas aeruginosa) were collected from 66 patients aged 2-64 years: 52 with acute leukemia (79%), 7 with lymphoma (10.5%), and 7 with other hematologic disorders (10.5%), between 2001 and 2009. The median age of the patients was 30 years. Isolates were collected mostly from bloodstreams (45%) and skin lesions (31.5%). The median time for microbiologic documentation was 8 days (range 0-35 days) from onset of neutropenia. At least 11 patients (16.6%) had recurrent (≥2) infections. The clinical symptoms observed were skin lesions (34%), diarrhea (20%), isolated fever (18%), and respiratory symptoms (14%). The isolates tested were found resistant to piperacillin/tazobactam (43%), ceftazidime (31%), imipenem-cilastatin (26%), ciprofloxacin (25%), and amikacin (26%). Septic shock occurred in 16.2% of episodes (13/80). Crude mortality due to septic shock occurred in 19.6% of patients (13/66). The median time for response to antibiotic therapy in the remaining 80.4% of patients (53/66) was 2.5 days. Univariate analysis revealed that factors associated with septic shock were: fever for ≥3 days in patients on antibiotic therapy (P = 0.019), serum lactate >5 mmol (P = 0.05), hemoglobin level <50 g/l (P = 0.042), hypoproteinemia <50 g/l (P = 0.01), procalcitonin >10 ng/ml (P = 0.031), and hypophosphatemia (P = 0.001). Multivariate analysis revealed that hypophosphatemia (P = 0.018), hypoproteinemia (P = 0.028), and high serum lactate (P = 0.012) are significant factors, independently associated with increased risk of septic shock in patients with hematologic malignancies and Pseudomonas infections.     

Daclizumab as useful treatment in refractory acute GVHD: a paediatric experience

GVHD remains a serious complication after allogeneic SCT. We describe 13 paediatric patients treated with daclizumab for refractory acute GVHD (aGVHD). After 30 days of daclizumab administration, all patients with cutaneous aGVHD reached complete response. Among patients with gastrointestinal disease, 50 and 30% had complete and partial response, respectively, whereas 11 and 55% of patients with hepatic aGVHD achieved CR and PR, respectively. Overall, complete (46%) and partial (46%) responses were demonstrated in 92% of our patients, whereas the remaining patients (8%) were nonresponders. No life-threatening infectious episodes were recorded within 100 days from transplant in this selected group of paediatric patients. Overall 46% of patients were alive at a median of 461 days from SCT, but 50% of them developed chronic GVHD. In our experience, daclizumab proved to be a useful and safe treatment for refractory and steroid-resistant/dependent aGVHD, in particular for cutaneous and low-moderate intestinal involvement.     

Bacterial Bloodstream Infection in Neutropenic Adult Patients after Myeloablative Cord Blood Transplantation: Experience of a Single Institution in Japan

Bacterial infection is one of the most important causes of morbidity and mortality after unrelated cord blood transplantation (CBT). In the present study, we studied 101 adult patients with respect to the incidence, outcome, and risk factors for bacterial bloodstream infection (BSI) within 30 days after CBT using a myeloablative conditioning regimen. Bacterial BSI occurred in 12 patients within 30 days after CBT. The cumulative incidence of bacterial BSI was 12%. The median time of onset was day +6 (range, day -1 to day +13) after CBT. In all patients, the neutrophil count was 0/microL at the onset of bacterial BSI. Eight (67%) and 4 (33%) of the isolates were Gram-positive and Gram-negative bacteria, respectively. Only 2 (17%) of the 12 patients who had bacterial BSI died within 100 days after CBT. No risk factors for the occurrence of bacterial BSI within 30 days after CBT were identified. The low mortality rate for bacterial BSI in the neutropenic period appeared to be associated with the low incidence (6%) of transplantation-related death at day +100 in our study patients. Early diagnosis of bacterial BSI and prompt treatment with effective antibiotics are necessary for neutropenic adult patients after myeloablative CBT.     

Determinants of Early Readmission After Hospitalization for Heart Failure

Background

Determination of factors increasing the likelihood of early readmission after hospitalization for heart failure (HF) is fundamental for identifying potential targets for intervention. Thus, we studied the characteristics of patients readmitted within 7 and 30 days after hospitalization for HF in Alberta, Canada.

Methods

Using hospital discharge abstract data, we followed patients with incident HF discharged from April 2004-March 2012 and determined their readmission status within 7 and 30 days after an index hospitalization. Logistic regression was used to determine variables associated with readmission.

Results

Of 18,590 patients with HF (49.8% women; mean age 76.4 years), 5.6% were readmitted within 7 days and 18% were readmitted within 30 days. Readmission rates within 7 and 30 days increased significantly with age. Seven-day all-cause readmissions were associated with history of kidney disease (adjusted odds ratio [aOR], 1.28; 95% confidence interval [CI], 1.08-1.53), and 30-day all-cause readmissions were associated with cancer, pulmonary, liver, and kidney disease. Discharge with home care services at the time of discharge was a risk factor for readmission within 7 days (aOR, 1.26; 95% CI, 1.07-1.49) and 30 days (aOR, 1.23; 95% CI, 1.11-1.35). Discharge from a hospital with HF services was associated with lower readmission at both 7 days (aOR, 0.65; 95% CI, 0.57-0.74) and 30 days (aOR, 0.71; 95% CI, 0.65-0.77).

Conclusions

Several factors were associated with increased risk of readmission, whereas patients discharged from hospitals with HF services had a lower risk of readmission within 7 and 30 days of discharge. The interaction of provision of home care and higher early readmission deserves further study.     

Treatment of early Lyme disease.

PURPOSE: To compare the safety and efficacy of azithromycin, amoxicillin/probenecid, and doxycycline for the treatment of early Lyme disease, to identify risk factors for treatment failure, and to describe the serologic response in treated patients. PATIENTS AND METHODS: Fifty-five patients with erythema migrans and two patients with flu-like symptoms alone and fourfold changes in antibody titers to Borrelia burgdorferi were randomized to receive (1) oral azithromycin, 500 mg on the first day followed by 250 mg once a day for 4 days; (2) oral amoxicillin 500 mg and probenecid 500 mg, three times a day for each for 10 days; or (3) doxcycline, 100 mg twice a day for 10 days. If symptoms were still present at 10 days, treatment was extended with amoxicillin/probenecid or doxycycline for 10 more days. Evaluations were done at study entry and 10, 30, and 180 days later. RESULTS: Three of the patients who initially had symptoms suggestive of spread of the spirochete to the nervous system, one from each antibiotic treatment group, subsequently developed neurologic abnormalities, but symptoms in the other 54 patients resolved within 3 to 30 days after study entry. Six of the 19 patients (32%) (95% confidence interval, 13% to 57%) given amoxicillin/probenecid developed a drug eruption, whereas none of the patients given azithromycin or doxycycline had this complication. The presence of dysesthesias at study entry was the only risk factor significantly associated with treatment failure (p less than 0.001). By convalescence, 72% of the patients were seropositive, and 56% still had detectable IgM responses to the spirochete 6 months later. CONCLUSIONS: The three antibiotic regimens tested in this study were generally effective for the treatment of early Lyme disease, but the regimens differ in the frequency of side effects and in ease of administration.     

Thyroid dysfunction during treatment of chronic hepatitis C with interferon alpha: no association with either interferon dosage or efficacy of therapy

OBJECTIVES: Treatment of chronic hepatitis C with interferon-alpha (IFN-alpha) may induce thyroid disorders. We evaluated whether this risk is related to the dosage of IFN-alpha or the virological treatment response. Other possible risk factors as well as the evolution of the thyroid abnormalities were also studied. METHODS: In this prospective trial (n=254), thyroid-stimulating hormone (TSH), free thyroxin (fT4) and thyroid peroxidase autoantibodies were measured before, during and after treatment for hepatitis C virus (HCV). The patients were randomized to either induction therapy [IFN-alpha 6 million units (MIU) daily for 4 weeks and 3 MIU 3/7 days for 22 weeks] or conventional therapy [IFN-alpha 3 MIU 3/7 days for 26 weeks]. In addition, all patients received ribavirin (1000 or 1200 mg) daily. Sustained virological response was defined as loss of detectable HCV RNA at 6 months follow-up. Thyroid dysfunction was defined as TSH level below or above the normal range (0.2-4.5 MIU L-1). RESULTS: Biochemical thyroid dysfunction developed in 30 (11.8%) of 254 patients. Hypothyroidism (TSH > 4.5 MIU L-1) was seen in 20 and hyperthyroidism (TSH < 0.2 MIU L-1) in 10 patients. Nine of the 30 patients developed symptomatic thyroid disease and HCV treatment was discontinued because of thyroid dysfunction in three of these patients. Thyroid dysfunction occurred in 15 (11.7%) of 128 patients who received high-dose IFN-alpha induction therapy as compared with 15 (11.9%) of 126 patients who received conventional IFN-alpha therapy (P=0.96). Amongst 231 patients who completed all 6 months of HCV treatment, a sustained virological response was obtained in 19 (66%) of 29 with thyroid dysfunction and 109 (54%) of 202 without (P=0.24). By multivariate analysis female gender and Asian origin were independent predictors of developing biochemical thyroid dysfunction (P < 0.01). CONCLUSION: Thyroid dysfunction occurred in 11.8% of patients treated for chronic hepatitis C with IFN-alpha and ribavirin. Neither the IFN-alpha dosage nor the virological response to treatment were related to the incidence of thyroid dysfunction.