Suchergebnisse

The article discusses the issues and modern trends of the regional policy implementation in countries of European Community (EC); the research is focused on one of the pressing directions suggested by the European Commission to increase competitiveness of EU in the global world – research and innovation; the estimate of the state and outlook of R&D in the regional section in countries of Central and Eastern Europe is given; comparative analysis is carried out; conclusions are drawn and recommendations are made. ; В статье обсуждаются проблемы и современные тенденции реализации региональной политики в странах Европейского союза (ЕС); исследование акцентировано на одном из актуальных направлений деятельности, предложенных Европейской комиссией для повышения конкурентоспособности ЕС в глобальном мире – исследования и инновации; дана оценка состояния и перспектив развития сферы НИОКР в региональном разрезе в странах Центральной и Восточной Европы; выполнен сравнительный анализ; сделаны выводы и рекомендации.

Hepatitis C (HCV) and HIV share common transmission pathways and the acquisition of both viruses are relatively common. Concurrent treatment for HCV with highly active anti‐retroviral therapy (HAART) should be considered in HIV co‐infected individuals to decrease the progression of liver damage. Adverse effects and less satisfactory treatment outcomes are often concerns when treating co‐infected individuals. Although, direct acting antivirals (DAAs) may increase SVR, they may not be possible because of drug‐drug interactions. he objective of this study is to investigate the difference in response rates of HCV treatment in HIV co‐infected inmates with varying doses of ribavirin. Retrospective medical chart reviews of 52 HCV/HIV co‐infected inmates who underwent HCV therapy between 2003 and 2010. All received standard doses of pegylated interferon alpha 2a or 2b and 800–1600 mg of ribavirin depending on weight. The recommended dosage for genotypes 2 and 3 is 800 mg/day. For other genotypes, if weight is<75 kg, the recommended ribavirin dose is 1000 mg/day or 1200 mg/day if>75 kg. Efficacy was defined as attaining sustained virological response (SVR) six months post treatment. Univariate analyses was performed using SPSS‐18; Chi‐square test with p‐value<0.05 was defined significant. 52 co‐infected (3 females & 49 males) were identified. Mean age was 40±7 years. Caucasians accounted for 84.6%; First Nations for 13.5% and Asians 1.9%. 36 were concurrently on HAART. The genotype distribution was: geno 1, 66.0%; geno 2, 7.5%; geno 3, 26.4%. SVR by ribavirin dosage ratio (actual dosage/recommended dosage):=1.0; 41.2% (14/34),>1.0; 58.8% (20/34). Doses greater than 1.5 times were associated with higher adverse events and lower SVR. Suboptimal doses of weight‐based ribavirin may be contributing to a lower treatment response in HCV/HIV co‐infectants. In our experience, the optimal dose of ribavirin is between 1 and 1.2 times the current recommended dose. We recommend that ribavirin dose be individualized in co‐infected in order to enhance the likelihood of achieving SVR. Dual therapy is more practical in many of our population because of chaotic lifestyle. Therefore optimizing the ribavirin dose should be initially undertaken.

Hepatitis C (HCV) and HIV are commonly acquired through intravenous drug use (IDU). Treatment of HCV is beneficial in reducing hepatic complications and likely decelerating the rate of progression of HIV. HCV therapy in HCV/HIV co‐infected individuals is increasingly being reported to be feasible. However, re‐infection is emerging as an important concern, especially in the prison population where likely related to surreptitious IDU. In this study, we report the re‐infection rate of inmates in the Pacific region of Canada who have HCV/HIV and were successfully treated for HCV. Retrospective medical chart reviews of 57 co‐infected inmates with a history of IDU who received HCV therapy between April 2003 and June 2012. All received standard doses of pegylated interferon alpha 2a or 2b and weight‐base ribavirin for durations of 24–48 weeks depending on genotypes. After successfully attaining SVR, inmates are routinely monitored for re‐infection every 6–12 months with HCV RNA qualitative analysis. Of the 57 inmates with HCV/HIV, 48 (82.8%) were Caucasians and 10 (17.2%) were First Nations. 94.7% (54) of the study population were males. The mean age at the start of treatment was 39.6±7.5 years. 100% (inclusion criteria) admitted to IDU before treatment and 7 (12.1%) admitted IDU after treatment. Genotype 1 made up 56.1% (32), followed by genotype 3 at 35.1% (20) and genotype 2 at 8.8% (5). Treatment was discontinued due to adverse side effects in 4 (6.9%) and discontinued due to no response in 9 (15.5%) inmates. 2 (3.7%) were lost to follow up due to discharge to community. SVR was attained in 33 (56.9%) inmates and of those 30.3% (10) were re‐infected. These re‐infected cases were noted mainly in genotype 3 (60%) and genotype 1 (40%). Six had viral relapsed. SVR results are pending for three. Achieving a SVR is encouraging in HCV/HIV co‐infected. Our study revealed that 30.3 % of the inmate population became re‐infected after treatment. Of note, these numbers are relatively small. However, it is important that counseling regarding harm reduction and strategies should be provided before, during and after treatment to help reduce the rate of re‐infection.