Among 89 patients with a follow-up longer than 60 months, 65 (73%) had aminotransferase levels lower than twice the upper limit of normal (2002 criteria), but only 23 (25.8%) consistently maintained normal aminotransferase levels (2010 criteria) with low steroid doses (2-4

mg of methylprednisolone daily or every other day). Interestingly, from a clinical standpoint, after a mean follow-up longer than 100 months, only 1 of the 23 patients (4%) fulfilling the 2010 criteria of remission experienced 5-Fluoracil datasheet histological worsening of the disease (mild to severe liver histology), whereas 36 of the 66 patients (54.5%) whose aminotransferase levels did not normalize had histological (14 with severe histology and 9 with cirrhosis) or clinical evidence (11 with end-stage liver disease, 1 with decompensated cirrhosis, and 1 with hepatocellular carcinoma) of uncontrolled and evolving liver disease. In summary, in our experience, the application of the 2010 criteria flips the previously codified remission rate from

73% to 26%. Complete-response patients have a very good long-term prognosis virtually free of significant clinical events, whereas patients whose serum aminotransferases 上海皓元医药股份有限公司 are unable to be stably normalized are those Akt inhibitor with the highest probability of developing long-term complications, which not rarely may prove to be lethal. These are the patients most likely to benefit from new pharmacological, cellular, and molecular therapies.4, 5 Luigi Muratori M.D.* †, Paolo Muratori M.D.* †, Giulia Lanzoni M.D.* †, Silvia Ferri M.D.* †, Marco Lenzi M.D.* †, * Department of Clinical Medicine, Alma Mater Studiorum–University of Bologna,

Bologna, Italy, † Sant’Orsola-Malpighi Polyclinic, Bologna, Italy. “
“We read with great interest the article by Pascale et al.,[1] reporting a man with chronic hepatitis C virus (HCV) genotype 1b infection who relapsed after telaprevir-based triple therapy and achieved sustained virologic response (SVR) with a subsequent 48-week course of dual therapy (peginterferon alfa/ribavirin). We think the definition of failure to respond to telaprevir-based triple therapy seems not appropriate. This patient received telaprevir, peginterferon alfa-2a, and ribavirin for only 12 weeks in the phase 2 study.