Introdução: Estudos recentes corroboram que a resposta virológica obtida à 4ª semana do tratamento da hepatite C crónica, denominada resposta virológica rápida representa o melhor valor preditivo positivo da resposta virológica sustentada (RVS). Objectivos: Caracterizar uma amostra de doentes, que à 4ª semana de tratamento apresentou carga vírica indetectável. Métodos: Análise retrospectiva dos processos clínicos dos doentes que terminaram tratamento num período de 2 anos (2004-2005). Resultados: Foram incluídos 42 doentes, 10 dos quais co-infectados pelo VIH. A maioria possuía genótipo 1 (52,4%), baixa carga vírica VHC basal, ou seja inferior a 800 000 UI/ml (92,9%) e ALT elevada. A RVS foi de 85,7%. Conclusões: A terapêutica deve ser individualizada e a relação custo-benefício deve ser ponderada com avaliação de eventuais efeitos tóxicos decorrentes da manutenção da terapêutica, especialmente nos indivíduos que, presumivelmente, não irão atingir uma RVS.

Introduction: Recent studies suggest that negative HCV-RNA at week 4 of HCV treatment, known as rapid virological response has a high positive predictive value of sustained virological response (SVR). Aim: To describe a group of patients who achieved undetectable levels of HCV-RNA after 4 weeks of HCV treatment. Methods: Retrospective study of patient’s clinical records of patients who have completed HCV treatment during a 2 years period (2004-2005). Results: 42 patients were included, 10 of them co-infected by HIV. The majority of patients had HCV genotype 1 (52,4%), low HCV viral load [≤800 000 IU/ml] (92,9%) and elevated ALT. SVR was 85,7%. Conclusions: Nowadays, an individualization of chronic hepatitis C treatment is required in order to allow those unlikely to achieve a SVR to be spared the expense and potential toxicities of continued therapy.

We report a case of spondylodiscitis caused by multiresistant Serratia marcescens in a cirrhotic patient who had several Serratia bacteremias after the placement of a transjugular intrahepatic portosystemic shunt (TIPS) device. We concluded that an endovascular stent that can not be removed makes management of recurrent bacteremia difficult. Furthermore, back pain due to bacteremia is indicative of spondylodiscitis. Serratia marcescens can be an aggressive pathogen, causing spinal infection.