Costs of diagnostic support were estimated based on published minimum prices of genotyping, hepatitis C virus antigen tests plus full blood count/clinical chemistry. Results:
MLN0128 Predicted minimum costs for 12-week courses of combination direct-acting antivirals with the most consistent efficacy results were: US$122 per person for sofosbuvir+daclatasvir, US$152 for sofosbuvir+ribavirin, US$192 for sofosbuvir+ledipasvir and US$115 for MK-8742+MK-5172. Diagnostic testing costs were estimated at US$90 for genotyping US$34 for two hepatitis C virus antigen tests and US$22 for two full blood count/clinical chemistry. Conclusions: Minimum costs of treatment and diagnostics to cure hepatitis C virus infection were estimated at US$171-360 per-person without genotyping or US$261-450 per-person with genotyping. These cost estimates assume that existing large-scale treatment programmes can be established. This article is protected by copyright. All rights reserved. “
“Childhood food allergy appears to be on the rise in ‘Westernized’
countries although little is known about whether this phenomenon is also occurring in developing countries.1 The potential allergenicity of cow’s milk protein was first convincingly demonstrated in the 1950s.2 Since then there has been a growing awareness that cow’s milk protein allergy (CMPA) can present in diverse ways. Immunoglobulin E (IgE)-mediated cow’s milk protein allergy is characterized by immediate-onset symptoms (within 1 hour of ingestion) to small volumes (usually less than 10 mL) of cow’s milk that include urticaria, facial angioedema, vomiting or even life-threatening anaphylaxis, whereas MAPK inhibitor non-IgE mediated syndromes are usually characterized by late-onset symptoms (hours to
days after ingestion) to larger volumes of cow’s milk that include vomiting, diarrhea, hematochezia, failure to thrive and iron deficiency anemia. Non-IgE mediated syndromes include cow’s milk protein-induced Rho enteropathy, proctocolitis and enterocolitis as well as cow’s milk induced gastro-esophageal reflux. Eosinophilic esophagitis may also respond to cow’s milk elimination although a more extensive six-food elimination regime is usually initiated for diet-responsive cases.3 Food-protein induced enterocolitis (FPIES) is most commonly caused by cow’s milk4 and is a curious, recently described syndrome where infants less than 12 months of age typically present with severe but self-limiting vomiting and diarrhea (although 15% present with hypovolemic shock) that occurs almost pathognomically 2–4 h after ingestion of an intermediate volume of milk (for example 20–40 mL). Table 1 outlines recommended formula feeding for the management of CMPA syndromes in infants. As many as 2% of children are believed to develop cow’s milk protein allergy in the first 3 years of life6 of which approximately 75% is attributed to non-IgE mediated allergy. The vast majority of CMPA resolves by age 5 years.