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Basson AA, Weil C, Marx SE, Dylla DE, Collins M, Hadadi S, Chodick G, Rahamim-Cohen D, Lavi IK, Shibolet O. Road to Hepatitis C Elimination in Israel: Improvements in Linkage to Care (2009-2020). Adv Ther 2025:10.1007/s12325-024-03102-6. [PMID: 39912989 DOI: 10.1007/s12325-024-03102-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2024] [Accepted: 12/20/2024] [Indexed: 02/07/2025]
Abstract
INTRODUCTION Disrupted linkage to care is a major barrier to hepatitis C virus (HCV) elimination leading to high attrition rates. This study aimed to describe (1) flow through the HCV care-cascade (2009-2020), and (2) monthly patterns in HCV care during the coronavirus disease 2019 (COVID-19) pandemic (2020) in Israel. METHODS Data were obtained from Maccabi Healthcare Services, a 2.6-million-member healthcare provider in Israel. Flow through the HCV care-cascade in 2009-2020 was described from individuals' first positive HCV antibody (Ab+) test to sustained virological response (SVR), and monthly data were obtained on individuals newly attaining a given stage in the HCV care-cascade in 2020. RESULTS Among 2809 new patients who were Ab+, 2651 (94.4%) had an HCV polymerase chain reaction (PCR) test, and 1417 (50.4%) were PCR+ during the study. Median time from Ab+ to PCR+ was 3.9 years, with 39.7% PCR+ within 12 months. Median time from PCR+ to HCV treatment was 3.3 years, with 639 (55.5%) of patients who were PCR+ purchasing direct-acting anti-viral agents (DAAs), and 413/416 patients attained SVR. A significant reduction was observed in the time from first HCV detection (Ab+) to HCV confirmation (PCR+) and from PCR+ test to HCV treatment purchase in the pre-DAA era compared to the post-DAA. Monthly data during 2020 (Part B) indicates a decline in the numbers of patients receiving HCV care during the first pandemic-related closure. CONCLUSION Real-world data from a nationally representative healthcare provider database suggest that HCV linkage to care improved over time alongside increased access to DAAs, despite observed declines in access to care in 2020.
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Affiliation(s)
| | - Clara Weil
- Maccabi Healthcare Services, Tel Aviv, Israel
| | - Steven E Marx
- AbbVie Inc, North Chicago, IL, USA.
- , 26525 Riverwoods Blvd, Mettawa, IL, 60048, USA.
| | | | | | | | - Gabriel Chodick
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
- Maccabi Healthcare Services, Tel Aviv, Israel
| | | | | | - Oren Shibolet
- Liver Unit, Department of Gastroenterology, Tel Aviv Medical Center, Tel-Aviv, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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2
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Gan C, Yuan Y, Shen H, Gao J, Kong X, Che Z, Guo Y, Wang H, Dong E, Xiao J. Liver diseases: epidemiology, causes, trends and predictions. Signal Transduct Target Ther 2025; 10:33. [PMID: 39904973 PMCID: PMC11794951 DOI: 10.1038/s41392-024-02072-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2024] [Revised: 10/06/2024] [Accepted: 11/12/2024] [Indexed: 02/06/2025] Open
Abstract
As a highly complex organ with digestive, endocrine, and immune-regulatory functions, the liver is pivotal in maintaining physiological homeostasis through its roles in metabolism, detoxification, and immune response. Various factors including viruses, alcohol, metabolites, toxins, and other pathogenic agents can compromise liver function, leading to acute or chronic injury that may progress to end-stage liver diseases. While sharing common features, liver diseases exhibit distinct pathophysiological, clinical, and therapeutic profiles. Currently, liver diseases contribute to approximately 2 million deaths globally each year, imposing significant economic and social burdens worldwide. However, there is no cure for many kinds of liver diseases, partly due to a lack of thorough understanding of the development of these liver diseases. Therefore, this review provides a comprehensive examination of the epidemiology and characteristics of liver diseases, covering a spectrum from acute and chronic conditions to end-stage manifestations. We also highlight the multifaceted mechanisms underlying the initiation and progression of liver diseases, spanning molecular and cellular levels to organ networks. Additionally, this review offers updates on innovative diagnostic techniques, current treatments, and potential therapeutic targets presently under clinical evaluation. Recent advances in understanding the pathogenesis of liver diseases hold critical implications and translational value for the development of novel therapeutic strategies.
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Affiliation(s)
- Can Gan
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Yuan Yuan
- Aier Institute of Ophthalmology, Central South University, Changsha, China
| | - Haiyuan Shen
- Department of Oncology, the First Affiliated Hospital; The Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Anhui Medical University, Hefei, China
| | - Jinhang Gao
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Xiangxin Kong
- Engineering and Translational Medicine, Medical College, Tianjin University, Tianjin, China
| | - Zhaodi Che
- Clinical Medicine Research Institute and Department of Anesthesiology, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Yangkun Guo
- Department of Gastroenterology, West China Hospital, Sichuan University, Chengdu, China
| | - Hua Wang
- Department of Oncology, the First Affiliated Hospital; The Key Laboratory of Anti-inflammatory and Immune Medicine, Ministry of Education, Anhui Medical University, Hefei, China.
| | - Erdan Dong
- Research Center for Cardiopulmonary Rehabilitation, University of Health and Rehabilitation Sciences Qingdao Hospital, School of Health and Life Sciences, University of Health and Rehabilitation Sciences, Qingdao, China.
- Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital, State Key Laboratory of Vascular Homeostasis and Remodeling, Peking University, Beijing, China.
| | - Jia Xiao
- Clinical Medicine Research Institute and Department of Anesthesiology, The First Affiliated Hospital of Jinan University, Guangzhou, China.
- Department of Gastroenterology, Qingdao Central Hospital, University of Health and Rehabilitation Sciences, Qingdao, China.
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3
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Pan CQ, Dai E, Mo Z, Zhang H, Zheng TQ, Wang Y, Liu Y, Chen T, Li S, Yang C, Wu J, Chen X, Zou H, Mei S, Zhu L. Tenofovir and Hepatitis B Virus Transmission During Pregnancy: A Randomized Clinical Trial. JAMA 2025; 333:390-399. [PMID: 39540799 PMCID: PMC11565373 DOI: 10.1001/jama.2024.22952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 10/13/2024] [Indexed: 11/16/2024]
Abstract
Importance Standard care for preventing mother-to-child transmission (MTCT) of hepatitis B virus (HBV) in highly viremic mothers consists of maternal antiviral prophylaxis beginning at gestational week 28 combined with an HBV vaccine series and HBV immune globulin (HBIG) at birth. However, HBIG is unavailable in some resource-limited areas. Objective To determine whether initiating tenofovir disoproxil fumarate (TDF) at gestational week 16 combined with HBV vaccinations for infants is noninferior to the standard care of TDF at gestational week 28 combined with HBV vaccinations and HBIG for infants in preventing MTCT in mothers with HBV and high levels of viremia. Design, Setting, and Participants An unblinded, 2-group, randomized, noninferiority clinical trial was conducted in 7 tertiary care hospitals in China. A total of 280 pregnant individuals (who all identified as women) with HBV DNA levels greater than 200 000 IU/mL were enrolled between June 4, 2018, and February 8, 2021. The final follow-up occurred on March 1, 2022. Interventions Pregnant individuals were randomly assigned to receive either TDF starting at gestational week 16 with HBV vaccinations for the infant or TDF starting at gestational week 28 with HBV vaccinations and HBIG administered to the infant. Main Outcomes and Measures The primary outcome was the MTCT rate, defined as detectable HBV DNA greater than 20 IU/mL or hepatitis B surface antigen positivity in infants at age 28 weeks. Noninferiority was established if the MTCT rate in the experimental group did not increase by more than an absolute difference of 3% compared with the standard care group, as measured by the upper limit of the 2-sided 90% CI. Results Among 280 pregnant individuals who enrolled in the trial (mean age, 28 years; mean gestational age at enrollment, 16 weeks), 265 (95%) completed the study. Among all live-born infants, using the last observation carried forward, the MTCT rate was 0.76% (1/131) in the experimental group and 0% (0/142) in the standard care group. In the per-protocol analysis, the MTCT rate was 0% (0/124) in the experimental group and 0% (0/141) in the standard care group. The between-group difference was 0.76% (upper limit of the 2-sided 90% CI, 1.74%) in all live-born infants and 0% (upper limit of the 2-sided 90% CI, 1.43%) in the per-protocol analysis. Both comparisons met the criterion for noninferiority. Rates of congenital defects and malformations were 2.3% (3/131) in the experimental group and 6.3% (9/142) in the standard care group (difference, 4% [2-sided 95% CI, -8.8% to 0.7%]). Conclusions and Relevance Among pregnant women with HBV and high levels of viremia, TDF beginning at gestational week 16 combined with HBV vaccination for infants was noninferior to the standard care of TDF beginning at gestational week 28 combined with HBIG and HBV vaccination for infants. These results support beginning TDF at gestational week 16 combined with infant HBV vaccine to prevent MTCT of HBV in geographic areas where HBIG is not available. Trial Registration ClinicalTrials.gov Identifier: NCT03476083.
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Affiliation(s)
- Calvin Q. Pan
- Guangzhou Medical Research Institute of Infectious Diseases, Center for Liver Diseases, Guangzhou Eighth People’s Hospital, Guangzhou Medical University, Guangzhou, China
- Division of Gastroenterology, Department of Medicine, NYU Langone Medical Center, New York University Grossman School of Medicine, New York
| | - Erhei Dai
- Hebei Key Laboratory of Immune Mechanism of Major Infectious Diseases and New Technology of Diagnosis and Treatment, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, China
| | - Zhongfu Mo
- Department of Obstetrics and Gynecology, Shijiazhuang Maternity and Child Healthcare Hospital, Shijiazhuang, China
| | - Hua Zhang
- Department of Obstetrics and Gynecology, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Thomas Q. Zheng
- Department of Obstetrics and Gynecology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
- Department of Obstetrics and Gynecology, University of Arizona College of Medicine, Phoenix
| | - Yuming Wang
- Southwest University Public Health Hospital, Chongqing, China
- Department of Infectious Diseases, Southwest Hospital, Chongqing, China
| | - Yingxia Liu
- Department for Infectious Diseases, Shenzhen Third People’s Hospital, Second Hospital Affiliated to Southern University of Science and Technology, Shenzhen, China
| | - Tianyan Chen
- Department of Infectious Diseases, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Suwen Li
- Department of Obstetrics and Gynecology, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, China
| | - Cuili Yang
- Department of Obstetrics and Gynecology, Shijiazhuang Maternity and Child Healthcare Hospital, Shijiazhuang, China
| | - Jinjuan Wu
- Department of Obstetrics and Gynecology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Xiuli Chen
- Hebei Key Laboratory of Immune Mechanism of Major Infectious Diseases and New Technology of Diagnosis and Treatment, The Fifth Hospital of Shijiazhuang, Hebei Medical University, Shijiazhuang, China
| | - Huaibin Zou
- The Fourth Department of Liver Disease, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Shanshan Mei
- Department of Obstetrics and Gynecology, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Lin Zhu
- Center of Liver Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
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4
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İlter SM, Tülüce D. The Level of Knowledge of Organ Transplantation and Attitudes Toward Organ Donation of Carers of Patients Receiving Hemodialysis. OMEGA-JOURNAL OF DEATH AND DYING 2025; 90:1430-1445. [PMID: 37947406 DOI: 10.1177/00302228231212739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
Purpose: Renal transplantation is the most effective treatment method for chronic renal failure and helps improve the quality of life of patients and caregivers.In the present study, the purpose was to determine the knowledge level of the primary caregivers of patients receiving hemodialysis treatment about organ transplantation and their attitudes toward organ donation.Method: The study was conducted in a descriptive fashion with the relatives of 71 patients who were receiving treatment in the hemodialysis unit for the end-stage renal failure of a state hospital between 01.08.2022 and 15.10.2022. The data of the study were collected face to face with a questionnaire form, Organ Donation Attitude Scale, and Organ Tissue Donation and Transplantation Information Scale. The SPSS 24 package program was used in the analysis of the data. Descriptive statistics, numbers, percentages, and mean values were used in the analysis of the data. The One-Sample Kolmogorov-Smirnov Test was used to evaluate the homogeneity of the data. The Studentt test, the One-Way Analysis of Variance, the Kruskal-Wallis Test, and the Tukey Post-Hoc Test were used for the analysis between the groups. Statistical significance was taken as p < .05.Results: The benevolence and moral values/beliefs sub-dimension score average of the participants was found to be 98.44 ± 14.61, the fear of medical neglect was 32.10 ± 10.09, and the mean bodily injury sub-dimension score was 30.45 ± 11.28. It was also found that the mean score of the Organ-Tissue Donation and Transplant Information Scale was 11.41 ± 2.59. A statistically significant and negative relationship was detected between the participants' medical neglect and bodily injury attitudes and the Organ-Tissue Donation and Transplant Information Scale score averages (p < .05).Conclusion and Suggestions: As a result, it was found that the positive attitudes of the caregivers of individuals receiving hemodialysis treatment about organ donation were at a good level, and as the level of organ transplantation knowledge increased, negative attitudes towards organ donation decreased. In this context, it can be suggested that healthcare professionals provide training on organ transplantation and donation to the relatives of patients receiving hemodialysis treatment.
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Affiliation(s)
- Sümeyra Mihrap İlter
- Department of Gerontology, Faculty of Health Sciences, Osmaniye Korkut Ata University, Osmaniye, Turkey
| | - Derya Tülüce
- Department of Nursing, Faculty of Health Sciences, Osmaniye Korkut Ata University, Osmaniye, Turkey
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5
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Gujarathi R, Klein JA, Liao CY, Pillai A. The Changing Demographics and Epidemiology of Hepatocellular Carcinoma. Clin Liver Dis 2025; 29:1-15. [PMID: 39608950 DOI: 10.1016/j.cld.2024.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2024]
Abstract
The epidemiology of hepatocellular carcinoma (HCC) has shifted significantly in the last 2 decades with non-viral etiologies such as metabolic dysfunction-associated steatotic liver disease and alcohol-associated liver disease on the rise. Key factors include the global obesity epidemic and the resurgence of alcohol use disorder, both of which were exacerbated by the coronavirus disease 2019 pandemic. While these non-viral etiologies of HCC are becoming the leading cause in developed countries, the potential impact of immigration patterns on Hepatitis B virus epidemiology cannot be ignored. The risk of HCC remains significant in individuals with cirrhosis and viral hepatitis after curative treatments.
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Affiliation(s)
- Rushabh Gujarathi
- Department of Internal Medicine, University of Chicago, Chicago, IL, USA
| | - Jeremy A Klein
- Department of Internal Medicine, University of Chicago, Chicago, IL, USA
| | - Chih-Yi Liao
- Department of Internal Medicine, University of Chicago, Chicago, IL, USA
| | - Anjana Pillai
- Department of Internal Medicine, University of Chicago, Chicago, IL, USA.
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6
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Wang H, Wang J, Zhang S, Zhang S, Zhang Z, Liu J, Pan Y, Jiang C, Xiong Y, Fan T, Huang R, Li L. Clinical Features and Transition of Acute Hepatitis B Virus Infection. J Viral Hepat 2025; 32:e14048. [PMID: 39729036 DOI: 10.1111/jvh.14048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 11/18/2024] [Accepted: 11/30/2024] [Indexed: 12/28/2024]
Abstract
Acute hepatitis B (AHB) is generally a self-limiting illness in adults and most patients achieve hepatitis B surface antigen (HBsAg) clearance within 6 months. We aimed to investigate the proportion and influencing factors of chronic outcome in adult AHB patients. A total of 126 consecutive AHB patients were included between January 2013 and October 2018. Multivariate regression analysis was conducted to evaluate the influencing factor of HBsAg clearance. Fourteen (11.1%) patients failed to achieve HBsAg clearance within 6 months. Among them, nine patients achieved HBsAg clearance within 6-12 months, while five patients had persistent HBsAg positive over 1 year. Patients with HBsAg clearance had lower baseline antibody to hepatitis B core antigen (anti-HBc) (7.0 S/CO vs. 8.0 S/CO, p = 0.090) and HBsAg levels than those with chronicity of AHB. Multivariate analysis revealed that HBsAg ≤ 250 IU/mL (HR 3.008, IQR 1.877, 4.820, p < 0.001) and anti-HBc levels (HR 0.830, IQR 0.755, 0.912, p < 0.001) was significantly associated with HBsAg clearance. Anti-HBc remained an independent predictor of HBsAg clearance in different HBsAg subgroups. Patients with HBsAg > 250 IU/mL (p < 0.001) and high anti-HBc (p = 0.001) had lower cumulative HBsAg clearance rates than those with low HBsAg and anti-HBc. 11.1% of AHB patients did not achieve HBsAg clearance within 6 months, while the proportion of patients with persistent HBsAg positive decreased to 4.0% after 1 year. Combination of baseline HBsAg and anti-HBc levels could identify patients who might have a possible risk of chronicity following AHB.
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Affiliation(s)
- Huali Wang
- Department of General Practice, Nanjing Second Hospital, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Jian Wang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, China
| | - Shaoqiu Zhang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Shuai Zhang
- Department of General Practice, Nanjing Second Hospital, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Zhiyi Zhang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Jiacheng Liu
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Yifan Pan
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Chao Jiang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Jiangsu University, Nanjing, Jiangsu, China
| | - Ye Xiong
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Tao Fan
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Rui Huang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, China
| | - Li Li
- Department of Hepatology, Nanjing Second Hospital, Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
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7
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Zhang Z, Wang J, Zhu L, Li Y, Zhang S, Pan Y, Chen Y, Yin S, Yan X, Liu X, Qiu Y, Wu C, Li J, Zhu C, Huang R. Optimization of the Use of APRI and FIB-4 for Ruling Out Liver Cirrhosis in Chronic Hepatitis B Patients With Normal Alanine Aminotransferase. J Viral Hepat 2025; 32:e14057. [PMID: 39751716 DOI: 10.1111/jvh.14057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2024] [Revised: 12/10/2024] [Accepted: 12/15/2024] [Indexed: 01/04/2025]
Abstract
The exclusion of cirrhosis is important in chronic hepatitis B (CHB) patients with normal alanine aminotransferase (ALT). We aimed to optimise the performance of the aspartate aminotransferase to platelet ratio index (APRI) and fibrosis score based on four factors (FIB-4) to exclude cirrhosis in these patients. Five hundred and eighty four patients with normal ALT who underwent liver biopsy were included in the study. The patients were divided into derivation and external validation sets. A grid search method was used to identify new cut-offs with a negative predictive value (NPV) of > 95% and a sensitivity of > 90% for detecting cirrhosis. The proportion of patients with cirrhosis in the derivation and validation sets was 19.4% and 7.5%, respectively. The conventional cut-offs of APRI (77.6%) and FIB-4 (41.8%) had high rates of cirrhosis misclassification. A new APRI cut-off of 0.21 had a sensitivity of 97.0% and an NPV of 95.6%, and only two (3.0%) patients with cirrhosis were misclassified in the derivation set. Using a new FIB-4 cut-off of 0.53, with a sensitivity of 98.5% and NPV of 96.2%, only one (1.5%) patient with cirrhosis was misclassified. External validation showed similar results. Using the new cut-offs of APRI and FIB-4, cirrhosis could be completely excluded for HBeAg-positive patients or those aged > 40 years. The conventional cut-offs had high misclassification rates for cirrhosis. The new cut-offs of APRI (≤ 0.21) and FIB-4 (≤ 0.53) could be used to exclude cirrhosis in CHB patients with normal ALT levels with a low misclassification rate.
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Affiliation(s)
- Zhiyi Zhang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
| | - Jian Wang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, China
| | - Li Zhu
- Department of Infectious Diseases, The Affiliated Infectious Diseases Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Yiguang Li
- Department of Infectious Diseases, The Fifth People's Hospital of Wuxi, Wuxi, Jiangsu, China
| | - Shaoqiu Zhang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Yifan Pan
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Yuxin Chen
- Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, China
- Department of Laboratory Medicine, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Shengxia Yin
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, China
| | - Xiaomin Yan
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
| | - Xingxiang Liu
- Department of Clinical Laboratory, Huai'an No. 4 People's Hospital, Huai'an, Jiangsu, China
| | - Yuanwang Qiu
- Department of Infectious Diseases, The Fifth People's Hospital of Wuxi, Wuxi, Jiangsu, China
| | - Chao Wu
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, China
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Jie Li
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, China
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
| | - Chuanwu Zhu
- Department of Infectious Diseases, The Affiliated Infectious Diseases Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Rui Huang
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China
- Department of Infectious Diseases, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, Jiangsu, China
- Institute of Viruses and Infectious Diseases, Nanjing University, Nanjing, Jiangsu, China
- Department of Infectious Diseases, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, China
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8
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Goldberg D, Wilder J, Terrault N. Health disparities in cirrhosis care and liver transplantation. Nat Rev Gastroenterol Hepatol 2025; 22:98-111. [PMID: 39482363 DOI: 10.1038/s41575-024-01003-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/02/2024] [Indexed: 11/03/2024]
Abstract
Morbidity and mortality from cirrhosis are substantial and increasing. Health disparities in cirrhosis and liver transplantation are reflective of inequities along the entire spectrum of chronic liver disease care, from screening and diagnosis to prevention and treatment of liver-related complications. The key populations experiencing disparities in health status and healthcare delivery include racial and ethnic minority groups, sexual and gender minorities, people of lower socioeconomic status and underserved rural communities. These disparities lead to delayed diagnosis of chronic liver disease and complications of cirrhosis (for example, hepatocellular carcinoma), to differences in treatment of chronic liver disease and its complications, and ultimately to unequal access to transplantation for those with end-stage liver disease. Calling out these disparities is only the first step towards implementing solutions that can improve health equity and clinical outcomes for everyone. Multi-level interventions along the care continuum for chronic liver disease are needed to mitigate these disparities and provide equitable access to care.
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Affiliation(s)
- David Goldberg
- Division of Digestive Health and Liver Diseases, University of Miami, Miami, FL, USA
| | - Julius Wilder
- Division of Gastroenterology, Duke University, Durham, NC, USA
| | - Norah Terrault
- Division of GI and Liver Diseases, University of Southern California, Los Angeles, CA, USA.
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9
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Chen Q, Huang S, Peng J, Wang P, Shi X, Luo R, Xu H, Zhang W, Shi L, Peng Y, Yuan F, Tang X. The Burden of Hepatitis B and C in Asia, 1990-2019: An Update Analysis From the Global Burden of Disease Study 2019. Liver Int 2025; 45:e70004. [PMID: 39840788 DOI: 10.1111/liv.70004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Revised: 12/11/2024] [Accepted: 01/10/2025] [Indexed: 01/23/2025]
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