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Scelza G, Amato A, Pagano AM, Matteis GD, Caruso R, Scelza A, Sisalli L, Biasi SD, Marigliano F, Gagliardi M, Martina S, Iandolo A. Effect of hepatitis C antiviral therapy on oral lichen planus and hyposalivation in inmates. Ann Gastroenterol 2022; 35:74-79. [PMID: 34987292 PMCID: PMC8713335 DOI: 10.20524/aog.2021.0672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/08/2021] [Indexed: 11/25/2022] Open
Abstract
Background Oral lichen planus (OLP) and hyposalivation have been reported as extrahepatic manifestations of hepatitis C virus (HCV) infection. Our study evaluated the effect of direct antiviral agents (DAAs) on OLP and hyposalivation in convicts with chronic hepatitis C, examining patients before, during and after the antiviral treatment period with direct acting antiviral agents (DAAs). Methods We screened 198 inmates for the presence of the HCV antibody. Patients found to be positive underwent a quantitative HCV-RNA test and HCV genotype typing, as well as an oral cavity examination using a scoring system for OLP (REU score) and the clinical oral dryness score (CODS). Subsequently, all patients underwent DAA therapy and a systematic physical examination of the oral cavity at 1, 3 and 6 months from the beginning of treatment. Results Fifty patients (25.25%) had a positive HCV-RNA test. At baseline, OLP was detected in 4 patients (8%), with a mean REU score of 10.13±4, and different degrees of hyposalivation were seen in 17 patients (34%), with a mean CODS score of 4.71±1.72. Six months after the start of DAA therapy, we observed resolution of OLP in 3 patients (75%) and improvement in the remaining subject with a significantly lower mean REU score (2±4). Hyposalivation disappeared in 5 patients, improved in 10, and remained unchanged in 2 patients with a significantly lower mean CODS score (0.06±0.24). Conclusion This study demonstrated the effectiveness of DAAs in the treatment of OLP and hyposalivation.
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Affiliation(s)
- Giuseppe Scelza
- Department of Medicine and Surgery, University of Salerno (Giuseppe Scelza, Alessandra Amato, Laura Sisalli, Stefano Martina, Alfredo Iandolo)
| | - Alessandra Amato
- Department of Medicine and Surgery, University of Salerno (Giuseppe Scelza, Alessandra Amato, Laura Sisalli, Stefano Martina, Alfredo Iandolo)
| | - Antonio Maria Pagano
- Health protection for adults and youth Unit, Penitentiary Institute (Antonio Maria Pagano, Giuseppe De Matteis, Rosa Caruso, Antonio Scelza, Sebastiana De Biasi, Francesca Marigliano)
| | - Giuseppe De Matteis
- Health protection for adults and youth Unit, Penitentiary Institute (Antonio Maria Pagano, Giuseppe De Matteis, Rosa Caruso, Antonio Scelza, Sebastiana De Biasi, Francesca Marigliano)
| | - Rosa Caruso
- Health protection for adults and youth Unit, Penitentiary Institute (Antonio Maria Pagano, Giuseppe De Matteis, Rosa Caruso, Antonio Scelza, Sebastiana De Biasi, Francesca Marigliano)
| | - Antonio Scelza
- Health protection for adults and youth Unit, Penitentiary Institute (Antonio Maria Pagano, Giuseppe De Matteis, Rosa Caruso, Antonio Scelza, Sebastiana De Biasi, Francesca Marigliano)
| | - Laura Sisalli
- Department of Medicine and Surgery, University of Salerno (Giuseppe Scelza, Alessandra Amato, Laura Sisalli, Stefano Martina, Alfredo Iandolo)
| | - Sebastiana De Biasi
- Health protection for adults and youth Unit, Penitentiary Institute (Antonio Maria Pagano, Giuseppe De Matteis, Rosa Caruso, Antonio Scelza, Sebastiana De Biasi, Francesca Marigliano)
| | - Francesca Marigliano
- Health protection for adults and youth Unit, Penitentiary Institute (Antonio Maria Pagano, Giuseppe De Matteis, Rosa Caruso, Antonio Scelza, Sebastiana De Biasi, Francesca Marigliano)
| | - Mario Gagliardi
- Gastroenterology Unit, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno (Mario Gagliardi), Salerno, Italy
| | - Stefano Martina
- Department of Medicine and Surgery, University of Salerno (Giuseppe Scelza, Alessandra Amato, Laura Sisalli, Stefano Martina, Alfredo Iandolo)
| | - Alfredo Iandolo
- Department of Medicine and Surgery, University of Salerno (Giuseppe Scelza, Alessandra Amato, Laura Sisalli, Stefano Martina, Alfredo Iandolo)
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Kong F, Wen X, Wen X, Wang X, Wu G, Lin S, Wang L, Xing H, Yan X, Zheng S, Ning Q, Wang Z, Zhang L, Lin J, Tong Z, Huang C, Su M, Tong L, Jia J, Xin Y, Zhu Q, Wang J, Chen L, Li X, Wu X, Niu D, Liu Q, Wei W, Zhang Y, Li G, Niu J. Seraprevir and sofosbuvir for treatment of chronic hepatitis C virus infection: A single-arm, open-label, phase 3 trial. J Gastroenterol Hepatol 2021; 36:2375-2382. [PMID: 33491236 PMCID: PMC8518536 DOI: 10.1111/jgh.15412] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 12/13/2020] [Accepted: 01/13/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND AND AIM This single-arm, open-label, multicenter, phase 3 trial evaluated the efficacy and safety of seraprevir, an hepatitis C virus (HCV) nonstructural protein 3/4A (NS3/4A) inhibitor, combined with sofosbuvir for treating Chinese patients with chronic HCV infection without cirrhosis. METHODS Treatment-naive or interferon-experienced adult patients without cirrhosis were treated with a universal, combinational regimen of seraprevir 100 mg, twice daily and sofosbuvir 400 mg, once daily, for 12 or 24 weeks. The primary efficacy endpoint was sustained virologic response at week 12 after treatment (SVR12). RESULTS Overall, 205 patients with genotype 1 HCV infection without cirrhosis were enrolled from 23 sites, 202 of whom completed the full treatment and post-treatment course and 3 discontinued follow-up. In total, 27 patients (13.2%) were interferon experienced. SVR12 was achieved by 201 out of 205 (98.0% [95% CI, 95.1%, 99.5%]) patients, 100.0% of patients with genotype 1a, and 98.0% of genotype 1b. In the other exploratory study, SVR 12 was achieved by 100% patients with genotype 2 (n = 21), genotype 3 (n = 7), and genotype 6 (n = 8). The majority of adverse events were mild to moderate and transient and did not require a specific medical intervention. CONCLUSIONS The all-oral, ribavirin-free regimen of seraprevir and sofosbuvir is an effective and well-tolerated treatment option for Chinese patients mono-infected with HCV, including those with a history of interferon treatment.
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Affiliation(s)
- Fei Kong
- Department of HepatologyThe First Hospital of Jilin UniversityChangchunChina,Department of Epidemiology and Biostatistics, School of Public HealthJilin UniversityChangchunChina
| | - Xiaoyu Wen
- Department of HepatologyThe First Hospital of Jilin UniversityChangchunChina
| | - Xiaofeng Wen
- Department of HepatologyLiuzhou People's HospitalLiuzhouChina
| | - Xiaozhong Wang
- Department of HepatologyXinjiang Uygur Autonomous Region Traditional Chinese Medicine HospitalUrumqiChina
| | - Guicheng Wu
- Department of HepatologyChongqing University Three Gorges Hosipital, Chongqing Three Gorges Central HospitalChongqingChina
| | - Shide Lin
- Department of Infectious DiseasesAffiliated Hospital of Zunyi Medical UniversityZunyiChina
| | - Li Wang
- Department of HepatologyPublic Health Clinical Center of ChengduChengduChina
| | - Huichun Xing
- Department of Hepatology Division 3Beijing Ditan Hospital, Capital Medical UniversityBeijingChina
| | - Xuebing Yan
- Department of Infectious DiseaseThe Affiliated Hospital of Xuzhou Medical UniversityXuzhouChina
| | - Sujun Zheng
- Difficult and Complicated Liver Diseases and Artificial Liver CenterBeijing YouAn Hospital, Capital Medical UniversityBeijingChina
| | - Qin Ning
- Department of Infectious Diseases, Tongji Hospital Affiliated to Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Zheng Wang
- Department of Infectious DiseasesWuxi No. 5 People's HospitalWuxiChina
| | - Liaoyun Zhang
- Department of Infectious DiseasesThe First Affiliated Hospital of Shanxi Medical UniversityTaiyuanChina
| | - Jianmei Lin
- Department of Infectious DiseasesSichuan Provincial People's HospitalChengduChina
| | - Zhaowei Tong
- Department of Infectious DiseasesHuzhou Central HospitalHuzhouChina
| | - Chengyu Huang
- Department of HepatologyChongqing Public Health Medical CenterChongqingChina
| | - Minghua Su
- Department of Infectious DiseaseThe First Affiliated Hospital of Guangxi Medical UniversityNanningChina
| | - Lixin Tong
- Center of Liver DiseasesThe First Affiliated Hospital of Hebei Medical UniversityShijiazhuangChina
| | - Jidong Jia
- Liver Research Center, Beijing Friendship HospitalCapital Medical UniversityBeijingChina
| | - Yongning Xin
- Department of Infectious DiseaseQingdao Municipal HospitalQingdaoChina
| | - Qingjing Zhu
- Department of HepatologyWuhan Public Health Medical CenterWuhanChina
| | - Jing Wang
- Department of HepatologyThe Affiliated TCM Hospital of Southwest Medical UniversityLuzhouChina
| | - Li Chen
- General Manager OfficeShanghai Viromedicine Co., Ltd.ShanghaiChina
| | - Xiaowen Li
- General Manager OfficeShanghai Viromedicine Co., Ltd.ShanghaiChina
| | - Xuegang Wu
- Department of Clinical ResearchShanghai Viromedicine Co., Ltd.ShanghaiChina
| | - Duan Niu
- Department of Clinical ResearchShanghai Viromedicine Co., Ltd.ShanghaiChina
| | - Quan Liu
- Department of Emerging Infectious Diseases, Institute of Translational MedicineThe First Hospital of Jilin UniversityChangchunChina
| | - Wei Wei
- Institute of Virology and AIDS ResearchThe First Hospital of Jilin UniversityChangchunChina
| | - Yuexin Zhang
- Department of Infectious DiseasesFirst Affiliated Hospital of Xinjiang Medical UniversityUrumqiChina
| | - Guangming Li
- Cirrhosis DepartmentZhengzhou Sixth Municipal People's HospitalZhengzhouChina
| | - Junqi Niu
- Department of HepatologyThe First Hospital of Jilin UniversityChangchunChina
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Frequency of Interferon-Resistance Conferring Substitutions in Amino Acid Positions 70 and 91 of Core Protein of the Russian HCV 1b Isolates Analyzed in the T-Cell Epitopic Context. J Immunol Res 2018; 2018:7685371. [PMID: 29577052 PMCID: PMC5821972 DOI: 10.1155/2018/7685371] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 11/29/2017] [Indexed: 12/17/2022] Open
Abstract
Amino acid substitutions R70Q/H and L91M in HCV subtype 1b core protein can affect the response to interferon and are associated with the development of hepatocellular carcinoma. We found that the rate of R70Q/H in HCV 1b from Russia was 31.2%, similar to that in HCV strains from Asia (34.0%), higher than that in the European (18.0%, p = 0.0010), but lower than that in the US HCV 1b strains (62.8%, p < 0.0001). Substitution L91M was found in 80.4% of the Russian HCV 1b isolates, higher than in Asian isolates (43.8%, p < 0.0001). Thus, a significant proportion of Russian HCV 1b isolates carry the unfavorable R70Q/H and/or L91M substitution. In silico analysis of the epitopic structure of the regions of substitutions revealed that both harbor clusters of T-cell epitopes. Peptides encompassing these regions were predicted to bind to a panel of HLA class I molecules, with substitutions impairing peptide recognition by HLA I molecules of the alleles prevalent in Russia. This indicates that HCV 1b with R70Q/H and L91M substitutions may have evolved as the immune escape variants. Impairment of T-cell recognition may play a part in the negative effect of these substitutions on the response to IFN treatment.
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Fan Z, Zhang Q, Chen H, He P, Li Y, Si M, Jiao X. Circulating microRNAs as a biomarker to predict therapy efficacy in hepatitis C patients with different genotypes. Microb Pathog 2017; 112:320-326. [PMID: 28993299 DOI: 10.1016/j.micpath.2017.10.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Revised: 10/01/2017] [Accepted: 10/04/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND Hepatitis C virus (HCV) genotype exerts a major influence on therapeutic response; however, the underlying mechanisms remain unclear. The aim of the study is to investigate the circulating microRNAs as the biomarkers to predict the response to therapy in chronic hepatitisC patients (HepC) with different genotypes. METHODS HepC patients were separated into 4 groups by genotype, healthy individuals were enrolled as the control. microRNA-122 (miR-122), microRNA-155 (miR-155) and HCV RNA in serum and exosome were measured, associations between microRNAs, viral load and other conventional biomarkers were analyzed. RESULTS Serum and exosomal HCV RNA in genotype 6a group was highest, followed by genotype 3a/2a, and in genotype 1b were the lowest. The significant correlations existed between exosomal HCV RNA and serum HCVRNA. MiR-122, both in serum (miR-122ser) and in exosome (miR-122exo), was higher in normal control than in HCV group. Specifically, miR-122exo were significantly higher in genotype 1b than other genotype groups (p < 0.05). On the contrary, miR-155exowas significantly lower in genotype 1b than in other groups (p < 0.05 for both). A strongly positive association was found between miR-122/155 and HCV viral load in patients with various genotypes. Higher miR-122ser at the start of therapy predicts a better outcome. CONCLUSIONS Expression of miR-122/155 differ in each genotypes, miR-122ser could be independent factor affecting the therapy efficacy, which had higher diagnostic value in predicting HCV outcome.
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Affiliation(s)
- Zhicheng Fan
- Cell Biology and Genetics Department of Shantou University Medical College, Shantou, China.
| | - Qiaoxin Zhang
- The First Affiliated Hospital of Shantou University Medical College, Shantou, China.
| | - Huanzhu Chen
- Cell Biology and Genetics Department of Shantou University Medical College, Shantou, China.
| | - Ping He
- Shantou University Medical College, Shantou, China.
| | - Yazhen Li
- Cell Biology and Genetics Department of Shantou University Medical College, Shantou, China.
| | - Mengya Si
- The First Affiliated Hospital of Shantou University Medical College, Shantou, China.
| | - Xiaoyang Jiao
- Cell Biology and Genetics Department of Shantou University Medical College, Shantou, China.
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Jiao X, Fan Z, Chen H, He P, Li Y, Zhang Q, Ke C. Serum and exosomal miR-122 and miR-199a as a biomarker to predict therapeutic efficacy of hepatitis C patients. J Med Virol 2017; 89:1597-1605. [PMID: 28401565 DOI: 10.1002/jmv.24829] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 03/08/2017] [Indexed: 02/05/2023]
Abstract
MicroRNA (miRNA), which has been shown to correlate with liver functions, has been proposed as a new biomarker reflecting liver injury. The aim of the study was to investigate miRNA-122 (miR-122) and mir-RNA-199a (miR-199a) as a biomarker for predicting therapeutic efficacy in hepatitis C (HepC) patients. A total of 47 HepC 1b patients and 16 healthy subjects were enrolled in the study. Serum and exosomal mir-RNAs and other conventional biomarkers reflecting liver function were evaluated. The miR-122 levels in serum (miR-122ser ) and exosomes (miR-122exo ) were significantly lower in the Hepatitis C virus (HCV) genotype 1b patients than in the normal controls, but these levels were higher compared to the non-genotype 1b group. The mean miR-122ser level in the sustained virological response (SVR) group was significantly higher than that in the non-response (NR) group (P < 0.01), and the miR-122exo level in the SVR group was also higher than that in the NR group (P > 0.05), although this difference was not significant. miR-199a levels showed similar trends with the miR-122 levels in serum and exosomes. HCV RNAser was negatively correlated with the miR-122ser (r = -0.473, P = 0.004) and miR-122exo (r = -0.424, P = 0.009) levels. miR-122ser levels were positively associated with miR-199aser levels (r = 0.453, P = 0.002). Univariate and multivariate regression analyses reveal that the miR-122ser levels and ALT/AST ratio demonstrated a predictive value in evaluating patient outcomes. Serum miR-122 and miR-199a are potential biomarkers that reflect therapeutic efficacy.
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Affiliation(s)
- Xiaoyang Jiao
- Cell Biology and Genetics Department, Shantou University Medical College, Shantou, Guangdong, P.R. China
| | - Zhicheng Fan
- Cell Biology and Genetics Department, Shantou University Medical College, Shantou, Guangdong, P.R. China
- Department of Clinical Laboratory, Henan Province Hospital of Traditional Chinese Medicine, Second Affiliated Hospital of Henan University of TCM, Henan, P.R. China
| | - Huanzhu Chen
- Cell Biology and Genetics Department, Shantou University Medical College, Shantou, Guangdong, P.R. China
| | - Ping He
- Cell Biology and Genetics Department, Shantou University Medical College, Shantou, Guangdong, P.R. China
| | - Yazhen Li
- Cell Biology and Genetics Department, Shantou University Medical College, Shantou, Guangdong, P.R. China
| | - Qiaoxin Zhang
- The First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, P.R. China
| | - Changwen Ke
- Cell Biology and Genetics Department, Shantou University Medical College, Shantou, Guangdong, P.R. China
- Center for Disease Control and Prevention of Guangdong Province, Guangzhou
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Peres-da-Silva A, Brandão-Mello CE, Lampe E. Prevalence of sofosbuvir resistance-associated variants in Brazilian and worldwide NS5B sequences of genotype-1 HCV. Antivir Ther 2017; 22:447-451. [PMID: 28085003 DOI: 10.3851/imp3131] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND The prevalence of natural polymorphisms associated with resistance to NS5B nucleoside/nucleotide (NI) sofosbuvir is distinct in different geographical regions. In Brazil, direct-acting anti-HCV therapy has recently changed with the introduction of interferon (IFN)-free regimens with sofosbuvir; however, the presence of resistant variants on clinical outcomes remains unknown. The aim of this study was to assess the natural polymorphisms associated with resistance to the NS5B NI sofosbuvir in Brazilian HCV-1 isolates and to compare it with that from other geographical regions. METHODS Nucleotide sequencing of the HCV NS5B gene was performed in serum samples of 95 therapy-naive Brazilian patients infected with subtype 1a (n=43) and 1b (n=52). The sequences were analysed along with 1,525 NS5B sequences from North America, Europe and Asia retrieved from public HCV databases. RESULTS In Brazilian HCV-1b patients who have never been exposed to a direct-acting anti-HCV drug, the C316N was detected in 15/52 (28.85%) patients, of these, 2 (3.85%) had single C316N variant, while 13 (25%) presented the double L159F-C316N mutant. A lower rate of L159F-C316N variants was detected in North American (n=9/238; 3.78%, P<0.001), European (n=17/281; 6.05%, P<0.001) and Asian (n=2/173; 1.16%, P<0.001) isolates. No sofosbuvir resistance-associated variants (RAVs) were identified in HCV-1a sequences. CONCLUSIONS Resistant variants to sofosbuvir were found at different frequencies in worldwide HCV-1b sequences but not in HCV-1a sequences. The high frequency of double mutation L159F-C316N observed in Brazilian HCV-1b patients contrast with the lower rate observed in the three continents studied. The association of these findings and the clinical implications awaits further analysis.
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Affiliation(s)
- Allan Peres-da-Silva
- Laboratório de Hepatites Virais, Instituto Oswaldo Cruz/FIOCRUZ, Rio de Janeiro, Brazil
| | | | - Elisabeth Lampe
- Laboratório de Hepatites Virais, Instituto Oswaldo Cruz/FIOCRUZ, Rio de Janeiro, Brazil
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Scagnolari C, Turriziani O, Monteleone K, Pierangeli A, Antonelli G. Consolidation of molecular testing in clinical virology. Expert Rev Anti Infect Ther 2016; 15:387-400. [PMID: 28002969 DOI: 10.1080/14787210.2017.1271711] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION The development of quantitative methods for the detection of viral nucleic acids have significantly improved our ability to manage disease progression and to assess the efficacy of antiviral treatment. Moreover, major advances in molecular technologies during the last decade have allowed the identification of new host genetic markers associated with antiviral drug response but have also strongly revolutionized the way we see and perform virus diagnostics in the coming years. Areas covered: In this review, we describe the history and development of virology diagnostic methods, dedicating particular emphasis on the gradual evolution and recent advances toward the introduction of multiparametric platforms for the syndromic diagnosis. In parallel, we outline the consolidation of viral genome quantification practice in different clinical settings. Expert commentary: More rapid, accurate and affordable molecular technology can be predictable with particular emphasis on emerging techniques (next generation sequencing, digital PCR, point of care testing and syndromic diagnosis) to simplify viral diagnosis in the next future.
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Affiliation(s)
- Carolina Scagnolari
- a Laboratory of Virology, Department of Molecular Medicine, and Istituto Pasteur Italia-Cenci Bolognetti Foundation , 'Sapienza' University of Rome , Rome , Italy
| | - Ombretta Turriziani
- a Laboratory of Virology, Department of Molecular Medicine, and Istituto Pasteur Italia-Cenci Bolognetti Foundation , 'Sapienza' University of Rome , Rome , Italy
| | - Katia Monteleone
- a Laboratory of Virology, Department of Molecular Medicine, and Istituto Pasteur Italia-Cenci Bolognetti Foundation , 'Sapienza' University of Rome , Rome , Italy
| | - Alessandra Pierangeli
- a Laboratory of Virology, Department of Molecular Medicine, and Istituto Pasteur Italia-Cenci Bolognetti Foundation , 'Sapienza' University of Rome , Rome , Italy
| | - Guido Antonelli
- a Laboratory of Virology, Department of Molecular Medicine, and Istituto Pasteur Italia-Cenci Bolognetti Foundation , 'Sapienza' University of Rome , Rome , Italy
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Eslam M, George J. Is hepatitis C subtyping still relevant in the era of direct-acting antiviral therapy? Hepatol Int 2014; 9:5-8. [PMID: 25788373 DOI: 10.1007/s12072-014-9600-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Accepted: 12/03/2014] [Indexed: 02/07/2023]
Affiliation(s)
- Mohammed Eslam
- Storr Liver Unit, Westmead Millennium Institute, Westmead Hospital and University of Sydney, Sydney, NSW, Australia
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