1
|
Tung HD, Chen JJ. Genetic history of hepatitis C virus genotype 6 in Taiwan. J Formos Med Assoc 2024; 123:926-933. [PMID: 37996321 DOI: 10.1016/j.jfma.2023.10.013] [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] [Received: 05/08/2022] [Revised: 03/09/2023] [Accepted: 10/12/2023] [Indexed: 11/25/2023] Open
Abstract
Unlike hepatitis C virus (HCV) genotype (GT) 6, which is widely circulated in Southeast Asia and South China, GT 6 was not reported in Taiwan until 2006. GT 1b and 2a, also known as global HCV subtypes, have been reported as major GTs circulating in Taiwan. Because of improvement in genotyping kits and sequencing techniques for the subtyping of HCV, an increasing number of GT 6 subtypes have been reported, especially subtype 6a among intravenous drug users with human immunodeficiency virus infection after an outbreak since 2003. Thus, HCV GT 6 infection is regarded to be closely associated with injection drug use. However, recently, we found an unexpectedly high GT 6 prevalence in the general population in Tainan, southern Taiwan. Most of these GT 6 samples belonged to a putative novel subtype closely related to 6g and 6w instead of 6a. Phylogenetic analyses indicated that this putative 6g-related novel subtype and 6w could be indigenous in southern Taiwan for centuries. Southern Taiwan could be the origin of HCV subtype 6w. This finding might change the perspective of HCV epidemiology in Taiwan.
Collapse
Affiliation(s)
- Hung-Da Tung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chi-Mei Medical Center, Liouying, Tainan, Taiwan
| | - Jyh-Jou Chen
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chi-Mei Medical Center, Liouying, Tainan, Taiwan.
| |
Collapse
|
2
|
Yang WW, Juan YC, Wu GHM, Pwu RF. The Critical Intersect of Regulations, Health Technology Assessment, and Drug Safety Assessments. Drug Saf 2024; 47:289-299. [PMID: 38113017 DOI: 10.1007/s40264-023-01386-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2023] [Indexed: 12/21/2023]
Abstract
Health technology assessment (HTA) is a multidisciplinary process that determines the value of health technology at different points in its lifecycle. Safety issues have become more important since regulatory authorities are increasingly adopting flexible standards, processes, and evidentiary requirements for drug approval. In this article, we compared the different role of regulatory authorities and HTA agencies. Additionally, the experience of regulatory-HTA collaboration for assessment and/or decision-making on safety issues in the lifecycle of a health technology is illustrated, including olmesartan (angiotensin II receptor antagonist) and the direct-acting hepatitis C virus (HCV) antiviral agents. Post-licensing data can be derived from various sources such as electronic health records, medical claims, drug and disease registries, post-authorization safety studies (PASS) or post-authorization safety efficacy studies (PAES), periodic benefit-risk assessment reports, as well as HTA reassessment reports, which incorporate utilization information from patients in a real-world setting and provide crucial evidence for various purposes. With the ongoing accumulation of safety and efficacy information during post-regulatory approval, a standardized process for continuous data collection and active reassessment of risk and benefit becomes crucial for managing the lifecycle of health technologies. In order to define evidence requirements clearly, reduce uncertainty, and minimize delays in HTA approval, early engagement and collaboration of HTA agencies in the regulatory review processes have become more common. However, there is currently limited interaction and collaboration between regulatory authorities and HTA agencies. This article aims to identify the challenges faced by regulators and HTA agencies today, emphasizing the significance of conducting regulatory reviews and health technology assessments throughout a technology's lifecycle, underlining the value of utilizing real-world data and evidence, and emphasizing the necessity of enhancing collaboration between regulatory authorities and HTA agencies, all within the overarching context of drug safety.
Collapse
Affiliation(s)
- Wen-Wen Yang
- Data Science Center, Fu Jen Catholic University, No. 510, Zhongzheng Rd., Xinzhuang Dist., New Taipei City, 242062, Taiwan, R.O.C
- Health Outcomes and Technology Teaching and Education Alliance, Taipei City, Taiwan, R.O.C
| | - Yi-Chen Juan
- National Taiwan University Hospital-Integrative Medical Database, Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan, R.O.C
| | - Grace Hui-Min Wu
- Health Outcomes and Technology Teaching and Education Alliance, Taipei City, Taiwan, R.O.C
- Department of Physical Therapy and Assistive Technology, National Yang Ming Chiao Tung University, Taipei, Taiwan, R.O.C
| | - Raoh-Fang Pwu
- Data Science Center, Fu Jen Catholic University, No. 510, Zhongzheng Rd., Xinzhuang Dist., New Taipei City, 242062, Taiwan, R.O.C..
- Health Outcomes and Technology Teaching and Education Alliance, Taipei City, Taiwan, R.O.C..
- School of Health Care Administration, Taipei Medical University, Taipei City, Taiwan, R.O.C..
| |
Collapse
|
3
|
Rusman RD, Daud NAS, Parewangi ML, Bakri S, Aman AM, Rasyid H, Seweng A, Tahir AS. Correlation of host factor with virological response to direct-acting antiviral treatment in hepatitis C patients. EGYPTIAN LIVER JOURNAL 2022. [DOI: https://doi.org/10.1186/s43066-022-00217-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Abstract
Background
Hepatitis C virus (HCV) infection is the global epidemic of this century, affecting almost 100 million people, and it is now the leading cause of liver-related mortality and liver transplantation. Interferon (IFN)-α was introduced as the first treatment for chronic hepatitis C but had several limitations, including factors that cause unresponsiveness to therapy, such as viral and host factors. The availability of non-interferon antiviral agents, direct-acting antivirals (DAAs), has led to a major paradigm shift in the treatment of HCV infection. This therapy has been shown to achieve higher cure rates and minimal side effect profiles in clinical trials. This study is aimed to determine the correlation between host factors, such as age, gender, and body mass index (BMI) with virological response to DAA treatment in hepatitis C patients.
Result
Observational research with a retrospective cohort approach was conducted at Wahidin Sudirohusodo Hospital, Makassar, Indonesia, from April 2021 to October 2021. The virological response was assessed using HCV-RNA quantitative and sustained virological response (SVR) 12 weeks after therapy. The research was conducted on 86 subjects consisting of 57 men and 29 women with a mean age of 48.69±13.94 years and mean BMI of 23.17±3.71 kg/m2, with SVR12 up to 90.7%. Study analysis did not find a significant correlation between age, gender, and BMI, with virological response SVR12 of chronic hepatitis C patients with direct-acting antiviral (p>0.05).
Conclusion
Age, gender, and body mass index do not influence the success of DAA therapy.
Collapse
|
4
|
Rusman RD, Daud NAS, Parewangi ML, Bakri S, Aman AM, Rasyid H, Seweng A, Tahir AS. Correlation of host factor with virological response to direct-acting antiviral treatment in hepatitis C patients. EGYPTIAN LIVER JOURNAL 2022. [DOI: 10.1186/s43066-022-00217-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Hepatitis C virus (HCV) infection is the global epidemic of this century, affecting almost 100 million people, and it is now the leading cause of liver-related mortality and liver transplantation. Interferon (IFN)-α was introduced as the first treatment for chronic hepatitis C but had several limitations, including factors that cause unresponsiveness to therapy, such as viral and host factors. The availability of non-interferon antiviral agents, direct-acting antivirals (DAAs), has led to a major paradigm shift in the treatment of HCV infection. This therapy has been shown to achieve higher cure rates and minimal side effect profiles in clinical trials. This study is aimed to determine the correlation between host factors, such as age, gender, and body mass index (BMI) with virological response to DAA treatment in hepatitis C patients.
Result
Observational research with a retrospective cohort approach was conducted at Wahidin Sudirohusodo Hospital, Makassar, Indonesia, from April 2021 to October 2021. The virological response was assessed using HCV-RNA quantitative and sustained virological response (SVR) 12 weeks after therapy. The research was conducted on 86 subjects consisting of 57 men and 29 women with a mean age of 48.69±13.94 years and mean BMI of 23.17±3.71 kg/m2, with SVR12 up to 90.7%. Study analysis did not find a significant correlation between age, gender, and BMI, with virological response SVR12 of chronic hepatitis C patients with direct-acting antiviral (p>0.05).
Conclusion
Age, gender, and body mass index do not influence the success of DAA therapy.
Collapse
|
5
|
Tan CH, Chang MC, Tsai WF, Chuang WL, Huang JF, Lin ZY, Dai CY, Yeh ML, Li CT, Yu RL. Different profiles of neurocognitive impairment in patients with hepatitis B and C virus infections. Sci Rep 2022; 12:10625. [PMID: 35739162 PMCID: PMC9226189 DOI: 10.1038/s41598-022-14736-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 06/13/2022] [Indexed: 11/20/2022] Open
Abstract
The direct impact of chronic hepatitis B and hepatitis C on neurocognition remains elusive due to the frequent comorbidities, and the domains of the neurocognitive functions affected have rarely been investigated comprehensively. We cross-sectionally assessed the neurocognitive functions of the individuals with chronic hepatitis B, chronic hepatitis C, treated chronic hepatitis C with a sustained virologic response, and their healthy control counterparts. Laboratory examinations were used to investigate the impact of inflammation on neurocognition, exclude the medical conditions that could interfere with neurocognition assessment, and assess liver function and fibrotic severity of the liver of the participants. This study found the detrimental impact of chronic hepatitis B on language and executive functions. In contrast, individuals with chronic hepatitis C showed deficits in executive functions, psychomotor speed, memory, and attention. Successful elimination of hepatitis C resulted in improved liver function, but not neuropsychological test performance. Moreover, erythrocyte sedimentation rate level was found to mediate the deficits in the attention of individuals with chronic hepatitis C. These results demonstrate the neurocognitive deficits and the difference in the profiles of neurocognitive deficits in individuals with chronic hepatitis B and chronic hepatitis C. Our study also provided results suggesting the mediation by systemic inflammation on the attention deficit in individuals with chronic hepatitis C.
Collapse
Affiliation(s)
- Chun-Hsiang Tan
- Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Meng-Chia Chang
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wei-Fang Tsai
- M.Sc. Program in Tropical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Wan-Long Chuang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jee-Fu Huang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Zu-Yau Lin
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chia-Yen Dai
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ming-Lun Yeh
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chi-Ting Li
- Department of Psychology, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Rwei-Ling Yu
- Institute of Behavioral Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
| |
Collapse
|
6
|
Su PY, Su WW, Hsu YC, Wang SY, Chiu PF, Yen HH. Micro-Elimination of Hepatitis C among Patients with Kidney Disease by Using Electronic Reminder System-A Hospital-Based Experience. J Clin Med 2022; 11:423. [PMID: 35054120 PMCID: PMC8778896 DOI: 10.3390/jcm11020423] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 12/31/2021] [Accepted: 01/11/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND Little is known about the use of an electronic reminder system for HCV screening among patients with kidney disease. In this study, we tried to determine whether reminder systems could improve the HCV screening rate in patients with kidney disease. METHODS Patients with kidney disease were enrolled from August 2019 to December 2020 to automatically screen and order HCV antibody and RNA testing in outpatient departments. RESULTS A total of 19,316 outpatients with kidney disease were included, and the mean age was 66.5 years. The assessment rate of HCV antibody increased from 53.1% prior to the reminder system to 79.8% after the reminder system (p < 0.001), and the assessment rate of HCV RNA increased from 71% to 82.9%. The anti-HCV seropositivity rate decreased from 7.3% at baseline to 2.5% after the implementation of the reminder system (p < 0.001), and the percentage of patients with detectable HCV RNA among those with anti-HCV seropositivity decreased from 69.1% at baseline to 46.8% (p < 0.001). CONCLUSIONS The feasibility of an electronic reminder system for HCV screening among patients with kidney disease in a hospital-based setting was demonstrated.
Collapse
Affiliation(s)
- Pei-Yuan Su
- Division of Gastroenterology, Department of Internal Medicine, Changhua Christian Hospital, Changhua 500, Taiwan; (W.-W.S.); (Y.-C.H.); (H.-H.Y.)
| | - Wei-Wen Su
- Division of Gastroenterology, Department of Internal Medicine, Changhua Christian Hospital, Changhua 500, Taiwan; (W.-W.S.); (Y.-C.H.); (H.-H.Y.)
| | - Yu-Chun Hsu
- Division of Gastroenterology, Department of Internal Medicine, Changhua Christian Hospital, Changhua 500, Taiwan; (W.-W.S.); (Y.-C.H.); (H.-H.Y.)
| | - Shu-Yi Wang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Changhua Christian Hospital, Changhua 500, Taiwan;
| | - Ping-Fang Chiu
- Division of Nephrology, Department of Internal Medicine, Changhua Christian Hospital, Changhua 500, Taiwan;
| | - Hsu-Heng Yen
- Division of Gastroenterology, Department of Internal Medicine, Changhua Christian Hospital, Changhua 500, Taiwan; (W.-W.S.); (Y.-C.H.); (H.-H.Y.)
- Artificial Intelligence Development Center, Changhua Christian Hospital, Changhua 500, Taiwan
- College of Medicine, National Chung Hsing University, Taichung 400, Taiwan
| |
Collapse
|