1
|
Yu ZQ, Bai XY, Ruan GC, Han W, Xu TM, Zhang MY, Wang BM, Zhang YJ, Guo MY, Yang H. Autoimmune pancreatitis associated with inflammatory bowel diseases: A retrospectively bidirectional case-control study in China. J Dig Dis 2023; 24:452-460. [PMID: 37503771 DOI: 10.1111/1751-2980.13209] [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: 03/27/2023] [Revised: 07/02/2023] [Accepted: 07/25/2023] [Indexed: 07/29/2023]
Abstract
OBJECTIVES Autoimmune pancreatitis (AIP) is a rare and enigmatic immune-mediated inflammatory disease. We aimed to investigate the prevalence, characteristics, and associated factors of AIP-inflammatory bowel disease (IBD) in China. METHODS A retrospective bidirectional case-control study was performed. The diagnoses of IBD and AIP were made based on the European Crohn's and Colitis Organization guidelines and the International Consensus Diagnostic Criteria. IBD controls were matched by age, sex, and IBD type at a ratio of 1:4, while AIP controls were matched by AIP types. RESULTS The age-standardized prevalence of AIP-IBD patients in the IBD and AIP population were 292.0 and 8151.93 per 100 000 population, respectively. IBD patients had a higher risk of AIP compared to non-IBD patients (odds ratio 8.4, 95% confidence interval 4.7-14.9, P < 0.0001), and AIP patients had a higher risk of developing IBD compared to the general population in China. The mean age at diagnosis of IBD and AIP was 34.83 years and 40.42 years. IBD was diagnosed before AIP in seven cases. The median total IBD and AIP duration was 43.5 months and 13.5 months. Use of mesalamine and tuberculosis were associated with AIP in IBD patients (P = 0.031). And fecal occult blood test was associated with IBD in AIP patients (P = 0.008). CONCLUSIONS Most AIP-IBD patients had ulcerative colitis and type 2 AIP. IBD patients are more likely to develop AIP compared to the general population, and vice versa. Use of mesalamine and tuberculosis infection were associated with AIP, and fecal occult blood test was associated with IBD.
Collapse
Affiliation(s)
- Zi Qing Yu
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xiao Yin Bai
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Ge Chong Ruan
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Wei Han
- Department of Epidemiology and Biostatistics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Tian Ming Xu
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Meng Yuan Zhang
- Department of Oncology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Bei Ming Wang
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yu Jia Zhang
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Ming Yue Guo
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Hong Yang
- Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| |
Collapse
|
2
|
Zhao X, Li M, Haihambo N, Wang X, Wang B, Sun M, Guo M, Han C. Periodic Characteristics of Hepatitis Virus Infections From 2013 to 2020 and Their Association With Meteorological Factors in Guangdong, China: Surveillance Study. JMIR Public Health Surveill 2023; 9:e45199. [PMID: 37318858 DOI: 10.2196/45199] [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: 12/20/2022] [Revised: 03/18/2023] [Accepted: 04/28/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND In the past few decades, liver disease has gradually become one of the major causes of death and illness worldwide. Hepatitis is one of the most common liver diseases in China. There have been intermittent and epidemic outbreaks of hepatitis worldwide, with a tendency toward cyclical recurrences. This periodicity poses challenges to epidemic prevention and control. OBJECTIVE In this study, we aimed to investigate the relationship between the periodic characteristics of the hepatitis epidemic and local meteorological elements in Guangdong, China, which is a representative province with the largest population and gross domestic product in China. METHODS Time series data sets from January 2013 to December 2020 for 4 notifiable infectious diseases caused by hepatitis viruses (ie, hepatitis A, B, C, and E viruses) and monthly data of meteorological elements (ie, temperature, precipitation, and humidity) were used in this study. Power spectrum analysis was conducted on time series data, and correlation and regression analyses were performed to assess the relationship between the epidemics and meteorological elements. RESULTS The 4 hepatitis epidemics showed clear periodic phenomena in the 8-year data set in connection with meteorological elements. Based on the correlation analysis, temperature demonstrated the strongest correlation with hepatitis A, B, and C epidemics, while humidity was most significantly associated with the hepatitis E epidemic. Regression analysis revealed a positive and significant coefficient between temperature and hepatitis A, B, and C epidemics in Guangdong, while humidity had a strong and significant association with the hepatitis E epidemic, and its relationship with temperature was relatively weak. CONCLUSIONS These findings provide a better understanding of the mechanisms underlying different hepatitis epidemics and their connection to meteorological factors. This understanding can help guide local governments in predicting and preparing for future epidemics based on weather patterns and potentially aid in the development of effective prevention measures and policies.
Collapse
Affiliation(s)
- Xixi Zhao
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Meijia Li
- Faculty of Psychology and Center for Neuroscience, Vrije Universiteit Brussel, Brussel, Belgium
| | - Naem Haihambo
- Faculty of Psychology and Center for Neuroscience, Vrije Universiteit Brussel, Brussel, Belgium
| | - Xinni Wang
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Bin Wang
- The National Clinical Research Center for Mental Disorders and Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Meirong Sun
- School of Psychology, Beijing Sport University, Beijing, China
| | - Mingrou Guo
- The Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - Chuanliang Han
- The Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- The Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, Shenzhen, China
- Chinese Academy of Sciences Key Laboratory of Brain Connectome and Manipulation, Shenzhen, China
- Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, China
| |
Collapse
|
3
|
Modeling the Impacts of Prevention and Treatment Interventions on Hepatitis C Among People Who Inject Drugs in China. Infect Dis Ther 2023; 12:1043-1055. [PMID: 36894824 PMCID: PMC10147892 DOI: 10.1007/s40121-023-00779-0] [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: 01/02/2023] [Accepted: 02/10/2023] [Indexed: 03/11/2023] Open
Abstract
INTRODUCTION Injection drug use is the main transmission route of hepatitis C virus (HCV) in China. The prevalence of HCV remains high at 40-50% among people who inject drugs (PWID). We developed a mathematical model to predict the impacts of different HCV intervention strategies on the HCV burden in Chinese PWID by 2030. METHODS We developed a dynamic deterministic mathematical model to simulate the transmission of HCV among PWID in China between 2016 and 2030, using domestic data based on the real cascade of HCV care. We considered various intervention scenarios, including treatment regimens, harm reduction program (HRP) coverage, enhanced testing and referral for treatment. RESULTS HCV incidence will exhibit a gradual but slow declining trend from 12,970 in 2016 to 11,761 in 2030 based on current screening and treatment practices among PWID (scenario 1). Scaled-up HCV screening and treatment integrated with HRPs (scenario 8) demonstrated the most substantial reduction in HCV burden, being the only intervention scenario that could achieve the World Health Organization's (WHO's) HCV elimination target. Specifically, the HCV incidence in 2030 is projected to be reduced by 81.42%, and HCV-related deaths are projected to be reduced by 91.94%. CONCLUSION Our study indicates that achieving WHO elimination targets is an extremely challenging goal that requires substantial improvements in HCV testing and treatment among PWID (scenario S8). The findings suggest that coordinated improvements in testing, treatment, and harm reduction programs could greatly reduce the HCV burden among PWID in China, and urgent policy changes are needed to integrate HCV testing and treatment into existing HRPs.
Collapse
|
4
|
Zhou Q, Liu A, Wang S, Li J, He M, Chen L. Hepatitis
C
virus screening reactive among blood donors in mainland
C
hina: A systematic review and meta‐analysis. Transfus Med 2022; 33:147-158. [PMID: 36349871 DOI: 10.1111/tme.12935] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/06/2022] [Accepted: 10/15/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Hepatitis C virus (HCV) can be transmitted by blood transfusion. The aim of this meta-analysis is to estimate the anti-HCV reactive rate and to define the demographic characteristics of blood donors who have potential threats to blood safety in mainland China for nearly 30 years, in order to provide a safe reference for blood transfusion and corresponding guidance for policymakers to increase blood safety. MATERIALS AND METHODS Literature reporting the anti-HCV screening reactive rate in Chinese blood donors was identified by systematic searching of four electronic databases from 1991 to 2017. The Preferred Reporting of Items for Systematic Reviews and Meta-Analyses guidelines were strictly followed, and data manipulation and statistical analysis were performed by Stata 15.0. RESULTS Our results showed that the post-donation anti-HCV reactive rate was 0.53% (95% confidence interval [CI], 0.51%-0.55%) with a significant variation from 1.58% (95% CI, 1.13%-2.03%) before 1998 to 0.51% (95% CI, 0.48%-0.53%) after 1998 when the Blood Donation Law was implemented in China. In addition, anti-HCV screening reactive rate for family or replacement donors was significantly higher than that in individual voluntary blood donors. CONCLUSION Our results indicated that blood centres in China should convert more eligible first-time donors into repeat donors and turn the 'real family or replacement donors' into individual voluntary blood donors to reduce the risk of transfusion-transmitted HCV. In the meantime, large surveys should be carried out among volunteer donors from high-risk populations.
Collapse
Affiliation(s)
- Qiaoling Zhou
- Department of Infectious Diseases Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital Chengdu Sichuan Province China
| | - Anqing Liu
- Institute of Blood Transfusion Chinese Academy of Medical Sciences Chengdu China
| | - Shaoli Wang
- Institute of Blood Transfusion Chinese Academy of Medical Sciences Chengdu China
- Laboratory of Radiation Oncology and Radiobiology Clinical Oncology School of Fujian Medical Uni‐versity and Fujian Cancer Hospital Fuzhou China
| | - Jian Li
- School of Basic Medical Sciences School of Medicine Chengdu China
| | - Miao He
- Institute of Blood Transfusion Chinese Academy of Medical Sciences Chengdu China
| | - Limin Chen
- Institute of Blood Transfusion Chinese Academy of Medical Sciences Chengdu China
| |
Collapse
|
5
|
Zhang CH, Cheng Y, Zhang S, Fan J, Gao Q. Changing epidemiology of hepatocellular carcinoma in Asia. Liver Int 2022; 42:2029-2041. [PMID: 35319165 DOI: 10.1111/liv.15251] [Citation(s) in RCA: 124] [Impact Index Per Article: 62.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/06/2021] [Accepted: 03/19/2022] [Indexed: 12/24/2022]
Abstract
Liver cancer is the fifth most common cancer and the second leading cause of malignant death in Asia, and Asia reports 72.5% of the world's cases in 2020. As the most common histological type, hepatocellular carcinoma (HCC) accounts for the majority of incidence and mortality of liver cancer cases. This review presents the changing epidemiology of HCC in Asian countries in recent years. Globally, aged, male and Asian populations remain the group with the highest risk of HCC. Hepatitis B virus (HBV) and hepatitis C virus (HCV) are still the leading risk factors of HCC with a slight decline in most Asian countries, which is mainly attributed to HBV vaccination of newborns, prevention of HCV horizontal transmission and treatment of chronic hepatitis. However, the prevalence of HCC caused by metabolic factors, including metabolic syndrome, obesity and non-alcoholic fatty liver diseases, is increasing rapidly in Asian countries, which may eventually become the major cause of HCC. Excessive alcohol consumption continues to be an important risk factor as the average consumption of alcohol is still growing. Hopefully, great effort has been made to better prevention and treatment of HCC in most Asian regions, which significantly prolongs the survival of HCC patients. Asian countries tend to use more aggressive intervention than European and American countries, but it remains unclear whether this preference is related to a better prognosis. In conclusion, HCC remains a major disease burden in Asia, and the management of HCC should be adjusted dynamically based on the changing epidemiology.
Collapse
Affiliation(s)
- Chen-Hao Zhang
- Liver Cancer Institute, Zhongshan Hospital, and Key Laboratory of Carcinogenesis and Cancer Invasion (Ministry of Education), Fudan University, Shanghai, China
| | - Yifei Cheng
- Liver Cancer Institute, Zhongshan Hospital, and Key Laboratory of Carcinogenesis and Cancer Invasion (Ministry of Education), Fudan University, Shanghai, China
| | - Shu Zhang
- Liver Cancer Institute, Zhongshan Hospital, and Key Laboratory of Carcinogenesis and Cancer Invasion (Ministry of Education), Fudan University, Shanghai, China
| | - Jia Fan
- Liver Cancer Institute, Zhongshan Hospital, and Key Laboratory of Carcinogenesis and Cancer Invasion (Ministry of Education), Fudan University, Shanghai, China
| | - Qiang Gao
- Liver Cancer Institute, Zhongshan Hospital, and Key Laboratory of Carcinogenesis and Cancer Invasion (Ministry of Education), Fudan University, Shanghai, China.,Key Laboratory of Medical Epigenetics and Metabolism, Institutes of Biomedical Sciences, Fudan University, Shanghai, China.,State Key Laboratory of Genetic Engineering, Fudan University, Shanghai, China
| |
Collapse
|
6
|
Marley G, Seto WK, Yan W, Chan P, Tucker JD, Tang W, Wong WCW. What facilitates hepatitis B and hepatitis C testing and the role of stigma among primary care patients in China? J Viral Hepat 2022; 29:637-645. [PMID: 35633086 DOI: 10.1111/jvh.13711] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 04/23/2022] [Accepted: 05/04/2022] [Indexed: 01/13/2023]
Abstract
Approximately 80% of primary healthcare facilities in China were ready to deliver hepatitis care services by 2021. This study aimed to assess hepatitis B and C test uptake, identify the factors associated with testing and determine the predictors of hepatitis stigma among primary care patients. We conducted a cross-sectional survey among patients seeking care in the family medicine and primary care unit of the University of Hong Kong-Shenzhen Hospital, China. Participants were 30 years or older and had not tested for HBV and HCV in the preceding 12 months. Test uptake was defined as self-reported previous HBV and HCV testing. Descriptive statistics, Chi-square test, forward multivariable logistic regression and stepwise multiple linear regression were conducted, and a p-value <.05 was deemed statistically significant. A total of 750 eligible patients completed the survey, and 54.5% (404 ± 0.9) were between 30 and 40 years old. Most participants were heterosexuals 98.0% (n = 735), female 57.5% (n = 431), married 78.3% (587) and earned ≤1500 USD per month 54.4% (n = 408). A 66.1% (n = 496) and 13.7% (n = 103) self-reported previous HBV and HCV testing, respectively, and 62% (n = 468) were vaccinated. HCV testing was associated with HBV testing (aOR = 13.7, 95% CI:2.1-91.5); and HBV testing was associated with family history of HBV (aOR = 2.4, 95%CI:1.1-5.5). Overall hepatitis stigma was about average and decreased with family history of HBV (p = .017). In conclusion, HCV testing uptake among primary care patients was low and needs to be further promoted. Integrating HBV and HCV testing interventions and fostering family-based support for disclosure could effectively improve testing uptake.
Collapse
Affiliation(s)
- Gifty Marley
- The University of North Carolina Project-China, Global Health Center Office, Guangzhou, China.,Social Entrepreneurship to Spur Health (SESH), Guangzhou, China
| | - Wai-Kay Seto
- Department of Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.,Department of Medicine and State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong, China
| | - Weihui Yan
- Department of Family Medicine & Primary Care, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Polin Chan
- World Health Organization Western Pacific Regional Office, Manila, The Philippines
| | - Joseph D Tucker
- The University of North Carolina Project-China, Global Health Center Office, Guangzhou, China.,Institute of Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina, USA.,Faculty of Infectious and Tropical Diseases, LSHTM, London, UK
| | - Weiming Tang
- The University of North Carolina Project-China, Global Health Center Office, Guangzhou, China.,Social Entrepreneurship to Spur Health (SESH), Guangzhou, China.,Institute of Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina, USA
| | - William C W Wong
- Department of Family Medicine & Primary Care, School of Clinical Medicine, Li Ka Shing Faculty Medicine, The University of Hong Kong, Hong Kong, China
| |
Collapse
|
7
|
A randomized controlled trial enhancing viral hepatitis testing in primary care via digital crowdsourced intervention. NPJ Digit Med 2022; 5:95. [PMID: 35853995 PMCID: PMC9296450 DOI: 10.1038/s41746-022-00645-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 06/24/2022] [Indexed: 11/20/2022] Open
Abstract
Despite the availability of hepatitis B virus (HBV) and hepatitis C virus (HCV) testing in primary care, testing rates in China remain low. Social media is an inexpensive means of disseminating information and could facilitate hepatitis testing promotion. We evaluated the capacity of digitally crowdsourced materials to promote HBV/HCV testing uptake via a randomized controlled trial (identifier: ChiCTR1900025771), which enrolled 750 Chinese primary care patients. We randomized patients (1:1) to receive crowdsourced HBV/HCV promotion materials through social media or facility-based care without promotional materials for four weeks. Exposure to all intervention materials was associated with increased odds of HBV (aOR = 1.79, 95% CI: 1.09–3.00) and HCV (aOR = 1.95, 95% CI: 1.29–2.99) testing compared to facility-based care. There was a significant reduction in hepatitis stigma among intervention group participants (HBV slope: −0.15, p < 0.05; and HCV slope: −0.13, p < 0.05). Digitally crowdsourced promotion messages could enhance hepatitis testing uptake and should be considered in hepatitis reduction strategies. Trial registration: Chinese Clinical Trial Registry (ChiCTR1900025771) on September 9, 2019. Available from: http://www.chictr.org.cn/showproj.aspx?proj=42788
Collapse
|
8
|
Lin J, Zhang H, Yu H, Bi X, Zhang W, Yin J, Zhao P, Liang X, Qu C, Wang M, Hu M, Liu K, Wang Y, Zhou Z, Wang J, Tan X, Liu W, Shao Z, Cai J, Tang W, Cao G. Epidemiological Characteristics of Primary Liver Cancer in Mainland China From 2003 to 2020: A Representative Multicenter Study. Front Oncol 2022; 12:906778. [PMID: 35800051 PMCID: PMC9253580 DOI: 10.3389/fonc.2022.906778] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 05/11/2022] [Indexed: 01/27/2023] Open
Abstract
Background The contribution of hepatitis B virus (HBV) and hepatitis C virus (HCV) to primary liver cancer (PLC) and their association with cancer aggressiveness remains uncertain in China, a country with half of global PLC. We aimed to characterize this using data from four representative medical centers. Methods In total, 15,801 PLC patients were enrolled from the centers distributed in Easter5n, Southern, Northern, and Western China from 2003 to 2020. Of those, 7585 with curative surgery were involved in survival analysis. A nomogram was constructed using preoperative parameters to predict postoperative survival. Results Hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma, and combined hepatocellular cholangiocarcinoma accounted for 93.0%, 4.3%, and 1.6% in PLC, respectively. The seropositivities of HBV and HCV were 84.4% and 3.2% in HCC, respectively. The seropositivity of anti-HCV antibody was significantly higher in HBV-negative than in HBV-positive HCC patients (13.2% vs. 1.1%). Compared to HCV-positive HCC (HCV-HCC), HBV-positive HCC (HBV-HCC) was associated with 12-year earlier onset, higher proportions of males, high α-fetoprotein, large tumor size, advanced Barcelona Clinic Liver Cancer (BCLC) stage, and vascular tumor thrombus. The proportions of HCC and HBV seropositivity increased, whereas that of anti-HCV decreased, from 2003 to 2020. Postoperative five-year survival rate was 73.5%, 64.1%, 34.9%, and 19.7% in HCC at BCLC stage 0, A, B, and C, respectively. The multivariate Cox regression analysis showed that HBV seropositivity, incomplete tumor capsule, vascular tumor thrombus, tumor diameter (≥3 cm), advanced BCLC stage (B+C), α-fetoprotein (≥20ng/ml), and direct bilirubin (>8µmol/L) contributed independently to shorter overall survival (OS); whereas post-operative radiofrequency ablation and second resection independently improved OS in HCC. HCV-HCC had a more favorable prognosis than did HBV-HCC (Log-rank test, P<0.001). A nomogram composed of age, gender, and the preoperative independent risk factors was accurate in predicting postoperative survival in HCC (C-index: 0.735; 95% confidence interval: 0.727–0.743). Conclusion HBV contributes to 84.4% of HCC in China, and actively promotes hepatocarcinogenesis and HCC progression. A favorable postoperative survival obtained in patients at the early BCLC stage highlights the importance of screening for early HCC in high-risk populations. Our preoperative prognosis prediction model is important in clinical decision-making.
Collapse
Affiliation(s)
- Jiansheng Lin
- Department of Epidemiology, Second Military Medical University, Shanghai, China
- Department of Epidemiology, School of Medicine, Jinan University, Guangzhou, China
| | - Hongwei Zhang
- Department of Epidemiology, Second Military Medical University, Shanghai, China
| | - Hongping Yu
- Department of Research, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Xinyu Bi
- Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Weilu Zhang
- Department of Epidemiology, School of Public Health, Fourth Military Medical University, Xi’an, China
| | - Jianhua Yin
- Department of Epidemiology, Second Military Medical University, Shanghai, China
| | - Pei Zhao
- Department of Research, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Xiumei Liang
- Office for Disease Process Management, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Chunfeng Qu
- State Key Lab of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Minjie Wang
- Department of Clinical Laboratory, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ming Hu
- Department of Epidemiology, Second Military Medical University, Shanghai, China
| | - Kun Liu
- Department of Epidemiology, School of Public Health, Fourth Military Medical University, Xi’an, China
| | - Yuting Wang
- State Key Lab of Molecular Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zihan Zhou
- Guangxi Office for Cancer Prevention and Control, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Junqi Wang
- Department of Epidemiology, Second Military Medical University, Shanghai, China
| | - Xiaojie Tan
- Department of Epidemiology, Second Military Medical University, Shanghai, China
| | - Wenbin Liu
- Department of Epidemiology, Second Military Medical University, Shanghai, China
| | - Zhongjun Shao
- Department of Epidemiology, School of Public Health, Fourth Military Medical University, Xi’an, China
- *Correspondence: Zhongjun Shao, ; Jianqiang Cai, ; Weizhong Tang, ; Guangwen Cao,
| | - Jianqiang Cai
- Department of Hepatobiliary Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- *Correspondence: Zhongjun Shao, ; Jianqiang Cai, ; Weizhong Tang, ; Guangwen Cao,
| | - Weizhong Tang
- Department of Gastrointestinal Surgery and Guangxi Clinical Research Center for Colorectal Cancer, Guangxi Medical University Cancer Hospital, Nanning, China
- *Correspondence: Zhongjun Shao, ; Jianqiang Cai, ; Weizhong Tang, ; Guangwen Cao,
| | - Guangwen Cao
- Department of Epidemiology, Second Military Medical University, Shanghai, China
- *Correspondence: Zhongjun Shao, ; Jianqiang Cai, ; Weizhong Tang, ; Guangwen Cao,
| |
Collapse
|
9
|
Gan L, Wang D, Bieber B, McCullough K, Jadoul M, Pisoni RL, Hou F, Liang X, Ni Z, Chen X, Chen Y, Zuo L. Hepatitis C Prevalence, Incidence, and Treatment in Chinese Hemodialysis Patients: Results From the Dialysis Outcomes and Practice Patterns Study-China (2019–21). Front Med (Lausanne) 2022; 9:910840. [PMID: 35783631 PMCID: PMC9240809 DOI: 10.3389/fmed.2022.910840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 05/24/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundPrior work from the Dialysis Outcomes and Practice Patterns Study (DOPPS) showed HCV prevalence in China in 2012–2015 being in the upper third and HCV incidence the 2nd highest among 15 different countries/regions investigated. The goal of the present investigation was to: (1) determine if HCV prevalence and incidence has changed, and (2) collect detailed data to understand how HCV is treated, monitored, and managed in Chinese HD facilities and non-dialysis chronic kidney disease (CKD) clinics.Data and MethodsDetailed data for 1,700 randomly selected HD patients were reported by 39 randomly selected HD facilities from Beijing, Shanghai, and Guangzhou participating in the DOPPS 7-China study from 2019 to 2021. The study site medical directors completed a survey regarding numerous aspects of HCV treatment and management in HD and ND-CKD patients.ResultsIn this 2019 to 2021 cohort, HCV prevalence was 7.4%, which was lower than the 14.8 and 11.5% HCV prevalence for the 2009–2011 and 2012–2015 cohorts, respectively. HCV incidence of 1.2 cases per 100 pt-yrs also was lower compared to the incidence of 2.1 for the 2012–2015 cohort. Although the great majority of study site medical directors indicated that all or nearly HCV+ patients should be treated for their HCV, very few HCV+ patients have been treated presumably due to substantial cost barriers for affording the new direct acting antivirals (DAAs). The randomly selected facilities in our DOPPS 7-China study appear to have excellent programs in place for frequent monitoring of patients and staff for HCV, education of staff, and referral of HCV cases to external infectious disease, gastroenterology, and liver disease specialists. Liver biopsies were not commonly performed in HCV+ HD patients. HCV genotyping also was rarely performed in participating units.ConclusionsOur study indicates a 50% decline in HCV prevalence and a >40% decline in HCV incidence in Chinese HD patients over the past 10–12 yrs. Chinese HD facilities and associated specialists appear to be well-equipped and organized for successfully treating and managing their HCV+ HD and CKD patients in order to achieve the WHO goal of eliminating HCV by 2030.
Collapse
Affiliation(s)
- Liangying Gan
- Department of Nephrology, Peking University People's Hospital, Beijing, China
| | - Dongyu Wang
- Arbor Research Collaborative for Health, Ann Arbor, MI, United States
| | - Brian Bieber
- Arbor Research Collaborative for Health, Ann Arbor, MI, United States
| | - Keith McCullough
- Arbor Research Collaborative for Health, Ann Arbor, MI, United States
| | - Michel Jadoul
- Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Ronald L. Pisoni
- Arbor Research Collaborative for Health, Ann Arbor, MI, United States
| | - Fanfan Hou
- State Key Laboratory of Organ Failure Research, Division of Nephrology, National Clinical Research Center of Kidney Disease, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xinling Liang
- Division of Nephrology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangdong, China
| | - Zhaohui Ni
- Renal Division, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaonong Chen
- Division of Nephrology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuqing Chen
- Renal Division, Peking University First Hospital, Beijing, China
| | - Li Zuo
- Department of Nephrology, Peking University People's Hospital, Beijing, China
- *Correspondence: Li Zuo
| |
Collapse
|
10
|
Tran NH. Shifting Epidemiology of Hepatocellular Carcinoma in Far Eastern and Southeast Asian Patients: Explanations and Implications. Curr Oncol Rep 2022; 24:187-193. [DOI: 10.1007/s11912-021-01160-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2021] [Indexed: 01/02/2023]
|
11
|
Prevalence of positivity to antibodies to hepatitis C virus among volunteer blood donors in China: a meta-analysis. Public Health 2021; 199:87-95. [PMID: 34571442 DOI: 10.1016/j.puhe.2021.07.011] [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: 12/12/2020] [Revised: 06/17/2021] [Accepted: 07/09/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Safe blood transfusion plays an important role in the prevention of transfusion-transmissible infections, and hepatitis C virus (HCV) infection is one of the major problems associated with this procedure. This meta-analysis aimed to determine the prevalence of HCV infection in Chinese blood donors. STUDY DESIGN The study design of this study is a meta-analysis. METHODS Eligible studies were retrieved from PubMed, Embase, China National Knowledge Infrastructure, China Science and Technology Journal Database and Wanfang literature databases from 2010 to 2020. The effect measure was presented as HCV prevalence with a 95% confidence interval (CI). Q test was used to assess the heterogeneity, and the I2 statistics was determined to decide whether a random effects model or a fixed effects model should be used as the pooling method. Subgroup analyses were also conducted. RESULTS A total of 62 eligible studies, including 9,007,220 HCV blood donors, were analysed. Of the total blood donors, 35,017 were infected with HCV. The pooled HCV prevalence was 0.415% (95% CI: 0.371-0.458). The subgroup analysis revealed that the prevalence of positivity to anti-HCV antibodies was significantly different in each year (P < 0.05). However, no significant difference was observed in HCV prevalence in terms of sex. Moreover, the prevalence of positivity to anti-HCV was remarkably higher in first-time blood donors than in repeat blood donors (P < 0.05), and the rate of HCV infection among university students was significantly lower than that among soldiers (P < 0.05). CONCLUSIONS The rate of HCV infection showed a downward trend from 2010 to 2014, increased in 2015-2016, and finally decreased in 2017-2018. Thus, the prevalence of HCV infection has decreased in Chinese blood donors after comprehensive prevention and treatment.
Collapse
|
12
|
Yang M, Parikh ND, Liu H, Wu E, Rao H, Feng B, Lin A, Wei L, Lok AS. Incidence and risk factors of hepatocellular carcinoma in patients with hepatitis C in China and the United States. Sci Rep 2020; 10:20922. [PMID: 33262356 PMCID: PMC7708980 DOI: 10.1038/s41598-020-77515-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2020] [Accepted: 11/09/2020] [Indexed: 02/06/2023] Open
Abstract
Hepatitis C virus (HCV) infection is the main cause of hepatocellular carcinoma (HCC) in the United States (US) and an increasingly common cause of HCC in China. We aimed to evaluate the incidence and risk factors of HCC in HCV patients in the US and China. 795 HCV RNA + patients without HCC from University of Michigan Health System (UMHS) in the US and 854 from Peking University Health Sciences Center (PUHSC) in China were prospectively followed for a median of 3.2 and 4.0 years, respectively. 45.4% UMHS and 16.2% PUHSC patients had cirrhosis. 57.6% UMHS and 52.0% PUHSC patients achieved SVR. 45 UMHS and 13 PUHSC patients developed HCC. Cumulative incidence of HCC at 5 years was 7.6% in UMHS and 1.8% in PUHSC cohort (P < 0.001). Ten patients not diagnosed with cirrhosis at enrollment but median APRI ≥ 2.0 developed HCC. Multivariate analysis showed age, gender, cirrhosis and APRI were predictors of HCC while study site and SVR were not. In this study of HCV patients, HCC incidence in the PUHSC cohort was lower than in the UMHS cohort, due to lower proportion of PUHSC patients with cirrhosis. APRI can identify risk of HCC among patients not diagnosed to have cirrhosis.
Collapse
Affiliation(s)
- Ming Yang
- Peking University People's Hospital, Peking University Hepatology Institute, Peking University Health Science Center, Beijing, China
| | - Neehar D Parikh
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Huixin Liu
- Department of Clinical Epidemiology and Biostatistics, Peking University People's Hospital, Beijing, China
| | - Elizabeth Wu
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Huiying Rao
- Peking University People's Hospital, Peking University Hepatology Institute, Peking University Health Science Center, Beijing, China
| | - Bo Feng
- Peking University People's Hospital, Peking University Hepatology Institute, Peking University Health Science Center, Beijing, China
| | - Andy Lin
- The Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA
| | - Lai Wei
- Peking University People's Hospital, Peking University Hepatology Institute, Peking University Health Science Center, Beijing, China
| | - Anna S Lok
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA.
| |
Collapse
|
13
|
Zhang J, Chen N, Chen Z, Liu Y, Zheng K, Qiu Y, Zhang N, Zhu J, Yu H, He Q. Low Mannose Binding Lectin, but Not L-Ficolin, Is Associated With Spontaneous Clearance of Hepatitis C Virus After Infection. Front Immunol 2020; 11:587669. [PMID: 33262767 PMCID: PMC7686574 DOI: 10.3389/fimmu.2020.587669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/13/2020] [Indexed: 11/23/2022] Open
Abstract
Some individuals can spontaneously clear the hepatitis C virus (HCV) after infection, whereas others develop a chronic infection. The exact mechanism of this phenomenon is unknown. We aimed to evaluate the association of plasma levels of MBL, L-ficolin, and cytokines with outcome of HCV infections in two groups of patients who cleared HCV spontaneously (CHS), and who developed chronic HCV infections (CHC). Altogether, 86 patients and 183 healthy controls were included. Of 86 patients, 36 had CHS and 50 had CHC. Concentrations of plasma MBL and L-ficolin were measured in patients and controls. Twenty plasma cytokines and adhesion molecules, including GM-CSF, ICAM-1, IFN-γ, IFN-α, IL-1α, IL-1β, IL-10, IL-12p70, IL-13, IL-17A, IL-4, IL-8, IP-10, MCP-1, IL-6, MIP-1α, MIP-1β, sE-Selectin, sP-Selectin, and TNF-α, were determined in all patients and randomly selected 45 controls. The level of MBL was significantly lower in subjects with CHS than in healthy controls (median: 293.10 vs. 482.64 ng/ml, p = 0.008), whereas the level of MBL was significantly higher in patients with CHC than in controls (median: 681.32 vs. 482.64 ng/ml, p = 0.001). No such differences in plasma L-ficolin were observed. Plasma levels of all cytokines and adhesion molecules, except ICAM-1, were significantly higher in patients than in controls. Moreover, patients with CHC had significantly higher levels of IFN-γ, IFN-α, IL-1α, IL-10, IL-13, IL-4, IL-6, and TNF-α than those with CHS. These findings implicate that lower levels of plasma MBL, together with lower levels of above mentioned cytokines may play a part in virus clearance of HCV infection.
Collapse
Affiliation(s)
- Jing Zhang
- The Third Unit, Department of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Ning Chen
- Department of Medical Microbiology, Capital Medical University, Beijing, China
| | - Zhiyun Chen
- Department of Medical Microbiology, Capital Medical University, Beijing, China
| | - Yali Liu
- The Third Unit, Department of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Kai Zheng
- Department of Medical Microbiology, Capital Medical University, Beijing, China
| | - Yundong Qiu
- Department of Traditional Chinese Medicine, Gu’an Hospital of Traditional Chinese Medicine, Gu’an, China
| | - Nan Zhang
- Department of Medical Microbiology, Capital Medical University, Beijing, China
| | - Junping Zhu
- Department of Medical Microbiology, Capital Medical University, Beijing, China
| | - Haibin Yu
- The Third Unit, Department of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Qiushui He
- Department of Medical Microbiology, Capital Medical University, Beijing, China
- Department of Medical Microbiology, University of Turku, Turku, Finland
| |
Collapse
|
14
|
Wong WCW, Yang NS, Li J, Li H, Wan EYF, Fitzpatrick T, Xiong Y, Seto WK, Chan P, Liu R, Tang W, Tucker JD. Crowdsourcing to promote hepatitis C testing and linkage-to-care in China: a randomized controlled trial protocol. BMC Public Health 2020; 20:1048. [PMID: 32615951 PMCID: PMC7330974 DOI: 10.1186/s12889-020-09152-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 06/18/2020] [Indexed: 12/12/2022] Open
Abstract
Background Hepatitis C virus (HCV) is a growing public health problem with a large disease burden worldwide. In China many people living with HCV are unaware of their hepatitis status and not connected to care and treatment. Crowdsourcing is a technique that invites the public to create health promotion materials and has been found to increase HIV testing uptake, including in China. This trial aims to evaluate crowdsourcing as a strategy to improve HCV awareness, testing and linkage-to-care in China. Methods A randomized controlled, two-armed trial (RCT) is being conducted in Shenzhen with 1006 participants recruited from primary care sectors of The University of Hong Kong-Shenzhen Hospital. Eligible participants are ≥30 years old; a resident in Shenzhen for at least one month after recruitment; no screening for HCV within the past 12 months and not known to have chronic HCV; and, having a WeChat social media account. Allocation is 1:1. Both groups will be administered a baseline and a follow-up survey (4-week post-enrollment). The intervention group will receive crowdsourcing materials to promote HCV testing once a week for two weeks and feedback will be collected thereafter, while the control group will receive no promotional materials. Feedback collected will be judged by a panel and selected to be implemented to improve the intervention continuously. Those identified positive for HCV antibodies will be referred to gastroenterologists for confirmation and treatment. The primary outcome will be confirmed HCV testing uptake, and secondary outcomes include HCV confirmatory testing and initiation of HCV treatment with follow-ups with specialist providers. Data will be collected on Survey Star@ via mobile devices. Discussion This will be the first study to evaluate the impact of crowdsourcing to improve viral hepatitis testing and linkage-to-care in the health facilities. This RCT will contribute to the existing literature on interventions to improve viral hepatitis testing in primary care setting, and inform future strategies to improve HCV care training for primary care providers in China. Trial registration Chinese Clinical Trial Registry. ChiCTR1900025771. Registered September 7th, 2019, http://www.chictr.org.cn/showprojen.aspx?proj=42788
Collapse
Affiliation(s)
- William C W Wong
- Department of General Practice, HKU-Shenzhen Hospital, Shenzhen, China.,Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China
| | - Nancy S Yang
- University of Minnesota Medical School, Minneapolis, MN, USA
| | - Jingjing Li
- University of North Carolina Project-China, 1 Global Health Center Office, 2nd Floor of Lao Gan Building, No. 7 Lujing Road, Yuexiu District, Guangzhou City, Guangdong Province, Guangzhou, China. .,Social Entrepreneurship to Spur Health (SESH), 1 Global Health Center Office, 2nd Floor of Lao Gan Building, No. 7 Lujing Road, Yuexiu District, Guangzhou City, Guangdong Province, Guangzhou, China.
| | - Hang Li
- Department of General Practice, HKU-Shenzhen Hospital, Shenzhen, China
| | - Eric Y F Wan
- Department of Family Medicine and Primary Care, The University of Hong Kong, Hong Kong, China.,Department of Pharmacology and Pharmacy, The University of Hong Kong, Hong Kong, China
| | | | - Yuan Xiong
- University of North Carolina Project-China, 1 Global Health Center Office, 2nd Floor of Lao Gan Building, No. 7 Lujing Road, Yuexiu District, Guangzhou City, Guangdong Province, Guangzhou, China.,Social Entrepreneurship to Spur Health (SESH), 1 Global Health Center Office, 2nd Floor of Lao Gan Building, No. 7 Lujing Road, Yuexiu District, Guangzhou City, Guangdong Province, Guangzhou, China
| | - Wai-Kay Seto
- Department of Medicine, The University of Hong Kong, Hong Kong, China.,State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong, China.,Department of Medicine, HKU-Shenzhen Hospital, Shenzhen, China
| | - Polin Chan
- World Health Organization Western Pacific Regional Office, Manila, Philippines
| | - Ruihong Liu
- Department of General Practice, HKU-Shenzhen Hospital, Shenzhen, China
| | - Weiming Tang
- University of North Carolina Project-China, 1 Global Health Center Office, 2nd Floor of Lao Gan Building, No. 7 Lujing Road, Yuexiu District, Guangzhou City, Guangdong Province, Guangzhou, China.,Dermatology Hospital of Southern Medical University, Guangzhou, China
| | - Joseph D Tucker
- University of North Carolina Project-China, 1 Global Health Center Office, 2nd Floor of Lao Gan Building, No. 7 Lujing Road, Yuexiu District, Guangzhou City, Guangdong Province, Guangzhou, China.,Social Entrepreneurship to Spur Health (SESH), 1 Global Health Center Office, 2nd Floor of Lao Gan Building, No. 7 Lujing Road, Yuexiu District, Guangzhou City, Guangdong Province, Guangzhou, China.,Institute of Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, NC, USA
| |
Collapse
|
15
|
Li J, Jin B, Wang T, Li W, Wang Z, Zhang H, Song Y, Li N. Serum microRNA expression profiling identifies serum biomarkers for HCV-related hepatocellular carcinoma. Cancer Biomark 2020; 26:501-512. [PMID: 31658041 DOI: 10.3233/cbm-181970] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND The identification of high-sensitivity biomarkers for detection of hepatocellular carcinoma (HCC) from high-risk individuals is essential. OBJECTIVE The present study was undertaken to identify and validate serum microRNAs (miRNAs) as potential biomarkers for hepatitis C virus (HCV)-related HCC. METHODS Illumina sequencing was employed to screen the expression profiles of miRNAs in serum samples of HCV-related HCC patients and liver cirrhosis (LC) patients. RT-qPCR was used to confirm the altered miRNAs between the two groups. Moreover, candidate miRNAs were examined in serum samples of 40 HCC patients, 54 LC patients, 55 patients with chronic HCV hepatitis and 45 healthy controls. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic performance of the miRNAs for the detection of HCC. RESULTS Four miRNAs (miR-122-5p, miR-331-3p, miR-494-3p, miR-224-5p) were significantly increased and two miRNAs (miR-185-5p, miR-23b-3p) were significantly decreased in HCC patients compared to LC patients. ROC curve analysis demonstrated that the six miRNAs could be used as potential biomarkers for HCC detection. Combination of the six miRNAs could efficiently detect HCC in LC patients with the area under the ROC curve (AUC) of 0.995 and combination of the six miRNAs also provided high diagnostic accuracy (AUC = 0.961) for detection of HCC in non-HCC subjects. CONCLUSIONS The six serum miRNAs can be utilized as a surrogate and non-invasive biomarker for HCV-related HCC diagnosis.
Collapse
Affiliation(s)
- Jian Li
- Department of Hepatobiliary Surgery, Hospital Affiliated to Chengde Medical University, Chengde, Hebei, China.,Department of Hepatobiliary Surgery, You'an Hospital Affiliated to Capital Medical University, Beijing, China
| | - Boxun Jin
- Department of Hepatobiliary Surgery, You'an Hospital Affiliated to Capital Medical University, Beijing, China
| | - Tiezheng Wang
- Department of Hepatobiliary Surgery, You'an Hospital Affiliated to Capital Medical University, Beijing, China
| | - Wenlei Li
- Department of Hepatobiliary Surgery, You'an Hospital Affiliated to Capital Medical University, Beijing, China
| | - Zhenshun Wang
- Department of Hepatobiliary Surgery, You'an Hospital Affiliated to Capital Medical University, Beijing, China
| | - Haitao Zhang
- Department of Hepatobiliary Surgery, You'an Hospital Affiliated to Capital Medical University, Beijing, China
| | - Yunjun Song
- Department of Hepatobiliary Surgery, You'an Hospital Affiliated to Capital Medical University, Beijing, China
| | - Ning Li
- Department of Hepatobiliary Surgery, You'an Hospital Affiliated to Capital Medical University, Beijing, China
| |
Collapse
|
16
|
Sarin SK, Kumar M, Eslam M, George J, Al Mahtab M, Akbar SMF, Jia J, Tian Q, Aggarwal R, Muljono DH, Omata M, Ooka Y, Han KH, Lee HW, Jafri W, Butt AS, Chong CH, Lim SG, Pwu RF, Chen DS. Liver diseases in the Asia-Pacific region: a Lancet Gastroenterology & Hepatology Commission. Lancet Gastroenterol Hepatol 2020; 5:167-228. [PMID: 31852635 PMCID: PMC7164809 DOI: 10.1016/s2468-1253(19)30342-5] [Citation(s) in RCA: 304] [Impact Index Per Article: 76.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 07/20/2019] [Accepted: 08/02/2019] [Indexed: 02/06/2023]
Abstract
The Asia-Pacific region is home to more than half of the global population and accounted for 62·6% of global deaths due to liver diseases in 2015. 54·3% of global deaths due to cirrhosis, 72·7% of global deaths due to hepatocellular carcinoma, and more than two-thirds of the global burden of acute viral hepatitis occurred in this region in 2015. Chronic hepatitis B virus (HBV) infection caused more than half of the deaths due to cirrhosis in the region, followed by alcohol consumption (20·8%), non-alcoholic fatty liver disease (NAFLD; 12·1%), and chronic infection with hepatitis C virus (HCV; 15·7%). In 2015, HBV accounted for about half the cases of hepatocellular carcinoma in the region. Preventive strategies for viral hepatitis-related liver disease include increasing access to clean drinking water and sanitation. HBV vaccination programmes for neonates have been implemented by all countries, although birth-dose coverage is extremely suboptimal in some. Availability of screening tests for blood and tissue, donor recall policies, and harm reduction strategies are in their initial stages in most countries. Many governments have put HBV and HCV drugs on their essential medicines lists and the availability of generic versions of these drugs has reduced costs. Efforts to eliminate viral hepatitis as a public health threat, together with the rapid increase in per-capita alcohol consumption in countries and the epidemic of obesity, are expected to change the spectrum of liver diseases in the Asia-Pacific region in the near future. The increasing burden of alcohol-related liver diseases can be contained through government policies to limit consumption and promote less harmful patterns of alcohol use, which are in place in some countries but need to be enforced more strictly. Steps are needed to control obesity and NAFLD, including policies to promote healthy lifestyles and regulate the food industry. Inadequate infrastructure and insufficient health-care personnel trained in liver diseases are issues that also need to be addressed in the Asia-Pacific region. The policy response of most governments to liver diseases has thus far been inadequate and poorly funded. There must be a renewed focus on prevention, early detection, timely referral, and research into the best means to introduce and improve health interventions to reduce the burden of liver diseases in the Asia-Pacific region.
Collapse
Affiliation(s)
- Shiv K Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi, India.
| | - Manoj Kumar
- Department of Hepatology, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi, India
| | - Mohammed Eslam
- Storr Liver Centre, The Westmead Institute for Medical Research, University of Sydney and Westmead Hospital, Westmead, Australia
| | - Jacob George
- Storr Liver Centre, The Westmead Institute for Medical Research, University of Sydney and Westmead Hospital, Westmead, Australia
| | - Mamun Al Mahtab
- Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Sheikh M Fazle Akbar
- Department of Pathology, Ehime University Proteo-Science Center, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - Jidong Jia
- Liver Research Center, Beijing Friendship Hospital, Capital Medial University, Beijing, China
| | - Qiuju Tian
- Liver Research Center, Beijing Friendship Hospital, Capital Medial University, Beijing, China
| | - Rakesh Aggarwal
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | | | - Masao Omata
- Department of Gastroenterology, Yamanashi Central Hospital, Yamanashi, Japan; University of Tokyo, Tokyo, Japan
| | - Yoshihiko Ooka
- Department of Gastroenterology, Chiba University Hospital, Chiba, Japan
| | - Kwang-Hyub Han
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Hye Won Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Wasim Jafri
- Department of Medicine, Section of Gastroenterology, The Aga Khan University, Karachi, Pakistan
| | - Amna S Butt
- Department of Medicine, Section of Gastroenterology, The Aga Khan University, Karachi, Pakistan
| | - Chern H Chong
- Division of Gastroenterology & Hepatology, National University Health System, Singapore; Division of General Medicine, Woodlands Health Campus, Singapore
| | - Seng G Lim
- Division of Gastroenterology & Hepatology, National University Health System, Singapore; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Raoh-Fang Pwu
- National Hepatitis C Program Office, Ministry of Health and Welfare, Taipei, Taiwan
| | - Ding-Shinn Chen
- Department of Internal Medicine, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan; Genomics Research Center, Academia Sinica, Taipei, Taiwan
| |
Collapse
|
17
|
Health-Related Quality of Life among Patients with Hepatitis C Virus Infection: A Cross-Sectional Study in Jianping County of Liaoning Province, China. Gastroenterol Res Pract 2020; 2020:6716103. [PMID: 32411200 PMCID: PMC7199638 DOI: 10.1155/2020/6716103] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 12/26/2019] [Indexed: 02/07/2023] Open
Abstract
Background Patients with chronic liver disease (CLD) have extrahepatic manifestations and impaired health-related quality of life (HRQOL), and hepatitis C virus (HCV) infection is a leading cause of CLD, cirrhosis, and hepatocellular carcinoma (HCC). This study is aimed at assessing HRQOL in patients with HCV infection in the rural areas and identifying factors associated with impairment of HRQOL. Methods A cross-sectional study was conducted in a county of Liaoning Province in northeast China. HRQOL of patients with HCV infection was assessed using the chronic liver disease questionnaire (CLDQ) and EuroQol-5 dimensions (EQ-5D). Data were transformed to score comparisons of six major CLDQ domains, EQ index, and visual analog scale (VAS). Results A total of 397 (93.4%) subjects, including 67 healthy subjects (HSs), 314 patients with chronic hepatitis C (CHC), and 16 patients with liver cirrhosis (LC) completed the study. The overall quartile CLDQ scores for HSs, patients with CHC, and patients with LC were 6.4 (6.0, 6.7), 5.8 (4.6, 6.4), and 4.1 (3.0, 6.0), respectively. The quartile scores of EQ index for the three groups were 1.0 (1.0, 1.0), 1.0 (0.8, 1.0), and 0.9 (0.6, 1.0), respectively. The median scores of EQ VAS for the three groups were 85.0, 60.0, and 60.0, respectively. Female sex, patients with family history of hepatitis, other comorbid chronic diseases, drinking, and disease duration ≥ 10 years were associated with significant improvement in overall CLDQ scores, and family history of hepatitis and other comorbid chronic diseases were considered predictive factors for EQ index and VAS, respectively. Conclusions Compared with HSs, HCV infection had a greater negative impact on HRQOL in patients with CHC and LC. The significant factors associated with HRQOL include female sex, patients with a family history of hepatitis, other comorbid chronic diseases, drinking, and disease duration ≥ 10 years. Patients with HCV infection in the rural areas should be paid careful attention regarding their HRQOL with proper health education and disease management.
Collapse
|
18
|
Zhang M, Wu R, Xu H, Uhanova J, Gish R, Wen X, Jin Q, Gerald MY, Nguyen MH, Gao Y, Niu J. Changing incidence of reported viral hepatitis in China from 2004 to 2016: an observational study. BMJ Open 2019; 9:e028248. [PMID: 31427323 PMCID: PMC6701656 DOI: 10.1136/bmjopen-2018-028248] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE China's national hepatitis burden is high. This study aims to provide a detailed national-level description of the reported incidence of viral hepatitis in China during 2004-2016. DESIGN Observational study. SETTING Data were obtained from China's National Notifiable Disease Reporting System, and changing trends were estimated by joinpoint regression analysis. PARTICIPANTS In this system, 16 927 233 reported viral hepatitis cases occurring during 2004-2016 were identified. PRIMARY OUTCOME MEASURE Incidence rates per 100 000 person-years and changing trends were calculated. RESULTS There were 16 927 233 new cases of viral hepatitis reported in China from 2004 to 2016. Hepatitis B (HBV) (n=13 543 137, 80.00%) and hepatitis C (HCV) (n=1 844 882, 10.90%) accounted for >90% of the cases. The overall annual percent change (APC) in reported cases of viral hepatitis and HBV were 0.3%(95% CI -2.0 to 0.8, p=0.6) and -0.2% (95% CI -1.6 to 1.2, p=0.8), respectively, showing a stable trend. HBV rates were highest in the 20-29 year old age group and lowest in younger individuals, likely resulting from the universal HBV vaccination. The reported incidence of HCV and hepatitis E (HEV) showed increasing trends; the APCs were 14.5% (95% CI 13.1 to 15.9, p<0.05) and 4.7% (95% CI 2.8 to 6.7, p<0.05), respectively. The hepatitis A (HAV) reporting incidence decreased, and the APC was -13.1% (95% CI -15.1 to -11.0, p<0.05). There were marked differences in the reporting of hepatitis among provinces. CONCLUSIONS HBV continues to constitute the majority of viral hepatitis cases in China. Over the entire study period, the HBV reporting incidence was stable, the HCV and HEV incidence increased and the HAV incidence decreased. There were significant interprovincial disparities in the burden of viral hepatitis, with higher rates in economically less-developed areas. Vaccination is important for viral hepatitis prevention and control.
Collapse
Affiliation(s)
- Mingyuan Zhang
- Hepatology Department, First Hospital of Jilin University, Changchun, Jilin, China
| | - Ruihong Wu
- Hepatology Department, First Hospital of Jilin University, Changchun, Jilin, China
| | - Hongqin Xu
- Hepatology Department, First Hospital of Jilin University, Changchun, Jilin, China
| | - Julia Uhanova
- Department of Internal Medicine, University of Manitoba College of Medicine, Winnipeg, Manitoba, Canada
| | - Robert Gish
- Department of Medicine, Stanford Hospital and Clinics, Stanford, California, USA
| | - Xiaoyu Wen
- Hepatology Department, First Hospital of Jilin University, Changchun, Jilin, China
| | - Qinglong Jin
- Hepatology Department, First Hospital of Jilin University, Changchun, Jilin, China
| | - Minuk Y Gerald
- Department of Internal Medicine, University of Manitoba College of Medicine, Winnipeg, Manitoba, Canada
| | - M H Nguyen
- Department of Medicine, Stanford Hospital and Clinics, Stanford, California, USA
| | - Yanhang Gao
- Hepatology Department, First Hospital of Jilin University, Changchun, Jilin, China
| | - J Niu
- Hepatology Department, First Hospital of Jilin University, Changchun, Jilin, China
- Key Laboratory of Organ Regeneration and Transplantation of Ministry of Education, First Hospital of Jilin University, Changchun, Jilin, China
| |
Collapse
|
19
|
Li J, Qiyu S, Wang T, Jin B, Li N. Improving the Detection of Hepatocellular Carcinoma Using Serum AFP Expression in Combination with GPC3 and Micro-RNA MiR-122 Expression. Open Life Sci 2019; 14:53-61. [PMID: 33817137 PMCID: PMC7874791 DOI: 10.1515/biol-2019-0007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 01/14/2019] [Indexed: 12/11/2022] Open
Abstract
Early diagnosis of hepatocellular carcinoma (HCC) greatly improves the survival and prognosisfor patients. In this study weevaluate the diagnostic promise of combining serum alpha-fetoprotein (AFP) expression with two potential biomarkers, serum glypican-3 (GPC3) and expression of the micro-RNA miR-122 for hepatitis C virus (HCV) related early-stage HCC. For this study serum samples from 47 patients with early-stage HCC, 54 chronic HCV (CH) carriers, 35 patients with liver cirrhosis (LC) and 54 health controls (HC) were collected. In addition to routine laboratory investigations, serum AFP, GPC3 and miR-122 were measured in all patients and healthy controls. Receiver operating characteristic (ROC) curves were used to present sensitivity and specificity for the biomarkers. The three markers were all significantly elevated in the serum samples from HCC patients. ROC curves showed the three markers had similar diagnostic capacities for distinguishing early-stage HCC from HCV-positive controls (LC + CH). In order to distinguish early-stage HCC from high-risk LC patients, the expression of miR-122 was superior to GPC3. Combination of the three markers as a panel showed a better diagnostic performance than any of the single markers (P <0.05). Overall, this study revealed that serum expression of GPC3 and miR-122 may be useful biomarkers to combine with serum AFP expression for the diagnosis of HCV related early-stage HCC.
Collapse
Affiliation(s)
- Jian Li
- Department of Hepatobiliary Surgery, Hospital Affiliated to Chengde Medical University, 36 Nanyingzi Road, Chengde, 067000, China
| | - Sun Qiyu
- Department of Hepatobiliary Surgery, Hospital Affiliated to Chengde Medical University, 36 Nanyingzi Road, Chengde, 067000, China
| | - Tiezheng Wang
- Department of Hepatobiliary Surgery, YouAn Hospital Affiliated to Capital Medical University, 8 Xitoutiao Road, Fengtai District, Beijing, 100069, China
| | - Boxun Jin
- Department of Hepatobiliary Surgery, YouAn Hospital Affiliated to Capital Medical University, 8 Xitoutiao Road, Fengtai District, Beijing, 100069, China
| | - Ning Li
- Department of Hepatobiliary Surgery, YouAn Hospital Affiliated to Capital Medical University, 8 Xitoutiao Road, Fengtai District, Beijing, 100069, China
| |
Collapse
|
20
|
Gao Y, Yang J, Sun F, Zhan S, Fang Z, Liu X, Zhuang H. Prevalence of Anti-HCV Antibody Among the General Population in Mainland China Between 1991 and 2015: A Systematic Review and Meta-analysis. Open Forum Infect Dis 2019; 6:ofz040. [PMID: 30863789 PMCID: PMC6408870 DOI: 10.1093/ofid/ofz040] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 01/24/2019] [Indexed: 12/13/2022] Open
Abstract
Our study aims to estimate the burden of hepatitis C virus (HCV) infection among the general population in Mainland China. We searched 4 databases for studies of the prevalence of anti-HCV antibody among the general population. Studies that met the selection criteria were included in the meta-analysis. Ninety-four studies with 10729 929 individuals were finally included. Overall, the prevalence of anti-HCV antibody among the general population in Mainland China is 0.91% (95% confidence interval, 0.81%–1.03%). The prevalence rates of anti-HCV antibody were geographically different, with a range of 0.32%–6.51%, and the East and South of China had a relatively lower prevalence. The prevalence of anti-HCV antibody increased successively from 0.16% to 3.95% with advancing age. It was noteworthy that the prevalence of anti-HCV antibody decreased continuously from 2.09% to 0.45% during 1991–2010, whereas it increased to 0.58% during 2011–2015.
Collapse
Affiliation(s)
- Yuhua Gao
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Beijing, China.,Department of Clinical Laboratory, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jun Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing, China
| | - Feng Sun
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing, China
| | - Siyan Zhan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, Beijing, China
| | - Zhongliao Fang
- Guangxi Key Laboratory of the Prevention and Control of Viral Hepatitis, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning, Guangxi, China
| | - Xueen Liu
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Beijing, China
| | - Hui Zhuang
- Department of Microbiology and Infectious Disease Center, School of Basic Medical Sciences, Beijing, China
| |
Collapse
|
21
|
Guo H, Cai C, Wang B, Zhuo F, Jiang R, Wang N, Li B, Zhang W, Zhu Y, Fan Y, Chen W, Chen W, Yang X, Shi Z. Novel hepacivirus in Asian house shrew, China. SCIENCE CHINA-LIFE SCIENCES 2019; 62:701-704. [PMID: 30701456 PMCID: PMC7088713 DOI: 10.1007/s11427-018-9435-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Accepted: 10/29/2018] [Indexed: 12/02/2022]
Affiliation(s)
- Hua Guo
- CAS Key Laboratory of Special Pathogens and Biosafety, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
- University of Chinese Academy of Sciences, Beijing, 101408, China
| | - Chunlin Cai
- Luohu Center for Disease Control and Prevention, Shenzhen, 518020, China
| | - Bo Wang
- CAS Key Laboratory of Special Pathogens and Biosafety, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
- Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany
| | - Fei Zhuo
- Luohu Center for Disease Control and Prevention, Shenzhen, 518020, China
| | - Rendi Jiang
- CAS Key Laboratory of Special Pathogens and Biosafety, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
- University of Chinese Academy of Sciences, Beijing, 101408, China
| | - Ning Wang
- CAS Key Laboratory of Special Pathogens and Biosafety, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
- University of Chinese Academy of Sciences, Beijing, 101408, China
| | - Bei Li
- CAS Key Laboratory of Special Pathogens and Biosafety, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
| | - Wei Zhang
- CAS Key Laboratory of Special Pathogens and Biosafety, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
| | - Yan Zhu
- CAS Key Laboratory of Special Pathogens and Biosafety, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
| | - Yi Fan
- CAS Key Laboratory of Special Pathogens and Biosafety, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
- University of Chinese Academy of Sciences, Beijing, 101408, China
| | - Wushen Chen
- Luohu Center for Disease Control and Prevention, Shenzhen, 518020, China
| | - Weihong Chen
- Luohu Center for Disease Control and Prevention, Shenzhen, 518020, China
| | - Xinglou Yang
- CAS Key Laboratory of Special Pathogens and Biosafety, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China.
| | - Zhengli Shi
- CAS Key Laboratory of Special Pathogens and Biosafety, Wuhan Institute of Virology, Chinese Academy of Sciences, Wuhan, 430071, China
| |
Collapse
|
22
|
Abstract
This Review presents current epidemiological trends of the most common liver diseases in Asia-Pacific countries. Hepatitis B virus (HBV) remains the primary cause of cirrhosis; despite declining prevalence in most Asian nations, this virus still poses a severe threat in some territories and regions. Mortality resulting from HBV infection is declining as a result of preventive measures and antiviral treatments. The epidemiological transition of hepatitis C virus (HCV) infection has varied in the region in the past few decades, but the medical burden of infection and the prevalence of its related cancers are increasing. The lack of licensed HCV vaccines highlights the need for novel treatment strategies. The prevalence of nonalcoholic fatty liver disease (NAFLD) has risen in the past decade, mostly owing to increasingly urbanized lifestyles and dietary changes. Alternative herbal medicine and dietary supplements are major causes of drug-induced liver injury (DILI) in some countries. Complications arising from these chronic liver diseases, including cirrhosis and liver cancer, are therefore emerging threats in the Asia-Pacific region. Key strategies to control these liver diseases include monitoring of at-risk populations, implementation of national guidelines and increasing public and physician awareness, in concert with improving access to health care.
Collapse
|
23
|
Liu CR, Li X, Chan PL, Zhuang H, Jia JD, Wang X, Lo YR, Walsh N. Prevalence of hepatitis C virus infection among key populations in China: A systematic review. Int J Infect Dis 2018; 80:16-27. [PMID: 30529371 DOI: 10.1016/j.ijid.2018.11.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 11/04/2018] [Accepted: 11/06/2018] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND AND AIM Chronic hepatitis C is a major global health challenge. China has the world's largest burden of hepatitis C and related liver disease, with several groups having an increased risk of acquiring hepatitis C virus (HCV) infection. We undertook a systematic review in Chinese and English literature to determine the seroprevalence of anti-HCV among men who have sex with men (MSM), sex workers, people who use drugs (PWUD) and migrant workers in China. METHODS We searched three Chinese databases (CNKI, Wanfang and Chongqing VIP Information) and four English databases (Pubmed, EMBASE, Global Health and CINAHL) for studies published between 2010 and 2015. Included were 89 studies for MSM, 112 for sex workers, 11 for migrant workers, 94 for people who inject drugs (PWID) and 67 for non-injectors. Random-effect models pooled estimates of anti-HCV seroprevalence in each population and a meta-regression model examined the relationship between anti-HCV seroprevalence and injecting drug use. RESULTS The overall pooled seroprevalence of anti-HCV among MSM was 0.67% (CI 95 0.51-0.86); for sex workers 0.65% (CI 95 0.53-0.77); for migrant workers 0.48 (CI 95 0.20-0.85); for IDUs 72.41% (CI 95 68.71-75.97); among non-injectors 25.07% (CI 95 21.51%-28.80%). Our meta-regression model predicted that the seroprevalence of anti-HCV among PWID increased by 8.6% for each 10% increase seroprevalence of reporting ever having injected drugs. CONCLUSIONS Overall, seroprevalence of HCV infection is high among PWUD, especially those who inject. Lower HCV seroprevalence (<1%) was found among MSM, sex workers and migrant workers. Our estimates for IDU seroprevalence are higher than that from the national surveillance system, though estimates for other at-risk populations are similar.
Collapse
Affiliation(s)
- Che-Rung Liu
- Division of Communicable Diseases, World Health Organization Regional Office for the Western Pacific, Philippines
| | - Xi Li
- Division of Communicable Diseases, World Health Organization Regional Office for the Western Pacific, Philippines
| | - Po-Lin Chan
- Division of Communicable Diseases, World Health Organization Regional Office for the Western Pacific, Philippines
| | - Hui Zhuang
- Department of Microbiology, Peking University Health Science Center, Beijing, China
| | - Ji-Dong Jia
- Beijing Friendship Hospital, Capital Medial University, Beijing, China
| | - Xiaochun Wang
- Department of Hepatitis C and STD Prevention and Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ying-Ru Lo
- Division of Communicable Diseases, World Health Organization Regional Office for the Western Pacific, Philippines
| | - Nick Walsh
- Division of Communicable Diseases, World Health Organization Regional Office for the Western Pacific, Philippines.
| |
Collapse
|
24
|
Chen W, Ward T, Tan MP, Yan J, Wang PF, Wygant GD, Gordon J. Daclatasvir combined with asunaprevir is a cost-effective and cost-saving treatment for hepatitis C infection in China. J Comp Eff Res 2018; 7:785-795. [PMID: 29860879 DOI: 10.2217/cer-2018-0005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To evaluate the cost-effectiveness of the novel all-oral direct-acting antiviral regimen daclatasvir + asunaprevir (DUAL), versus interferon-based regimens for the treatment of chronic hepatitis C virus genotype 1b infection. Methods: Inputs for a lifetime Markov model were sourced from clinical trials and published literature. Outputs include disease management costs, life expectancy, quality-adjusted life-years and cost-effectiveness. Sensitivity analyses assessed the drivers of cost-effectiveness and sustained virologic response thresholds at which DUAL is cost-saving. Results: DUAL was associated with discounted incremental quality-adjusted life-years of 1.29-3.85 and incremental life-years of 0.85-2.59 per patient, with discounted lifetime cost savings of USD$1415-8525. Associated sustained virologic response rates could fall to 45.1-84.8%, while remaining dominant. Conclusion: Treatment with DUAL provides significant clinical benefit, while accruing lower lifetime costs.
Collapse
Affiliation(s)
- Wen Chen
- Department of Health Economics, Fudan University, Shanghai, China
| | - Thomas Ward
- Health Economics and Outcomes Research Ltd, Cardiff, UK
| | - Mai Ping Tan
- Health Economics and Outcomes Research Ltd, Cardiff, UK
| | - Jing Yan
- Health Economics & Outcomes Research, Bristol-Myers Squibb Pharmaceuticals Ltd, Shanghai, China
| | - Peter Feng Wang
- World Wide Health Economics & Outcomes Research, Bristol-Myers Squibb Company, Princeton, New Jersey, USA
| | - Gail D Wygant
- World Wide Health Economics & Outcomes Research, Bristol-Myers Squibb Company, Princeton, New Jersey, USA
| | - Jason Gordon
- Health Economics and Outcomes Research Ltd, Cardiff, UK.,School of Medicine, University of Nottingham, Nottingham, United Kingdom
| |
Collapse
|
25
|
Wei L, Xie Q, Hou JL, Jia J, Li W, Xu M, Li J, Wu S, Cheng J, Jiang J, Wang G, Yang Y, Mou Z, Gao ZL, Gong G, Niu JQ, Hu P, Tang H, Lin F, Dou X, Li L, Zhang LL, Nan Y, Massetto B, Yang JC, Knox SJ, Kersey K, German P, Mo H, Jiang D, Brainard DM, Jiang J, Ning Q, Duan Z. Sofosbuvir plus ribavirin with or without peginterferon for the treatment of hepatitis C virus: Results from a phase 3b study in China. J Gastroenterol Hepatol 2018; 33:1168-1176. [PMID: 29380415 DOI: 10.1111/jgh.14102] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 01/10/2018] [Accepted: 01/17/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND AIM Sofosbuvir is a nucleotide analog inhibitor of the hepatitis C virus (HCV) NS5B RNA polymerase with pangenotypic potency. This phase 3b study evaluated the safety and efficacy of sofosbuvir + ribavirin ± peginterferon in Chinese patients infected with HCV genotype 1, 2, 3, or 6. METHODS Patients with genotype 1 or 6 received sofosbuvir + peginterferon/ribavirin for 12 weeks or sofosbuvir + ribavirin for 24 weeks, depending on prior treatment and interferon eligibility. Patients with genotype 2 or 3 received sofosbuvir + ribavirin for 12 or 24 weeks, respectively. The primary endpoint was sustained virologic response at 12 weeks after the end of treatment (SVR12). RESULTS Of 389 patients, 42% had genotype 1, 16% genotype 2, 32% genotype 3, and 9% genotype 6. Half were male, 58% were treatment-naïve, and 15% had cirrhosis. SVR12 rates for patients receiving 12 weeks of sofosbuvir + peginterferon/ribavirin were 94% (95% confidence interval [CI], 87-98%) for HCV genotype 1 and 97% (95% CI, 84-100%) for genotype 6. SVR12 rates for those receiving sofosbuvir + ribavirin for 24 weeks were 95% (95% CI, 87-99%) for genotype 1, 100% (95% CI, 40-100%) for genotype 6, and 95% (95% CI, 90-98%) for genotype 3. For genotype 2 patients receiving sofosbuvir + ribavirin for 12 weeks, the SVR12 rate was 92% (95% CI, 83-97%). Twenty patients (5%) relapsed. Ten (3%) experienced serious adverse events. Three (< 1%) discontinued treatment because of adverse events, of whom one died because of treatment-unrelated adverse events. CONCLUSIONS Sofosbuvir-based regimens were highly effective and safe in Chinese patients with HCV genotype 1, 2, 3, or 6, suggesting sofosbuvir could serve as the backbone for HCV treatment in China irrespective of genotype.
Collapse
Affiliation(s)
- Lai Wei
- Peking University People's Hospital, Beijing, China
| | - Qing Xie
- Shanghai Jiaotong University Ruijin Hospital, Shanghai, China
| | - Jin Lin Hou
- Nanfang Hospital of Southern Medical University, Guangzhou, China
| | - Jidong Jia
- Beijing Friendship Hospital Affiliated with Capital Medical University, Beijing, China
| | - Wu Li
- The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Min Xu
- Guangzhou Eighth People's Hospital, Guangzhou, China
| | - Jun Li
- First Affiliated Hospital, Nanjiang Medical University, Nanjing, China
| | - Shanming Wu
- Clinical Center of Shanghai Public Health, Shanghai, China
| | - Jun Cheng
- Beijing Ditan Hospital Affiliated with Capital Medical University, Beijing, China
| | - Jianning Jiang
- The First Affiliated Hospital of Guangxi Medical University, Guangxi, China
| | | | | | | | - Zhi Liang Gao
- The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Guozhong Gong
- The Second Xiangya Hospital of Central South University, Changsha, China
| | - Jun Qi Niu
- The First Hospital of Jilin University, Changchun, China
| | - Peng Hu
- The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Hong Tang
- West China Hospital, Sichuan University, Chengdu, China
| | - Feng Lin
- Hainan General Hospital, Hainan, China
| | - Xiaoguang Dou
- Shengjing Hospital of China Medical University, Shenyang, China
| | - Lanjuan Li
- The First Affiliated Hospital Zhejiang University Medical College, Hangzhou, China
| | - Lun Li Zhang
- The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yuemin Nan
- The Third Hospital of Hebei Medical University, Hebei, China
| | | | | | | | | | | | - Hongmei Mo
- Gilead Sciences, Inc., Foster City, CA, USA
| | | | | | - Jiaji Jiang
- First Affiliated Hospital of Fujian Medical University, Fujian, China
| | - Qin Ning
- Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhongping Duan
- Beijing You'an Hospital Affiliated with Capital Medical University, Beijing, China
| |
Collapse
|
26
|
Lu Y, Jin X, Duan CAX, Chang F. Cost-effectiveness of daclatasvir plus asunaprevir for chronic hepatitis C genotype 1b treatment-naïve patients in China. PLoS One 2018; 13:e0195117. [PMID: 29634736 PMCID: PMC5892899 DOI: 10.1371/journal.pone.0195117] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2017] [Accepted: 03/17/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Hepatitis C is the second fastest growing infectious disease in China. The standard-of-care for chronic hepatitis C in China is Pegylated interferon plus ribavirin (PR), which is associated with tolerability and efficacy issues. An interferon- and ribavirin-free, all-oral regimen comprising daclatasvir (DCV) and asunaprevir (ASV), which displays higher efficacy and tolerability, has recently been approved in China. OBJECTIVES This study is to estimate the cost-effectiveness of DCV+ASV (24 weeks) for chronic hepatitis C genotype 1b treatment-naïve patients compared with PR regimen (48 weeks) in China. METHODS A cohort-based Markov model was developed from Chinese payer perspective to project the lifetime outcomes of treating 10,000 patients with an average age of 44.5 with two hypothetical regimens, DCV+ASV and PR. Chinese-specific health state costs and efficacy data were used. The annual discount rate was 5%. Base-case analysis and sensitivity analysis were conducted. RESULTS For HCV Genotype 1b treatment-naïve patients, DCV+ASV proved to be dominant over PR, with a cost saving of ¥33,480(5,096 USD) and gains in QALYs and life years of 1.29 and 0.85, respectively. The lifetime risk of compensated cirrhosis, decompensated cirrhosis, hepatocellular carcinoma and liver-related death was greatly reduced with DCV+ASV. Univariate sensitivity analysis demonstrated that key influencers were the discount rate, time horizon, initial disease severity and sustained virological response rate of DCV+ASV, with all scenarios resulting in additional benefit. Probabilistic sensitivity analysis demonstrated that DCV+ASV has a high likelihood (100%) of being cost-effective. CONCLUSION DCV+ASV is not only an effective and well-tolerated regimen to treat chronic HCV genotype 1b infection treatment-naïve patients, but also is more cost-effective than PR regimen. DCV+ASV can benefit both the public health and reimbursement system in China.
Collapse
Affiliation(s)
- Yun Lu
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, Jiangsu, China
| | - Xiuze Jin
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, Jiangsu, China
| | - Cheng-a-xin Duan
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, Jiangsu, China
| | - Feng Chang
- School of International Pharmaceutical Business, China Pharmaceutical University, Nanjing, Jiangsu, China
| |
Collapse
|
27
|
Risk Assessment of Hepatocellular Carcinoma in Patients with Hepatitis C in China and the USA. Dig Dis Sci 2017; 62:3243-3253. [PMID: 28948495 DOI: 10.1007/s10620-017-4776-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 09/19/2017] [Indexed: 12/22/2022]
Abstract
BACKGROUND Hepatitis C (HCV) infection is an increasingly common cause of hepatocellular carcinoma (HCC) in China. AIMS We aimed to determine differences in demographic and behavioral profiles associated with HCC in HCV+ patients in China and the USA. METHODS Consecutive HCV+ patients were recruited from centers in China and the USA. Clinical data and lifestyle profiles were obtained through standardized questionnaires. Multivariable analysis was conducted to determine factors associated with HCC diagnosis within groups. RESULTS We included 41 HCC patients from China and 71 from the USA, and 931 non-HCC patients in China and 859 in China. Chinese patients with HCC were significantly younger, less likely to be male and to be obese than US patients with HCC (all p < 0.001). Chinese patients with HCC had a significantly lower rate of cirrhosis diagnosis (36.6 vs. 78.9%, p < 0.001); however, they also had a higher rate of hepatitis B core antibody positivity (63.4 vs. 36.8%, p = 0.007). In a multivariable analysis of the entire Chinese cohort, age > 55, male sex, the presence of diabetes, and time from maximum weight were associated with HCC, while tea consumption was associated with a decreased HCC risk (OR 0.37, 95% CI 0.16-0.88). In the US cohort, age > 55, male sex, and cirrhosis were associated with HCC on multivariable analysis. CONCLUSIONS With the aging Chinese population and increasing rates of diabetes, there will likely be continued increase in the incidence of HCV-related HCC in China. The protective effect of tea consumption on HCC development deserves further validation.
Collapse
|
28
|
Zhang X, Chen Y, Li Y, Hu J, Zhang C, Li Z, Stallones L, Xiang H. Needlestick and Sharps Injuries Among Nursing Students in Nanjing, China. Workplace Health Saf 2017; 66:276-284. [DOI: 10.1177/2165079917732799] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Needlestick and sharps injuries (NSIs) are a major cause of occupational injuries for health care workers worldwide. In this study, the authors report the prevalence of and risk factors for NSIs among Chinese nursing students. A cross-sectional survey was distributed to 442 nursing students; 393 completed questionnaires were submitted. A total of 237 (60.3%) nursing students reported NSIs, which were more commonly reported by female students, younger students, students who worked frequent night shifts, students without safety training, and students who did not use personal protective equipment. Among those injured, 59.9% were injured by syringe needles, 21.9% by glass items, and 3.4% by scissors. Of those needles and sharps causing injuries, 36.3% of devices had been used on patients, 41% were unused, and 22.7% were unknown. Opening ampoules or vials was the most common injury agent. A total of 86.9% of NSIs were not reported to hospital infection control. Nursing students are at high risk of NSIs in China. Occupational safety training should be developed and implemented to prevent NSIs among this vulnerable population.
Collapse
Affiliation(s)
| | - Yu Chen
- Zhenjiang Center for Disease Control and Prevention
| | - Yang Li
- Southeast University, Nanjing
| | - Jie Hu
- Southeast University, Nanjing
| | | | - Zhen Li
- Southeast University, Nanjing
| | | | - Henry Xiang
- The Ohio State University College of Medicine, Columbus
| |
Collapse
|
29
|
Pan PP, Wang J, Luo J, Wang SH, Zhou YF, Chen SZ, Du Z. Silibinin affects the pharmacokinetics of methadone in rats. Drug Test Anal 2017. [PMID: 28643437 DOI: 10.1002/dta.2235] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Pei-Pei Pan
- Department of Pharmacy; Taizhou Central Hospital; Taizhou Zhejiang PR China
| | - Jun Wang
- Department of Pharmacy; The Second Affiliated Hospital of Wenzhou Medical University and Yuying Children's Hospital; Wenzhou Zhejiang PR_China
| | - Jun Luo
- Department of Pharmacy; Maternal and Child Health Hospital of Taizhou; Zhejiang PR China
| | - Shuang-Hu Wang
- Department of Pharmacy; People's Hospital of Lishui; Lishui Zhejiang PR China
| | - Yun-Fang Zhou
- Department of Pharmacy; People's Hospital of Lishui; Lishui Zhejiang PR China
| | - Sai-Zhen Chen
- Department of Pharmacy; Taizhou Central Hospital; Taizhou Zhejiang PR China
| | - Zhou Du
- Department of General Surgery; The First Affiliated Hospital of Wenzhou Medical University; Wenzhou Zhejiang PR China
| |
Collapse
|
30
|
Liu Z, Wang S, Qi W, Wang X, Sun D, Wang H, Zhang Y, Li Z, Zhu L, Zhao P, Guo H, Zhou C, Wang J. The relationship between ITPA rs1127354 polymorphisms and efficacy of antiviral treatment in Northeast Chinese CHC patients. Medicine (Baltimore) 2017; 96:e7554. [PMID: 28723780 PMCID: PMC5521920 DOI: 10.1097/md.0000000000007554] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 06/22/2017] [Accepted: 06/26/2017] [Indexed: 01/04/2023] Open
Abstract
This prospective study investigated the relationship between 2 inosine triphosphatase (ITPA) polymorphisms (rs7270101 and rs1127354) and the efficacy of ribavirin-based antiviral therapy in hepatitis C virus (HCV)-infected Chinese patients.A total of 906 patients diagnosed with chronic hepatitis C receiving pegylated interferon (PEG-IFN) plus ribavirin combination therapy between January 2011 and January 2014 from 5 hepatitis centers in Northeast China were enrolled. The patients were divided into genotype 1 and non-genotype 1 groups according to the genotype of infected HCV. ITPA single nucleotide polymorphism (SNP) genotyping was performed for all patients. Ribavirin-induced hemolytic anemia and virological response (VR) were monitored during treatment and follow-up. Multivariate regression analysis was used to analyze the predictors for sustained virological response (SVR).IPTA rs7270101 variants were not detected. IPTA rs1127354 variants were detected and showed no difference between the genotype 1 and non-genotype 1 groups. IPTA rs1127354 genotype CC was related to a higher incidence of ribavirin-induced hemolytic anemia. For patients who received >80% of the planned ribavirin dose, rs1127354 variants and related ITPase were related to better SVR. Multivariate analysis showed that IPTA rs1127354 non-genotype CC, HCV genotype, a baseline HCV RNA level <4 × 10 IU/mL, IL-28B rs12979860 genotype CC, and low liver fibrosis were independent predictors for SVR during the combination therapy.IPTA rs1127354 variants and related ITPase were not only related with ribavirin-induced hemolytic anemia but also directly affected the SVR to PEG-IFN plus ribavirin combination therapy in Chinese HCV-infected patients.
Collapse
Affiliation(s)
- Zhenhua Liu
- Department of Digestive of China-Japan Union Hospital affiliated to Jilin University
| | - Song Wang
- Department of Urology of First Hospital affiliated to Jilin University, Changchun
| | - Wenqian Qi
- Department of Digestive of China-Japan Union Hospital affiliated to Jilin University
| | - Xu Wang
- Department of Digestive of China-Japan Union Hospital affiliated to Jilin University
| | - Derong Sun
- Department of Digestive of the Second Hospital of Daqing
| | - Hongguang Wang
- Department of Digestive of the People's Hospital of Jilin City
| | - Yonggui Zhang
- Department of Digestive of China-Japan Union Hospital affiliated to Jilin University
| | - Zhongxie Li
- Department of Digestive of the People's Hospital of Hunchun City, Jilin
| | - Liying Zhu
- Department of Infectious Diseases of the Fourth Hospital of Harbin Medical University, Heilongjiang, China
| | - Ping Zhao
- Department of Digestive of China-Japan Union Hospital affiliated to Jilin University
| | - Honghua Guo
- Department of Digestive of China-Japan Union Hospital affiliated to Jilin University
| | - Changyu Zhou
- Department of Digestive of China-Japan Union Hospital affiliated to Jilin University
| | - Jiangbin Wang
- Department of Digestive of China-Japan Union Hospital affiliated to Jilin University
| |
Collapse
|
31
|
Song P, Yu J, Wang M, Chang X, Wang J, An L. Prevalence and Correlates of Suspected Nonalcoholic Fatty Liver Disease in Chinese Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14050465. [PMID: 28448433 PMCID: PMC5451916 DOI: 10.3390/ijerph14050465] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 04/07/2017] [Accepted: 04/19/2017] [Indexed: 02/06/2023]
Abstract
Nonalcoholic fatty liver disease (NAFLD) has become a serious public health problem worldwide; however, the availability of information on the prevalence of NAFLD in the general pediatric population is still limited. The primary aim of this study was to reveal the prevalence and correlates of suspected NAFLD in Chinese children at the national level. Data from the China Health and Nutrition Surveys (CHNS) was used. Weight, height, waist circumference (WC), blood pressure (BP) were measured for children aged 7–18 years. Blood samples were collected and analyzed. Children were classified as having suspected NAFLD if common causes of liver disease were excluded, and serum alanine aminotransferase (ALT) values were above the established thresholds (>22.1 IU/L for girls and >25.8 IU/L for boys). A percentage of 9.03% (75 out of 831) of Chinese children was found to have suspected NAFLD. Overweight and obesity according to BMI percentiles, abdominal obesity, hyperuricemia (uric acid (UA) > 327 μmol/L), and elevated total cholesterol (TC) were all detected as the correlates of childhood suspected NAFLD when adjusting for other factors. Our study revealed the prevalence of suspected NAFLD in general Chinese children at the national level for the first time. Our findings indicate that suspected NAFLD in children is associated with increasing childhood morbidities, further studies are needed to better understand the prevalence of childhood NAFLD and its correlates, and large-scale programs should be launched to screen NAFLD in the pediatric population in China.
Collapse
Affiliation(s)
- Peige Song
- Department of Child, Adolescent and Women's Health, School of Public Health, Peking University, Beijing 100191, China.
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh EH8 9AG, UK.
| | - Jinyue Yu
- Division of Medicine, School of Life and Medical Science, University College London, London WC1E 6BT, UK.
| | - Manli Wang
- Department of Child, Adolescent and Women's Health, School of Public Health, Peking University, Beijing 100191, China.
| | - Xinlei Chang
- Department of Child, Adolescent and Women's Health, School of Public Health, Peking University, Beijing 100191, China.
| | - Jiawen Wang
- Institute of Medical Humanities, Peking University, Beijing 100191, China.
| | - Lin An
- Department of Child, Adolescent and Women's Health, School of Public Health, Peking University, Beijing 100191, China.
| |
Collapse
|
32
|
Berto A, Day J, Van Vinh Chau N, Thwaites GE, My NN, Baker S, Darton TC. Current challenges and possible solutions to improve access to care and treatment for hepatitis C infection in Vietnam: a systematic review. BMC Infect Dis 2017; 17:260. [PMID: 28399806 PMCID: PMC5387342 DOI: 10.1186/s12879-017-2360-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2016] [Accepted: 03/29/2017] [Indexed: 12/24/2022] Open
Abstract
Background Hepatitis C infection is a major public health concern in low- and middle-income countries where an estimated 71.1 million individuals are living with chronic infection. The World Health Organization (WHO) has recently released new guidance for hepatitis C virus (HCV) treatment programs, which include improving the access to new direct-acting antiviral agents. In Vietnam, a highly populated middle-income country, the seroprevalence of HCV infection is approximately 4% and multiple genotypes co-circulate in the general population. Here we review what is currently known regarding the epidemiology of HCV in Vietnam and outline options for reducing the significant burden of morbidity and mortality in our setting. Methods We performed a systematic review of the currently available literature to evaluate what has been achieved to date with efforts to control HCV infection in Vietnam. Results This search retrieved few publications specific to Vietnam indicating a significant gap in baseline epidemiological and public health data. Key knowledge gaps identified included an understanding of the prevalence in specific high-risk groups, characterization of circulating HCV genotypes in the population and likely response to treatment, and the extent to which HCV treatment is available, accessed and utilized. Conclusions We conclude that there is an urgent need to perform up to date assessments of HCV disease burden in Vietnam, especially in high-risk groups, in whom incidence is high and cross infection with multiple genotypes is likely to be frequent. Coordinating renewed surveillance measures with forthcoming HCV treatment studies should initiate the traction required to achieve the WHO goal of eliminating HCV as a public health threat by 2030, at least in this region.
Collapse
Affiliation(s)
- Alessandra Berto
- Oxford University Clinical Research Unit, Vietnam Wellcome Trust Major Overseas Programme, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam. .,Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.
| | - Jeremy Day
- Oxford University Clinical Research Unit, Vietnam Wellcome Trust Major Overseas Programme, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam.,Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | | | - Guy E Thwaites
- Oxford University Clinical Research Unit, Vietnam Wellcome Trust Major Overseas Programme, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam.,Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Ngoc Nghiem My
- Oxford University Clinical Research Unit, Vietnam Wellcome Trust Major Overseas Programme, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam
| | - Stephen Baker
- Oxford University Clinical Research Unit, Vietnam Wellcome Trust Major Overseas Programme, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam.,Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK.,The London School of Hygiene and Tropical Medicine, London, UK
| | - Thomas C Darton
- Oxford University Clinical Research Unit, Vietnam Wellcome Trust Major Overseas Programme, 764 Vo Van Kiet, District 5, Ho Chi Minh City, Vietnam.,Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
| |
Collapse
|
33
|
Zhao N, Liu J, Sun D. Detection of HCV genotypes 1b and 2a by a reverse transcription loop-mediated isothermal amplification assay. J Med Virol 2017; 89:1048-1054. [PMID: 27935066 DOI: 10.1002/jmv.24747] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2016] [Revised: 11/29/2016] [Accepted: 12/01/2016] [Indexed: 02/06/2023]
Abstract
Hepatitis C virus (HCV) genotypes 1b and 2a are the major cause of liver disease in northern China; however, conventional detection tools are labor-consuming, technically demanding, and costly. Here, we assessed the specificity, sensitivity, and clinical utility of reverse transcription loop-mediated isothermal amplification (RT-LAMP) assay for detection of HCV genotypes 1b and 2a. Firstly, clinical samples were collected from HCV genotype 1b and 2a infected patients and the RNA were extracted. Secondly, specificity of RT-LAMP assay for detection HCV genotypes 1b and 2a were tested against viral genomes of other hepatitis viruses. Sensitivity of RT-LAMP assay was determined using serial dilutions of standard HCV genotypes 1b and 2a. The amplified products were detected by both electrophoresis and calcein/Mn2+ -dependent visual methods. Finally, we compared the clinical detection rate of RT-LAMP to that of real-time PCR. RT-LAMP assay showed high specificity to detect HCV genotypes 1b and 2b since there was no cross-reactivity with other hepatitis viruses. Sensitivity of RT-LAMP was 100 IU/mL for both genotypes detected by either electrophoresis or calcein/Mn2+ -dependent visual methods. The detection rate of RT-LAMP assay in clinical samples was also comparable to that of real-time PCR without significant difference between the both assays. This study proposes a newly developed RT-LAMP assay for detection of HCV genotypes 1b and 2a. RT-LAMP is highly specific, sensitive, and simple diagnostic tool which would be useful for screening and early diagnosis of HCV especially in resource-limited environments.
Collapse
Affiliation(s)
- Na Zhao
- The Liver Disease Diagnosis and Treatment Center of PLA, Bethune International Peace Hospital, Shijiazhuang, Hebei Province, China.,The Experiment Center of Pathogen Biology, Chengde Medical University, Chengde, Hebei Province, China
| | - Jinxia Liu
- The Experiment Center of Pathogen Biology, Chengde Medical University, Chengde, Hebei Province, China
| | - Dianxing Sun
- The Liver Disease Diagnosis and Treatment Center of PLA, Bethune International Peace Hospital, Shijiazhuang, Hebei Province, China
| |
Collapse
|
34
|
Lin H, Chen X, Zhu S, Mao P, Zhu S, Liu Y, Huang C, Sun J, Zhu J. Prevalence of Occult Hepatitis C Virus Infection among Blood Donors in Jiangsu, China. Intervirology 2017; 59:204-210. [PMID: 28208127 DOI: 10.1159/000455854] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 01/04/2017] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE In 2010, only 1 donor blood sample was found to be anti-hepatitis C virus (HCV) negative and HCV RNA positive, as detected by nucleic acid testing. In occult HCV infection (OCI), HCV RNA is found in peripheral blood mononuclear cells (PBMCs). We investigated the prevalence of OCI among blood donors. METHODS We collected 513 samples from 334 eligible and 179 deferred donors, including 55 anti-HCV-positive, 113 alanine aminotransferase (ALT)-elevated, and 11 hepatitis B virus surface antigen (HBsAg)-positive blood donors. PBMCs were isolated, the 5'-untranslated region of HCV RNA was amplified by reverse transcription nested PCR, and the genotype of the core region was determined. RESULTS No HCV RNA was detected among the eligible samples. Among the deferred donors, 15 (27.2%) had detectable HCV RNA in 55 anti-HCV PBMC specimens. HCV RNA was detected in 1 (9.1%) HBsAg-positive and 9 (8%) ALT-elevated samples. The prevalence of OCI in the blood donors was 2.2% (10/458). HCV genotypes were determined in 10 subjects, indicating that 2 (20.0%) were subtype 2a, 7 (70.0%) were 1b, and 1 (10%) was 6a. CONCLUSIONS This study showed that OCI does exist among Chinese blood donors. However, to determine the epidemiology and outcome of this HCV infection, further follow-up with more participants and patients receiving blood components with OCI is needed.
Collapse
Affiliation(s)
- Hong Lin
- Jiangsu Province Blood Center, Nanjing, China
| | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Wei L, Li J, Yang X, Wang G, Feng B, Hou J, Duan Z, Jia J, Ren H, Niu J, Chen X, Wang FS, Shang J, Bo Q, Li R, Liu Y, Zhuang H. Nationwide survey of specialist knowledge on current standard of care (Peg-IFN/RBV) and barriers of care in chronic hepatitis C patients in China. J Gastroenterol Hepatol 2016; 31:1995-2003. [PMID: 27043040 DOI: 10.1111/jgh.13399] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 03/15/2016] [Accepted: 03/25/2016] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND AIM Chronic hepatitis C virus (HCV) infection is the leading cause of liver diseases including cirrhosis and hepatocellular carcinoma. In China, it is a major national health problem that demands nationwide coordinated emphasis on prevention and treatment. To inform these initiatives, a nationwide survey was conducted from January to April 2015 to evaluate the knowledge, awareness, and perceived obstacles to HCV care. METHODS A sample of 1000 HCV specialists across mainland China were recruited. Respondents were asked a series of 30 open-ended single or multiple response and Likert-scale questions about their HCV treatment knowledge, experience, assessment of HCV care status in China, and perceptions about treatment barriers. RESULTS Sixty percent of the respondents answered incorrectly to more than half of the questions on basic HCV treatment principles. Over half of them incorrectly believed that maintenance therapy should be prescribed for non-responders (72%) and longer treatment duration improved sustained viral response rates (62%), regardless of HCV RNA level changes. Sixty-six percent of them believed that HCV treatment would still be interferon-based therapy in the next 5 years in China. Patient-related barriers, in particular lack of disease awareness, were considered to be the most significant barriers to HCV care. Payer and medical-provider barriers included affordability issues, lack of reimbursement coverage for testing and treatments, and lack of referral to HCV specialists. CONCLUSIONS Focused and intense patient and provider education should be carried out to increase awareness. More effective direct-acting antivirals should be made available and affordable in China.
Collapse
Affiliation(s)
- Lai Wei
- Peking University People's Hospital, Peking University Hepatology Institute
| | - Jie Li
- School of Basic Medical Sciences, Peking University Health Science Center
| | - Xizhong Yang
- Chinese Foundation for Hepatitis Prevention and Control
| | | | - Bo Feng
- Peking University People's Hospital, Peking University Hepatology Institute
| | - Jinlin Hou
- Southern Medical University Nanfang Hospital
| | - Zhongping Duan
- Beijing You'An Hospital Affiliated to the Capital Medical University
| | - Jidong Jia
- Beijing Friendship Hospital Affiliated to the Capital Medical University
| | - Hong Ren
- The Second Affiliated Hospital of Chongqing Medical University
| | - Junqi Niu
- The First Hospital of Jilin University
| | - Xinyue Chen
- Beijing You'An Hospital Affiliated to the Capital Medical University
| | | | | | | | | | | | - Hui Zhuang
- School of Basic Medical Sciences, Peking University Health Science Center
| |
Collapse
|
36
|
Chen JH, Wang YY, Lv WB, Gan Y, Chang W, Tian NN, Huang XH, Liu L, Yu XF, Chen SD. Effects of interactions between environmental factors and KIF1B genetic variants on the risk of hepatocellular carcinoma in a Chinese cohort. World J Gastroenterol 2016; 22:4183-4190. [PMID: 27122668 PMCID: PMC4837435 DOI: 10.3748/wjg.v22.i16.4183] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2015] [Revised: 01/17/2016] [Accepted: 02/22/2016] [Indexed: 02/06/2023] Open
Abstract
AIM: To examine the effect of the potential interaction between KIF1B variants (rs17401966 and rs3748578) and environmental factors on the risk of hepatocellular carcinoma (HCC) in a high-risk region in China.
METHODS: Three hundred and six patients with HCC and 306 hospital-based control participants residing in the Shunde region of Guangdong Province, China were enrolled. Clinical characteristics were collected by reviewing the complete medical histories from the patient archives, and epidemiological data were collected using a questionnaire and clinical examination. Two single nucleotide polymorphisms (SNPs) of KIF1B (rs17401966 and rs3748578) were chosen for the current study. All subjects were genotyped using a TaqMan real-time polymerase chain reaction. Multiplicative and additive logistic regression models were used to evaluate various gene-environment interactions.
RESULTS: Smoking, frequent consumption of raw freshwater fish, hepatitis B virus (HBV) infection, and a family history of HCC were important risk factors for HCC in this population. Chronic infection with HBV was the most important environmental risk factor for HCC [odds ratio (OR) = 12.02; 95% confidence interval (95%CI): 6.02-24.00]. No significant association was found between the KIF1B variants alone and the risk of HCC. Nevertheless, a significant additive effect modification was observed between rs17401966 and alcohol consumption (P for additive interaction = 0.0382). Compared with non-drinkers carrying either the AG or GG genotype of rs17401966, individuals classified as alcohol consumers with the AA genotype of rs17401966 had a significantly increased risk of HCC (OR = 2.36; 95%CI: 1.49-3.74).
CONCLUSION: The gene-environment interaction between the KIF1B rs17401966 variant and alcohol consumption may contribute to the development of HCC in Chinese individuals.
Collapse
|
37
|
Yang L, Jiang C, Hu S, Diao Q, Li J, Si W, Chen M, Zhao RY. Evolving Diversity of Hepatitis C Viruses in Yunnan Honghe, China. Int J Mol Sci 2016; 17:403. [PMID: 26999127 PMCID: PMC4813258 DOI: 10.3390/ijms17030403] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Revised: 02/26/2016] [Accepted: 03/09/2016] [Indexed: 12/23/2022] Open
Abstract
The Chinese Honghe Autonomous Prefecture (Honghe) in Yunnan Province is a unique ethnic area because it is inhabited by more than ten different minority ethnic groups. Geographically, Honghe directly shares a border with Vietnam. The objective of this study was to investigate genetic diversity and distribution of the Hepatitis C virus (HCV) in Honghe. Ninety nine subjects who were infected with HCV or HCV/HIV (Human Immunodeficiency Virus Type 1) were recruited into this study. HCV genotypes and subtypes were determined based on the sequences of the core/envelope 1 (C/E1) and the nonstructural protein 5B (NS5B) genomic regions. The viral diversity and origins of dissemination were examined by phylogenetic analyses. Three HCV genotypes (1, 3 and 6) with six subtypes (1b, 3b, 3a, 6a, 6n and 6v) were identified. The most predominant form was genotype 3 (54.6%) followed by 6 (34.3%), and 1 (9.1%). The HCV subtype 3b appeared to be the most frequent form (38.4%) followed by 6n (20.2%) and 3a (16.2%). Statistical analyses suggested a possible rise of the genotype 6a in Honghe among intravenous drug users with HCV/HIV co-infections. Further phylogenetic analyses suggested that similar HCV-6a viruses might have been circulating in the Honghe area for more than a decade, which likely originated from Vietnam or vice versa. Two HCV samples with single HCV infection (SC34 and SC45) were isolated that could represent new recombinant variants. Although the genetic prevalence of HCV in Honghe is in general agreement with that of Southwest China and Yunnan Province, the diversity of HCV genotypes and subtypes in Honghe is somewhat unique and evolving. Information presented here should provide useful information for future health surveillance and prevention of HCV infection in this area.
Collapse
Affiliation(s)
- Lanhui Yang
- Department of Clinical Laboratory, The First People's Hospital of Honghe, Mengzi 661100, China.
- Division of Molecular Pathology, Department of Pathology, University of Maryland School of Medicine, Baltimore, 21201 MD, USA.
| | - Chenyan Jiang
- Division of Life Science, College of Life Science and Technology, Honghe University, Mengzi 661100, China.
| | - Song Hu
- Department of Infectious Diseases, The First People's Hospital of Honghe, Mengzi 661100, China.
| | - Qiongni Diao
- Division of Life Science, College of Life Science and Technology, Honghe University, Mengzi 661100, China.
| | - Jia Li
- Department of Infectious Diseases, The First People's Hospital of Honghe, Mengzi 661100, China.
| | - Wei Si
- Department of Clinical Laboratory, The First People's Hospital of Honghe, Mengzi 661100, China.
| | - Mei Chen
- Department of Infectious Diseases, The First People's Hospital of Honghe, Mengzi 661100, China.
| | - Richard Y Zhao
- Division of Molecular Pathology, Department of Pathology, University of Maryland School of Medicine, Baltimore, 21201 MD, USA.
| |
Collapse
|
38
|
Zhou M, Li H, Ji Y, Ma Y, Hou F, Yuan P. Hepatitis C virus infection in the general population: A large community-based study in Mianyang, West China. Biosci Trends 2016; 9:97-103. [PMID: 25971694 DOI: 10.5582/bst.2015.01033] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Abstract
Hepatitis C virus (HCV) infection remains a major public health problem. The objective of the current study was to reveal the seroepidemiology of HCV in the general population in Mianyang City. This study collected 438,575 blood samples from participants who had enrolled in the National Science and Technology Development Project and their demographic information, and then evaluated HCV antibody and alanine aminotransferase (ALT) levels. The overall anti-HCV positive rate was 0.80% (3,491/438,575) in the Mianyang general population, and it was 1.19% in rural population and 0.20% in urban. Anti-HCV positive rate increased with age, peaked at 45-54 years (2.01%), and then decreased. Anti-HCV prevalence was higher in males (0.89%) than that in females (0.73%). The prevalence of anti-HCV in participants with a history of blood transfusion, surgery, or with a previous diagnosis of hypertension was higher. The abnormal ALT levels (> 40 IU/L) were observed in 50.11% and 7.74% of anti-HCV positive and negative groups, respectively. In anti-HCV positive groups, the rate of abnormal ALT levels was higher in 55-64 age groups, male, and rural population. Though Mianyang was a low endemic area for HCV infection, the alarming fact was the large number of abnormal ALT levels in patients related to hepatitis C. This revealed delayed diagnosis and treatment of HCV infections. It is a necessity to promote early diagnosis and timely treatment of HCV infections.
Collapse
Affiliation(s)
- Min Zhou
- Department of Epidemiology and Biostatistics, West China School of Public Health, Sichuan University
| | | | | | | | | | | |
Collapse
|
39
|
Chen F, Sun D, Guo Y, Guo W, Ding Z, Li P, Li J, Ge L, Li N, Li D, Wang Z, Wang L. Spatiotemporal Scan and Age-Period-Cohort Analysis of Hepatitis C Virus in Henan, China: 2005-2012. PLoS One 2015; 10:e0129746. [PMID: 26075599 PMCID: PMC4468242 DOI: 10.1371/journal.pone.0129746] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 05/12/2015] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Studies have shown that hepatitis C virus (HCV) infection increased during the past decades in China. However, little evidence is available on when, where, and who were infected with HCV. There are gaps in knowledge on the epidemiological burden and evolution of the HCV epidemic in China. METHODS Data on HCV cases were collected by the disease surveillance system from 2005 to 2012 to explore the epidemic in Henan province. Spatiotemporal scan statistics and age-period-cohort (APC) model were used to examine the effects of age, period, birth cohort, and spatiotemporal clustering. RESULTS 177,171 HCV cases were reported in Henan province between 2005 and 2012. APC modelling showed that the HCV reported rates significantly increased in people aged > 50 years. A moderate increase in HCV reported rates was observed for females aged about 25 years. HCV reported rates increased over the study period. Infection rates were greatest among people born between 1960 and 1980. People born around 1970 had the highest relative risk of HCV infection. Women born between 1960 and 1980 had a five-fold increase in HCV infection rates compared to men, for the same birth cohort. Spatiotemporal mapping showed major clustering of cases in northern Henan, which probably evolved much earlier than other areas in the province. CONCLUSIONS Spatiotemporal mapping and APC methods are useful to help delineate the evolution of the HCV epidemic. Birth cohort should be part of the criteria screening programmes for HCV in order to identify those at highest risk of infection and unaware of their status. As Henan is unique in the transmission route for HCV, these methods should be used in other high burden provinces to help identify subpopulations at risk.
Collapse
Affiliation(s)
- Fangfang Chen
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dingyong Sun
- Institute for AIDS/STD Control and Prevention, Henan Center for Disease Control and Prevention, Zhengzhou, China
| | - Yuming Guo
- Division of Epidemiology and Biostatistics, School of Public Health, University of Queensland, Brisbane, Australia
| | - Wei Guo
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhengwei Ding
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Peilong Li
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jie Li
- Institute for AIDS/STD Control and Prevention, Henan Center for Disease Control and Prevention, Zhengzhou, China
| | - Lin Ge
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ning Li
- Institute for AIDS/STD Control and Prevention, Henan Center for Disease Control and Prevention, Zhengzhou, China
| | - Dongmin Li
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhe Wang
- Institute for AIDS/STD Control and Prevention, Henan Center for Disease Control and Prevention, Zhengzhou, China
| | - Lu Wang
- National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| |
Collapse
|
40
|
A review of the burden of hepatitis C virus infection in China, Japan, South Korea and Taiwan. Hepatol Int 2015; 9:378-90. [DOI: 10.1007/s12072-015-9629-x] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2014] [Accepted: 03/30/2015] [Indexed: 12/19/2022]
|
41
|
Zhang X, Gu Y, Cui M, Stallones L, Xiang H. Needlestick and Sharps Injuries Among Nurses at a Teaching Hospital in China. Workplace Health Saf 2015; 63:219-25. [PMID: 26031696 DOI: 10.1177/2165079915580035] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Needlestick and sharps injuries (NSIs) are a major occupational injury to health care workers worldwide. This study aimed to report the prevalence and risk factors of NSIs among nurses working at a Chinese teaching hospital. From 463 nurses, 402 completed questionnaires were obtained. A total of 261 (64.9%) nurses reported needlestick or sharps injuries. NSIs were more common among females, young nurses, surgical nurses, and junior nurses. Logistic regression analysis suggests that age and work department were independent risk factors for NSIs. By type of devices, syringe needles accounted for the highest proportion of all NSIs (59%), followed by glass items (22%), and trocar core/catheter wires (4%). NSIs remain an important occupational hazard issue or Chinese nurses. Programs must be developed to prevent injuries caused by needlesticks and sharps.
Collapse
|