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Khan SZ, Talha MU, Iftikhar B, Noor A, Laique T, Latif A, Malik J. Induction of Combination Therapy for the Management of Hepatitis C: An Observational Study. Cureus 2020; 12:e10259. [PMID: 33042697 PMCID: PMC7536117 DOI: 10.7759/cureus.10259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background and objective Hepatitis C infection is prevalent in Pakistan. The purpose of this study was to observe the therapeutic effects of conventional interferon in combination with ribavirin among treatment-naive hepatitis C patients. Methods This descriptive cross-sectional study of hepatitis C combination therapy was conducted at our institute after approval. All the patients received treatment with conventional interferon (5-MU three times weekly) and ribavirin (1000mg/day) for four weeks. A follow-up for the rapid virological response (RVR) was done in the fourth week of treatment. Results The mean age of the patients was 37.43. There was a gradual decrease in RVR with increasing age after four weeks of treatment. Conclusion The combination therapy showed good RVR in the fourth week among all hepatitis C patients.
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Chen YY, Chen CL, Chen JW, Hsu NT, Wei ST, Hou SM, Lu SN, Chen PJ. Secular Trends and Geographic Maps of Hepatitis C Virus Infection among 4 Million Blood Donors in Taiwan from 1999 to 2017. Hepatol Commun 2020; 4:1193-1205. [PMID: 32766478 PMCID: PMC7395065 DOI: 10.1002/hep4.1531] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 04/08/2020] [Accepted: 04/23/2020] [Indexed: 12/27/2022] Open
Abstract
The prevalence of hepatitis C virus (HCV) infection in Taiwan was approximately 4% a decade ago, much higher than the worldwide average. This study aimed to assess the HCV burden among 4 million voluntary blood donors after 2 decades of prevention and treatment policies. We retrieved screening results for anti‐HCV and HCV RNA from the Database for Evaluating Voluntary Taiwanese Eligible Donors. First‐time blood donors who donated blood after 1999 and repeat donors who donated blood more than once between 2013 and 2017 were included to estimate HCV prevalence and incidence, respectively. The Cox proportional hazards model was used to estimate hazard ratios. Geographic variation in HCV prevalence and incidence in 364 townships was also analyzed. The prevalence study included 3,656,598 first‐time donors. The overall crude prevalence of anti‐HCV decreased from 15.5 to 4.5 per 1,000 donors between 1999 and 2017. Younger birth cohorts had a significantly lower prevalence of anti‐HCV. The majority of townships (64.3%) in Taiwan showed a significantly decreased prevalence. The incidence study included 1,393,014 repeat donors followed for 3,436,607 person‐years. Ninety‐eight donors seroconverted to HCV RNA positivity, resulting in an HCV incidence of 2.9 per 100,000 person‐years. Donors living in townships where HCV RNA prevalence was greater than 2 per 1,000 had at least 2.5‐fold greater risk of new HCV infection. Conclusion: HCV prevalence in Taiwanese first‐time blood donors decreased by 71% in the last 2 decades. However, townships with higher HCV prevalence also showed higher HCV incidence and require more active intervention.
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Affiliation(s)
- Yun-Yuan Chen
- Head Office Taiwan Blood Services Foundation Taipei Taiwan
| | - Chi-Ling Chen
- Graduate Institute of Clinical Medicine College of Medicine National Taiwan University Taipei Taiwan.,Institute of Epidemiology and Preventive Medicine College of Public Health National Taiwan University Taipei Taiwan
| | - Jen-Wei Chen
- Head Office Taiwan Blood Services Foundation Taipei Taiwan
| | - Nien-Tzu Hsu
- Division of Hepatogastroenterology Department of Internal Medicine Kaohsiung Chang Gung Memorial Hospital Kaohsiung Taiwan.,Biostatistics Center, Kaohsiung Chang Gung Memorial Hospital Kaohsiung Taiwan
| | - Sheng-Tang Wei
- Head Office Taiwan Blood Services Foundation Taipei Taiwan
| | - Sheng-Mou Hou
- Head Office Taiwan Blood Services Foundation Taipei Taiwan.,Shin Kong Wu Ho-Su Memorial Hospital Taipei Taiwan
| | - Sheng-Nan Lu
- Division of Hepatogastroenterology Department of Internal Medicine Kaohsiung Chang Gung Memorial Hospital Kaohsiung Taiwan.,Graduate Institute of Clinical Medical Sciences College of Medicine Chang Gung University Taoyuan Taiwan.,Division of Hepatogastroenterology Department of Internal Medicine Chiayi Chang Gung Memorial Hospital Chiayi Taiwan
| | - Pei-Jer Chen
- Graduate Institute of Clinical Medicine College of Medicine National Taiwan University Taipei Taiwan.,Department of Internal Medicine National Taiwan University Hospital Taipei Taiwan.,Hepatitis Research Center National Taiwan University Hospital Taipei Taiwan
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Amino acid derivatives. Part 6. Synthesis, in vitro antiviral activity and molecular docking study of new N-α-amino acid derivatives conjugated spacer phthalimide backbone. Med Chem Res 2016. [DOI: 10.1007/s00044-016-1693-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Chao CH, Juang SH, Chan HH, Shen DY, Liao YR, Shih HC, Huang CH, Cheng JC, Chen FA, Hung HY, Wu TS. UV-guided isolation of polyynes and polyenes from the roots of Codonopsis pilosula. RSC Adv 2015. [DOI: 10.1039/c5ra02765a] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
UV-guided isolation of polyacetylenes from Codonopsis pilosula has successfully led to the characterization of new polyynes and polyenes. The HCVcc infection assay was used to evaluate the anti-HCV activity of compounds 1–12.
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Translational research of telecare for the treatment of hepatitis C. BIOMED RESEARCH INTERNATIONAL 2014; 2014:195097. [PMID: 25013762 PMCID: PMC4071777 DOI: 10.1155/2014/195097] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Accepted: 05/13/2014] [Indexed: 12/31/2022]
Abstract
Objective. Chronic hepatitis C virus (HCV) infection is a serious health problem in Taiwan. The high dropout rate due to side effects limits the efficacy of treatment. The objective of this study is to investigate the effectiveness of telecare for the treatment of chronic hepatitis. Material and Methods. Two hundred and ninety-eight patients randomly chose either of the two support programs. Group 1 was offered public health nurse consultation at outpatient clinic. Group 2 was offered telecare program with 24 hours of consultation services via a health communication center. All patients were treated with standard therapy and followed up for 72 weeks. Results. Normalization of serum biochemistry was noted in both Group 1 (150 patients) and Group 2 (148 patients). The most common types of side effect in both groups were influenza-like symptoms. Patient compliance was 88% (Group 1) and 94.6% (Group 2). Total dropout cases were 18 (12%) in Group 1 and 8 (5.4%) in Group 2. The program costs were 232,632 USD (Group 1) and 112,500 USD (Group 2). Conclusion. Telecare system with health care communication center model is significant in reducing dropout rate and is more effective with easy access.
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Chao CH, Cheng JC, Shen DY, Wu TS. Anti-hepatitis C virus dinorditerpenes from the roots of Flueggea virosa. JOURNAL OF NATURAL PRODUCTS 2014; 77:22-28. [PMID: 24400834 DOI: 10.1021/np400528h] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Along with four known terpenoids (1-4), eight new dinorditerpenes (5-12) were isolated and identified from the roots of Flueggea virosa. The absolute configurations of 4-6 were determined by the Mosher's method, and that of 5 was confirmed by single-crystal X-ray diffraction analysis. Using the hepatitis C virus cell culture infection system, compounds 1, 3, 11, and 12 exhibited significant anti-HCV activity with EC50 values of 5.6, 5.0, 7.5, and 6.6 μM, respectively. Compounds 11 and 12 were nontoxic toward the tested Huh7.5 cell lines.
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Affiliation(s)
- Chih-Hua Chao
- School of Pharmacy, China Medical University , Taichung 40402, Taiwan
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Chang ML, Lin YJ, Chang CJ, Yeh C, Chen TC, Yeh TS, Lee WC, Yeh CT. Occult and Overt HBV Co-Infections Independently Predict Postoperative Prognosis in HCV-Associated Hepatocellular Carcinoma. PLoS One 2013; 8:e64891. [PMID: 23805180 PMCID: PMC3689779 DOI: 10.1371/journal.pone.0064891] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2013] [Accepted: 04/18/2013] [Indexed: 02/07/2023] Open
Abstract
Objective and Background The roles of chronic hepatitis B virus (HBV) co-infection (CI) in carcinogenesis of hepatitis C virus (HCV)-associated hepatocellular carcinoma (HCC) remained controversial. To gain new insights into this issue, we investigated the postoperative prognostic value of HBVCI in HCV-associated HCC. Methods A study cohort of 115 liver tissues obtained from the noncancerous parts of surgically removed HCV-associated HCCs were subjected to virological analysis in a tertiary care setting. Assayed factors included clinicopathological variables, tissue amounts of viral genomes, genotypic characterization of viruses, as well as the presence of overt (serum HBsAg positive) or occult (serum HBsAg negative but tissue HBV-DNA positive) HBVCI. Cox proportional hazard model was used to estimate postoperative survivals. Results Of the 115 patients, overt and occult HBVCIs were detected in 35 and 16 patients, respectively. Multivariate analysis revealed that tumor size >3 cm (adjusted hazard ratio (AHR), 2.079 [95% confidence interval, 1.149∼3.761]), alpha-fetoprotein >8 ng/mL (AHR, 5.976 [2.007∼17.794]) albumin <4 g/dL(AHR, 2.539 [1.399∼4.606]), ALT >50 U/L (AHR,1.086 [1.006∼1.172]), presence of occult HBVCI (AHR, 2.708 [1.317∼5.566]), and absence of overt HBVCI (AHR, 2.216 [1.15∼4.269]) were independently associated with unfavorable disease-free survival. Patients with occult HBVCI had a shorter disease-free (P = 0.002), a shorter overall survival (P = 0.026), a higher bilirubin level (P = 0.003) and a higher prevalence of precore G1896A mutation (P = 0.006) compared with those with overt HBVCI. Conclusion Occult and overt HBVCI served as independent predictors for postoperative survival in HCV-associated HCC.
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Affiliation(s)
- Ming-Ling Chang
- Liver Research Center and Department of Hepato-Gastroenterology, Chang Gung Memorial Hospital, Linko, Taiwan
- Graduate Institute of Clinical Medical Sciences, Chang Gung University, College of Medicine, Linko, Taiwan
| | - Yu-Jr Lin
- Resource Center for Clinical Research, Chang Gung Memorial Hospital, Linko, Taiwan
| | - Chee-Jen Chang
- Resource Center for Clinical Research, Chang Gung Memorial Hospital, Linko, Taiwan
| | - Charisse Yeh
- Flintridge Sacred Heart Academy, La Canada, Flintridge, California, United States of America
| | - Tse-Ching Chen
- Department of Pathology, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - Ta-Sen Yeh
- Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - Wei-Chen Lee
- Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Taipei, Taiwan
| | - Chau-Ting Yeh
- Liver Research Center and Department of Hepato-Gastroenterology, Chang Gung Memorial Hospital, Linko, Taiwan
- * E-mail:
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Jafar NNA, Al-Masoudi NA, Baqir SJ, Leyssen P, Pannecouque C. Exploration of the in vitro Antiviral Activity of a Series of New Pyrimidine Analogues on the Replication of HIV and HCV. ACTA ACUST UNITED AC 2013; 23:103-12. [DOI: 10.3851/imp2400] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/17/2012] [Indexed: 12/17/2022]
Abstract
Background: In continuation of our search for new anti-HIV and anti-HCV agents, the suggestion, synthesis and structure elucidation of a new series of 2,6-diamino-4-alkylthio- or (2-benzylhydrazinyl)-5- p-chlorophenylazopyrimidines), 2,6-diamino-4-(2-benzylhydrazinyl)-5-(aryl-[1,1′-biphenyl]-4-yl)pyrimidines, 2,6-diamino-4-(aryl)-5-(aryl[1,1′-biphenyl]-4-yl) pyrimidines), 6-(aryl)-1,3-dimethyl-5-nitro pyrimidine-2,4-dione and 6-amino-4-methoxy- N,N-dimethyl-6-arylpyrimidines were described. Methods: The anti-HIV-1 (strain IIIB) and HIV-2 (strain ROD) activity of the newly synthesized pyrimidine analogues was evaluated in vitro in human MT-4 cells using the MT-4/MTT assay. Similarly, the same compounds were evaluated in vitro for their selective antiviral activity against HCV in the Huh 5–2 replicon system (type 1b, Con1 strain). Results: None of the tested compounds exhibited inhibition of HIV-1 and HIV-2 replication in cell culture. Even though many compounds yielded a 50% effective concentration in the HCV replicon system with selectivity indexes up to 6.9, none of the compounds matched the selection criteria of a selective inhibitor of virus replication in this assay (that is, >70% inhibition at concentrations that do not elicit an anti-metabolic effect on the host cells). Conclusions: Structural modification of these compounds might optimize their anti-HCV activity by introducing diverse and potent functional groups at the pyrimidine backbone, like nitrile residue. Because of the nature of the molecules, these new derivatives will also be evaluated for their potential anti-HIV activity.
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Affiliation(s)
- Nadhir NA Jafar
- Department of Chemistry, College of Science, University of Babylon, Babylon, Iraq
| | - Najim A Al-Masoudi
- Present address: Fachbereich Chemie, Universitaet Konstanz, Konstanz, Germany
- Department of Chemistry, College of Science, University of Basrah, Basrah, Iraq
| | - Sadiq J Baqir
- Department of Chemistry, College of Science, University of Babylon, Babylon, Iraq
| | - Pieter Leyssen
- Faculty of Medicine, Rega Institute for Medical Research, Department of Microbiology and Immunology, Laboratory for Virology and Chemotherapy, Katholieke Universiteit Leuven, Leuven, Belgium
| | - Christophe Pannecouque
- Faculty of Medicine, Rega Institute for Medical Research, Department of Microbiology and Immunology, Laboratory for Virology and Chemotherapy, Katholieke Universiteit Leuven, Leuven, Belgium
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Tsai HB, Chen PC, Liu CH, Hung PH, Chen MT, Chiang CK, Kao JH, Hung KY. Association of hepatitis C virus infection and malnutrition-inflammation complex syndrome in maintenance hemodialysis patients. Nephrol Dial Transplant 2011; 27:1176-83. [DOI: 10.1093/ndt/gfr458] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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Sievert W, Altraif I, Razavi HA, Abdo A, Ahmed EA, Alomair A, Amarapurkar D, Chen CH, Dou X, El Khayat H, Elshazly M, Esmat G, Guan R, Han KH, Koike K, Largen A, McCaughan G, Mogawer S, Monis A, Nawaz A, Piratvisuth T, Sanai FM, Sharara AI, Sibbel S, Sood A, Suh DJ, Wallace C, Young K, Negro F. A systematic review of hepatitis C virus epidemiology in Asia, Australia and Egypt. Liver Int 2011; 31 Suppl 2:61-80. [PMID: 21651703 DOI: 10.1111/j.1478-3231.2011.02540.x] [Citation(s) in RCA: 417] [Impact Index Per Article: 32.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The hepatitis C pandemic has been systematically studied and characterized in North America and Europe, but this important public health problem has not received equivalent attention in other regions. AIM The objective of this systematic review was to characterize hepatitis C virus (HCV) epidemiology in selected countries of Asia, Australia and Egypt, i.e. in a geographical area inhabited by over 40% of the global population. METHODOLOGY Data references were identified through indexed journals and non-indexed sources. In this work, 7770 articles were reviewed and 690 were selected based on their relevance. RESULTS We estimated that 49.3-64.0 million adults in Asia, Australia and Egypt are anti-HCV positive. China alone has more HCV infections than all of Europe or the Americas. While most countries had prevalence rates from 1 to 2% we documented several with relatively high prevalence rates, including Egypt (15%), Pakistan (4.7%) and Taiwan (4.4%). Nosocomial infection, blood transfusion (before screening) and injection drug use were identified as common risk factors in the region. Genotype 1 was common in Australia, China, Taiwan and other countries in North Asia, while genotype 6 was found in Vietnam and other Southeast Asian countries. In India and Pakistan genotype 3 was predominant, while genotype 4 was found in Middle Eastern countries such as Egypt, Saudi Arabia and Syria. CONCLUSION We recommend implementation of surveillance systems to guide effective public health policy that may lead to the eventual curtailment of the spread of this pandemic infection.
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Affiliation(s)
- William Sievert
- Monash Medical Centre and Monash University, Melbourne, Vic., Australia
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Risk factors of isolated antibody against core antigen of hepatitis B virus: association with HIV infection and age but not hepatitis C virus infection. J Acquir Immune Defic Syndr 2010; 54:122-8. [PMID: 20386111 DOI: 10.1097/qai.0b013e3181daafd5] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Isolated antibody to hepatitis B core antigen (anti-HBc) is defined as seropositivity for anti-HBc in the absence of hepatitis B surface antigen (HBsAg) and antibody to HBsAg (anti-HBs). It is commonly found in HIV-infected persons or hepatitis C virus (HCV)-infected persons, but the risk factors for isolated anti-HBc remain uncertain, especially in regions that are hyperendemic for hepatitis B virus (HBV) infection. METHODS This cross-sectional study included a cohort of 955 nonhemophiliac, HIV-infected patients, diagnosed between 1988 and 2009, and 643 HIV-uninfected injection drug users (IDUs) attending the methadone clinic between August 2007 and May 2009, with available HBV serological data. The medical records were reviewed to identify the risk factors associated with seropositivity of isolated anti-HBc. RESULTS The overall seroprevalence of isolated anti-HBc was 12.1% (193 of 1598), in which occult HBV infection accounted for 1.6% (3 of 185) and the majority (91.2 %, 176 of 193) had low titers of anti-HBs (3.6 +/- 2.9 IU/L). Subjects with isolated anti-HBc were significantly older (40.7 +/- 9.3 versus 36.9 +/- 8.0, respectively, P < 0.0001). There was a significantly increasing trend in the prevalence of isolated anti-HBc with age, from 4.0% in those younger than 30 years to 22.5% after 50 years of age (test for trend, P < 0.0001). A significantly higher prevalence of isolated anti-HBc was observed in HIV-infected subjects [14.0% (134 of 955) versus 9.2% (59 of 643), adjusted odds ratio, 1.64; P < 0.01], but not in those with HCV infection (P = 0.18). CONCLUSIONS Isolated anti-HBc seropositivity was significantly associated with HIV infection, and older age. HCV infection was not associated with isolated anti-HBc in a country hyperendemic with HBV infection, even in populations with a high prevalence of HCV infection. The majority was not attributable to occult HBV infection, but rather, low level of anti-HBs, suggesting that HBV vaccination may not be required.
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Lin LH, Lu SY, Lu SN. Seroprevalence of anti-HCV among patients with oral lichen planus in Southern Taiwan. ACTA ACUST UNITED AC 2010; 109:408-14. [DOI: 10.1016/j.tripleo.2009.10.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2009] [Revised: 09/25/2009] [Accepted: 10/01/2009] [Indexed: 12/28/2022]
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Lu SY, Lin LH, Lu SN, Wang JH, Hung CH. Increased oral lichen planus in a chronic hepatitis patient associated with elevated transaminase levels before and after interferon/ribavirin therapy. J Dent Sci 2009. [DOI: 10.1016/s1991-7902(09)60026-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
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Bioactivity-guided screening identifies pheophytin a as a potent anti-hepatitis C virus compound from Lonicera hypoglauca Miq. Biochem Biophys Res Commun 2009; 385:230-5. [PMID: 19450556 DOI: 10.1016/j.bbrc.2009.05.043] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2009] [Accepted: 05/13/2009] [Indexed: 11/20/2022]
Abstract
Chronic hepatitis C virus (HCV) infection is a worldwide public issue. In this study, we performed bioactivity-guided screening of the Lonicera hypoglauca Miq. crude extracts to find for naturally chemical entities with anti-HCV activity. Pheophytin a was identified from the ethanol-soluble fraction of L. hypoglauca that elicited dose-dependent inhibition of HCV viral proteins and RNA expression in both replicon cells and cell culture infectious system. Computational modeling revealed that pheophytin a can bind to the active site of HCV-NS3, suggesting that NS3 is a potent molecular target of pheophytin a. Biochemical analysis further revealed that pheophytin a inhibited NS3 serine protease activity with IC(50)=0.89 microM. Notably, pheophytin a and IFNalpha-2a elicited synergistic anti-HCV activity in replicon cells with no significant cytotoxicity. This study thereby demonstrates for the first time that pheophytin a is a potent HCV-NS3 protease inhibitor and offers insight for development of novel anti-HCV regimens.
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Lee HC, Ko NY, Lee NY, Chang CM, Ko WC. Seroprevalence of viral hepatitis and sexually transmitted disease among adults with recently diagnosed HIV infection in Southern Taiwan, 2000-2005: upsurge in hepatitis C virus infections among injection drug users. J Formos Med Assoc 2008; 107:404-11. [PMID: 18492625 DOI: 10.1016/s0929-6646(08)60106-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND/PURPOSE The purpose of this study was to compare the seroprevalence of viral hepatitis and sexually transmitted disease (STD) co-infections among three populations at risk recently diagnosed with HIV infection. METHODS A retrospective review of medical records was performed to determine the prevalence of several co-infections among adults recently diagnosed with HIV infection between 2000 and 2005 at National Cheng Kung University Hospital in Tainan, Taiwan. RESULTS Among a total of 484 adults, 124 (25.6%) were men having sex with men (MSM), 105 (21.7%) were heterosexual adults, and 255 (52.7%) were injection drug users (IDUs). The case number of adults with recently diagnosed HIV infection increased annually, from 27 in 2000 to 142 in 2005 (p < 0.001). This trend appeared to be attributable to the upsurge in HIV infection among IDUs beginning in 2003. At the time of HIV diagnosis, mean CD4+ counts were significantly higher and plasma HIV-1 RNA loads were lower in the IDU group than the MSM or heterosexual groups. The hepatitis B virus (HBV) carrier rate was similar in all three groups, with an average rate of 16.5%. The prevalence of treponemal antibody and Entamoeba histolytica indirect hemagglutination antibody was higher in MSM (37.5% and 9.4%, respectively) than in heterosexuals (19.6% and 7.3%, respectively) or IDUs (3.2% and 2.1%). The seroprevalence of hepatitis A virus infection increased with age, with 94.2% (97/103) of patients who were older than 40 years. Hepatitis C virus (HCV) or HBV-HCV co-infections were noted more often in IDUs (97.9% and 16.9%, respectively) than in heterosexuals (10.9% and 2.2%, respectively) and MSM (5.3% and 3.6%, respectively). CONCLUSION There was a recent upsurge in HIV-HCV co-infected IDUs in southern Taiwan. A higher rate of co-infection with STDs among HIV-infected MSM highlights the need for integrated STD control efforts in current HIV prevention programs.
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Affiliation(s)
- Hsin-Chun Lee
- Department of Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Acute Q fever in southern Taiwan: atypical manifestations of hyperbilirubinemia and prolonged fever. Diagn Microbiol Infect Dis 2008; 60:211-6. [DOI: 10.1016/j.diagmicrobio.2007.09.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2007] [Revised: 08/28/2007] [Accepted: 09/10/2007] [Indexed: 11/21/2022]
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Cheng JT, Hsien C, Sun HEJ, Tong MJ. The emerging importance of chronic hepatitis C infection in Asian Americans. Am J Gastroenterol 2006; 101:2737-43. [PMID: 17227521 DOI: 10.1111/j.1572-0241.2006.00831.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To study the demographics, epidemiology, and natural history of chronic hepatitis C in Asian Americans. METHODS This retrospective survey describes 260 Asian Americans with chronic hepatitis C referred to one tertiary center. RESULTS Ninety-two percent of patients were born in Asia. Fifty-one percent reported a history of unsafe therapeutic injections, which was a risk factor only in those with exposure outside the United States (p < 0.0001). A history of transfusion was reported in 41% of patients and was more frequent in those with exposure within the Unites States (p < 0.0001). Only 3.8% reported a history of intravenous drug abuse, which was more frequent in those with exposure within the United States (p < 0.0001). Hepatitis C genotype 1 was detected in 64.2% of patients, genotype 2 in 18.3%, and genotype 6 in 11.3%. Genotype 1 had a significantly lower sustained virologic response rate (32.8%) to interferon treatment, compared with genotype 2 (77.8%) or 6 (69.2%). During a mean follow-up of 6 yr, 26 patients developed hepatocellular carcinoma (HCC). Logistic regression model revealed fibrosis stage 4 (odds ratio [OR] 8.87, 95% confidence interval [CI] 2.97-26.48, p < 0.0001), age at presentation (55 vs 35 yr--OR 3.45, 95% CI 1.22-9.75, p= 0.0194), and baseline albumin level (3.0 vs 4.0 mg/dL--OR 3.47, 95% CI 1.02-11.76, p= 0.0464) were independent predictive factors for HCC development. CONCLUSIONS Asian Americans with a history of unsafe therapeutic injections must be screened for chronic hepatitis C. Antiviral treatment should be initiated prior to development of cirrhosis. Surveillance for HCC must be routinely performed in cirrhosis patients.
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Affiliation(s)
- Jason Tzuying Cheng
- The Liver Center, Huntington Medical Research Institutes, Pasadena, California 91105, USA
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Lin WA, Tarn YH, Tang SL. Cost-utility analysis of different peg-interferon alpha-2b plus ribavirin treatment strategies as initial therapy for naïve Chinese patients with chronic hepatitis C. Aliment Pharmacol Ther 2006; 24:1483-93. [PMID: 17081165 DOI: 10.1111/j.1365-2036.2006.03105.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Different peg-interferon alpha-2b plus ribavirin treatment strategies are more effective in treating hepatitis C. However, no cost-effectiveness data have been published using the clinical data from the peg-interferon alpha-2b and ribavirin in the treatment of patients with hepatitis C in Taiwan. AIM To estimate the cost-effectiveness of different treatments with peg-interferon alpha-2b plus ribavirin for the initial treatment of patients with different genotype chronic hepatitis C. METHODS Individual patient level data from a randomized clinical trial with peg-interferon plus ribavirin were applied to a Markov model to project lifelong clinical outcomes. Economic estimates and quality of life were based on published data and Taiwan patient data. We used a societal perspective and applied a 3% annual discount rate. RESULTS Compared with different combination therapy strategies, peg-interferon alpha-2b plus weight-based dosing of ribavirin in all patients for 24 weeks is the most cost-effective treatment strategy. If the sustained virological response of peg-interferon plus ribavirin treatment for 48 weeks therapy in genotype 1 patients was higher than 67.8%, the best strategy of treating patients will be the peg-interferon plus weight-based dosing of ribavirin therapy for 48 weeks in genotype 1 patients and for 24 weeks in non-genotype 1 patients. CONCLUSIONS Peg-interferon alpha-2b plus ribavirin combination for 24 weeks therapy in all genotype patients should reduce the incidence of liver complications, prolong life, improve quality of life and be cost-effective for the initial treatment of chronic hepatitis C.
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Affiliation(s)
- W-A Lin
- Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan ROC
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