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Prior antiviral treatment and mortality among patients with hepatitis C virus-related hepatocellular carcinoma: A national cohort study. PLoS One 2021; 16:e0255624. [PMID: 34343200 PMCID: PMC8330890 DOI: 10.1371/journal.pone.0255624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 07/19/2021] [Indexed: 12/20/2022] Open
Abstract
Background The current antiviral treatments available for hepatitis C virus (HCV) infection decrease the risk of hepatocellular carcinoma (HCC). Hence, patients with HCV infection who have not received antiviral treatment and have developed HCC may be those who missed timely antiviral treatment for HCV. However, the proportion of patients who missed timely antiviral treatment and its implications are largely unexplored. Methods A nationwide retrospective cohort of 4,592 newly diagnosed HCV-related HCC patients (2013–2017) was identified from the Korean National Health Insurance Service database. Prior antiviral treatment for HCV was defined as a history of at least one HCV-specific antiviral treatment before HCC diagnosis. The outcome was all-cause mortality. Results Prior antiviral treatment for HCV was identified in 802 (17.4%) patients, and 16%, 16%, 17%, 19%, and 19% of patients received antiviral treatment in the years 2013, 2014, 2015, 2016, and 2017, respectively (P = 0.21). During 8,085 person-years of follow-up (median, 1.4; maximum, 5.3 years of follow-up), 1,970 patients died. Mortality rates were lower in patients with prior antiviral treatment (15 deaths/100 person-years) than in those without prior antiviral treatment (27 deaths/100 person-years). The adjusted hazard ratio (95% confidence interval) for all-cause mortality on comparing patients who did and did not receive prior antiviral treatment was 0.68 (0.59, 0.79). Conclusion Timely antiviral treatment for HCV was suboptimal at the population level. Prior antiviral treatment for HCV reduced mortality rate in HCV-related HCC patients. Intensive HCV control strategies are needed to reduce the number of patients with HCV infection who miss timely HCV treatment.
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Ahn SH, Choe WH, Kim YJ, Heo J, Latarska-Smuga D, Kang J, Paik SW. Impact of Interferon-Based Treatment on Quality of Life and Work-Related Productivity of Korean Patients with Chronic Hepatitis C. Gut Liver 2021; 14:368-376. [PMID: 31533395 PMCID: PMC7234875 DOI: 10.5009/gnl18100] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 05/17/2019] [Accepted: 05/17/2019] [Indexed: 12/29/2022] Open
Abstract
Background/Aims Chronic hepatitis C virus (HCV) infections put patients at risk of serious liver disease and adversely affects patient quality of life (QoL). MOSAIC (International Multicenter Prospective Observational Study to Evaluate the Epidemiology, Humanistic and Economic Outcomes of Treatment for Chronic Hepatitis C Virus) was a prospective, non-interventional, international, multicenter study that aimed to describe the epidemiology of the infection, the impact of the infection on health-related QoL (HRQoL) and daily activities, and healthcare resource use related to HCV and treatment. Here, we present the results on HRQoL and daily activity impairment in consecutively enrolled South Korean patients treated with interferon (IFN)-containing regimens prospectively followed for up to 48 weeks. Methods General HRQoL, HCV-specific HRQoL, perceived health state, and work/general activity impairments were measured using the EuroQoL 5-dimension 5-level (EQ-5D-5L), HCV patient-reported outcomes (HCV-PRO), EQ-5D Visual Analog Scale, and Work Productivity and Activity Impairment questionnaires, respectively. Results Thirty-three of the 100 enrolled patients initiated IFN-based treatment, with an intended duration of 24 weeks for 20 patients and 48 weeks for 12 patients; this information was missing for one patient. Fourteen patients (42.4%) prematurely withdrew. After treatment initiation, IFN-treated patients showed a trend towards deterioration of both general (baseline: 0.87±0.103, week 4: 0.77±0.153) and HCV-specific (baseline: 76.2±19.5, week 4: 68.2±22.3) HRQoL. The scores recovered somewhat towards the end of treatment (EOT) (0.84±0.146 for EQ-5D-5L and 70.8±21.9 for HCV-PRO). The perceived health state and work/general activity impairment displayed similar temporal patterns. Conclusions Initiating IFN-based treatment prompted some deterioration in general and HCV-related HRQoL, accompanied by impaired daily activities and most work productivity measures; however, the HRQoL and productivity scores improved towards the EOT. HRQoL impairment upon treatment initiation likely contributed to treatment discontinuation.
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Affiliation(s)
- Sang Hoon Ahn
- Department of Internal Medicine, Brain Korea 21 Project for Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Won Hyeok Choe
- Department of Internal Medicine, Konkuk University Hospital, Seoul, Korea
| | - Yoon Jun Kim
- Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea
| | - Jeong Heo
- Department of Internal Medicine, Medical Research Institute, Pusan National University Hospital, Pusan National University College of Medicine, Busan, Korea
| | | | | | - Seung Woon Paik
- Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Jeong JY, Jun DW, Park SJ, Sohn JH, Kim SG, Lee SW, Jeong SW, Kim MY, Kim W, Shim JJ, Kim HS, Suk KT, Ahn SB. Effects of vitamin D supplements in patients with chronic hepatitis C: a randomized, multi-center, open label study. Korean J Intern Med 2020; 35:1074-1083. [PMID: 31710801 PMCID: PMC7487303 DOI: 10.3904/kjim.2018.273] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 11/05/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND/AIMS We aimed to assess the role of vitamin D supplementation in the response to pegylated interferon-α (PEG-IFN-α) plus ribavirin (RBV) treatment in patients with chronic hepatitis C (CHC). METHODS Our study was a multi-center, randomized controlled trial in 11 hospitals. CHC patients were randomly assigned (1:1) to two groups namely, PEGIFN-α plus RBV (control group) or PEG-IFN-α plus RBV + vitamin D (800 IU daily) (vitamin D group). The primary end-point was the rate of sustained virologic response (SVR). RESULTS One hundred forty eight CHC patients were randomly assigned to two groups. Seventy-one patients received the PEG-IFN-α plus RBV and 77 patients received the PEG-IFN-α plus RBV + vitamin D. A total of 105 patients completed the study (control group, 47 vs. vitamin D group, 58). Baseline characteristics were mostly similar in both the groups. There was a modest but non-significant increase in SVR in the vitamin D group compared to the control group with the intention to treat analysis (64.0% vs. 49.3 %, p = 0.071) as well as in the per protocol analysis (control group vs. vitamin D group: 74.5% vs. 84.5%, p = 0.202). Fifty-two patients (73.2%) in the control group and 63 patients (81.8%) in the vitamin D group experienced at least one adverse event. The drop-out rate due to adverse effects was not different between both groups (control group vs. vitamin D group: 19.7% vs. 10.4%, p = 0.111). CONCLUSION Vitamin D supplement did not increase SVR in treatment naïve patients with CHC irrespective of genotype.
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Affiliation(s)
- Jae Yoon Jeong
- Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea
| | - Dae Won Jun
- Department of Internal Medicine, Hanyang University Hospital, Seoul, Korea
- Correspondence to Dae Won Jun, M.D. Department of Internal Medicine, Hanyang University College of Medicine, 222-1 Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea. Tel: +82-2-2290-8338, Fax: +82-2-972-0068, E-mail:
| | - Sol Ji Park
- Department of Clinical Pharmacology, Sungkyunkwan University, Seoul, Korea
| | - Joo Hyun Sohn
- Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea
| | - Sang Gyune Kim
- Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Se Whan Lee
- Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea
| | - Soung Won Jeong
- Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - Moon Young Kim
- Department of Internal Medicine, Yonsei University Wonju Severance Christian Hospital, Wonju, Korea
| | - Won Kim
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - Jae-Jun Shim
- Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea
| | - Hyoung Su Kim
- Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Ki Tae Suk
- Department of Internal Medicine, Hallym University Chuncheon Sacred Heart Hospital, Chuncheon, Korea
| | - Sang Bong Ahn
- Department of Internal Medicine, Eulji University School of Medicine, Seoul, Korea
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Park SK, Choi CH, Chun J, Lee H, Kim ES, Park JJ, Park CH, Lee BI, Jung Y, Park DI, Kim DY, Park H, Jeen YT. Prevention and management of viral hepatitis in inflammatory bowel disease: a clinical practice guideline by the Korean Association for the Study of Intestinal Diseases. Intest Res 2020; 18:18-33. [PMID: 32013312 PMCID: PMC7000641 DOI: 10.5217/ir.2019.09155] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 12/27/2019] [Indexed: 02/06/2023] Open
Abstract
The treatment of inflammatory bowel disease (IBD) has been revolutionized for the last 10 years by the increasing use of immunomodulators and biologics. With immunosuppression of this kind, opportunistic infection is an important safety concern for patients with IBD. In particular, viral hepatitis is determined by the interaction between the virus and the host's immunity, and the risk of reactivation increases if immunity is compromised by immunosuppression therapy. Parts of Asia, including Korea, still show intermediate endemicity for the hepatitis A virus and hepatitis B virus compared with the United States and Western Europe. Thus, members of IBD research group of the Korean Association for the Study of Intestinal Diseases have produced a guideline on the prevention and management of viral hepatitis in IBD.
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Affiliation(s)
- Soo-Kyung Park
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chang Hwan Choi
- Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jaeyoung Chun
- Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Heeyoung Lee
- Center for Preventive Medicine and Public Health, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Eun Sun Kim
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jae Jun Park
- Department of Internal Medicine, Institute of Gastroenterology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Chan Hyuk Park
- Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea
| | - Bo-In Lee
- Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yunho Jung
- Division of Gastroenterology, Department of Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Dong-Il Park
- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Do Young Kim
- Department of Internal Medicine, Institute of Gastroenterology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Hana Park
- Health Screening and Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yoon Tae Jeen
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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- Division of Gastroenterology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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Lee HW, Oh SR, Kim DY, Jeong Y, Kim S, Kim BK, Kim SU, Kim DY, Ahn SH, Han KH, Park JY. Daclatasvir Plus Asunaprevir for the Treatment of Patients with Hepatitis C Virus Genotype 1b Infection: Real-World Efficacy, Changes in Liver Stiffness and Fibrosis Markers, and Safety. Gut Liver 2018; 12:324-330. [PMID: 29409309 PMCID: PMC5945264 DOI: 10.5009/gnl17298] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 09/20/2017] [Accepted: 09/20/2017] [Indexed: 12/17/2022] Open
Abstract
Background/Aims The treatment with daclatasvir plus asunaprevir (DCV+ASV) is associated with potent antiviral effects in patients with genotype 1b hepatitis C virus (HCV) infection. We investigated the real-world efficacy, changes in liver stiffness and noninvasive fibrosis markers, and the safety of DCV+ASV treatment in Korean patients. Methods In total, 363 patients with chronic hepatitis C were treated with DCV+ASV between August 2015 and January 2017. Finally, we analyzed the data of 270 patients who were monitored for at least 12 weeks after the end of treatment. Results The mean age was 60.7 years, and females predominated (60.4%). Most patients (64.8%) were treatment-naïve, and 56 patients (20.7%) had cirrhosis. Two hundred fifty-seven (95.2%) and 251 (93.0%) patients achieved end-of-treatment responses and sustained virological responses at 12 weeks posttreatment (SVR12), respectively. The SVR12 rates were higher in patients who were <65 years of age, males, without cirrhosis and had lower HCV RNA levels. All LS values and fibrosis-4 and aspartate aminotransferase-to-platelet ratio index values declined from baseline to the time of assessment of SVR12. Conclusions The DCV+ASV therapy resulted in a high SVR12 and improved liver fibrosis; the treatment was well tolerated in patients with genotype 1b HCV infections.
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Affiliation(s)
- Hye Won Lee
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.,Yonsei Liver Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Se Rim Oh
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Dong Yun Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Yechan Jeong
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Brain Korea 21 PLUS Project for Medical Science College of Medicine, Seoul, Korea
| | - Seungtaek Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.,Yonsei Liver Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Beom Kyung Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.,Yonsei Liver Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Seung Up Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.,Yonsei Liver Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Do Young Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.,Yonsei Liver Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Hoon Ahn
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.,Yonsei Liver Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Kwang-Hyub Han
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.,Yonsei Liver Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jun Yong Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.,Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea.,Yonsei Liver Center, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Yeon JE. Recent update of the 2017 Korean Association for the Study of the Liver (KASL) treatment guidelines of chronic hepatitis C: Comparison of guidelines from other continents, 2017 AASLD/IDSA and 2016 EASL. Clin Mol Hepatol 2018; 24:278-293. [PMID: 29716179 PMCID: PMC6166106 DOI: 10.3350/cmh.2018.1002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 02/14/2018] [Indexed: 12/15/2022] Open
Abstract
The paradigm for the treatment of chronic hepatitis C (CHC) has been changed due to the development of direct acting antivirals (DAAs) of hepatitis C virus (HCV). The high sustained virologic response rate and ease of administration makes the DAAs approach ideal to contribute to the complete eradication of HCV. Currently, treatment options for individual patients vary depending on the genotype or subtype of HCV, presence or absence of liver cirrhosis, previous experience of antiviral treatment or resistance associated substitutions. Because of drug avalilability, cost-effectiveness, preference, compliance and greater possibility of desirable effects and presumed patient-important outcomes may vary between countries, treatment options for individual patients are different. The review focuses on the comparing the current treatment options for CHC in other continents with the 2017 Korea Association for the Study of the Liver guidelines.
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Affiliation(s)
- Jong Eun Yeon
- Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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Kao JH, Yu ML, Peng CY, Heo J, Chu CJ, Chang TT, Lee YJ, Hu TH, Yoon KT, Paik SW, Lim YS, Ahn SH, Isakov V, McPhee F, Hu W, Scott Swenson E, Yin PD, Treitel M. Daclatasvir/asunaprevir/beclabuvir, all-oral, fixed-dose combination for patients with chronic hepatitis C virus genotype 1. J Gastroenterol Hepatol 2017; 32:1998-2005. [PMID: 28370350 DOI: 10.1111/jgh.13796] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 03/17/2017] [Accepted: 03/23/2017] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND AIM This multinational (Taiwan, South Korea, Russia) phase 3 study evaluated the all-oral, ribavirin-free, fixed-dose combination (DCV-TRIO) of daclatasvir (NS5A inhibitor) 30 mg, asunaprevir (NS3 inhibitor) 200 mg, and beclabuvir (NS5B inhibitor) 75 mg, in patients with chronic hepatitis C virus genotype-1 infection, with or without compensated cirrhosis. METHODS UNITY-4 (NCT02170727) was an open-label, two-cohort study in which 169 patients, treatment-naive (n = 138) or treatment-experienced (n = 31), received twice-daily DCV-TRIO for 12 weeks with 24 weeks of post-treatment follow-up. The primary efficacy end point was sustained virologic response at post-treatment week 12 (SVR12) in treatment-naive patients. RESULTS Eighty-eight (52%) patients were men, 81 (48%) Taiwanese, 78 (46%) Korean, and 10 (6%) Russian; 23 (14%) had compensated cirrhosis, and 52 (31%) were IL28B (rs1297860) non-CC genotype. Baseline resistance-associated NS5A polymorphisms (L31 and/or Y93) were detected in 25/165 (15%) patients with available genotype-1 sequencing data. SVR12 was achieved by 98.6% (136/138; 95% confidence interval: 94.9-99.8%) of treatment-naive and 100% (31/31; 95% confidence interval: 88.8-100%) of treatment-experienced patients. Both virologic failures were found to be infected with hepatitis C virus genotype-6g; 100% SVR12 was observed for genotype-1a (n = 8) and genotype-1b (n = 157). Two patients experienced serious adverse events. Eight (5%) patients experienced reversible grade 3/4 alanine aminotransferase or aspartate aminotransferase elevations, leading to discontinuation in four (2%); all achieved SVR12. There were no grade 3/4 total bilirubin increases and no deaths. CONCLUSIONS Twelve weeks of DCV-TRIO was well tolerated and provided 100% SVR12 in treatment-naive and treatment-experienced patients with genotype-1 infection, with or without cirrhosis, including those with baseline NS5A-L31 or NS5A-Y93 resistance-associated substitutions.
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Affiliation(s)
| | - Ming-Lung Yu
- Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Cheng-Yuan Peng
- School of Medicine, China Medical University, Taichung, Taiwan
| | - Jeong Heo
- College of Medicine, Pusan National University and Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - Chi-Jen Chu
- Taipei Veterans General Hospital, Taipei, Taiwan
| | | | - Youn-Jae Lee
- Inje University Busan Paik Hospital, Busan, Korea
| | - Tsung-Hui Hu
- Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung City, Taiwan
| | - Ki Tae Yoon
- Pusan National University School of Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | | | | | - Sang Hoon Ahn
- Yonsei University College of Medicine, Seoul, South Korea
| | | | - Fiona McPhee
- Bristol-Myers Squibb, Princeton, New Jersey, USA
| | - Wenhua Hu
- Bristol-Myers Squibb, Princeton, New Jersey, USA
| | | | - Philip D Yin
- Bristol-Myers Squibb, Princeton, New Jersey, USA
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Yu JH, Lee JI, Lee KS, Kim JK. Real-life prevalence of resistance-associated variants against non-structural protein 5A inhibitors and efficiency of Daclatasvir + Asunaprevir therapy in Korean patients with genotype 1b hepatitis C. Virol J 2017; 14:164. [PMID: 28836992 PMCID: PMC5571669 DOI: 10.1186/s12985-017-0826-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Accepted: 08/14/2017] [Indexed: 02/08/2023] Open
Abstract
Background Direct-acting antivirals (DAAs) for chronic hepatitis C (CHC) treatment are tolerable and highly effective in a shorter period of time than before. However, resistance-associated variants (RAVs) can affect the efficacy of DAAs. The aim of this study was to investigate the real-life prevalence of RAVs against non-structural protein 5A (NS5A) inhibitors in Korean patients with genotype 1b chronic hepatitis C. Methods All consecutive patients with CHC genotype 1b who underwent a RAV test at a single referral hospital were enrolled. Results A total of 142 patients (male 53, female 89) were tested for RAVs. The average age of the patients was 58 years. Liver cirrhosis was found in 34.5% (49/142) of patients, and 19.0% (29/142) of patients had previously undergone interferon-based treatment. Twenty-nine patients (20.4%) had RAVs (Y93 or L31). Y93H, L31, or Y93H with L31 were detected in 22 (15.5%), 8 (5.6%), and 1 (0.7%) patients, respectively. The presence of RAV was not affected by previous interferon-based treatment or by the existence of liver cirrhosis. Among 113 patients without baseline NS5A RAVs, 72 patients started daclatasvir (DCV) + asunaprevir (ASV) treatment and 95% (68/72) patients achieved virologic response at week 4. Virologic response at end of treatment and sustained virologic response at 12 weeks after treatment were achieved by 94% (68/72) and 94% (68/72), respectively. Conclusions In Korean patients with genotype 1b CHC, 20.4% (29 of 142) of patients showed RAVs against NS5A inhibitors. Patient without RAVs who received treatment with DCV + ASV showed high virologic response rates in Korea.
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Affiliation(s)
- Jung Hwan Yu
- Gangnam Severance Hospital, Department of Internal Medicine, Yonsei University College of Medicine, 20, 63-gil, Eonju-ro Gangnam-gu, Seoul, 06229, South Korea
| | - Jung Il Lee
- Gangnam Severance Hospital, Department of Internal Medicine, Yonsei University College of Medicine, 20, 63-gil, Eonju-ro Gangnam-gu, Seoul, 06229, South Korea
| | - Kwan Sik Lee
- Gangnam Severance Hospital, Department of Internal Medicine, Yonsei University College of Medicine, 20, 63-gil, Eonju-ro Gangnam-gu, Seoul, 06229, South Korea
| | - Ja Kyung Kim
- Gangnam Severance Hospital, Department of Internal Medicine, Yonsei University College of Medicine, 20, 63-gil, Eonju-ro Gangnam-gu, Seoul, 06229, South Korea.
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9
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Ko BJ, Kim YS, Kim SG, Park JH, Lee SH, Jeong SW, Jang JY, Kim HS, Kim BS, Kim SM, Kim YD, Cheon GJ, Lee BR. Relationship between 25-Hydroxyvitamin D Levels and Liver Fibrosis as Assessed by Transient Elastography in Patients with Chronic Liver Disease. Gut Liver 2017; 10:818-25. [PMID: 27114415 PMCID: PMC5003207 DOI: 10.5009/gnl15331] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 09/28/2015] [Accepted: 12/01/2015] [Indexed: 12/11/2022] Open
Abstract
Background/Aims Deficiencies of 25-hydroxyvitamin D (25(OH)D) are prevalent in patients with chronic liver disease (CLD). Liver fibrosis is the main determinant of CLD prognosis. The present study was performed to evaluate the correlation between 25(OH)D levels and liver fibrosis as assessed by transient elastography (TE) in patients with compensated CLD. Methods Serum 25(OH)D levels and liver stiffness were determined in a total of 207 patients who were subjected to the following exclusion criteria: patients with decompensated CLD; patients who had malignancies; patients who were taking medications; and patients who were pregnant. Results The most common etiology was chronic hepatitis B (53.1%). Advanced liver fibrosis (defined by TE [≥9.5 kPa]) was present in 75 patients (36.2%). There was a significant correlation between 25(OH)D deficiency and liver stiffness. Based on the multivariate analysis, the following factors were independently associated with advanced liver fibrosis: 25(OH)D deficiency (odds ratio [OR], 3.46; p=0.004), diabetes mellitus (OR, 3.04; p=0.041), and fibrosis-4 index (OR, 2.01; p<0.001). Conclusions Patients with compensated CLD exhibit a close correlation between vitamin D level and liver stiffness as assessed by TE. Vitamin D deficiency was independently associated with advanced liver fibrosis.
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Affiliation(s)
- Bong Jin Ko
- Digestive Disease Center and Research Institute, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Young Seok Kim
- Digestive Disease Center and Research Institute, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Sang Gyune Kim
- Digestive Disease Center and Research Institute, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Jung Hwan Park
- Digestive Disease Center and Research Institute, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Sae Hwan Lee
- Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Soung Won Jeong
- Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Jae Young Jang
- Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Hong Soo Kim
- Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - Boo Sung Kim
- Digestive Disease Center and Research Institute, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Sun Mi Kim
- Digestive Disease Center and Research Institute, Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Young Don Kim
- Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Gab Jin Cheon
- Department of Internal Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea
| | - Bo Ra Lee
- Department of Biostatistical Consulting, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
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10
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Lee K, Sinn DH, Gwak GY, Cho HC, Jung SH, Paik YH, Choi MS, Lee JH, Koh KC, Paik SW. Prediction of the Risk of Hepatocellular Carcinoma in Chronic Hepatitis C Patients after Sustained Virological Response by Aspartate Aminotransferase to Platelet Ratio Index. Gut Liver 2017; 10:796-802. [PMID: 27114418 PMCID: PMC5003204 DOI: 10.5009/gnl15368] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2015] [Revised: 11/01/2015] [Accepted: 11/01/2015] [Indexed: 01/10/2023] Open
Abstract
Background/Aims Following sustained virological response (SVR) for chronic hepatitis C (CHC) infection, patients with advanced fibrosis require regular monitoring for hepatocellular carcinoma (HCC). The aspartate aminotransferase to platelet ratio index (APRI) is a simple noninvasive surrogate marker known to reflect fibrosis. Methods We retrospectively analyzed 598 patients who achieved SVR with interferon-based therapy for CHC. Results Over a median of 5.1 years of follow-up, there were eight patients diagnosed with HCC and a 5-year cumulative incidence rate of 1.3%. The median pretreatment APRI was 0.83, which decreased to 0.29 after achieving SVR (p<0.001). Both the pre- and posttreatment indices were associated with HCC development. The 5-year cumulative HCC incidence rates were 0% and 2.8% for patients with pretreatment APRI <1.0 and ≥1.0, respectively (p=0.001) and 0.8% and 12.8% for patients with posttreatment APRI <1.0 and ≥1.0, respectively (p<0.001). Pretreatment APRI at a cutoff of 1.0 had a 100% negative predictive value until 10 years after SVR. Conclusions HCC development was observed among CHC patients who achieved SVR. The pre- and post-treatment APRI could stratify HCC risk, indicating that the APRI could be a useful marker to classify HCC risk in CHC patients who achieved SVR. However, given the small number of HCC patients, this finding warrants further validation.
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Affiliation(s)
- Keol Lee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong Hyun Sinn
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Geum-Youn Gwak
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyun Chin Cho
- Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Korea
| | - Sin-Ho Jung
- Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Seoul, Korea
| | - Yong-Han Paik
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Moon Seok Choi
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Joon Hyeok Lee
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kwang Cheol Koh
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Seung Woon Paik
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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11
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Shin SK, Park SY, Jung YK, Kim EJ, Lee HN, Lee JJ, Kwon OS, Choi DJ, Kim YS, Kim JH. [Prevalence, risk factors and clinical characteristics in patients with genotype 6 chronic hepatitis C: a single institute experience]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2017; 65:105-11. [PMID: 25716713 DOI: 10.4166/kjg.2015.65.2.105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND/AIMS Hepatitis C genotypes 1 and 2 are widely distributed globally. In contrast, genotype 6 is found mainly in Southeast Asia, while genotype 6 is rare in Korea. This study aims to investigate the prevalence, risk factors and clinical characteristics of patients with genotype 6 chronic hepatitis C. METHODS We retrospectively identified 133 HCV-infected patients who underwent HCV genotype analysis between January 2012 and December 2012, and analyzed the prevalence, risk factors and clinical characteristics of patients diagnosed with genotype 6 chronic hepatitis C. RESULTS Among 133 patients, 53 patients (39.8%) were infected with genotype 1, 62 patients (46.6%) with genotype 2, 2 patients (1.5%) with genotype 3, 14 patients (10.5%) with genotype 6, and 2 patients (1.5%) with mixed genotypes (genotype 1 and 6). The risk factors associated with genotype 6 were acupuncture (n=4, 28.6%), intravenous drug use (n=3, 21.4%), tattoo (n=2, 14.3%), and transfusion (n=2, 14.3%). Of the 14 patients with genotype 6, 6 patients were treated with pegylated interferon and ribavirin. Five patients had reached the end of treatment. All patients reaching end of treatment for genotype 6 showed early virological response and sustained virological response. CONCLUSIONS The prevalence of genotype 6 is 10.5% and mixed infections of genotype 1 and 6 are 1.5% in patients with chronic hepatitis C. A major potential risk factor is intravenous drug use and the treatment response rate to pegylated interferon plus ribavirin is high in patients with genotype 6 chronic hepatitis C. Large scale multicenter studies are needed.
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Affiliation(s)
- Seung Kak Shin
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Department of Internal Medicine, Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Soo Yong Park
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Department of Internal Medicine, Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Young Kul Jung
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Department of Internal Medicine, Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Eui Joo Kim
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Department of Internal Medicine, Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Heon Nam Lee
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Department of Internal Medicine, Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Jong Joon Lee
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Department of Internal Medicine, Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Oh Sang Kwon
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Department of Internal Medicine, Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Duck Joo Choi
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Department of Internal Medicine, Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Yun Soo Kim
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Department of Internal Medicine, Ansan Hospital, Korea University College of Medicine, Ansan, Korea
| | - Ju Hyun Kim
- Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Department of Internal Medicine, Ansan Hospital, Korea University College of Medicine, Ansan, Korea
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12
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Jung YK. [Renewed 2015 Clinical Practice Guidelines for Management of Hepatitis C by Korean Association for the Study of the Liver; What Has Been Changed? - Treatment of Chronic Hepatitis C Genotype 2 and 3]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2017; 67:132-6. [PMID: 26996182 DOI: 10.4166/kjg.2016.67.3.132] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Ever since direct-acting antiviral agents (DAA) have been approved and released into the world, numerous studies on the efficacy, adverse effects and drug-drug interactions of interferon-free DAA combination therapy have been studied and published. With all oral DAA therapy showing sustained virological response rate of 80-90% with minimal adverse events, HCV eradication has now become a realistic goal. DAA combination treatments were approved and adapted to practice in Korea in 2015, and Korean Association for the Study of the Liver (KASL) has revised the guideline based on the systematic approach that reflects evidence-based medicine and expert opinions. In this article, new recommendations for treatment of chronic HCV genotype 2 and 3 infected patients will be introduced base on KASL practice guidelines for management of hepatitis C that has been updated in 2015.
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Affiliation(s)
- Young Kul Jung
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Korea
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13
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Kim KA. [Renewed 2015 Clinical Practice Guidelines for Management of Hepatitis C by Korean Association for the Study of the Liver; What Has Been Changed? - Indications for Treatment]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2017; 67:123-6. [PMID: 26996180 DOI: 10.4166/kjg.2016.67.3.123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The landscape of treatment for HCV infection has evolved substantially with the advent of highly effective direct-acting antiviral agents (DAA). The Korean Association for the Study of the Liver updated guideline for managemnt of hepatitis C in accordance with the introduction of DAA into practice in late 2015. Due to high effectiveness and few side effects of DAA, indications for treatment has been widened to include patients who had been contraindicated for the combination treatment of peginterferon-α and ribavirin, i.e. decompensated cirrhosis and pre- and post-liver transplant setting. As succeesul treatment of HCV can reduce complications of cirrhosis, development of hepatocelluar carcinoma and liver-related mortality, and improve extrahepatic manifestions, all HCV-infected patients with no contraindication should be considered for treatment. Considering the risk for morbidity and mortality and benefit of treatment, patients with advanced fibrosis ≥F3 including compensated and decompensated cirrhosis, those in the pre- and post-tranplasnt setting, and those with severe extrahepatic manifestations including HCV-related mixed cryoglobulinemia and glomerulonephritis should be given priority for treatment.
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Affiliation(s)
- Kyung-Ah Kim
- Department of Internal Medicine, Inje University Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
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14
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Kim DY, Han KH, Jun B, Kim TH, Park S, Ward T, Webster S, McEwan P. Estimating the Cost-Effectiveness of One-Time Screening and Treatment for Hepatitis C in Korea. PLoS One 2017; 12:e0167770. [PMID: 28060834 PMCID: PMC5218507 DOI: 10.1371/journal.pone.0167770] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Accepted: 11/18/2016] [Indexed: 02/06/2023] Open
Abstract
Background and Aims This study aims to investigate the cost-effectiveness of a one-time hepatitis C virus (HCV) screening and treatment program in South Korea where hepatitis B virus (HBV) prevails, in people aged 40–70, compared to current practice (no screening). Methods A published Markov model was used in conjunction with a screening and treatment decision tree to model patient cohorts, aged 40–49, 50–59 and 60–69 years, distributed across chronic hepatitis C (CHC) and compensated cirrhosis (CC) health states (82.5% and 17.5%, respectively). Based on a published seroepidemiology study, HCV prevalence was estimated at 0.60%, 0.80% and 1.53%, respectively. An estimated 71.7% of the population was screened. Post-diagnosis, 39.4% of patients were treated with a newly available all-oral direct-acting antiviral (DAA) regimen over 5 years. Published rates of sustained virologic response, disease management costs, transition rates and utilities were utilised. Results Screening resulted in the identification of 43,635 previously undiagnosed patients across all cohorts. One-time HCV screening and treatment was estimated to be cost-effective across all cohorts; predicted incremental cost-effectiveness ratios ranged from $5,714 to $8,889 per quality-adjusted life year gained. Incremental costs associated with screening, treatment and disease management ranged from $156.47 to $181.85 million USD; lifetime costs-offsets associated with the avoidance of end stage liver disease complications ranged from $51.47 to $57.48 million USD. Conclusions One-time HCV screening and treatment in South Korean people aged 40–70 is likely to be highly cost-effective compared to the current practice of no screening.
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Affiliation(s)
- Do Young Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Kwang-Hyub Han
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
- * E-mail:
| | - Byungyool Jun
- Department of Preventive Medicine, Cha University College of Medicine, Kyung-Gi Province, South Korea
| | - Tae Hyun Kim
- Graduate School of Public Health, Yonsei University, Seoul, South Korea
| | - Sohee Park
- Graduate School of Public Health, Yonsei University, Seoul, South Korea
| | - Thomas Ward
- HEOR Ltd, Singleton Court Business Park, Monmouth, Wales, United Kingdom
| | - Samantha Webster
- HEOR Ltd, Singleton Court Business Park, Monmouth, Wales, United Kingdom
| | - Phil McEwan
- HEOR Ltd, Singleton Court Business Park, Monmouth, Wales, United Kingdom
- School of Human & Health Sciences, Swansea University, Wales, United Kingdom
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15
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Kim CY, Kim BR, Lee SS, Jeon DH, Lee CM, Kim WS, Cho HC, Kim JJ, Lee JM, Kim HJ, Ha CY, Kim HJ, Kim TH, Jung WT, Lee OJ. Clinical features of hepatitis B and C virus infections, with high α-fetoprotein levels but not hepatocellular carcinoma. Medicine (Baltimore) 2017; 96:e5844. [PMID: 28079817 PMCID: PMC5266179 DOI: 10.1097/md.0000000000005844] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The appropriate α-fetoprotein (AFP) level to confirm hepatocellular carcinoma (HCC) could be 100 ng/mL; however, the clinical significance of falsely elevated AFP in patients without HCC has not been fully studied. We investigated the clinical features and outcome of patients without HCC but with high AFP levels (100 ng/mL), especially with chronic hepatitis B (CHB) or C (CHC).The sample included 124 consecutive patients with CHB (n = 97) or CHC (n = 27), with AFP levels >100 ng/mL and without HCC at baseline. Multivariate Cox proportional regression analysis was performed to determine the factors associated with AFP normalization and HCC development.During the mean 52-month follow-up, the proportion of patients with CHB with AFP normalization (90.7%) was significantly higher than the proportion of patients with CHC (59.3%, P < 0.001). Initial aspartate aminotransferase levels (hazard ratio [HR] = 1.02 per 10 U/L increase, P = 0.021) and antiviral therapy (HR = 2.89, P < 0.001) were significantly associated with AFP normalization. Of the 16 (12.9%) patients who developed HCC, hepatitis B virus infection (HR = 10.82, P = 0.001), initiation of antiviral treatment postenrollment (HR = 0.23, P = 0.030), and AFP normalization within 12 months (HR = 0.13, P = 0.011) were associated with HCC development.CHB and CHC were the most common causes of falsely elevated AFP (>100 ng/mL). With either CHB or CHC, persistent AFP elevation (>12 months), regardless of antiviral treatment, might be an important marker of HCC development.
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Affiliation(s)
- Cha Young Kim
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
| | - Bo Ra Kim
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
| | - Sang Soo Lee
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon
| | - Dae-Hong Jeon
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
| | - Chang Min Lee
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
| | - Wan Soo Kim
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon
| | - Hyun Chin Cho
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
| | - Jin Joo Kim
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon
| | - Jae Min Lee
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon
| | - Hong Jun Kim
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
| | - Chang Yoon Ha
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
| | - Hyun Jin Kim
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon
- Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea
| | - Tae Hyo Kim
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
- Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea
| | - Woon Tae Jung
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
- Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea
| | - Ok-Jae Lee
- Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju
- Institute of Health Sciences, Gyeongsang National University, Jinju, Republic of Korea
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16
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Kim MN, Kim HS, Kim JK, Kim BK, Kim SU, Park JY, Kim DY, Ahn SH, Han KH. Clinical Utility of a New Automated Hepatitis C Virus Core Antigen Assay for Prediction of Treatment Response in Patients with Chronic Hepatitis C. J Korean Med Sci 2016; 31:1431-7. [PMID: 27510387 PMCID: PMC4974185 DOI: 10.3346/jkms.2016.31.9.1431] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Accepted: 06/03/2016] [Indexed: 12/13/2022] Open
Abstract
Hepatitis C virus core antigen (HCV Ag) is a recently developed marker of hepatitis C virus (HCV) infection. We investigated the clinical utility of the new HCV Ag assay for prediction of treatment response in HCV infection. We analyzed serum from 92 patients with HCV infection who had been treated with pegylated interferon and ribavirin. HCV Ag levels were determined at baseline in all enrolled patients and at week 4 in 15 patients. Baseline HCV Ag levels showed good correlations with HCV RNA (r = 0.79, P < 0.001). Mean HCV Ag levels at baseline were significantly lower in patients with a sustained virologic response (SVR) than in those with a non SVR (relapse plus non responder) based on HCV RNA analysis (2.8 log₁₀fmol/L vs. 3.27 log₁₀fmol/L, P = 0.023). Monitoring of the viral kinetics by determination of HCV RNA and HCV Ag levels resulted in similarly shaped curves. Patients with undetectable HCV Ag levels at week 4 had a 92.3% probability of achieving SVR based on HCV RNA assay results. The HCV Ag assay may be used as a supplement for predicting treatment response in HCV infection, but not as an alternative to the HCV RNA assay.
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Affiliation(s)
- Mi Na Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
- Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Hyon Suk Kim
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Ja Kyung Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Beom Kyung Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Seung Up Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jun Yong Park
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Do Young Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Sang Hoon Ahn
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Kwang Hyub Han
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
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17
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Ok KS, Jeong SH, Jang ES, Kim YS, Lee YJ, Kim IH, Cho SB, Bae SH, Lee HC. The clinical outcomes of chronic hepatitis C in South Korea: A prospective, multicenter cohort study. Medicine (Baltimore) 2016; 95:e4594. [PMID: 27583874 PMCID: PMC5008558 DOI: 10.1097/md.0000000000004594] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
This prospective cohort study aimed to elucidate the clinical outcome and its related factors of chronic hepatitis C in a hepatitis B-dominant Asian region.From January 2007 to October 2012, 382 patients with chronic hepatitis C without liver cirrhosis were prospectively enrolled at 6 university hospitals, and regularly followed until Apr 2014 to identify the development of liver cirrhosis, decompensated cirrhosis, hepatocellular carcinoma (HCC), and overall survival.During the median follow-up of 39.0 months (range 18.0-81.0 months), liver cirrhosis, hepatic decompensation, and HCC developed in 42 patients (11.0%), 4 patients (1.0%), and 12 patients (3.1%), respectively. The cumulative probability of development of cirrhosis at 3 years and at 5 years was 9.6% and 16.7%, respectively. That of HCC at 3 and 5 years was 1.6% and 4.5%, respectively. The 3-year and 5-year overall survival rate was 99.7% and 96.0%, respectively. Pegylated interferon-based antiviral therapy was undertaken in 237 patients (62.0%) with a sustained virologic response (SVR) rate of 74.3%. The factors related to the overall clinical outcomes were age ≥55 years (HR 2.924, P = 0.016), platelet counts <150 × 10/L (HR 3.195, P = 0.007), and the achievement of SVR (HR 0.254, P = 0.002).The clinical outcomes of this Korean chronic hepatitis C cohort were modest with minimal mortality, but significant disease progression occurred in the patients with old age, low platelet, and non-SVR after interferon-based antiviral treatment or no treatment, suggesting priority for direct acting antiviral therapy.
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Affiliation(s)
- Kyeong Sam Ok
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam
| | - Sook-Hyang Jeong
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam
- Correspondence: Sook-Hyang Jeong, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea (e-mail: )
| | - Eun Sun Jang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam
| | - Young Seok Kim
- Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon
| | - Youn Jae Lee
- Department of Internal Medicine, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan
| | - In Hee Kim
- Departement of Internal Medicine, Chonbuk National University Hospital, Chonbuk National University College of Medicine, Jeonju
| | - Sung Bum Cho
- Department of Internal Medicine, Chonnam National University Hwasun Hospital, Hwasun
| | - Si Hyun Bae
- Department of Internal Medicine, The Catholic University of Korea, Seoul Saint Mary's Hospital
| | - Han Chu Lee
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
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18
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Lim YS, Ahn SH, Lee KS, Paik SW, Lee YJ, Jeong SH, Kim JH, Yoon SK, Yim HJ, Tak WY, Han SY, Yang JC, Mo H, Garrison KL, Gao B, Knox SJ, Pang PS, Kim YJ, Byun KS, Kim YS, Heo J, Han KH. A phase IIIb study of ledipasvir/sofosbuvir fixed-dose combination tablet in treatment-naïve and treatment-experienced Korean patients chronically infected with genotype 1 hepatitis C virus. Hepatol Int 2016; 10:947-955. [PMID: 27198664 DOI: 10.1007/s12072-016-9726-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Accepted: 03/16/2016] [Indexed: 12/21/2022]
Abstract
BACKGROUND The standard-of-care regimen for chronic hepatitis C virus (HCV) infection in Korea, pegylated-interferon-alpha plus ribavirin, is poorly tolerated. Ledipasvir/sofosbuvir is a two-drug, fixed-dose combination tablet approved in the USA, European Union, and Japan for chronic genotype 1 HCV infection. METHODS This single-arm, phase IIIb study (NCT02021656) investigated the efficacy and safety of ledipasvir/sofosbuvir fixed-dose combination tablet for 12 weeks in treatment-naïve and treatment-experienced Korean patients chronically infected with genotype 1 HCV with or without compensated cirrhosis. RESULTS The proportion of patients with sustained virologic response 12 weeks after treatment discontinuation (SVR12) was 99 % (92/93), with rates of 100 % (46/46) and 98 % (46/47) in treatment-naïve and treatment-experienced patients, respectively. There were no on-treatment failures. One patient relapsed after the end of treatment. The most common treatment-emergent adverse events were headache (8 %, 7/93) and fatigue (6 %, 6/93). There were no grade 3 or 4 adverse events, seven grade 3 laboratory abnormalities, and one premature discontinuation of study treatment (due to nonserious mouth ulceration). None of the three reported serious adverse events were related to treatment. CONCLUSIONS These data suggest that 12 weeks of ledipasvir/sofosbuvir is effective and well tolerated in treatment-naïve and treatment-experienced Korean patients with chronic genotype 1 HCV infection.
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Affiliation(s)
- Young-Suk Lim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Sang Hoon Ahn
- Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea
| | - Kwan Sik Lee
- Department of Gastroenterology and Hepatology, Gangnam Severance Hospital, Yonsei University Health System, Seoul, South Korea
| | - Seung Woon Paik
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Youn-Jae Lee
- Department of Infectious Diseases, Gastroenterology, and Hepatology, Inje University, Pusan Paik Hospital, Busan, South Korea
| | - Sook-Hyang Jeong
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
| | - Ju-Hyun Kim
- Department of Internal Medicine, Gachon University Gil Hospital, Incheon, South Korea
| | - Seung Kew Yoon
- Department of Gastroenterology, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, South Korea
| | - Hyung Joon Yim
- Department of Internal Medicine, Korea University Ansan Hospital, Ansan-si, Gyeonggi-do, South Korea
| | - Won Young Tak
- Department of Internal Medicine, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, South Korea
| | - Sang-Young Han
- Department of Internal Medicine, Dong-A University Medical Center, Busan, South Korea
| | | | - Hongmei Mo
- Gilead Sciences, Inc, Foster City, CA, USA
| | | | - Bing Gao
- Gilead Sciences, Inc, Foster City, CA, USA
| | | | | | - Yoon Jun Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine and Liver Research Institute, Seoul, South Korea
| | - Kwan-Soo Byun
- Department of Internal Medicine, Korea University Guro Hospital, Seoul, South Korea
| | - Young Seok Kim
- Department of Internal Medicine, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea
| | - Jeong Heo
- Department of Internal Medicine, Pusan National University and Medical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Kwang-Hyub Han
- Department of Internal Medicine, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, South Korea.
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19
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Ahn SH, Lim YS, Lee KS, Paik SW, Lee YJ, Jeong SH, Kim JH, Yoon SK, Yim HJ, Tak WY, Han SY, Yang JC, Mo H, Mathias A, Han L, Knox SJ, Brainard DM, Kim YJ, Byun KS, Kim YS, Heo J, Han KH. A phase 3b study of sofosbuvir plus ribavirin in treatment-naive and treatment-experienced Korean patients chronically infected with genotype 2 hepatitis C virus. J Viral Hepat 2016; 23:358-65. [PMID: 26864153 DOI: 10.1111/jvh.12499] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 11/05/2015] [Indexed: 01/04/2023]
Abstract
In Korea, patients with chronic hepatitis C virus (HCV) infection are typically treated with pegylated interferon-alpha plus ribavirin, but interferons are contraindicated in many patients and are often poorly tolerated, particularly by the elderly and those with advanced liver disease. No interferon-free treatment regimens are approved in Korea. Sofosbuvir is an oral nucleotide analog inhibitor of the HCV nonstructural 5B RNA polymerase. It is approved in the USA, European Union and Japan for treating a number of HCV genotypes, including genotype 2. Genotype 2 has a seroprevalence of 38-46% in Korea. This single-arm, phase 3b study (NCT02021643) examined the efficacy and safety of sofosbuvir plus ribavirin (12-week duration) in chronic genotype 2 HCV-infected treatment-naive and treatment-experienced Korean patients with and without cirrhosis. The proportion of patients with sustained virologic response 12 weeks after treatment discontinuation (SVR12) was 97% (125/129), with 96% (101/105) of treatment-naive and 100% (24/24) of treatment-experienced patients achieving SVR12. Two patients experienced virologic failure (n = 1, on-treatment failure; n = 1, relapse). No patient discontinued study treatment due to an adverse event (AE). The most common treatment-emergent AEs were headache (18%, 23/129) and pruritus (15%, 19/129). Few patients had grade 3 AEs (5%, 6/129) or grade 3 laboratory abnormalities (12%, 15/129). No grade 4 AE was reported. These data suggest that 12 weeks of treatment with the all-oral, interferon-free regimen of sofosbuvir plus ribavirin is effective and well tolerated in Korean patients with chronic genotype 2 HCV infection.
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Affiliation(s)
- S H Ahn
- Yonsei University College of Medicine, Seoul-Korea, South Korea
| | - Y S Lim
- Asan Medical Center, University of Ulsan College of Medicine, Seoul-Korea, South Korea
| | - K S Lee
- Gangnam Severance Hospital, Yonsei University Health System, Seoul-Korea, South Korea
| | - S W Paik
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul-Korea, South Korea
| | - Y J Lee
- Pusan Paik Hospital, Inje University, Busan-Korea, South Korea
| | - S H Jeong
- Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam-Korea, South Korea
| | - J H Kim
- Gachon University Gil Hospital, Incheon-Korea, South Korea
| | - S K Yoon
- Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul-Korea, South Korea
| | - H J Yim
- Korea University Ansan Hospital, Ansan-si, Gyeonggi-do-Korea, South Korea
| | - W Y Tak
- Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, South Korea
| | - S Y Han
- Dong-A University Medical Center, Busan-Korea, South Korea
| | - J C Yang
- Gilead Sciences Inc., Foster City, CA, USA
| | - H Mo
- Gilead Sciences Inc., Foster City, CA, USA
| | - A Mathias
- Gilead Sciences Inc., Foster City, CA, USA
| | - L Han
- Gilead Sciences Inc., Foster City, CA, USA
| | - S J Knox
- Gilead Sciences Inc., Foster City, CA, USA
| | | | - Y J Kim
- Seoul National University Hospital, Seoul National University College of Medicine and Liver Research Institute, Seoul, Korea
| | - K S Byun
- Korea University Guro Hospital, Seoul-Korea, South Korea
| | - Y S Kim
- Soonchunhyang University Bucheon Hospital, Bucheon-Korea, South Korea
| | - J Heo
- Pusan National University and Medical Research Institute, Pusan National University Hospital, Busan, Korea
| | - K H Han
- Yonsei University College of Medicine, Seoul-Korea, South Korea
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20
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Kwon JH. [Hope for Cirrhosis Patients with Genotype 1 Hepatitis C Virus Who Failed the Previous Treatment]. THE KOREAN JOURNAL OF GASTROENTEROLOGY 2016; 66:131-3. [PMID: 26513826 DOI: 10.4166/kjg.2015.66.2.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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21
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Kim WS, Lee SS, Lee CM, Kim HJ, Ha CY, Kim HJ, Kim TH, Jung WT, Lee OJ, Hong JW, You HS, Cho HC. Hepatitis C and not Hepatitis B virus is a risk factor for anti-tuberculosis drug induced liver injury. BMC Infect Dis 2016; 16:50. [PMID: 26833347 PMCID: PMC4736472 DOI: 10.1186/s12879-016-1344-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Accepted: 01/12/2016] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The risk of anti-tuberculosis (TB) drug-induced liver injury (DILI) in patients with chronic viral hepatitis (CVH) is not clear. The aim of this study was to investigate incidence and risk factors associated with TB DILI in CVH and non-CVH patients. METHODS Retrospectively, a total of 128 CVH patients who received anti-TB medication from January 2005 to February 2014 were reviewed. Among these, 83 patients had hepatitis B virus (HBV), 41 patients had hepatitis C virus (HCV) and 4 patients were dual hepatitis B and hepatitis C virus co-infected (HBV + HCV) with 251 non-CVH patients who received anti-TB medication selected as the controls. There were no human immunodeficiency virus co-infected patients. Risk factors for DILI were analyzed using cox regression analysis. RESULTS The incidence of DILI was significantly higher in the HCV group (13/41 [31.7%], p < 0.001) and HBV + HCV groups (3/4 [75.0%], p = 0.002) compared to the control group (25/251 [10.0%]). The incidence of transient liver function impairment in the hepatitis B virus group was higher than in the control group (18/83 [21.7%] vs. 27/251 [10.8%] p = 0.010), but not in DILI (11/83 [13.3%] vs. 25/251 [10.0%], p = 0.400). In total patients, HCV, HBV + HCV co-infection, older age, and baseline liver function abnormality were independent factors of DILI. CONCLUSIONS It is recommended to carefully monitor for DILI in patients with HCV or HBV/HCV co-infection, older age, and baseline liver function abnormality.
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Affiliation(s)
- Wan Soo Kim
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Gangnam-ro 79, Jinju, Gyeognam, 660-702, South Korea.
| | - Sang Soo Lee
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Gangnam-ro 79, Jinju, Gyeognam, 660-702, South Korea.
| | - Chang Min Lee
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Gangnam-ro 79, Jinju, Gyeognam, 660-702, South Korea.
| | - Hong Jun Kim
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Gangnam-ro 79, Jinju, Gyeognam, 660-702, South Korea.
| | - Chang Yoon Ha
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Gangnam-ro 79, Jinju, Gyeognam, 660-702, South Korea.
| | - Hyun Jin Kim
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Gangnam-ro 79, Jinju, Gyeognam, 660-702, South Korea.
| | - Tae Hyo Kim
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Gangnam-ro 79, Jinju, Gyeognam, 660-702, South Korea.
| | - Woon Tae Jung
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Gangnam-ro 79, Jinju, Gyeognam, 660-702, South Korea.
| | - Ok Jae Lee
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Gangnam-ro 79, Jinju, Gyeognam, 660-702, South Korea.
| | - Jeong Woo Hong
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Gangnam-ro 79, Jinju, Gyeognam, 660-702, South Korea.
| | - Hyun Seon You
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Gangnam-ro 79, Jinju, Gyeognam, 660-702, South Korea.
| | - Hyun Chin Cho
- Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Palyong-ro, 158, MasanHoiwon-gu, Chang-Won, Republic of Korea.
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22
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Liakina V, Hamid S, Tanaka J, Olafsson S, Sharara AI, Alavian SM, Gheorghe L, El Hassan ES, Abaalkhail F, Abbas Z, Abdou A, Abourached A, Al Braiki F, Al Hosani F, Al Jaberi K, Al Khatry M, Al Mulla MA, Al Quraishi H, Al Rifai A, Al Serkal Y, Alam A, Alashgar HI, Alawadhi S, Al-Dabal L, Aldins P, Alfaleh FZ, Alghamdi AS, Al-Hakeem R, Aljumah AA, Almessabi A, Alqutub AN, Alswat KA, Altraif I, Alzaabi M, Andrea N, Assiri AM, Babatin MA, Baqir A, Barakat MT, Bergmann OM, Bizri AR, Blach S, Chaudhry A, Choi MS, Diab T, Djauzi S, El Khoury S, Estes C, Fakhry S, Farooqi JI, Fridjonsdottir H, Gani RA, Ghafoor Khan A, Goldis A, Gottfredsson M, Gregorcic S, Hajarizadeh B, Han KH, Hasan I, Hashim A, Horvath G, Hunyady B, Husni R, Jafri W, Jeruma A, Jonasson JG, Karlsdottir B, Kim DY, Kim YS, Koutoubi Z, Lesmana LA, Lim YS, Löve A, Maimets M, Makara M, Malekzadeh R, Matičič M, Memon MS, Merat S, Mokhbat JE, Mourad FH, Muljono DH, Nawaz A, Nugrahini N, Priohutomo S, Qureshi H, Rassam P, Razavi H, Razavi-Shearer D, Razavi-Shearer K, Rozentale B, Sadik M, Saeed K, Salamat A, Salupere R, Sanai FM, Sanityoso Sulaiman A, Sayegh RA, Schmelzer JD, Sibley A, Siddiq M, Siddiqui AM, Sigmundsdottir G, Sigurdardottir B, Speiciene D, Sulaiman A, Sultan MA, Taha M, Tarifi H, Tayyab G, Tolmane I, Ud Din M, Umar M, Valantinas J, Videčnik-Zorman J, Yaghi C, Yunihastuti E, Yusuf MA, Zuberi BF, Gunter J. Historical epidemiology of hepatitis C virus (HCV) in select countries - volume 3. J Viral Hepat 2015; 22 Suppl 4:4-20. [PMID: 26513445 DOI: 10.1111/jvh.12475] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 09/06/2015] [Indexed: 02/05/2023]
Abstract
Detailed, country-specific epidemiological data are needed to characterize the burden of chronic hepatitis C virus (HCV) infection around the world. With new treatment options available, policy makers and public health officials must reconsider national strategies for infection control. In this study of 15 countries, published and unpublished data on HCV prevalence, viraemia, genotype, age and gender distribution, liver transplants and diagnosis and treatment rates were gathered from the literature and validated by expert consensus in each country. Viraemic prevalence in this study ranged from 0.2% in Iran and Lebanon to 4.2% in Pakistan. The largest viraemic populations were in Pakistan (7 001 000 cases) and Indonesia (3 187 000 cases). Injection drug use (IDU) and a historically unsafe blood supply were major risk factors in most countries. Diagnosis, treatment and liver transplant rates varied widely between countries. However, comparison across countries was difficult as the number of cases changes over time. Access to reliable data on measures such as these is critical for the development of future strategies to manage the disease burden.
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Affiliation(s)
- V Liakina
- Centre of Hepatology, Gastroenterology, and Dietetics, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Department of Biomechanics, Vilnius Gediminas Technical University, Vilnius, Lithuania
| | - S Hamid
- The Aga Khan University, Karachi, Pakistan
| | - J Tanaka
- Department of Epidemiology, Infectious Disease Control and Prevention, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima, Japan
| | - S Olafsson
- Division of Gastroenterology and Hepatology, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - A I Sharara
- Division of Gastroenterology, American University of Beirut Medical Center, Beirut, Lebanon
| | - S M Alavian
- Baqiatallah Research Center for Gastroenterology and Liver Diseases, Baqiatallah University of Medical Sciences, Tehran, Iran.,Middle East Liver Diseases Centre, Tehran, Iran
| | - L Gheorghe
- Center of Gastroenterology & Hepatology, Fundeni Clinical Institute, Bucharest, Romania
| | | | - F Abaalkhail
- Department of Liver and Small Bowel Transplantation, King Faisal Specialist Hospital and Research Center, Alfaisal University, Riyadh, Saudi Arabia
| | - Z Abbas
- Ziauddin University, Karachi, Pakistan
| | - A Abdou
- Rashid Hospital, Dubai Health Authority, Dubai, UAE
| | - A Abourached
- National Hepatitis Program, Ministry of Public Health, Beirut, Lebanon
| | - F Al Braiki
- Abu Dhabi Health Services Company, Abu Dhabi, UAE
| | - F Al Hosani
- Communicable Diseases Department, Health Authority Abu Dhabi, Abu Dhabi, UAE
| | - K Al Jaberi
- Health Regulation Division, Health Authority Abu Dhabi, Abu Dhabi, UAE
| | - M Al Khatry
- Ras Al Khaimah Hospital, Ras Al Khaimah, UAE
| | - M A Al Mulla
- Communicable Diseases Department, Health Authority Abu Dhabi, Abu Dhabi, UAE
| | | | | | - Y Al Serkal
- Hospitals Sector, Ministry of Health, Al-Ain, UAE
| | - A Alam
- Shaikh Zayed Hospital, Lahore, Pakistan
| | - H I Alashgar
- Department of Medicine, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - S Alawadhi
- Rashid Hospital, Dubai Health Authority, Dubai, UAE
| | - L Al-Dabal
- Department of Pulmonary Medicine, Rashid Hospital, Dubai Health Authority, Dubai, UAE
| | - P Aldins
- Infection Control Department, Pauls Stradins Clinical University Hospital, Riga, Latvia
| | - F Z Alfaleh
- Liver Disease Research Center, King Saud University, Riyadh, Saudi Arabia
| | - A S Alghamdi
- Gastroenterology and Hepatology Unit, Medical Specialties Department, King Fahad Hospital, Riyadh, Saudi Arabia
| | - R Al-Hakeem
- Department of Preventive Medicine, Ministry of Health, Riyadh, Saudi Arabia
| | - A A Aljumah
- King Abdulaziz Medical City and King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - A Almessabi
- Abu Dhabi Health Services Company, Abu Dhabi, UAE
| | - A N Alqutub
- Gastroenterology and Hepatology Unit, Medical Specialties Department, King Fahad Hospital, Riyadh, Saudi Arabia
| | - K A Alswat
- Department of Medicine, King Saud University Liver Disease Research Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - I Altraif
- King Abdulaziz Medical City and King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - M Alzaabi
- Zayed Military Hospital, Abu Dhabi, UAE
| | - N Andrea
- Daman National Health Insurance Company, Abu Dhabi, UAE
| | - A M Assiri
- Department of Preventive Medicine, Ministry of Health, Riyadh, Saudi Arabia
| | - M A Babatin
- Gastroenterology and Hepatology Unit, Medical Specialties Department, King Fahad Hospital, Riyadh, Saudi Arabia
| | - A Baqir
- Seyal Medical Centre, Multan, Pakistan
| | | | - O M Bergmann
- Division of Gastroenterology and Hepatology, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - A R Bizri
- Faculty of Medicine, Division of Infectious Diseases, American University of Beirut Medical Center, Beirut, Lebanon
| | - S Blach
- Center for Disease Analysis (CDA), Louisville, CO, USA
| | - A Chaudhry
- Gujranwala Liver Foundation, Siddiq Sadiq Hospital, Gujranwala, Pakistan
| | - M S Choi
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - T Diab
- Al Ain Hospital, Al Ain, UAE
| | - S Djauzi
- Division of Hepatobiliary, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - S El Khoury
- Gastroenterology Department, Saint George Hospital, University of Balamand, Balamand, Lebanon
| | - C Estes
- Center for Disease Analysis (CDA), Louisville, CO, USA
| | - S Fakhry
- Abu Dhabi Police, Abu Dhabi, UAE
| | - J I Farooqi
- Postgraduate Medical Institute, Khyber Medical University, Peshawar, Pakistan.,Government Lady Reading Hospital, Peshawar, Pakistan
| | - H Fridjonsdottir
- Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - R A Gani
- Division of Hepatobiliary, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - A Ghafoor Khan
- Department of Gastroenterology & Hepatology, Lady Reading Hospital, Peshawar, Pakistan
| | - A Goldis
- Clinic of Gastroenterology, University of Medicine 'Victor Babes', Timisoara, Romania
| | - M Gottfredsson
- Faculty of Medicine, School of Health Sciences, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - S Gregorcic
- Clinic for Infectious Diseases and Febrile Illnesses, University Medical Centre, Ljubljana, Slovenia
| | - B Hajarizadeh
- The Kirby Institute, University of New South Wales Australia, Sydney, NSW, Australia.,The Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, VIC, Australia
| | - K H Han
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - I Hasan
- Division of Hepatobiliary, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - A Hashim
- Liver Transplantation, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - G Horvath
- Hepatology Center of Buda, Budapest, Hungary
| | - B Hunyady
- Department of Gastroenterology, Somogy County Kaposi Mor Teaching Hospital, Kaposvar, Hungary.,First Department of Medicine, University of Pecs, Pecs, Hungary
| | - R Husni
- Lebanese American University Medical Center, Rizk Hospital, Beirut, Lebanon
| | - W Jafri
- Aga Khan University, Karachi, Pakistan
| | - A Jeruma
- Department of Hepatology, Infectology Center of Latvia, Riga, Latvia.,Department of Infectology and Dermatology, Riga Stradins University, Riga, Latvia
| | - J G Jonasson
- Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.,Icelandic Cancer Registry, Reykjavik, Iceland.,The Faculty of Medicine, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - B Karlsdottir
- Division of Infectious Disease, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - D Y Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Y S Kim
- Department of Internal Medicine, Soon Chun Hyang University Bucheon Hospital, Bucheon, Korea
| | - Z Koutoubi
- Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
| | - L A Lesmana
- Division of Hepatobiliary, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.,Digestive Disease and GI Oncology Center, Medistra Hospital, Jakarta, Indonesia
| | - Y S Lim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - A Löve
- Faculty of Medicine, School of Health Sciences, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland.,Department of Virology, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - M Maimets
- University of Tartu, Tartu University Hospital, Tartu, Estonia
| | - M Makara
- Central Outpatient Clinic, Saint Laszlo Hospital, Budapest, Hungary
| | - R Malekzadeh
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - M Matičič
- Clinic for Infectious Diseases and Febrile Illnesses, University Medical Centre, Ljubljana, Slovenia
| | - M S Memon
- Asian Institute of Medical Science (AIMS), Hyderabad, Pakistan
| | - S Merat
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - J E Mokhbat
- Division of Infectious Diseases and Division of Clinical Microbiology, Lebanese American University Medical Center Rizk Hospital, Beirut, Lebanon
| | - F H Mourad
- Division of Gastroenterology, American University of Beirut Medical Center, Beirut, Lebanon
| | - D H Muljono
- Eijkman Institute for Molecular Biology, Jakarta, Indonesia.,Department of Hepatitis & Emerging Infectious Diseases, University of Sydney, Sydney, NSW, Australia
| | - A Nawaz
- Department of Gastroenterology, Fatima Memorial Hospital College of Medicine and Dentistry, Lahore, Pakistan
| | - N Nugrahini
- Sub-Directorate for Gastrointestinal Infection, Diarrheal Diseases, and Hepatitis, Directorate of Direct Transmitted Disease Control, Disease Control & Environmental Health, Ministry of Health, Jakarta, Indonesia
| | - S Priohutomo
- Directorate of Direct Transmitted Disease Control, Disease Control & Environmental Health, Ministry of Health, Jakarta, Indonesia
| | - H Qureshi
- Pakistan Medical Research Council, Islamabad, Pakistan
| | - P Rassam
- Gastroenterology Department, Saint George Hospital, University of Balamand, Balamand, Lebanon
| | - H Razavi
- Center for Disease Analysis (CDA), Louisville, CO, USA
| | | | | | - B Rozentale
- Department of Hepatology, Infectology Center of Latvia, Riga, Latvia.,Department of Infectology and Dermatology, Riga Stradins University, Riga, Latvia
| | - M Sadik
- Asian Institute of Medical Science (AIMS), Hyderabad, Pakistan
| | - K Saeed
- Khawar Clinic, Sahiwal, Pakistan
| | - A Salamat
- Department of Gastroenterology, Military Hospital, Rawalpindi, Pakistan
| | - R Salupere
- University of Tartu, Tartu University Hospital, Tartu, Estonia
| | - F M Sanai
- Liver Disease Research Center, King Saud University, Riyadh, Saudi Arabia
| | - A Sanityoso Sulaiman
- Division of Hepatobiliary, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
| | - R A Sayegh
- Department of Hepatology and Gastroenterology, School of Medical Science, Saint Joseph University, Beirut, Lebanon
| | - J D Schmelzer
- Center for Disease Analysis (CDA), Louisville, CO, USA
| | - A Sibley
- Center for Disease Analysis (CDA), Louisville, CO, USA
| | - M Siddiq
- Jinnah Memorial Hospital, Rawalpindi, Pakistan.,Yusra Medical College, Rawalpindi, Pakistan
| | | | - G Sigmundsdottir
- Centre for Health Security and Communicable Disease Control, Directorate of Health in Iceland, Reykjavik, Iceland
| | - B Sigurdardottir
- Division of Infectious Disease, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - D Speiciene
- Centre of Hepatology, Gastroenterology, and Dietetics, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - A Sulaiman
- Division of Hepatobiliary, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia.,Klinik Hati Prof. Ali Sulaiman, Jakarta, Indonesia
| | - M A Sultan
- Health Funding Department, Enaya Insurance Company, Abu Dhabi, UAE
| | - M Taha
- Department of Medicine, Tawam Hospital, Al Ain, UAE
| | - H Tarifi
- Pharmacy Department, Tawam Hospital, Al Ain, UAE
| | - G Tayyab
- Postgraduate Medical Institute, Lahore General Hospital, Lahore, Pakistan.,Doctors Hospital and Medical Center, Lahore, Pakistan
| | - I Tolmane
- Department of Hepatology, Infectology Center of Latvia, Riga, Latvia.,Department of Infectology and Dermatology, Riga Stradins University, Riga, Latvia
| | - M Ud Din
- Pakistan Society of Gastroenterology, Karachi, Pakistan
| | - M Umar
- Department of Medicine, Rawalpindi Medical College, Rawalpindi, Pakistan.,Department of Medicine, Holy Family Hospital, Rawalpindi, Pakistan
| | - J Valantinas
- Centre of Hepatology, Gastroenterology, and Dietetics, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - J Videčnik-Zorman
- Clinic for Infectious Diseases and Febrile Illnesses, University Medical Centre, Ljubljana, Slovenia
| | - C Yaghi
- Department of Hepatology and Gastroenterology, School of Medical Science, Saint Joseph University, Beirut, Lebanon
| | - E Yunihastuti
- Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Jakarta, Indonesia
| | - M A Yusuf
- Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore, Pakistan
| | | | - J Gunter
- Center for Disease Analysis (CDA), Louisville, CO, USA
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23
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Hwang Y, Kim W, Kwon SY, Yu HM, Kim JH, Choe WH. Incidence of and risk factors for thyroid dysfunction during peginterferon α and ribavirin treatment in patients with chronic hepatitis C. Korean J Intern Med 2015; 30:792-800. [PMID: 26552454 PMCID: PMC4642008 DOI: 10.3904/kjim.2015.30.6.792] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2014] [Revised: 07/22/2014] [Accepted: 09/18/2014] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND/AIMS Thyroid dysfunction (TD) is more likely to occur in patients with chronic hepatitis C (CHC) and is particularly associated with interferon (IFN) treatment. The purpose of this study was to investigate the incidence, outcomes, and risk factors for TD during pegylated interferon (PEG-IFN) and ribavirin (RBV) combined therapy in patients with CHC. METHODS A total of 242 euthyroid patients with CHC treated with PEG-IFN/RBV were included. Thyroid function and autoantibodies were measured at baseline, and virologic response and thyroid function were assessed every 3 months during therapy. RESULTS TD developed in 67 patients (27.7%) during the PEG-IFN/RBV treatment. The types of TD were subclinical hypothyroidism (50.7%), hypothyroidism (14.9%), thyroiditis (11.9%), subclinical hyperthyroidism (10.4%), and hyperthyroidism (10.4%). Most of the patients with TD recovered spontaneously; however, seven patients (10.4%) needed thyroid treatment. The sustained virological response rate was higher in patients with TD than those without (65.7% vs. 49.1%, p = 0.02). Baseline thyroid stimulating hormone (TSH) concentrations (odds ratio [OR], 2.09; 95% confidence interval [CI], 1.96 to 8.77; p < 0.001), presence of the thyroid peroxidase antibody (OR, 8.81; 95% CI, 1.74 to 44.6; p = 0.009), and PEG-IFNα-2b (OR, 3.01; 95% CI, 1.43 to 6.39; p = 0.004) were independent risk factors for the development of TD. CONCLUSIONS TD developed in 27.7% of patients with CHC during PEG-IFN/RBV treatment, and 10.4% of these patients needed thyroid treatment. TD is associated with a favorable virologic response to PEG-IFN/RBV. Assessment of TSH and thyroid autoantibodies at baseline and close monitoring of thyroid function during PEG-IFN/RBV therapy are necessary for early detection and management of IFN-induced TD.
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Affiliation(s)
- Yong Hwang
- Department of Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Won Kim
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea
| | - So Young Kwon
- Department of Medicine, Konkuk University School of Medicine, Seoul, Korea
- Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
- Correspondence to So Young Kwon, M.D. Department of Internal Medicine, Konkuk University Medical Center, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Korea Tel: +82-2-2030-5027 Fax: +82-2-2030-5029 E-mail:
| | - Hyung Min Yu
- Department of Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Jeong Han Kim
- Department of Medicine, Konkuk University School of Medicine, Seoul, Korea
| | - Won Hyeok Choe
- Department of Medicine, Konkuk University School of Medicine, Seoul, Korea
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Rou WS, Lee BS. Hepatitis C virus infection in patients with hemophilia in Korea: Is antiviral therapy effective and safe? Clin Mol Hepatol 2015; 21:122-4. [PMID: 26157748 PMCID: PMC4493354 DOI: 10.3350/cmh.2015.21.2.122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2015] [Revised: 05/10/2015] [Indexed: 11/13/2022] Open
Affiliation(s)
- Woo Sun Rou
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Byung Seok Lee
- Division of Gastroenterology, Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea
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Ahn SB, Jun DW, Kim SG, Lee SH, Shin HP, Choe WH, Kim JK, Jung KS, Kim DY, Shim JJ, Park SY, Seo YS, Kim W, Chung JI. Efficacy and safety of pegylated interferon base treatment in patients with chronic hepatitis C on dialysis. Eur J Intern Med 2015; 26:292-6. [PMID: 25877760 DOI: 10.1016/j.ejim.2015.03.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 03/07/2015] [Accepted: 03/28/2015] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Patients with chronic hepatitis C (CHC) and end-stage renal disease (ESRD) on dialysis are difficult to treat and show higher dropout rates during treatment. The aim of this study was to analyze the treatment outcomes in patients with CHC and underlying end-stage renal disease on dialysis in Korea. METHODS A retrospective multi-center study of 35 patients with CHC and underlying ESRD on regular dialysis from 13 centers were analyzed. We investigated the tolerability and efficacy of pegylated interferon therapy with or without ribavirin on dialysis patients. RESULTS Twenty patients (57%) were genotype 1. Sixteen patients (46%) were treated with pegylated interferon monotherapy. Nineteen patients (54%) were treated with pegylated interferon and ribavirin. The overall sustained virological response (SVR) rate was 65.7% in all subjects. Thirteen patients (37%) dropped out before completion of treatment, and six patients (46.2%) showed SVR despite premature termination of treatment. Twenty patients (90.9%) achieved SVR among the 22 patients who completed the scheduled course. The most common side effects were anemia and neutropenia. The patients receiving ribavirin treatment showed a higher dropout rate (52.6% vs. 18.8%, p=0.04) and higher SVR rate (68.4% vs. 62.5%, p=0.07) compared to the pegylated interferon mono-treatment group. CONCLUSIONS The difficulty in treating HCV patients with ESRD was attributed to higher dropout rate. However, despite the high dropout rate (37%), the SVR rate in genotype 1 was 65% and in genotypes 2 and 3 was 66%. Patients who completed the treatment showed a high SVR rate of 89.5%.
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Affiliation(s)
- Sang Bong Ahn
- Department of Internal Medicine, Eulji University College of Medicine, Republic of Korea
| | - Dae Won Jun
- Department of Internal Medicine, Hanyang University College of Medicine, Republic of Korea.
| | - Sang Gyune Kim
- Department of Internal Medicine, Soonchunhyang University, Bucheon Hospital, Republic of Korea
| | - Sae Hwan Lee
- Department of Internal Medicine, Soonchunhyang University, Bucheon Hospital, Republic of Korea
| | - Hyun Phil Shin
- Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Republic of Korea
| | - Won Hyeok Choe
- Department of Internal Medicine, Konkuk University School of Medicine, Republic of Korea
| | - Ja Kyung Kim
- Department of Internal Medicine, Yonsei University School of Medicine, Republic of Korea
| | - Kyu Sik Jung
- Department of Internal Medicine, Yonsei University School of Medicine, Republic of Korea
| | - Do Young Kim
- Department of Internal Medicine, Yonsei University School of Medicine, Republic of Korea
| | - Jae-Jun Shim
- Department of Internal Medicine, Kyung Hee University School of Medicine, Republic of Korea
| | - Soo Young Park
- Department of Internal Medicine, Kyungpook National University Hospital, Republic of Korea
| | - Yeon Seok Seo
- Department of Internal Medicine, Korea University School of Medicine, Republic of Korea
| | - Won Kim
- Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Jae Il Chung
- Sahmyook Medical Center, Seoul, Republic of Korea
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Abstract
Liver-related biomarkers have been developed and validated mainly in patients with chronic hepatitis C for the prediction of liver fibrosis or cirrhosis, which is a final pathway of chronic liver injury. They are noninvasive, traceable, and easy-to-use. Biomarkers provide implications related to screening, diagnosis, treatment, and prognosis of chronic hepatitis. For the improvement of performance and coverage, biomarker panels, imaging biomarkers, and even genetic biomarkers have been developed. With the advancement of genomics and proteomics, earlier and more precise prediction is expected in the near future. In this review, multiple biomarker panels for the estimation of the degree of fibrosis in chronic hepatitis C, biomarkers for the screening and diagnosis of hepatitis C, biomarkers for the treatment of hepatitis C, biomarkers for the prediction of complications related to the chronic hepatitis C, and future perspectives will be summarized.
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Affiliation(s)
- Seung Ha Park
- Department of Internal Medicine, Inje University College of Medicine, Busan, South Korea
| | - Chang Seok Bang
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, South Korea
| | - Dong Joon Kim
- Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, South Korea.
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Jeong SH. New direct-acting antivirals for the treatment of chronic hepatitis C. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2015. [DOI: 10.5124/jkma.2015.58.12.1154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Sook-Hyang Jeong
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
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Sinn DH, Gwak GY, Cho J, Paik SW, Yoo BC. Comparison of clinical manifestations and outcomes between hepatitis B virus- and hepatitis C virus-related hepatocellular carcinoma: analysis of a nationwide cohort. PLoS One 2014; 9:e112184. [PMID: 25372403 PMCID: PMC4221592 DOI: 10.1371/journal.pone.0112184] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 10/13/2014] [Indexed: 12/24/2022] Open
Abstract
Background We analyzed whether difference exist in the clinical manifestations and outcomes of hepatocellular carcinoma (HCC) according to the two major etiologies of HCC from a nationwide, population-based, random HCC registry. Methods Of the 31,521 new HCC cases registered at the Korea Central Cancer Registry between 2003 and 2005, 4,630 (14.7%) were randomly abstracted, and followed up until December 2011. Of those, 2,785 hepatitis B virus (HBV)-related and 447 hepatitis C virus (HCV)-related HCC patients were compared. Results The mean annual incidence rates of HBV- and HCV-related HCC incidence per 100,000 persons were 20.8 and 4.9, respectively. The annual incidence rate of HBV-related HCC peaked at 50–59 age group (46.5 per 100,000 persons), while the annual incidence rate of HCV-related HCC increased gradually to the ≥70 year age group (13.2 per 100,000 persons). Large tumors (≥5 cm) and portal vein invasion at initial diagnosis were more frequent in HBV-related HCC, while multiple tumors were more frequent in HCV-related HCC. In outcome analysis, HBV-related HCC showed poorer survival than HCV-related HCC [median survival: 1.34 vs. 2.17 years, adjusted hazard ratio (95% confidence interval): 0.88 (0.78–0.98), P = 0.03, adjusted for age, gender, Child-Pugh class, AJCC/mUICC stage, and initial treatment modality]. However, when divided according to the AJCC/mUICC stage, survival difference was observed only for those with AJCC/mUICC stage IV tumor, but not for AJCC/mUICC stage I, II or III tumors. The treatment outcome of each modality (resection, ablation, and transartherial chemoeombolization) was comparable between the two etiologies. Conclusion HBV-related and HCV-related HCC have clear differences in clinical manifestation, requiring different screening strategy according to etiology to optimize HCC surveillance in HBV-endemic area. However, etiology did not affect treatment outcomes and long-term survival within the same stage except for far advanced tumors.
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Affiliation(s)
- Dong Hyun Sinn
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Geum-Youn Gwak
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- * E-mail:
| | - Juhee Cho
- Department of Health Science and Technology, Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, Seoul, Korea
- Department of Health, Behavior and Society and Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, United States of America
| | - Seung Woon Paik
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Byung Chul Yoo
- Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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