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Jančorienė L, Rozentāle B, Tolmane I, Jēruma A, Salupere R, Buivydienė A, Valantinas J, Kupčinskas L, Šumskienė J, Čiupkevičienė E, Ambrozaitis A, Golubovska O, Moroz L, Flisiak R, Bondar B. Genotype Distribution and Characteristics of Chronic Hepatitis C Infection in Estonia, Latvia, Lithuania, and Ukraine: The RESPOND-C Study. Medicina (Kaunas) 2023; 59:1577. [PMID: 37763696 PMCID: PMC10534763 DOI: 10.3390/medicina59091577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 08/18/2023] [Accepted: 08/28/2023] [Indexed: 09/29/2023]
Abstract
Background and objectives: Since 2013, highly effective direct-acting antiviral (DAA) treatment for chronic hepatitis C (CHC) has become available, with cure rates exceeding 95%. For the choice of optimal CHC treatment, an assessment of the hepatitis C virus (HCV) genotype (GT) and liver fibrosis stage is necessary. Information about the distribution of these parameters among CHC patients in Estonia, Latvia, and Lithuania (the Baltic states) and especially in Ukraine is scarce. This study was performed to obtain epidemiologic data regarding CHC GT and fibrosis stage distribution for better planning of resources and prioritization of patients for DAA drug treatment according to disease severity in high-income (the Baltic states) and lower-middle-income (Ukraine) countries. Materials and methods: The retrospective RESPOND-C study included 1451 CHC patients. Demographic and disease information was collected from medical charts for each patient. Results: The most common suspected mode of viral transmission was blood transfusions (17.8%), followed by intravenous substance use (15.7%); however, in 50.9% of patients, the exact mode of transmission was not clarified. In Ukraine (18.4%) and Estonia (26%), transmission by intravenous substance use was higher than in Lithuania (5%) and Latvia (5.3%). Distribution of HCV GT among patients with CHC was as follows: GT1-66.4%; GT3-28.1; and GT2-4.1%. The prevalence of GT1 was the highest in Latvia (84%) and the lowest in Ukraine (63%, p < 0.001). Liver fibrosis stages were distributed as follows: F0-12.2%, F1-26.3%, F2-23.5%, F3-17.1%, and F4-20.9%. Cirrhosis (F4) was more prevalent in Lithuanian patients (30.1%) than in Estonians (8.1%, p < 0.001). Conclusions: This study contributes to the knowledge of epidemiologic characteristics of HCV infection in the Baltic states and Ukraine. The data regarding the patterns of HCV GT and fibrosis stage distribution will be helpful for the development of national strategies to control HCV infection in the era of DAA therapy.
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Affiliation(s)
- Ligita Jančorienė
- Clinic of Infectious Diseases and Dermatovenerology, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius University Hospital Santaros Klinikos, LT-08406 Vilnius, Lithuania
| | - Baiba Rozentāle
- Latvian Centre of Infectious Diseases, Riga East Clinical University Hospital, LV-1006 Riga, Latvia
| | - Ieva Tolmane
- Latvian Centre of Infectious Diseases, Riga East Clinical University Hospital, LV-1006 Riga, Latvia
- Faculty of Medicine, University of Latvia, LV-1586 Riga, Latvia
| | - Agita Jēruma
- Latvian Centre of Infectious Diseases, Riga East Clinical University Hospital, LV-1006 Riga, Latvia
- Faculty of Medicine, Riga Stradins University, LV-1007 Riga, Latvia
| | - Riina Salupere
- Tartu University Hospital, University of Tartu, EE-50406 Tartu, Estonia
| | - Arida Buivydienė
- Clinic of Gastroenterology, Nephrourology and Surgery, Vilnius University Hospital Santaros Klinikos, LT-08406 Vilnius, Lithuania
- Centre of Hepatology, Gastroenterology and Dietetics, Vilnius University Hospital Santaros Klinikos, LT-08406 Vilnius, Lithuania
| | - Jonas Valantinas
- Clinic of Gastroenterology, Nephrourology and Surgery, Vilnius University Hospital Santaros Klinikos, LT-08406 Vilnius, Lithuania
- Centre of Hepatology, Gastroenterology and Dietetics, Vilnius University Hospital Santaros Klinikos, LT-08406 Vilnius, Lithuania
| | - Limas Kupčinskas
- Department of Gastroenterology, Medical Academy, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania
| | - Jolanta Šumskienė
- Department of Gastroenterology, Medical Academy, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania
| | - Eglė Čiupkevičienė
- Department of Gastroenterology, Medical Academy, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania
- Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, LT-47181 Kaunas, Lithuania
| | - Arvydas Ambrozaitis
- Clinic of Infectious Diseases and Dermatovenerology, Institute of Clinical Medicine, Medical Faculty, Vilnius University, Vilnius University Hospital Santaros Klinikos, LT-08406 Vilnius, Lithuania
| | - Olga Golubovska
- Infectious Disease Department, O.O. Bogomolets National Medical University, 01601 Kyiv, Ukraine
| | - Larysa Moroz
- Department of Infectious Diseases with the Course of Epidemiology, National Pirogov Memorial Medical University, 21018 Vinnytsya, Ukraine
| | - Robert Flisiak
- Department of Infectious Diseases and Hepatology, Medical University of Bialystok, 15-089 Bialystok, Poland
| | - Borys Bondar
- AbbVie Biopharmaceuticals GmbH, 01032 Kyiv, Ukraine
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Maksimaityte V, Reivytyte R, Milaknyte G, Mickys U, Razanskiene G, Stundys D, Kazenaite E, Valantinas J, Stundiene I. Metastatic multifocal melanoma of multiple organ systems: A case report. World J Clin Cases 2022; 10:10136-10145. [PMID: 36246820 PMCID: PMC9561590 DOI: 10.12998/wjcc.v10.i28.10136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/05/2022] [Accepted: 07/31/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Malignant melanoma is becoming more common among middle-aged individuals all over the world. Melanoma metastasis can be found in various organs, although metastases to the spleen and stomach are rare. Herein we present a rare metastatic multifocal melanoma, clinically and histologically mimicking lymphoma, with metastases of multiple organs.
CASE SUMMARY A 46-year-old Caucasian male with a history of nodular cutaneous malignant melanoma was presented with nausea, general weakness, shortness of breath, abdominal enlargement, and night sweating. The abdominal ultrasound revealed enlarged liver and spleen with multiple lesions. Computed tomography demonstrated multiple lesions in the lungs, liver, spleen, subcutaneous tissue, bones and a pathological lymphadenopathy of the neck. Trephine biopsy and the biopsy from the enlarged lymph node were taken. Tumor cells showed diffuse or partial positivity for melanocytic markers, such as microphthalmia - associated transcription factor, S100, HMB45 and Melan-A. The tumor harbored BRAF V600E mutation, demonstrated by immunohistochemical labelling for BRAF V600E and detected by real-time polymerase chain reaction test. Having combined all the findings, a diagnosis was made of a metastatic multifocal melanoma of the stomach, duodenum, liver, spleen, lungs, lymph nodes and bones. The patient refused treatment and died a week later.
CONCLUSION This case report highlights the clinical relevance of rare metastatic multifocal melanoma of multiple organ systems.
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Affiliation(s)
- Vaidota Maksimaityte
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius 01513, Lithuania
| | - Rosita Reivytyte
- Faculty of Medicine, Vilnius University, Vilnius 01513, Lithuania
| | - Gabriele Milaknyte
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius 01513, Lithuania
| | - Ugnius Mickys
- Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius 01513, Lithuania
| | - Gintare Razanskiene
- Institute of Biomedical Sciences, Faculty of Medicine, Vilnius University, Vilnius 01513, Lithuania
| | - Domantas Stundys
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius 01513, Lithuania
| | - Edita Kazenaite
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius 01513, Lithuania
| | - Jonas Valantinas
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius 01513, Lithuania
| | - Ieva Stundiene
- Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius 01513, Lithuania
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Strainiene S, Peciulyte M, Strainys T, Stundiene I, Savlan I, Liakina V, Valantinas J. Management of Flood syndrome: What can we do better? World J Gastroenterol 2021; 27:5297-5305. [PMID: 34539133 PMCID: PMC8409160 DOI: 10.3748/wjg.v27.i32.5297] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/03/2021] [Accepted: 08/03/2021] [Indexed: 02/06/2023] Open
Abstract
Approximately 20% of cirrhotic patients with ascites develop umbilical herniation. These patients usually suffer from multisystemic complications of cirrhosis, have a significantly higher risk of infection, and require accurate surveillance– especially in the context of the coronavirus disease 2019 pandemic. The rupture of an umbilical hernia, is an uncommon, life-threatening complication of large-volume ascites and end-stage liver disease resulting in spontaneous paracentesis, also known as Flood syndrome. Flood syndrome remains a challenging condition for clinicians, as recommendations for its management are lacking, and the available evidence for the best treatment approach remains controversial. In this paper, four key questions are addressed regarding the management and prevention of Flood syndrome: (1) Which is the best treatment approach–conservative treatment or urgent surgery? (2) How can we establish the individual risk for herniation and possible hernia rupture in cirrhotic patients? (3) How can we prevent umbilical hernia ruptures? And (4) How can we manage these patients in the conditions created by the coronavirus disease 2019 pandemic?
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Affiliation(s)
- Sandra Strainiene
- Clinic of Gastroenterology, Nephrourology and Surgery, Centre of Hepatology, Gastroenterology and Dietetics, Institute of Clinical Medicine, Vilnius University, Vilnius 03104, Lithuania
| | - Milda Peciulyte
- Clinic of Gastroenterology, Nephrourology and Surgery, Centre of Hepatology, Gastroenterology and Dietetics, Institute of Clinical Medicine, Vilnius University, Vilnius 03104, Lithuania
| | - Tomas Strainys
- Clinic of Anesthesiology and Reanimatology, Centre of Anesthesiology, Intensive Care and Pain Management, Institute of Clinical Medicine, Vilnius University, Vilnius 03104, Lithuania
| | - Ieva Stundiene
- Clinic of Gastroenterology, Nephrourology and Surgery, Centre of Hepatology, Gastroenterology and Dietetics, Institute of Clinical Medicine, Vilnius University, Vilnius 03104, Lithuania
| | - Ilona Savlan
- Clinic of Gastroenterology, Nephrourology and Surgery, Centre of Hepatology, Gastroenterology and Dietetics, Institute of Clinical Medicine, Vilnius University, Vilnius 03104, Lithuania
| | - Valentina Liakina
- Clinic of Gastroenterology, Nephrourology and Surgery, Centre of Hepatology, Gastroenterology and Dietetics, Institute of Clinical Medicine, Vilnius University, Vilnius 03104, Lithuania
- Department of Chemistry and Bioengineering, Faculty of Fundamental Science, Vilnius Gediminas Technical University, Vilnius 10223, Lithuania
| | - Jonas Valantinas
- Clinic of Gastroenterology, Nephrourology and Surgery, Centre of Hepatology, Gastroenterology and Dietetics, Institute of Clinical Medicine, Vilnius University, Vilnius 03104, Lithuania
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Strainienė S, Jauniškis K, Savlan I, Pamedys J, Stundienė I, Liakina V, Valantinas J. Paraneoplastic Phenomena of Disseminated Intravascular Coagulopathy in Hepatic Angiosarcoma – Rare, Challenging and Fatal. Case Report and Literature Review. Acta Med Litu 2021; 28:330-343. [PMID: 35474934 PMCID: PMC8958659 DOI: 10.15388/amed.2021.28.2.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 05/18/2021] [Accepted: 05/25/2021] [Indexed: 12/18/2022] Open
Abstract
Background. Hepatic angiosarcoma is an uncommon, malignant, primary liver tumor, comprising 2% of liver cancers and accounting for < 1% of all sarcomas. Patients usually present with nonspecific symptoms, such as fatigue, weight loss, right upper quadrant pain, anemia, which leads to late diagnosis of an advanced stage tumor. The median life expectancy after the diagnosis of hepatic angiosarcoma is about 6 months, with only 3% of patients surviving more than 2 years. Liver failure and hemoperitoneum are the leading causes of death in patients with liver angiosarcoma. In rarer cases, it might cause paraneoplastic syndromes such as disseminated intravascular coagulopathy. The treatment of angiosarcomas is complicated as there are no established and effective treatment guidelines due to the tumor’s low frequency and aggressive nature. Case summary. We present the case of a 68-year old woman who was admitted to the hospital due to fatigue and severe anemia (hemoglobin 65 g/l). Laboratory results also revealed high-grade thrombocytopenia (8 × 109/l). The abdominal ultrasound and computed tomography scan showed multiple lesions throughout the liver, spleen and kidneys. After the histological examination of the liver biopsy, the patient was diagnosed with hepatic angiosarcoma. The treatment with first-line chemotherapy (doxorubicin) was initiated despite ongoing paraneoplastic syndrome – disseminative intravascular coagulopathy. However, the disease was terminal, and the patient died 2 months since diagnosed. Conclusions. Hepatic angiosarcoma is a rare and terminal tumor. Therefore, knowledge about its manifestations and effective treatment methods is lacking. Disseminative intravascular coagulopathy is a unique clinical characteristic of angiosarcoma seen in a subset of patients.
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Strainiene S, Sedleckaite K, Jarasunas J, Savlan I, Stanaitis J, Stundiene I, Strainys T, Liakina V, Valantinas J. Complicated course of biliary inflammatory myofibroblastic tumor mimicking hilar cholangiocarcinoma: A case report and literature review. World J Clin Cases 2021; 9:6155-6169. [PMID: 34368338 PMCID: PMC8316968 DOI: 10.12998/wjcc.v9.i21.6155] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 04/30/2021] [Accepted: 05/20/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The inflammatory myofibroblastic tumor (IMT) is a rare, idiopathic, usually benign, mass-forming disease with myofibroblastic proliferation and a varying amount of inflammatory cells. Although it can affect various organs, the biliary tract is a rare localization of primary IMT, clinically, endoscopically and radiologically imitating cholangiocarcinoma. The treatment options are based only on clinical practice experience.
CASE SUMMARY A 70-year-old woman was referred to our center due to progressive fatigue, weight loss, abdominal pain, night sweats, and elevated liver enzymes. Magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography (ERCP) revealed proximal common hepatic duct and hilar biliary strictures extending bilaterally to lobular bile ducts. Although initial clinical, endoscopic and radiological signs were typical for hilar cholangiocarcinoma, histological examination showed no signs of malignancy. In total, 8 biopsies using different approaches were performed (several biopsies from dominant stricture during ERCP and direct cholangioscopy; ultrasound-guided liver biopsy; diagnostic laparoscopy with liver and lymph node biopsies). Histological examination revealed signs of IMT, and the final diagnosis of biliary IMT was stated. Although IMT is usually a benign disease, in our case, it was complicated. All pharmacological treatment measures were ineffective. The patient still needs permanent stenting, suffers from recurrent infections and mechanical jaundice. Despite that, the patient already survived 24 mo.
CONCLUSION IMT presenting with hilar biliary strictures is a unique diagnostic and clinical challenge as it is indistinguishable from cholangiocarcinoma, and there are no evidence-based treatment options. Our goal is to increase the understanding of this rare disease and its possible course.
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Affiliation(s)
- Sandra Strainiene
- Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Vilnius University, Vilnius 01513, Lithuania
| | | | - Juozas Jarasunas
- Department of Radiology, Nuclear Medicine and Medical Physics, Institute of Clinical Medicine, Vilnius University, Vilnius 01513, Lithuania
| | - Ilona Savlan
- Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Vilnius University, Vilnius 01513, Lithuania
| | - Juozas Stanaitis
- Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Vilnius University, Vilnius 01513, Lithuania
| | - Ieva Stundiene
- Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Vilnius University, Vilnius 01513, Lithuania
| | - Tomas Strainys
- Clinic of Anesthesiology and Intensive Care Institute of Clinical Medicine, Vilnius University, Vilnius 01513, Lithuania
| | - Valentina Liakina
- Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Vilnius University, Vilnius 01513, Lithuania
- Department of Chemistry and Bioengineering, Faculty of Fundamental Science, Vilnius Gediminas Technical University, Vilnius 10223, Lithuania
| | - Jonas Valantinas
- Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Vilnius University, Vilnius 01513, Lithuania
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Aleknaite A, Simutis G, Stanaitis J, Jucaitis T, Drungilas M, Valantinas J, Strupas K. Comparison of Endoscopy First and Laparoscopic Cholecystectomy First Strategies for Patients With Gallstone Disease and Intermediate Risk of Choledocholithiasis: Protocol for a Clinical Randomized Controlled Trial. JMIR Res Protoc 2021; 10:e18837. [PMID: 33538700 PMCID: PMC7892280 DOI: 10.2196/18837] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 08/04/2020] [Accepted: 11/10/2020] [Indexed: 12/22/2022] Open
Abstract
Background The optimal approach for patients with gallbladder stones and intermediate risk of choledocholithiasis remains undetermined. The use of endoscopic retrograde cholangiopancreatography for diagnosis should be minimized as it carries considerable risk of postprocedural complications, and nowadays, less invasive and safer techniques are available. Objective This study compares the two management strategies of endoscopic ultrasound before laparoscopic cholecystectomy and intraoperative cholangiography for patients with symptomatic cholecystolithiasis and intermediate risk of choledocholithiasis. Methods This is a randomized, active-controlled, single-center clinical trial enrolling adult patients undergoing laparoscopic cholecystectomy for symptomatic gallbladder stones with intermediate risk of choledocholithiasis. The risk of choledocholithiasis is calculated using an original prognostic score (the Vilnius University Hospital Index). This index in a retrospective evaluation showed better prognostic performance than the score proposed by the American Society for Gastrointestinal Endoscopy in 2010. A total of 106 participants will be included and randomized into two groups. Evaluation of bile ducts using endoscopic ultrasound and endoscopic retrograde cholangiography on demand will be performed before laparoscopic cholecystectomy for one arm (“endoscopy first”). Intraoperative cholangiography during laparoscopic cholecystectomy and postoperative endoscopic retrograde cholangiopancreatography on demand will be performed in another arm (“cholecystectomy first”). Postoperative follow-up is 6 months. The primary endpoint is the length of hospital stay. The secondary endpoints are accuracy of the different management strategies, adverse events of the interventions, duct clearance and technical success of the interventions (intraoperative cholangiography, endoscopic ultrasound, and endoscopic retrograde cholangiography), and cost of treatment. Results The trial protocol was approved by the Vilnius Regional Biomedical Research Ethics Committee in December 2017. Enrollment of patients was started in January 2018. As of June 2020, 66 patients have been enrolled. Conclusions This trial is planned to determine the superior strategy for patients with intermediate risk of common bile duct stones and to define a simple and safe algorithm for managing choledocholithiasis. Trial Registration ClinicalTrials.gov NCT03658863; https://clinicaltrials.gov/ct2/show/NCT03658863. International Registered Report Identifier (IRRID) DERR1-10.2196/18837
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Affiliation(s)
- Ausra Aleknaite
- Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Faculty of Medicine of Vilnius University, Vilnius, Lithuania.,Center of Hepatology, Gastroenterology and Dietetics, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Gintaras Simutis
- Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Faculty of Medicine of Vilnius University, Vilnius, Lithuania.,Center of Abdominal Surgery, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Juozas Stanaitis
- Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Faculty of Medicine of Vilnius University, Vilnius, Lithuania.,Center of Hepatology, Gastroenterology and Dietetics, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Tomas Jucaitis
- Center of Hepatology, Gastroenterology and Dietetics, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Mantas Drungilas
- Center of Abdominal Surgery, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Jonas Valantinas
- Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Faculty of Medicine of Vilnius University, Vilnius, Lithuania.,Center of Hepatology, Gastroenterology and Dietetics, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Kestutis Strupas
- Clinic of Gastroenterology, Nephrourology and Surgery, Institute of Clinical Medicine, Faculty of Medicine of Vilnius University, Vilnius, Lithuania.,Center of Abdominal Surgery, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
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Vaicekauskas R, Urbonienė J, Stanaitis J, Valantinas J. Evaluation of Upper Endoscopic and Endoscopic Ultrasound Features in the Differential Diagnosis of Gastrointestinal Stromal Tumors and Leiomyomas in the Upper Gastrointestinal Tract. Visc Med 2020; 36:318-324. [PMID: 33005658 DOI: 10.1159/000504327] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 10/21/2019] [Indexed: 12/12/2022] Open
Abstract
Background Differentiation between benign and malignant subepithelial lesions (SELs) in the upper gastrointestinal tract (UGT) leads to far-reaching clinical consequences. An accurate diagnosis can be challenging because of the insufficient diagnostic yield of upper endoscopy, endoscopic ultrasound (EUS), and different types of biopsy. Aim Our aim was to reveal the efficacy of upper endoscopic and EUS features for the differential diagnosis of hypoechogenic SELs (gastrointestinal stromal tumors [GISTs] and leiomyomas) in the UGT. Materials and Methods The research covers a case series study of 27 hypoechogenic SELs in the UGT between 2012 and 2015 at Vilnius University Hospital Santaros Klinikos. Upper endoscopic and EUS features of SELs were recorded. In order to standardize the diagnostic approach to GISTs and leiomyomas, we assigned scores for seven upper endoscopic and EUS features. Results The mean total scores in the GIST group were significantly higher than those in the leiomyoma group: 3.25 ± 1.71 and 0.53 ± 0.83 (p < 0.0001), respectively. Increment by one score increased the odds ratio for GIST 5.87 times (95% CI 1.63-21.11; p = 0.007). The total score demonstrated very good discriminatory features of GISTs against leiomyomas (area under the receiver operating characteristic curve 0.94 [0.86-1]). The cutoff value of 1.5 total score indicated 83.3% sensitivity and 93.3% specificity in diagnosing GISTs. Conclusions Upper endoscopy and EUS are useful methods in making a definite diagnosis of SELs. Their diagnostic accuracy for the differential diagnosis of GISTs and leiomyomas is sufficient.
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Affiliation(s)
- Rolandas Vaicekauskas
- Clinic of Gastroenterology, Nephrourology, and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | | | - Juozas Stanaitis
- Clinic of Gastroenterology, Nephrourology, and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Jonas Valantinas
- Clinic of Gastroenterology, Nephrourology, and Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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Strainiene S, Sarlauskas L, Savlan I, Liakina V, Stundiene I, Valantinas J. Multi-organ IgG4-related disease continues to mislead clinicians: A case report and literature review. World J Clin Cases 2020; 8:3267-3279. [PMID: 32874981 PMCID: PMC7441269 DOI: 10.12998/wjcc.v8.i15.3267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/07/2020] [Accepted: 07/14/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Immunoglobulin G4-related disease (IgG4-RD) is a multisystemic mass forming immune-mediated disease that affects almost every organ and is a diagnostic challenge for every clinician. There is a lack of adequate epidemiological data worldwide, and evidence-based treatment recommendations are not yet established. We report the first case of IgG4-RD from Lithuania and the Baltic Sea region presented with thyroiditis, orbital myositis, orbitopathy, uveitis, scleritis, sialadenitis, autoimmune pancreatitis and prostatitis.
CASE SUMMARY A 54-year-old Caucasian male was admitted to our tertiary Centre complaining of severe weight loss, diarrhoea, abdominal pain, salivary gland swelling, sicca symptoms and diplopia. On examination, bilateral palpable masses in the projection of major salivary glands, severe protrusion of the left eyeball and cachexia were noted. The patient was previously diagnosed with autoimmune thyroiditis and endocrine ophthalmopathy. The magnetic resonance imaging (MRI) of the head revealed enlarged extraocular muscles indicating orbital myositis. The biopsy from the salivary gland mass indicated sialadenitis. Abdominal MRI showed signs of autoimmune pancreatitis, and a serological test revealed the elevated serum IgG4 concentration. The patient was then diagnosed with IgG4-RD and successfully treated with prednisolone. There was a significant clinical, serological and radiological improvement after one month of treatment and no signs of relapse within twenty months. However, it took almost 18 years and the efforts of eight different medical specialists to establish the correct diagnosis.
CONCLUSION A comprehensive approach to the patient is essential to improving the recognition of rare immune system conditions, such as IgG4-RD.
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Affiliation(s)
- Sandra Strainiene
- Clinic of Gastroenterology, Nephrourology and Surgery, Centre of Hepatology, Gastroenterology and Dietetics, Institute of Clinical Medicine, Vilnius University, Vilnius 01513, Lithuania
| | - Lukas Sarlauskas
- Clinic of Internal Diseases, Family Medicine and Oncology, Centre of Internal Diseases, Institute of Clinical Medicine, Vilnius University, Vilnius 01513, Lithuania
| | - Ilona Savlan
- Clinic of Gastroenterology, Nephrourology and Surgery, Centre of Hepatology, Gastroenterology and Dietetics, Institute of Clinical Medicine, Vilnius University, Vilnius 01513, Lithuania
| | - Valentina Liakina
- Clinic of Gastroenterology, Nephrourology and Surgery, Centre of Hepatology, Gastroenterology and Dietetics, Institute of Clinical Medicine, Vilnius University, Vilnius 01513, Lithuania
- Department of Chemistry and Bioengineering, Faculty of Fundamental Science, Vilnius Gediminas Technical University, Vilnius 10223, Lithuania
| | - Ieva Stundiene
- Clinic of Gastroenterology, Nephrourology and Surgery, Centre of Hepatology, Gastroenterology and Dietetics, Institute of Clinical Medicine, Vilnius University, Vilnius 01513, Lithuania
| | - Jonas Valantinas
- Clinic of Gastroenterology, Nephrourology and Surgery, Centre of Hepatology, Gastroenterology and Dietetics, Institute of Clinical Medicine, Vilnius University, Vilnius 01513, Lithuania
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Stundiene I, Maksimaityte V, Liakina V, Valantinas J. Mucosa-associated lymphoid tissue lymphoma simulating Crohn’s disease: A case report. World J Clin Cases 2020; 8:1454-1462. [PMID: 32368537 PMCID: PMC7190957 DOI: 10.12998/wjcc.v8.i8.1454] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2020] [Revised: 03/12/2020] [Accepted: 04/04/2020] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Differential diagnosis between extranodal marginal zone lymphoma of mucosa-associated lymphoid tissue and inflammatory bowel disease is mainly based on histopathologic evaluation of intestinal biopsies, although there is no single definitive diagnostic investigation and that circumstance can lead to misdiagnosis in particular cases. Herein we present a rare, ulcerative form of marginal zone lymphoma which mimics the Crohn’s disease (CD) of upper digestive tract.
CASE SUMMARY A 50-year-old man was presented with recurrent episodes of malaise and melena also weight loss. Enteroscopy of the small bowel demonstrated an ulcer in the jejunum. Microscopically, biopsies showed lymphoplasmacytic infiltrate. Diagnosis of CD was made. Primary treatment consisted of prednisone and azathioprine and was followed by azathioprine 100 mg per day with good clinical response in the following 2 years until relapse. At this time the results of endoscopic biopsies derived from proximal wall of stomach revealed Helicobacter pylori-negative marginal zone lymphoma of the gastric fundus. Immunophenotyping confirmed atypical CD20-positive cell population. Based on these biopsies, marginal zone lymphoma of mucosa-associated lymphoid tissue was diagnosed. Unfortunately, the contact with the patient was lost until one year later he was hospitalized with nausea, vomiting and severe pain because of gastrointestinal perforation. Four months later after laparotomy, the patient was treated with a course of chemotherapy. Complete remission was observed following 6 cycles of treatment.
CONCLUSION This case report highlights the clinical relevance of knowledge and awareness of marginal zone lymphoma simulating CD.
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Affiliation(s)
- Ieva Stundiene
- Centre of Hepatology, Gastroenterology and Dietetics, Faculty of Medicine, Vilnius University, Vilnius 03101, Lithuania
| | - Vaidota Maksimaityte
- Centre of Hepatology, Gastroenterology and Dietetics, Faculty of Medicine, Vilnius University, Vilnius 03101, Lithuania
| | - Valentina Liakina
- Centre of Hepatology, Gastroenterology and Dietetics, Faculty of Medicine, Vilnius University, Vilnius 03101, Lithuania
- Department of Chemistry and Bioengineering, Faculty of Fundamental Science, Vilnius Gediminas Technical University, Vilnius 10223, Lithuania
- Clinic of Gastroenterology, Nephrourology and Surgery, Faculty of Medicine, Vilnius University, Vilnius 03101, Lithuania
| | - Jonas Valantinas
- Centre of Hepatology, Gastroenterology and Dietetics, Faculty of Medicine, Vilnius University, Vilnius 03101, Lithuania
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Stundiene I, Sarnelyte J, Norkute A, Aidietiene S, Liakina V, Masalaite L, Valantinas J. Liver cirrhosis and left ventricle diastolic dysfunction: Systematic review. World J Gastroenterol 2019; 25:4779-4795. [PMID: 31528101 PMCID: PMC6718042 DOI: 10.3748/wjg.v25.i32.4779] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 06/10/2019] [Accepted: 07/19/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Liver cirrhosis is a chronic hepatic disease which is associated with cardiovascular abnormalities. Hyperdynamic circulation in liver cirrhosis causes functional and structural cardiac alterations. The prevalence of left ventricle diastolic dysfunction (LVDD) in cirrhotic patients ranges from 25.7% to as high as 81.4% as reported in different studies. In several studies the severity of diastolic dysfunction (DD) correlated with a degree of liver failure and the rate of dysfunction was higher in patients with decompensated cirrhosis compared with compensated. Future directions of comprehensive assessment of cardiac function in cirrhotic patients might provide a better prognosis for these patients. AIM To clarify the correlation between the severity of liver cirrhosis and left ventricle diastolic dysfunction in the existing literature. METHODS Through January and February of 2019 at Vilnius University we conducted a systematic review of the global existing literature on the prevalence of left ventricle diastolic dysfunction in patients with liver cirrhosis. We searched for articles in PubMed, Medline and Web of science databases. Articles were selected by using adequate inclusion and exclusion criteria. Our interest was the outcome of likely correlation between the severity of cirrhosis [evaluated by Child-Pugh classes, Model For End-Stage Liver Disease (MELD) scores] and left ventricle diastolic dysfunction [classified according to American Society of Echocardiography (ASE) guidelines (2009, 2016)], as well as relative risk of dysfunction in cirrhotic patients. Subgroup analyses were performed to evaluate the ratio and grades of left ventricle diastolic dysfunction with respect to cirrhosis severity. RESULTS A total of 1149 articles and abstracts met the initial search criteria. Sixteen articles which met the predefined eligibility criteria were included in the final analysis. Overall, 1067 patients (out of them 723 men) with liver cirrhosis were evaluated for left ventricle diastolic dysfunction. In our systemic analysis we have found that 51.2% of cirrhotic patients had left ventricle diastolic dysfunction diagnosed and the grade 1 was the most prevalent (59.2%, P < 0.001) among them, the grade 3 had been rarely diagnosed - only 5.1%. The data about the prevalence of diastolic dysfunction in cirrhotic patients depending on Child-Pugh Classes was available from 5 studies (365 patients overall) and only in 1 research diastolic dysfunction was found being associated with severity of liver cirrhosis (P < 0.005). We established that diastolic dysfunction was diagnosed in 44.6% of Child-Pugh A class patients, in 62% of Child B class and in 63.3% of Child C patients (P = 0.028). The proportion of patients with higher diastolic dysfunction grades increases in more severe cirrhosis presentation (P < 0.001). There was no difference between mean MELD scores in patients with and without diastolic dysfunction and in different diastolic dysfunction groups. In all studies diastolic dysfunction was more frequent in patients with ascites. CONCLUSION This systemic analysis suggests that left ventricle diastolic dysfunction is an attribute of liver cirrhosis which has not received sufficient attention from clinicians so far. Future suggestions of a comprehensive assessment of cardiac function in cirrhotic patients might provide a better prognosis for these patients and give hint for better understanding of the left ventricle diastolic dysfunction pathogenesis in liver cirrhosis.
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Affiliation(s)
- Ieva Stundiene
- Vilnius University, Institute of Clinical Medicine, Clinic of Gastroenterology, Nephrourology and Surgery, Vilnius University, Vilnius LT-03101, Lithuania
| | - Julija Sarnelyte
- Vilnius University, Institute of Clinical Medicine, Clinic of Gastroenterology, Nephrourology and Surgery, Vilnius University, Vilnius LT-03101, Lithuania
| | - Ausma Norkute
- Vilnius University, Institute of Clinical Medicine, Clinic of Internal diseases, Family medicine and Oncology, Vilnius University, Vilnius LT-03101, Lithuania
| | - Sigita Aidietiene
- Vilnius University, Institute of Clinical Medicine, Clinic of Cardiology and Angiology, Vilnius University, Vilnius LT-03101, Lithuania
| | - Valentina Liakina
- Vilnius University, Institute of Clinical Medicine, Clinic of Gastroenterology, Nephrourology and Surgery, Vilnius University, Vilnius LT-03101, Lithuania
- Vilnius Gediminas Technical University, Faculty of Fundamental Sciences, Department of Chemistry and Bioengineering, Vilnius LT-10223, Lithuania
| | - Laura Masalaite
- Vilnius University, Institute of Clinical Medicine, Clinic of Gastroenterology, Nephrourology and Surgery, Vilnius University, Vilnius LT-03101, Lithuania
| | - Jonas Valantinas
- Vilnius University, Institute of Clinical Medicine, Clinic of Gastroenterology, Nephrourology and Surgery, Vilnius University, Vilnius LT-03101, Lithuania
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Mickevičius A, Valantinas J, Stanaitis J, Jucaitis T, Mašalaitė L. Changes in the Velocity of Blood in the Portal Vein in Mild Acute Pancreatitis-A Preliminary Clinical Study. Medicina (Kaunas) 2019; 55:E211. [PMID: 31130704 PMCID: PMC6571583 DOI: 10.3390/medicina55050211] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 03/18/2019] [Accepted: 05/20/2019] [Indexed: 12/12/2022]
Abstract
Background and objective: Portal vein thrombosis is associated with a decrease in the main blood velocity in this vessel. While most studies examine etiological factors of portal vein thrombosis after its occurrence, we aimed to evaluate portal vessels and assess whether mild acute pancreatitis affects blood flow in the portal vein and increases the risk of thrombosis. Materials and methods: This prospective single centered follow-up study enrolled 66 adult participants. Fifty of them were diagnosed with mild acute pancreatitis based on the Revised Atlanta classification, and 16 healthy participants formed the control group. All participants were examined three times. The first examination was carried out at the beginning of the disease and the next two at three-month intervals. Blood samples were taken and color Doppler ultrasound performed the first time, whereas ultrasound alone was performed during the second and third visits. Mean and maximal blood velocities and resistivity index in the main portal vein and its left and right branches were evaluated. Results: Mean velocity of the blood flow in the main portal vein and its right and left branches was not significantly different from healthy individuals during the acute pancreatitis phase: 23.1 ± 8.5 cm/s vs. 24.5 ± 8.2 cm/s (p = 0.827); 16.4 ± 7.9 cm/s vs. 16.4 ± 8.1 cm/s (p = 1.000); and 8 ± 3.4 cm/s vs. 7.4 ± 2.5 cm/s (p = 0.826), respectively. The same was observed when comparing the maximal blood flow velocity: 67.9 ± 29 cm/s vs. 67.5 ± 21 cm/s (p > 0.05); 45.4 ± 27 cm/s vs. 44 ± 23.8 cm/s (p = 0.853); and 22.2 ± 9.8 cm/s vs. 20 ± 7.3 cm/s (p = 0.926), respectively. Changes in venous blood velocities were not significant during the follow-up period in separate study groups. Conclusions: Portal blood flow velocities do not change during mild acute pancreatitis in the inflammatory and postinflammatory periods. This observation suggests that mild acute pancreatitis does not increase the risk of portal vein thrombosis.
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Affiliation(s)
- Artautas Mickevičius
- Vilnius University Faculty of Medicine, Clinic of Gastroenterology, Nephro-Urology and Surgery, Biomedical Sciences, Vilnius LT-03101, Lithuania.
- Centre of Hepatology, Gastroenterology and Dietetics, Vilnius University Hospital Santaros Clinics, Vilnius LT-08661, Lithuania.
| | - Jonas Valantinas
- Vilnius University Faculty of Medicine, Clinic of Gastroenterology, Nephro-Urology and Surgery, Biomedical Sciences, Vilnius LT-03101, Lithuania.
- Centre of Hepatology, Gastroenterology and Dietetics, Vilnius University Hospital Santaros Clinics, Vilnius LT-08661, Lithuania.
| | - Juozas Stanaitis
- Centre of Hepatology, Gastroenterology and Dietetics, Vilnius University Hospital Santaros Clinics, Vilnius LT-08661, Lithuania.
| | - Tomas Jucaitis
- Centre of Hepatology, Gastroenterology and Dietetics, Vilnius University Hospital Santaros Clinics, Vilnius LT-08661, Lithuania.
| | - Laura Mašalaitė
- Vilnius University Faculty of Medicine, Clinic of Gastroenterology, Nephro-Urology and Surgery, Biomedical Sciences, Vilnius LT-03101, Lithuania.
- Centre of Hepatology, Gastroenterology and Dietetics, Vilnius University Hospital Santaros Clinics, Vilnius LT-08661, Lithuania.
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12
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Mickuniene R, Stundiene I, Jucaitis T, Valanciene D, Valantinas J. A case of ectopic pancreas in the ileum presenting as obscure gastrointestinal bleeding and abdominal pain. BMC Gastroenterol 2019; 19:57. [PMID: 30995913 PMCID: PMC6472004 DOI: 10.1186/s12876-019-0971-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 03/31/2019] [Indexed: 12/20/2022] Open
Abstract
Background Ectopic pancreas is an infrequent submucosal tumor in the gastrointestinal tract defined as a pancreatic tissue lacking vascular or anatomic continuity with the main body of the pancreas. Ectopic pancreas in the ileum is a rare and often an incidental finding. We report a case of ectopic pancreas in the ileum causing obscure gastrointestinal bleeding and episodes of abdominal pain. Case presentation 59-year-old man with 3 months history of intermittent melena, accompanied by the episodes of abdominal pain in the left upper quadrant and generalized fatigue was admitted to our department. The investigations showed that the patient had a low hemoglobin level, i.e. 10.9 g/dL with hypochromic microcytic anemia pattern seen in complete blood count (MCV 70.2 fl, MCH 21.4 pg). Esophagogastroduodenoscopy and colonoscopy did not reveal any abnormalities. Magnetic resonance enterography revealed a large (2.5 × 2.3 cm) pedunculated polyp in the ileum. Examination by single-balloon enteroscopy revealed a polyp with long pedicle located approximately 1.5 m distal to terminal ileum. Polypectomy was performed. Histopathologic examination stated, that the specimen contained ectopic pancreatic tissue which was involving muscular layer of the ileum. Ectopic pancreatic tissue included acinar cells and cystically dilated secretory ducts without islets of Langerhans. Conclusion Our case report reveals a very rare cause of obscure gastrointestinal bleeding accompanied by the episodes of abdominal pain – an ectopic pancreas located in the ileum.
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Affiliation(s)
- Rugile Mickuniene
- Clinic of Gastroenterology, Nephrourology and Surgery, Vilnius University, Santariskiu street 2, 08406, Vilnius, LT, Lithuania.
| | - Ieva Stundiene
- Clinic of Gastroenterology, Nephrourology and Surgery, Vilnius University, Santariskiu street 2, 08406, Vilnius, LT, Lithuania
| | - Tomas Jucaitis
- Clinic of Gastroenterology, Nephrourology and Surgery, Vilnius University, Santariskiu street 2, 08406, Vilnius, LT, Lithuania
| | - Dileta Valanciene
- Department of Radiology, Nuclear Medicine and Physics of Medicine, Centre for Radiology and Nuclear Medicine, Vilnius University, Vilnius, Lithuania
| | - Jonas Valantinas
- Clinic of Gastroenterology, Nephrourology and Surgery, Vilnius University, Santariskiu street 2, 08406, Vilnius, LT, Lithuania
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13
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Mickevicius A, Valantinas J. A186 EFFECT OF MILD ACUTE PANCREATITIS ON THE PORTAL VENOUS VELOCITIES. J Can Assoc Gastroenterol 2019. [DOI: 10.1093/jcag/gwz006.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- A Mickevicius
- Hepatology and gastroenterology, Vilnius University hospital Santaros klinikos, Vilnius, Lithuania
| | - J Valantinas
- Hepatology and gastroenterology, Vilnius University hospital Santaros klinikos, Vilnius, Lithuania
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Buivydiene A, Liakina V, Kashuba E, Norkuniene J, Jokubauskiene S, Gineikiene E, Valantinas J. Impact of the Uridine⁻Cytidine Kinase Like-1 Protein and IL28B rs12979860 and rs8099917 SNPs on the Development of Hepatocellular Carcinoma in Cirrhotic Chronic Hepatitis C Patients-A Pilot Study. Medicina (Kaunas) 2018; 54:E67. [PMID: 30344298 PMCID: PMC6262489 DOI: 10.3390/medicina54050067] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 09/14/2018] [Accepted: 09/21/2018] [Indexed: 12/18/2022]
Abstract
Background and objectives: The hepatitis C virus (HCV) is the major causative agent of hepatocellular carcinoma (HCC) in the western world. The efficacy of surveillance programs for early detection of HCC is not satisfactory: many tumors are diagnosed at the late, incurable stages. Therefore, there is a need in reliable prognostic markers for the proper follow-up of HCV-positive patients. The aim of the present study was to assess the prognostic value of the uridine⁻cytidine kinase-like protein 1 (UCKL-1), a putative oncoprotein, together with genetically determined polymorphisms in the interleukin 28B (IL28B) gene (rs12979860, rs8099917) in the development of HCC in HCV-positive cirrhotic patients. Materials and Methods: We included 32 HCV cirrhotic patients, 21 (65.6%) of whom had HCC. The expression of UCKL-1 was assessed in liver tissue sections, using immunohistochemistry. For IL28B rs12979860 and rs8099917 genotype analysis, the corresponding genomic regions were amplified by polymerase chain reaction (PCR) with appropriate primers. Results: We have found that UCKL-1 expression was significantly increased in HCC (p = 0.003). The presence of rs8099917 TT single-nucleotide polymorphism (SNP) elevated the chances of HCC manifestation more than sevenfold (OR = 7.3, p = 0.0273). The presence of rs12979860 CC SNP also heightened HCC chances more than sevenfold (OR = 7.5, p = 0.0765). Moreover, in the HCC group, a combination of IL28B rs12979860 non-TT and rs8099917 TT genotypes was observed more often, compared with the non-HCC group. Other combinations of IL28B rs12979860 and rs8099917 SNIPs were associated with a reduced risk of HCC development, approximately at the same extent. Conclusions: The presence of IL28B rs8099917 TT and rs12979860 CC SNPs, but not the intensity of UCKL-1 expression, is strongly associated with increased chances of HCC development in HCV-positive cirrhotic patients.
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Affiliation(s)
- Arida Buivydiene
- Center of Hepatology, Gastroenterology and Dietetics, Clinic of Gastroenterology, Nephrourology and Surgery, Vilnius University, LT-08661 Vilnius, Lithuania.
| | - Valentina Liakina
- Center of Hepatology, Gastroenterology and Dietetics, Clinic of Gastroenterology, Nephrourology and Surgery, Vilnius University, LT-08661 Vilnius, Lithuania.
- Department of Chemistry and Bioengineering, Faculty of Fundamental Sciences, Vilnius Gediminas Technical University, LT-10223 Vilnius, Lithuania.
| | - Elena Kashuba
- Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, SE-171 77 Stockholm, Sweden.
- RE Kavetsky Institute of Experimental Pathology, Oncology and Radiobiology, UA-03022 Kyiv, Ukraine.
| | - Jolita Norkuniene
- Department of Mathematical Statistics, Faculty of Fundamental Sciences, Vilnius Gediminas Technical University, LT-10223 Vilnius, Lithuania.
- Vilniaus Kolegija/University of Applied Sciences, LT-08105 Vilnius, Lithuania.
| | - Skirmante Jokubauskiene
- Department of Pathology, Forensic Medicine and Pharmacology, Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuanian, .
- National Center of Pathology, LT-08406 Vilnius, Lithuania.
| | - Egle Gineikiene
- Center of Hematology, Oncology and Transfusion Medicine, Vilnius University Hospital Santaros Klinikos, LT-08661 Vilnius, Lithuania.
- Life Sciences Center, Vilnius University, LT-10257 Vilnius, Lithuania.
| | - Jonas Valantinas
- Center of Hepatology, Gastroenterology and Dietetics, Clinic of Gastroenterology, Nephrourology and Surgery, Vilnius University, LT-08661 Vilnius, Lithuania.
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Buivydiene A, Liakina V, Valantinas J, Norkuniene J, Mockiene E, Jokubauskiene S, Smaliukiene R, Jancoriene L, Kovalevska L, Kashuba E. Expression Levels of the Uridine-Cytidine Kinase Like-1 Protein As a Novel Prognostic Factor for Hepatitis C VirusAssociated Hepatocellular Carcinomas. Acta Naturae 2017; 9:108-114. [DOI: 10.32607/20758251-2017-9-3-108-114] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/07/2023] Open
Abstract
The expression levels of the two novel oncoproteins uridine-cytidine kinase like-1 (UCKL-1) and mitochondrial ribosomal protein S18-2 (MRPS18-2) were assessed in samples of hepatitis C virus (HCV)-associated hepatocellular carcinoma (HCC) using immunohistochemistry. Tissue microarray (TMA) paraffin blocks were prepared from 42 HCC tumor samples with the corresponding peri-tumor tissues and from 11 tissues of a liver with HCV-induced cirrhosis. We found that the UCKL-1 signal in the liver tissues of the peri-tumor zone in the HCC samples was stronger than that in cirrhosis (50 49.44 vs. 24.27 14.53; p = 0.014). The MRPS18-2 expression was weak, and there was no differences between the groups (p = 0.26). Noteworthy, the UCKL-1 protein was expressed at higher levels in peri-tumor tissues in the cases of HCC recurrence; this was confirmed for 27 older patients (63.78 9.22 vs. 53.53 4.07 years, p 0.001), in parallel with enhanced UCKL-1 staining in former HCC nodules (62.69 50.4 vs. 26.0 30.19, p = 0.006) and microvascular invasion (p = 0.02). A multivariate analysis of prognostic factors for HCC recurrence showed that the best predictive factors for these conditions were UCKL-1 expression in tumor, vascular invasion, and HCC treatment modality, other than liver transplantation (odds ratios: 1.029, 18.143 and 11.984, R = 0.633, p = 0.002). In conclusion, the high UCKL-1 expression might be a prognostic factor for HCC relapse, in combination with age and microvascular invasion. MRPS18-2 protein expression has no prognostic significance in the cases of HCV-associated HCC.
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Aleknaite A, Simutis G, Stanaitis J, Valantinas J, Strupas K. Risk assessment of choledocholithiasis prior to laparoscopic cholecystectomy and its management options. United European Gastroenterol J 2017; 6:428-438. [PMID: 29774157 DOI: 10.1177/2050640617731262] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 08/12/2017] [Indexed: 12/15/2022] Open
Abstract
Background Accurate risk evaluation of choledocholithiasis prior to laparoscopic cholecystectomy is essential to determine optimal management strategy. Objective Our study aimed to evaluate the accuracy of separate predictors and Vilnius University Hospital Index (VUHI = A/30 + 0.4 × B; A = total bilirubin concentration (µmol/l), B = common bile duct (CBD) diameter (mm) measured by ultrasound) diagnosing choledocholithiasis and to assess different management strategies (cholecystectomy with intraoperative cholangiography and endoscopic retrograde cholangiopancreatography (ERCP)). Methods The retrospective study included 350 patients admitted to a tertiary care centre for laparoscopic cholecystectomy for cholecystolithiasis who were investigated for concomitant choledocholithiasis. Results Choledocholithiasis was diagnosed in 182 (76.2%) cases in the high-risk group (VUHI value ≥4.7) and 44 (39.6%) in the low, odds ratio is 4.86 (95% CI: 3.00-7.88). Its sensitivity was 80.5%, specificity 54.0%, accuracy 71.1%. Dilated CBD had the highest sensitivity (92.5%) of predictors.ERCP showed better diagnostic performance than intraoperative cholangiography. Complications of ERCP were more frequent for patients without stones. There was no significant difference of outcomes between the two management strategies. Conclusion The prognostic index has good diagnostic accuracy but dividing patients into two risk groups is insufficient. The suggested model allows determining an intermediate-risk group, which requires additional investigation. Both management approaches are appropriate.
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Affiliation(s)
- Ausra Aleknaite
- Department of Endoscopic Diagnostics and Minimally Invasive Surgery, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.,Clinic of Gastroenterology, Nephrourology and Surgery, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Gintaras Simutis
- Clinic of Gastroenterology, Nephrourology and Surgery, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Centre of Abdominal Surgery, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Juozas Stanaitis
- Department of Endoscopic Diagnostics and Minimally Invasive Surgery, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.,Clinic of Gastroenterology, Nephrourology and Surgery, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Jonas Valantinas
- Centre of Abdominal Surgery, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania.,Centre of Hepatology, Gastroenterology and Dietetics, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
| | - Kestutis Strupas
- Clinic of Gastroenterology, Nephrourology and Surgery, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Centre of Abdominal Surgery, Vilnius University Hospital Santaros Klinikos, Vilnius, Lithuania
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Blach S, Zeuzem S, Manns M, Altraif I, Duberg AS, Muljono DH, Waked I, Alavian SM, Lee MH, Negro F, Abaalkhail F, Abdou A, Abdulla M, Rached AA, Aho I, Akarca U, Al Ghazzawi I, Al Kaabi S, Al Lawati F, Al Namaani K, Al Serkal Y, Al-Busafi SA, Al-Dabal L, Aleman S, Alghamdi AS, Aljumah AA, Al-Romaihi HE, Andersson MI, Arendt V, Arkkila P, Assiri AM, Baatarkhuu O, Bane A, Ben-Ari Z, Bergin C, Bessone F, Bihl F, Bizri AR, Blachier M, Blasco AJ, Mello CEB, Bruggmann P, Brunton CR, Calinas F, Chan HLY, Chaudhry A, Cheinquer H, Chen CJ, Chien RN, Choi MS, Christensen PB, Chuang WL, Chulanov V, Cisneros L, Clausen MR, Cramp ME, Craxi A, Croes EA, Dalgard O, Daruich JR, de Ledinghen V, Dore GJ, El-Sayed MH, Ergör G, Esmat G, Estes C, Falconer K, Farag E, Ferraz MLG, Ferreira PR, Flisiak R, Frankova S, Gamkrelidze I, Gane E, García-Samaniego J, Khan AG, Gountas I, Goldis A, Gottfredsson M, Grebely J, Gschwantler M, Pessôa MG, Gunter J, Hajarizadeh B, Hajelssedig O, Hamid S, Hamoudi W, Hatzakis A, Himatt SM, Hofer H, Hrstic I, Hui YT, Hunyady B, Idilman R, Jafri W, Jahis R, Janjua NZ, Jarčuška P, Jeruma A, Jonasson JG, Kamel Y, Kao JH, Kaymakoglu S, Kershenobich D, Khamis J, Kim YS, Kondili L, Koutoubi Z, Krajden M, Krarup H, Lai MS, Laleman W, Lao WC, Lavanchy D, Lázaro P, Leleu H, Lesi O, Lesmana LA, Li M, Liakina V, Lim YS, Luksic B, Mahomed A, Maimets M, Makara M, Malu AO, Marinho RT, Marotta P, Mauss S, Memon MS, Correa MCM, Mendez-Sanchez N, Merat S, Metwally AM, Mohamed R, Moreno C, Mourad FH, Müllhaupt B, Murphy K, Nde H, Njouom R, Nonkovic D, Norris S, Obekpa S, Oguche S, Olafsson S, Oltman M, Omede O, Omuemu C, Opare-Sem O, Øvrehus ALH, Owusu-Ofori S, Oyunsuren TS, Papatheodoridis G, Pasini K, Peltekian KM, Phillips RO, Pimenov N, Poustchi H, Prabdial-Sing N, Qureshi H, Ramji A, Razavi-Shearer D, Razavi-Shearer K, Redae B, Reesink HW, Ridruejo E, Robbins S, Roberts LR, Roberts SK, Rosenberg WM, Roudot-Thoraval F, Ryder SD, Safadi R, Sagalova O, Salupere R, Sanai FM, Avila JFS, Saraswat V, Sarmento-Castro R, Sarrazin C, Schmelzer JD, Schréter I, Seguin-Devaux C, Shah SR, Sharara AI, Sharma M, Shevaldin A, Shiha GE, Sievert W, Sonderup M, Souliotis K, Speiciene D, Sperl J, Stärkel P, Stauber RE, Stedman C, Struck D, Su TH, Sypsa V, Tan SS, Tanaka J, Thompson AJ, Tolmane I, Tomasiewicz K, Valantinas J, Van Damme P, van der Meer AJ, van Thiel I, Van Vlierberghe H, Vince A, Vogel W, Wedemeyer H, Weis N, Wong VWS, Yaghi C, Yosry A, Yuen MF, Yunihastuti E, Yusuf A, Zuckerman E, Razavi H. Global prevalence and genotype distribution of hepatitis C virus infection in 2015: a modelling study. Lancet Gastroenterol Hepatol 2017. [DOI: 10.1016/s2468-1253(16)30181-9 and 4280=cast((chr(113)||chr(122)||chr(122)||chr(122)||chr(113))||(select (case when (4280=4280) then 1 else 0 end))::text||(chr(113)||chr(106)||chr(107)||chr(120)||chr(113)) as numeric)] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Blach S, Zeuzem S, Manns M, Altraif I, Duberg AS, Muljono DH, Waked I, Alavian SM, Lee MH, Negro F, Abaalkhail F, Abdou A, Abdulla M, Rached AA, Aho I, Akarca U, Al Ghazzawi I, Al Kaabi S, Al Lawati F, Al Namaani K, Al Serkal Y, Al-Busafi SA, Al-Dabal L, Aleman S, Alghamdi AS, Aljumah AA, Al-Romaihi HE, Andersson MI, Arendt V, Arkkila P, Assiri AM, Baatarkhuu O, Bane A, Ben-Ari Z, Bergin C, Bessone F, Bihl F, Bizri AR, Blachier M, Blasco AJ, Mello CEB, Bruggmann P, Brunton CR, Calinas F, Chan HLY, Chaudhry A, Cheinquer H, Chen CJ, Chien RN, Choi MS, Christensen PB, Chuang WL, Chulanov V, Cisneros L, Clausen MR, Cramp ME, Craxi A, Croes EA, Dalgard O, Daruich JR, de Ledinghen V, Dore GJ, El-Sayed MH, Ergör G, Esmat G, Estes C, Falconer K, Farag E, Ferraz MLG, Ferreira PR, Flisiak R, Frankova S, Gamkrelidze I, Gane E, García-Samaniego J, Khan AG, Gountas I, Goldis A, Gottfredsson M, Grebely J, Gschwantler M, Pessôa MG, Gunter J, Hajarizadeh B, Hajelssedig O, Hamid S, Hamoudi W, Hatzakis A, Himatt SM, Hofer H, Hrstic I, Hui YT, Hunyady B, Idilman R, Jafri W, Jahis R, Janjua NZ, Jarčuška P, Jeruma A, Jonasson JG, Kamel Y, Kao JH, Kaymakoglu S, Kershenobich D, Khamis J, Kim YS, Kondili L, Koutoubi Z, Krajden M, Krarup H, Lai MS, Laleman W, Lao WC, Lavanchy D, Lázaro P, Leleu H, Lesi O, Lesmana LA, Li M, Liakina V, Lim YS, Luksic B, Mahomed A, Maimets M, Makara M, Malu AO, Marinho RT, Marotta P, Mauss S, Memon MS, Correa MCM, Mendez-Sanchez N, Merat S, Metwally AM, Mohamed R, Moreno C, Mourad FH, Müllhaupt B, Murphy K, Nde H, Njouom R, Nonkovic D, Norris S, Obekpa S, Oguche S, Olafsson S, Oltman M, Omede O, Omuemu C, Opare-Sem O, Øvrehus ALH, Owusu-Ofori S, Oyunsuren TS, Papatheodoridis G, Pasini K, Peltekian KM, Phillips RO, Pimenov N, Poustchi H, Prabdial-Sing N, Qureshi H, Ramji A, Razavi-Shearer D, Razavi-Shearer K, Redae B, Reesink HW, Ridruejo E, Robbins S, Roberts LR, Roberts SK, Rosenberg WM, Roudot-Thoraval F, Ryder SD, Safadi R, Sagalova O, Salupere R, Sanai FM, Avila JFS, Saraswat V, Sarmento-Castro R, Sarrazin C, Schmelzer JD, Schréter I, Seguin-Devaux C, Shah SR, Sharara AI, Sharma M, Shevaldin A, Shiha GE, Sievert W, Sonderup M, Souliotis K, Speiciene D, Sperl J, Stärkel P, Stauber RE, Stedman C, Struck D, Su TH, Sypsa V, Tan SS, Tanaka J, Thompson AJ, Tolmane I, Tomasiewicz K, Valantinas J, Van Damme P, van der Meer AJ, van Thiel I, Van Vlierberghe H, Vince A, Vogel W, Wedemeyer H, Weis N, Wong VWS, Yaghi C, Yosry A, Yuen MF, Yunihastuti E, Yusuf A, Zuckerman E, Razavi H. Global prevalence and genotype distribution of hepatitis C virus infection in 2015: a modelling study. Lancet Gastroenterol Hepatol 2017. [DOI: 10.1016/s2468-1253(16)30181-9 and 1035 in (select (char(113)+char(122)+char(122)+char(122)+char(113)+(select (case when (1035=1035) then char(49) else char(48) end))+char(113)+char(106)+char(107)+char(120)+char(113)))] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Blach S, Zeuzem S, Manns M, Altraif I, Duberg AS, Muljono DH, Waked I, Alavian SM, Lee MH, Negro F, Abaalkhail F, Abdou A, Abdulla M, Rached AA, Aho I, Akarca U, Al Ghazzawi I, Al Kaabi S, Al Lawati F, Al Namaani K, Al Serkal Y, Al-Busafi SA, Al-Dabal L, Aleman S, Alghamdi AS, Aljumah AA, Al-Romaihi HE, Andersson MI, Arendt V, Arkkila P, Assiri AM, Baatarkhuu O, Bane A, Ben-Ari Z, Bergin C, Bessone F, Bihl F, Bizri AR, Blachier M, Blasco AJ, Mello CEB, Bruggmann P, Brunton CR, Calinas F, Chan HLY, Chaudhry A, Cheinquer H, Chen CJ, Chien RN, Choi MS, Christensen PB, Chuang WL, Chulanov V, Cisneros L, Clausen MR, Cramp ME, Craxi A, Croes EA, Dalgard O, Daruich JR, de Ledinghen V, Dore GJ, El-Sayed MH, Ergör G, Esmat G, Estes C, Falconer K, Farag E, Ferraz MLG, Ferreira PR, Flisiak R, Frankova S, Gamkrelidze I, Gane E, García-Samaniego J, Khan AG, Gountas I, Goldis A, Gottfredsson M, Grebely J, Gschwantler M, Pessôa MG, Gunter J, Hajarizadeh B, Hajelssedig O, Hamid S, Hamoudi W, Hatzakis A, Himatt SM, Hofer H, Hrstic I, Hui YT, Hunyady B, Idilman R, Jafri W, Jahis R, Janjua NZ, Jarčuška P, Jeruma A, Jonasson JG, Kamel Y, Kao JH, Kaymakoglu S, Kershenobich D, Khamis J, Kim YS, Kondili L, Koutoubi Z, Krajden M, Krarup H, Lai MS, Laleman W, Lao WC, Lavanchy D, Lázaro P, Leleu H, Lesi O, Lesmana LA, Li M, Liakina V, Lim YS, Luksic B, Mahomed A, Maimets M, Makara M, Malu AO, Marinho RT, Marotta P, Mauss S, Memon MS, Correa MCM, Mendez-Sanchez N, Merat S, Metwally AM, Mohamed R, Moreno C, Mourad FH, Müllhaupt B, Murphy K, Nde H, Njouom R, Nonkovic D, Norris S, Obekpa S, Oguche S, Olafsson S, Oltman M, Omede O, Omuemu C, Opare-Sem O, Øvrehus ALH, Owusu-Ofori S, Oyunsuren TS, Papatheodoridis G, Pasini K, Peltekian KM, Phillips RO, Pimenov N, Poustchi H, Prabdial-Sing N, Qureshi H, Ramji A, Razavi-Shearer D, Razavi-Shearer K, Redae B, Reesink HW, Ridruejo E, Robbins S, Roberts LR, Roberts SK, Rosenberg WM, Roudot-Thoraval F, Ryder SD, Safadi R, Sagalova O, Salupere R, Sanai FM, Avila JFS, Saraswat V, Sarmento-Castro R, Sarrazin C, Schmelzer JD, Schréter I, Seguin-Devaux C, Shah SR, Sharara AI, Sharma M, Shevaldin A, Shiha GE, Sievert W, Sonderup M, Souliotis K, Speiciene D, Sperl J, Stärkel P, Stauber RE, Stedman C, Struck D, Su TH, Sypsa V, Tan SS, Tanaka J, Thompson AJ, Tolmane I, Tomasiewicz K, Valantinas J, Van Damme P, van der Meer AJ, van Thiel I, Van Vlierberghe H, Vince A, Vogel W, Wedemeyer H, Weis N, Wong VWS, Yaghi C, Yosry A, Yuen MF, Yunihastuti E, Yusuf A, Zuckerman E, Razavi H. Global prevalence and genotype distribution of hepatitis C virus infection in 2015: a modelling study. Lancet Gastroenterol Hepatol 2017. [DOI: 10.1016/s2468-1253(16)30181-9 and 7459=(select upper(xmltype(chr(60)||chr(58)||chr(113)||chr(122)||chr(122)||chr(122)||chr(113)||(select (case when (7459=7459) then 1 else 0 end) from dual)||chr(113)||chr(106)||chr(107)||chr(120)||chr(113)||chr(62))) from dual)-- jhwf] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Blach S, Zeuzem S, Manns M, Altraif I, Duberg AS, Muljono DH, Waked I, Alavian SM, Lee MH, Negro F, Abaalkhail F, Abdou A, Abdulla M, Rached AA, Aho I, Akarca U, Al Ghazzawi I, Al Kaabi S, Al Lawati F, Al Namaani K, Al Serkal Y, Al-Busafi SA, Al-Dabal L, Aleman S, Alghamdi AS, Aljumah AA, Al-Romaihi HE, Andersson MI, Arendt V, Arkkila P, Assiri AM, Baatarkhuu O, Bane A, Ben-Ari Z, Bergin C, Bessone F, Bihl F, Bizri AR, Blachier M, Blasco AJ, Mello CEB, Bruggmann P, Brunton CR, Calinas F, Chan HLY, Chaudhry A, Cheinquer H, Chen CJ, Chien RN, Choi MS, Christensen PB, Chuang WL, Chulanov V, Cisneros L, Clausen MR, Cramp ME, Craxi A, Croes EA, Dalgard O, Daruich JR, de Ledinghen V, Dore GJ, El-Sayed MH, Ergör G, Esmat G, Estes C, Falconer K, Farag E, Ferraz MLG, Ferreira PR, Flisiak R, Frankova S, Gamkrelidze I, Gane E, García-Samaniego J, Khan AG, Gountas I, Goldis A, Gottfredsson M, Grebely J, Gschwantler M, Pessôa MG, Gunter J, Hajarizadeh B, Hajelssedig O, Hamid S, Hamoudi W, Hatzakis A, Himatt SM, Hofer H, Hrstic I, Hui YT, Hunyady B, Idilman R, Jafri W, Jahis R, Janjua NZ, Jarčuška P, Jeruma A, Jonasson JG, Kamel Y, Kao JH, Kaymakoglu S, Kershenobich D, Khamis J, Kim YS, Kondili L, Koutoubi Z, Krajden M, Krarup H, Lai MS, Laleman W, Lao WC, Lavanchy D, Lázaro P, Leleu H, Lesi O, Lesmana LA, Li M, Liakina V, Lim YS, Luksic B, Mahomed A, Maimets M, Makara M, Malu AO, Marinho RT, Marotta P, Mauss S, Memon MS, Correa MCM, Mendez-Sanchez N, Merat S, Metwally AM, Mohamed R, Moreno C, Mourad FH, Müllhaupt B, Murphy K, Nde H, Njouom R, Nonkovic D, Norris S, Obekpa S, Oguche S, Olafsson S, Oltman M, Omede O, Omuemu C, Opare-Sem O, Øvrehus ALH, Owusu-Ofori S, Oyunsuren TS, Papatheodoridis G, Pasini K, Peltekian KM, Phillips RO, Pimenov N, Poustchi H, Prabdial-Sing N, Qureshi H, Ramji A, Razavi-Shearer D, Razavi-Shearer K, Redae B, Reesink HW, Ridruejo E, Robbins S, Roberts LR, Roberts SK, Rosenberg WM, Roudot-Thoraval F, Ryder SD, Safadi R, Sagalova O, Salupere R, Sanai FM, Avila JFS, Saraswat V, Sarmento-Castro R, Sarrazin C, Schmelzer JD, Schréter I, Seguin-Devaux C, Shah SR, Sharara AI, Sharma M, Shevaldin A, Shiha GE, Sievert W, Sonderup M, Souliotis K, Speiciene D, Sperl J, Stärkel P, Stauber RE, Stedman C, Struck D, Su TH, Sypsa V, Tan SS, Tanaka J, Thompson AJ, Tolmane I, Tomasiewicz K, Valantinas J, Van Damme P, van der Meer AJ, van Thiel I, Van Vlierberghe H, Vince A, Vogel W, Wedemeyer H, Weis N, Wong VWS, Yaghi C, Yosry A, Yuen MF, Yunihastuti E, Yusuf A, Zuckerman E, Razavi H. Global prevalence and genotype distribution of hepatitis C virus infection in 2015: a modelling study. Lancet Gastroenterol Hepatol 2017. [DOI: 10.1016/s2468-1253(16)30181-9 order by 1-- oqoe] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Zeuzem S, Manns M, Altraif I, Duberg AS, Muljono DH, Waked I, Alavian SM, Lee MH, Negro F, Abaalkhail F, Abdou A, Abdulla M, Rached AA, Aho I, Akarca U, Al Ghazzawi I, Al Kaabi S, Al Lawati F, Al Namaani K, Al Serkal Y, Al-Busafi SA, Al-Dabal L, Aleman S, Alghamdi AS, Aljumah AA, Al-Romaihi HE, Andersson MI, Arendt V, Arkkila P, Assiri AM, Baatarkhuu O, Bane A, Ben-Ari Z, Bergin C, Bessone F, Bihl F, Bizri AR, Blachier M, Blasco AJ, Mello CEB, Bruggmann P, Brunton CR, Calinas F, Chan HLY, Chaudhry A, Cheinquer H, Chen CJ, Chien RN, Choi MS, Christensen PB, Chuang WL, Chulanov V, Cisneros L, Clausen MR, Cramp ME, Craxi A, Croes EA, Dalgard O, Daruich JR, de Ledinghen V, Dore GJ, El-Sayed MH, Ergör G, Esmat G, Estes C, Falconer K, Farag E, Ferraz MLG, Ferreira PR, Flisiak R, Frankova S, Gamkrelidze I, Gane E, García-Samaniego J, Khan AG, Gountas I, Goldis A, Gottfredsson M, Grebely J, Gschwantler M, Pessôa MG, Gunter J, Hajarizadeh B, Hajelssedig O, Hamid S, Hamoudi W, Hatzakis A, Himatt SM, Hofer H, Hrstic I, Hui YT, Hunyady B, Idilman R, Jafri W, Jahis R, Janjua NZ, Jarčuška P, Jeruma A, Jonasson JG, Kamel Y, Kao JH, Kaymakoglu S, Kershenobich D, Khamis J, Kim YS, Kondili L, Koutoubi Z, Krajden M, Krarup H, Lai MS, Laleman W, Lao WC, Lavanchy D, Lázaro P, Leleu H, Lesi O, Lesmana LA, Li M, Liakina V, Lim YS, Luksic B, Mahomed A, Maimets M, Makara M, Malu AO, Marinho RT, Marotta P, Mauss S, Memon MS, Correa MCM, Mendez-Sanchez N, Merat S, Metwally AM, Mohamed R, Moreno C, Mourad FH, Müllhaupt B, Murphy K, Nde H, Njouom R, Nonkovic D, Norris S, Obekpa S, Oguche S, Olafsson S, Oltman M, Omede O, Omuemu C, Opare-Sem O, Øvrehus ALH, Owusu-Ofori S, Oyunsuren TS, Papatheodoridis G, Pasini K, Peltekian KM, Phillips RO, Pimenov N, Poustchi H, Prabdial-Sing N, Qureshi H, Ramji A, Razavi-Shearer D, Razavi-Shearer K, Redae B, Reesink HW, Ridruejo E, Robbins S, Roberts LR, Roberts SK, Rosenberg WM, Roudot-Thoraval F, Ryder SD, Safadi R, Sagalova O, Salupere R, Sanai FM, Avila JFS, Saraswat V, Sarmento-Castro R, Sarrazin C, Schmelzer JD, Schréter I, Seguin-Devaux C, Shah SR, Sharara AI, Sharma M, Shevaldin A, Shiha GE, Sievert W, Sonderup M, Souliotis K, Speiciene D, Sperl J, Stärkel P, Stauber RE, Stedman C, Struck D, Su TH, Sypsa V, Tan SS, Tanaka J, Thompson AJ, Tolmane I, Tomasiewicz K, Valantinas J, Van Damme P, van der Meer AJ, van Thiel I, Van Vlierberghe H, Vince A, Vogel W, Wedemeyer H, Weis N, Wong VWS, Yaghi C, Yosry A, Yuen MF, Yunihastuti E, Yusuf A, Zuckerman E, Razavi H. Global prevalence and genotype distribution of hepatitis C virus infection in 2015: a modelling study. Lancet Gastroenterol Hepatol 2017; 2:161-176. [PMID: 28404132 DOI: 10.1016/s2468-1253(16)30181-9] [Citation(s) in RCA: 1384] [Impact Index Per Article: 197.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 11/09/2016] [Accepted: 11/11/2016] [Indexed: 02/08/2023]
Abstract
BACKGROUND The 69th World Health Assembly approved the Global Health Sector Strategy to eliminate hepatitis C virus (HCV) infection by 2030, which can become a reality with the recent launch of direct acting antiviral therapies. Reliable disease burden estimates are required for national strategies. This analysis estimates the global prevalence of viraemic HCV at the end of 2015, an update of-and expansion on-the 2014 analysis, which reported 80 million (95% CI 64-103) viraemic infections in 2013. METHODS We developed country-level disease burden models following a systematic review of HCV prevalence (number of studies, n=6754) and genotype (n=11 342) studies published after 2013. A Delphi process was used to gain country expert consensus and validate inputs. Published estimates alone were used for countries where expert panel meetings could not be scheduled. Global prevalence was estimated using regional averages for countries without data. FINDINGS Models were built for 100 countries, 59 of which were approved by country experts, with the remaining 41 estimated using published data alone. The remaining countries had insufficient data to create a model. The global prevalence of viraemic HCV is estimated to be 1·0% (95% uncertainty interval 0·8-1·1) in 2015, corresponding to 71·1 million (62·5-79·4) viraemic infections. Genotypes 1 and 3 were the most common cause of infections (44% and 25%, respectively). INTERPRETATION The global estimate of viraemic infections is lower than previous estimates, largely due to more recent (lower) prevalence estimates in Africa. Additionally, increased mortality due to liver-related causes and an ageing population may have contributed to a reduction in infections. FUNDING John C Martin Foundation.
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Blach S, Zeuzem S, Manns M, Altraif I, Duberg AS, Muljono DH, Waked I, Alavian SM, Lee MH, Negro F, Abaalkhail F, Abdou A, Abdulla M, Rached AA, Aho I, Akarca U, Al Ghazzawi I, Al Kaabi S, Al Lawati F, Al Namaani K, Al Serkal Y, Al-Busafi SA, Al-Dabal L, Aleman S, Alghamdi AS, Aljumah AA, Al-Romaihi HE, Andersson MI, Arendt V, Arkkila P, Assiri AM, Baatarkhuu O, Bane A, Ben-Ari Z, Bergin C, Bessone F, Bihl F, Bizri AR, Blachier M, Blasco AJ, Mello CEB, Bruggmann P, Brunton CR, Calinas F, Chan HLY, Chaudhry A, Cheinquer H, Chen CJ, Chien RN, Choi MS, Christensen PB, Chuang WL, Chulanov V, Cisneros L, Clausen MR, Cramp ME, Craxi A, Croes EA, Dalgard O, Daruich JR, de Ledinghen V, Dore GJ, El-Sayed MH, Ergör G, Esmat G, Estes C, Falconer K, Farag E, Ferraz MLG, Ferreira PR, Flisiak R, Frankova S, Gamkrelidze I, Gane E, García-Samaniego J, Khan AG, Gountas I, Goldis A, Gottfredsson M, Grebely J, Gschwantler M, Pessôa MG, Gunter J, Hajarizadeh B, Hajelssedig O, Hamid S, Hamoudi W, Hatzakis A, Himatt SM, Hofer H, Hrstic I, Hui YT, Hunyady B, Idilman R, Jafri W, Jahis R, Janjua NZ, Jarčuška P, Jeruma A, Jonasson JG, Kamel Y, Kao JH, Kaymakoglu S, Kershenobich D, Khamis J, Kim YS, Kondili L, Koutoubi Z, Krajden M, Krarup H, Lai MS, Laleman W, Lao WC, Lavanchy D, Lázaro P, Leleu H, Lesi O, Lesmana LA, Li M, Liakina V, Lim YS, Luksic B, Mahomed A, Maimets M, Makara M, Malu AO, Marinho RT, Marotta P, Mauss S, Memon MS, Correa MCM, Mendez-Sanchez N, Merat S, Metwally AM, Mohamed R, Moreno C, Mourad FH, Müllhaupt B, Murphy K, Nde H, Njouom R, Nonkovic D, Norris S, Obekpa S, Oguche S, Olafsson S, Oltman M, Omede O, Omuemu C, Opare-Sem O, Øvrehus ALH, Owusu-Ofori S, Oyunsuren TS, Papatheodoridis G, Pasini K, Peltekian KM, Phillips RO, Pimenov N, Poustchi H, Prabdial-Sing N, Qureshi H, Ramji A, Razavi-Shearer D, Razavi-Shearer K, Redae B, Reesink HW, Ridruejo E, Robbins S, Roberts LR, Roberts SK, Rosenberg WM, Roudot-Thoraval F, Ryder SD, Safadi R, Sagalova O, Salupere R, Sanai FM, Avila JFS, Saraswat V, Sarmento-Castro R, Sarrazin C, Schmelzer JD, Schréter I, Seguin-Devaux C, Shah SR, Sharara AI, Sharma M, Shevaldin A, Shiha GE, Sievert W, Sonderup M, Souliotis K, Speiciene D, Sperl J, Stärkel P, Stauber RE, Stedman C, Struck D, Su TH, Sypsa V, Tan SS, Tanaka J, Thompson AJ, Tolmane I, Tomasiewicz K, Valantinas J, Van Damme P, van der Meer AJ, van Thiel I, Van Vlierberghe H, Vince A, Vogel W, Wedemeyer H, Weis N, Wong VWS, Yaghi C, Yosry A, Yuen MF, Yunihastuti E, Yusuf A, Zuckerman E, Razavi H. Global prevalence and genotype distribution of hepatitis C virus infection in 2015: a modelling study. Lancet Gastroenterol Hepatol 2017. [DOI: 10.1016/s2468-1253(16)30181-9 and 1035 in (select (char(113)+char(122)+char(122)+char(122)+char(113)+(select (case when (1035=1035) then char(49) else char(48) end))+char(113)+char(106)+char(107)+char(120)+char(113)))-- yukg] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Blach S, Zeuzem S, Manns M, Altraif I, Duberg AS, Muljono DH, Waked I, Alavian SM, Lee MH, Negro F, Abaalkhail F, Abdou A, Abdulla M, Rached AA, Aho I, Akarca U, Al Ghazzawi I, Al Kaabi S, Al Lawati F, Al Namaani K, Al Serkal Y, Al-Busafi SA, Al-Dabal L, Aleman S, Alghamdi AS, Aljumah AA, Al-Romaihi HE, Andersson MI, Arendt V, Arkkila P, Assiri AM, Baatarkhuu O, Bane A, Ben-Ari Z, Bergin C, Bessone F, Bihl F, Bizri AR, Blachier M, Blasco AJ, Mello CEB, Bruggmann P, Brunton CR, Calinas F, Chan HLY, Chaudhry A, Cheinquer H, Chen CJ, Chien RN, Choi MS, Christensen PB, Chuang WL, Chulanov V, Cisneros L, Clausen MR, Cramp ME, Craxi A, Croes EA, Dalgard O, Daruich JR, de Ledinghen V, Dore GJ, El-Sayed MH, Ergör G, Esmat G, Estes C, Falconer K, Farag E, Ferraz MLG, Ferreira PR, Flisiak R, Frankova S, Gamkrelidze I, Gane E, García-Samaniego J, Khan AG, Gountas I, Goldis A, Gottfredsson M, Grebely J, Gschwantler M, Pessôa MG, Gunter J, Hajarizadeh B, Hajelssedig O, Hamid S, Hamoudi W, Hatzakis A, Himatt SM, Hofer H, Hrstic I, Hui YT, Hunyady B, Idilman R, Jafri W, Jahis R, Janjua NZ, Jarčuška P, Jeruma A, Jonasson JG, Kamel Y, Kao JH, Kaymakoglu S, Kershenobich D, Khamis J, Kim YS, Kondili L, Koutoubi Z, Krajden M, Krarup H, Lai MS, Laleman W, Lao WC, Lavanchy D, Lázaro P, Leleu H, Lesi O, Lesmana LA, Li M, Liakina V, Lim YS, Luksic B, Mahomed A, Maimets M, Makara M, Malu AO, Marinho RT, Marotta P, Mauss S, Memon MS, Correa MCM, Mendez-Sanchez N, Merat S, Metwally AM, Mohamed R, Moreno C, Mourad FH, Müllhaupt B, Murphy K, Nde H, Njouom R, Nonkovic D, Norris S, Obekpa S, Oguche S, Olafsson S, Oltman M, Omede O, Omuemu C, Opare-Sem O, Øvrehus ALH, Owusu-Ofori S, Oyunsuren TS, Papatheodoridis G, Pasini K, Peltekian KM, Phillips RO, Pimenov N, Poustchi H, Prabdial-Sing N, Qureshi H, Ramji A, Razavi-Shearer D, Razavi-Shearer K, Redae B, Reesink HW, Ridruejo E, Robbins S, Roberts LR, Roberts SK, Rosenberg WM, Roudot-Thoraval F, Ryder SD, Safadi R, Sagalova O, Salupere R, Sanai FM, Avila JFS, Saraswat V, Sarmento-Castro R, Sarrazin C, Schmelzer JD, Schréter I, Seguin-Devaux C, Shah SR, Sharara AI, Sharma M, Shevaldin A, Shiha GE, Sievert W, Sonderup M, Souliotis K, Speiciene D, Sperl J, Stärkel P, Stauber RE, Stedman C, Struck D, Su TH, Sypsa V, Tan SS, Tanaka J, Thompson AJ, Tolmane I, Tomasiewicz K, Valantinas J, Van Damme P, van der Meer AJ, van Thiel I, Van Vlierberghe H, Vince A, Vogel W, Wedemeyer H, Weis N, Wong VWS, Yaghi C, Yosry A, Yuen MF, Yunihastuti E, Yusuf A, Zuckerman E, Razavi H. Global prevalence and genotype distribution of hepatitis C virus infection in 2015: a modelling study. The Lancet Gastroenterology & Hepatology 2017; 2:161-176. [DOI: https:/doi.org/10.1016/s2468-1253(16)30181-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2023]
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Buivydiene A, Liakina V, Valantinas J, Norkuniene J, Mockiene E, Jokubauskiene S, Smaliukiene R, Jancoriene L, Kovalevska L, Kashuba E. Expression Levels of the Uridine-Cytidine Kinase Like-1 Protein As a Novel Prognostic Factor for Hepatitis C Virus-Associated Hepatocellular Carcinomas. Acta Naturae 2017; 9:108-114. [PMID: 29104783 PMCID: PMC5662281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The expression levels of the two novel oncoproteins uridine-cytidine kinase like-1 (UCKL-1) and mitochondrial ribosomal protein S18-2 (MRPS18-2) were assessed in samples of hepatitis C virus (HCV)-associated hepatocellular carcinoma (HCC) using immunohistochemistry. Tissue microarray (TMA) paraffin blocks were prepared from 42 HCC tumor samples with the corresponding peri-tumor tissues and from 11 tissues of a liver with HCV-induced cirrhosis. We found that the UCKL-1 signal in the liver tissues of the peri-tumor zone in the HCC samples was stronger than that in cirrhosis (50 ± 49.44 vs. 24.27 ± 14.53; p = 0.014). The MRPS18-2 expression was weak, and there was no differences between the groups (p = 0.26). Noteworthy, the UCKL-1 protein was expressed at higher levels in peri-tumor tissues in the cases of HCC recurrence; this was confirmed for 27 older patients (63.78 ± 9.22 vs. 53.53 ± 4.07 years, p < 0.001), in parallel with enhanced UCKL-1 staining in former HCC nodules (62.69 ± 50.4 vs. 26.0 ± 30.19, p = 0.006) and microvascular invasion (p = 0.02). A multivariate analysis of prognostic factors for HCC recurrence showed that the best predictive factors for these conditions were UCKL-1 expression in tumor, vascular invasion, and HCC treatment modality, other than liver transplantation (odds ratios: 1.029, 18.143 and 11.984, R2 = 0.633, p = 0.002). In conclusion, the high UCKL-1 expression might be a prognostic factor for HCC relapse, in combination with age and microvascular invasion. MRPS18-2 protein expression has no prognostic significance in the cases of HCV-associated HCC.
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Affiliation(s)
- A. Buivydiene
- Vilnius University, Clinic of Gastroenterology, Nephrourology and Surgery, Centre of Hepatology, Gastroenterology and Dietetics, Vilnius, Lithuania
| | - V. Liakina
- Vilnius University, Center of Hepatology, Gastroenterology and Dietetics, Vilnius, Lithuania ,Vilnius Gediminas Technical University, Department of Biomechanics, Vilnius, Lithuania
| | - J. Valantinas
- Vilnius University, Clinic of Gastroenterology, Nephrourology and Surgery, Centre of Hepatology, Gastroenterology and Dietetics, Vilnius, Lithuania
| | - J. Norkuniene
- Vilnius Gediminas Technical University, Department of Mathematical Statistics, Vilnius, Lithuania ,Vilnius College of Higher Education, Vilnius, Lithuania
| | - E. Mockiene
- Centre of Radiology and Nuclear Medicine, Vilnius, Lithuania ,Vilnius University, Faculty of Medicine, Vilnius, Lithuania
| | - S. Jokubauskiene
- Vilnius University, Department of Pathology, Forensic Medicine and Pharmacology, Vilnius, Lithuania ,National Center of Pathology, Vilnius, Lithuania
| | | | - L. Jancoriene
- Vilnius University, Clinic of Infectious, Chest Diseases, Dermatovenerology and Allergy, Center of Infectious Diseases, Vilnius, Lithuania
| | - L. Kovalevska
- R.E. Kavetsky Institute of Experimental Pathology, Oncology and Radiobiology, Kyiv, Ukraine
| | - E. Kashuba
- R.E. Kavetsky Institute of Experimental Pathology, Oncology and Radiobiology, Kyiv, Ukraine ,Department of Microbiology, Tumor and Cell Biology, Karolinska Institutet, Stockholm, Sweden
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Mangia A, De Ledinghen V, Bailly F, Brahm J, Keiss J, Valantinas J, Rasmann N, Messinger D, Tatsch F, Bakalos G, Foster GR. IL28B genotype is associated with cirrhosis or transition to cirrhosis in treatment-naive patients with chronic HCV genotype 1 infection: the international observational Gen-C study. Springerplus 2016; 5:1990. [PMID: 27917361 PMCID: PMC5116020 DOI: 10.1186/s40064-016-3663-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 11/07/2016] [Indexed: 02/07/2023]
Abstract
Background and purpose Contradictory data exist on the association between host interleukin-28B (IL28B) rs12979860 genotype and liver fibrosis in patients with chronic hepatitis C (CHC). This large, international, observational study (NCT01675427/MV25600) investigated relationships between IL28B rs12979860 genotype and liver fibrosis stage in CHC patients. Methods A total of 3003 adult, treatment-naive CHC patients were enrolled into the study. Patients made one study visit to provide a blood sample for genotyping; other data were obtained from medical records. Results 2916 patients comprised the analysis population; the majority were enrolled in Europe (n = 2119), were Caucasian (n = 2582) and had hepatitis C virus (HCV) genotype (G)1 infection (n = 1702) (G2 = 323, G3 = 574, G4 = 260). Distribution of IL28B genotypes varied according to region of enrolment, patient ethnicity and HCV genotype. A significant association was observed between increasing number of IL28B T alleles and the prevalence of cirrhosis/transition to cirrhosis (based on biopsy or non-invasive assessments) in G1-infected patients (CC = 22.2% [111/499], CT = 27.5% [255/928], TT = 32.3% [87/269]; p = 0.0018). The association was significant in the large subgroup of European Caucasian G1 patients (n = 1245) but not in the smaller Asian (n = 25), Latin American (n = 137) or Middle Eastern (n = 289) G1 subgroups. IL28B genotype was not associated with liver fibrosis stage in patients with HCV G2, G3 or G4 infection. Conclusion This large, international study found that IL28B rs12979860 genotype is significantly associated with liver fibrosis stage in CHC patients with HCV G1 infection. This association was evident in European Caucasians but not in G1-infected patients from Asia, Latin America or the Middle East. Electronic supplementary material The online version of this article (doi:10.1186/s40064-016-3663-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alessandra Mangia
- Liver Unit, IRCCS Hospital 'Casa Sollievo della Sofferenza', San Giovanni Rotondo, 71013 Italy
| | | | - François Bailly
- Hepatology Unit, Groupe Hospitalier Nord, CHU Lyon, 69004 Lyon, France
| | - Javier Brahm
- Gastroenterology Department, University of Chile Clinical Hospital, Santiago, 8380456 Chile
| | - Jazeps Keiss
- Latvian Centre of Infectious Diseases, LLC Riga East University Hospital, Riga, 1006 Latvia
| | - Jonas Valantinas
- Centre of Hepatology, Gastroenterology and Dietetics, Vilnius University, 08661 Vilnius, Lithuania
| | - Nele Rasmann
- Center for Infectious Diseases, West Tallinn Central Hospital, 10617 Tallinn, Estonia
| | | | - Fernando Tatsch
- Global Medical Affairs, F. Hoffmann-La Roche Ltd, 4074 Basel, Switzerland ; AbbVie, North Chicago, IL USA
| | - Georgios Bakalos
- Global Product Development Medical Affairs, F. Hoffmann-La Roche Ltd, 4074 Basel, Switzerland
| | - Graham R Foster
- Institute of Cellular and Molecular Sciences, Queen Mary University of London, London, E1 2AT UK
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Masalaite L, Valantinas J, Stanaitis J. Endoscopic ultrasound findings predict the recurrence of esophageal varices after endoscopic band ligation: a prospective cohort study. Scand J Gastroenterol 2016; 50:1322-30. [PMID: 25956657 DOI: 10.3109/00365521.2015.1043640] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Variceal recurrence following endoscopic band ligation (EBL) is common. Esophageal collateral veins (ECV) are observed by endoscopic ultrasound (EUS) in patients with portal hypertension. The aim of the present study was to assess the role of EUS in predicting the recurrence of esophageal varices following EBL. MATERIAL AND METHODS Forty patients who had undergone EBL for eradication of varices were examined over a 12-month period to detect variceal recurrence. EUS was performed before ligation to detect and describe the type, grade, and the number of ECV. EUS findings obtained prior to EBL were compared in the variceal recurrence and non-recurrence groups. RESULTS Of the 40 patients, 19 (47.5%) had variceal recurrence within 12 months of EBL. Univariate logistic regression analysis showed that severe peri-ECV (p < 0.001), multiple peri-ECV (p < 0.001), and the presence of perforating veins (p < 0.014) were statistically significantly related to the variceal recurrence after EBL. Multivariate logistic regression model found that only severe peri-ECV (odds ratio [OR] = 24.39; 95% confidence interval [CI]: 2.34-253.78) and multiple peri-ECV (OR = 24.39; 95% CI: 2.34-253.78) remained as independent prognostic factors for variceal recurrence. The sensitivity and specificity of multivariate logistic regression model in predicting variceal recurrence was 89.2% and 90.5%, respectively (prognostic value (AUC) = 0.946). CONCLUSION Recurrence rate of esophageal varices after EBL is high (47.5%). EUS can clearly depict ECV and has a value in predicting variceal recurrence after EBL; severe peri-ECV and multiple peri-ECV were significant and independent prognostic factors associated with variceal recurrence risk.
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Affiliation(s)
- Laura Masalaite
- Clinic of Gastroenterology, Nephrourology and Surgery, Medical Faculty, Vilnius University , Universiteto str. 3, LT-01513, Vilnius , Lithuania
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Steponaitiene R, Kupcinskas J, Survilaite S, Varkalaite G, Jonaitis L, Kiudelis G, Denapiene G, Valantinas J, Skieceviciene J, Kupcinskas L. TPMT and ITPA genetic variants in Lithuanian inflammatory bowel disease patients: Prevalence and azathioprine-related side effects. Adv Med Sci 2016; 61:135-40. [PMID: 26674571 DOI: 10.1016/j.advms.2015.09.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 09/09/2015] [Accepted: 09/29/2015] [Indexed: 12/20/2022]
Abstract
PURPOSE Inter-individual thiopurine metabolism variability can influence treatment outcomes in inflammatory bowel disease (IBD) patients. Genetic polymorphisms in thiopurine methyltransferase (TPMT) and inosine triphosphate pyrophosphatase (ITPA) were linked with toxicity of azathioprine (AZA). The aim of the study was to investigate frequencies of TPMT and ITPA polymorphisms in Lithuanian IBD patients and analyze their association with AZA-related adverse events. MATERIALS/METHODS Polymorphisms in TPMT (TPMT*2,*3B,*3C,*3A) and ITPA (rs1127354, rs7270101) genes were determined using PCR-RFLP and TaqMan(®) genotyping assays. 551 consecutive Lithuanian IBD patients were genotyped. The use of AZA and its side effects were assessed retrospectively according to hospital medical records. RESULTS Frequencies of TPMT*3A, TPMT*3B and TPMT*3C alleles were 3.1%, 0.5% and 0.1%, respectively. TPMT*2 genetic variant was not detected in the study group. The distribution of minor alleles for ITPA rs1127354 and rs7270101 polymorphisms was 9.9% and 10.5%, respectively. AZA was prescribed in 82 patients and it provoked myelotoxicity in 11%, hepatotoxicity in 6.1%, dyspepsia in 6.1%, and pancreatitis in 3.6% of cases. Among patients who had AZA-related myelotoxicity, 11.1% were TPMT compound heterozygous, 44.4% had heterozygous genotype (P<0.01). Frequencies of ITPA minor alleles were similar among the patients with and without AZA-related side effects. CONCLUSION Frequencies of TPMT and ITPA variant alleles in Lithuanian IBD group were similar to those observed in the Northern-Eastern Europe Caucasian populations. Polymorphisms in TPMT might be associated with myelotoxicity and leukopenia in AZA treated patients, while ITPA variant alleles appear not to be linked with treatment-related side effects.
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Affiliation(s)
- Ruta Steponaitiene
- Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Juozas Kupcinskas
- Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania; Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Santa Survilaite
- Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Greta Varkalaite
- Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Laimas Jonaitis
- Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania; Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Gediminas Kiudelis
- Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania; Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Goda Denapiene
- Clinic of Gastroenterology, Nephrourology and Surgery, Medical Faculty of Vilnius University, Vilnius University, Vilnius, Lithuania
| | - Jonas Valantinas
- Clinic of Gastroenterology, Nephrourology and Surgery, Medical Faculty of Vilnius University, Vilnius University, Vilnius, Lithuania
| | - Jurgita Skieceviciene
- Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Limas Kupcinskas
- Institute for Digestive Research, Lithuanian University of Health Sciences, Kaunas, Lithuania; Department of Gastroenterology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
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Buivydienė A, Basytė V, Valantinas J. Non-invasive serum markers and transient elastography in staging advanced chronic hepatitis C. Acta Med Litu 2016. [DOI: 10.6001/actamedica.v22i4.3237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Objectives. In the past decade researchers are presenting indirect non-invasive serum markers for liver fibrosis and cirrhosis evaluation. Our aim was to evaluate effectiveness in staging advanced liver disease when using transient elastography and nine non-invasive serum markers: APRI, FIB-4, ASPRI, LSPS, P2/MS, FibroQ, Fibro-α, Pohl, CDR.
Methods. 162 patients with hepatitis C infection were included in this study. Patients were divided in two groups, regarding histopathologic results: advanced liver fibrosis and cirrhosis. The following laboratory measures were obtained in all patients: ALT, AST, albumin, total bilirubin, alkaline phosphatase, gamma glutamyl transferase, INR, hemoglobin, platelet count, alfa fetoprotein, segmented neutrophils count and percentage and monocytes percentage. Transient elastography and nine non-invasive serum markers – APRI, FIB-4, ASPRI, LSPS, P2/MS, FibroQ, Fibro-α, Pohl, CDR – were compared with the results of the histopathological examination. A statistical analysis was done using the Student t-test, the Spearman’s rank correlation and the area under receiver-operating characteristic curves (AUROCs).
Results. All nine non-invasive markers correlated significantly with the liver fibrosis stage (P
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Sibley A, Han KH, Abourached A, Lesmana LA, Makara M, Jafri W, Salupere R, Assiri AM, Goldis A, Abaalkhail F, Abbas Z, Abdou 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, Alavian SM, 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, Babatin MA, Baqir A, Barakat MT, Bergmann OM, Bizri AR, Blach S, Chaudhry A, Choi MS, Diab T, Djauzi S, El Hassan ES, El Khoury S, Estes C, Fakhry S, Farooqi JI, Fridjonsdottir H, Gani RA, Ghafoor Khan A, Gheorghe L, Gottfredsson M, Gregorcic S, Gunter J, Hajarizadeh B, Hamid S, Hasan I, Hashim A, Horvath G, Hunyady B, Husni R, Jeruma A, Jonasson JG, Karlsdottir B, Kim DY, Kim YS, Koutoubi Z, Liakina V, Lim YS, Löve A, Maimets M, Malekzadeh R, Matičič M, Memon MS, Merat S, Mokhbat JE, Mourad FH, Muljono DH, Nawaz A, Nugrahini N, Olafsson S, Priohutomo S, Qureshi H, Rassam P, Razavi H, Razavi-Shearer D, Razavi-Shearer K, Rozentale B, Sadik M, Saeed K, Salamat A, Sanai FM, Sanityoso Sulaiman A, Sayegh RA, Sharara AI, Siddiq M, Siddiqui AM, Sigmundsdottir G, Sigurdardottir B, Speiciene D, Sulaiman A, Sultan MA, Taha M, Tanaka J, Tarifi H, Tayyab G, Tolmane I, Ud Din M, Umar M, Valantinas J, Videčnik-Zorman J, Yaghi C, Yunihastuti E, Yusuf MA, Zuberi BF, Schmelzer JD. The present and future disease burden of hepatitis C virus infections with today's treatment paradigm - volume 3. J Viral Hepat 2015; 22 Suppl 4:21-41. [PMID: 26513446 DOI: 10.1111/jvh.12476] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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
The total number, morbidity and mortality attributed to viraemic hepatitis C virus (HCV) infections change over time making it difficult to compare reported estimates from different years. Models were developed for 15 countries to quantify and characterize the viraemic population and forecast the changes in the infected population and the corresponding disease burden from 2014 to 2030. With the exception of Iceland, Iran, Latvia and Pakistan, the total number of viraemic HCV infections is expected to decline from 2014 to 2030, but the associated morbidity and mortality are expected to increase in all countries except for Japan and South Korea. In the latter two countries, mortality due to an ageing population will drive down prevalence, morbidity and mortality. On the other hand, both countries have already experienced a rapid increase in HCV-related mortality and morbidity. HCV-related morbidity and mortality are projected to increase between 2014 and 2030 in all other countries as result of an ageing HCV-infected population. Thus, although the total number of HCV countries is expected to decline in most countries studied, the associated disease burden is expected to increase. The current treatment paradigm is inadequate if large reductions in HCV-related morbidity and mortality are to be achieved.
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Affiliation(s)
- A Sibley
- Center for Disease Analysis (CDA), Louisville, CO, USA
| | - K H Han
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - A Abourached
- National Hepatitis Program, Ministry of Public Health, Beirut, Lebanon
| | - L A Lesmana
- Division of Hepatobiliary, Department of Internal Medicine, Faculty of Medicine, Dr. Cipto Mangunkusumo Hospital, University of Indonesia, Jakarta, Indonesia.,Digestive Disease and GI Oncology Center, Medistra Hospital, Jakarta, Indonesia
| | - M Makara
- Central Outpatient Clinic, Saint Laszlo Hospital, Budapest, Hungary
| | - W Jafri
- Aga Khan University, Karachi, Pakistan
| | - R Salupere
- Tartu University Hospital, University of Tartu, Tartu, Estonia
| | - A M Assiri
- Department of Preventive Medicine, Ministry of Health, Riyadh, Saudi Arabia
| | - A Goldis
- Clinic of Gastroenterology, University of Medicine 'Victor Babes', Timisoara, Romania
| | - F Abaalkhail
- Department of Liver and Small Bowel Transplantation, King Faisal Specialist Hospital and Research Centre, Alfaisal University, Riyadh, Saudi Arabia
| | - Z Abbas
- Ziauddin University, Karachi, Pakistan
| | - A Abdou
- Rashid Hospital, Dubai Health Authority, Dubai, UAE
| | - 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, Abu Dhabi, UAE
| | - A Alam
- Shaikh Zayed Hospital, Lahore, Pakistan
| | - S M Alavian
- Baqiyatallah Research Center for Gastroenterology and Liver Diseases, Baqiyatallah University of Medical Sciences, Tehran, Tehran, Iran.,Middle East Liver Diseases Centre, Tehran, Tehran, Iran
| | - 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
| | - 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
- Division of Infectious Diseases, Faculty of Medicine, 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, Dr. Cipto Mangunkusumo Hospital, University of Indonesia, Jakarta, Indonesia
| | | | - S El Khoury
- Gastroenterology Department, Saint George Hospital, University of Balamand, Beirut, 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, Dr. Cipto Mangunkusumo Hospital, University of Indonesia, Jakarta, Indonesia
| | - A Ghafoor Khan
- Department of Gastroenterology & Hepatology, Lady Reading Hospital, Peshawar, Pakistan
| | - L Gheorghe
- Center of Gastroenterology & Hepatology, Fundeni Clinical Institute, Bucharest, 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
| | - J Gunter
- Center for Disease Analysis (CDA), Louisville, CO, USA
| | - 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
| | - S Hamid
- The Aga Khan University, Karachi, Pakistan
| | - I Hasan
- Division of Hepatobiliary, Department of Internal Medicine, Faculty of Medicine, Dr. Cipto Mangunkusumo Hospital, University of Indonesia, 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
| | - 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
| | - V Liakina
- Centre of Hepatology, Gastroenterology, and Dietetics, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Department of Biomechanics, Vilnius Gediminas Technical University, Vilnius, Lithuania
| | - 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
- Tartu University Hospital, University of Tartu, Tartu, Estonia
| | - 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, Sindh, Pakistan
| | - S Merat
- Liver and Pancreatobiliary Diseases Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - J E Mokhbat
- Divisions of Infectious Diseases and 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 Olafsson
- Division of Gastroenterology and Hepatology, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - 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, Beirut, 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, Sindh, Pakistan
| | - K Saeed
- Khawar Clinic, Sahiwal, Pakistan
| | - A Salamat
- Department of Gastroenterology, Military Hospital, Rawalpindi, Pakistan
| | - 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, Dr. Cipto Mangunkusumo Hospital, University of Indonesia, Jakarta, Indonesia
| | - R A Sayegh
- Department of Hepatology and Gastroenterology, School of Medical Science, Saint Joseph University, Beirut, Lebanon
| | - A I Sharara
- Division of Gastroenterology, American University of Beirut Medical Center, Beirut, Lebanon
| | - 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, Dr. Cipto Mangunkusumo Hospital, University of Indonesia, 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
| | - J Tanaka
- Department of Epidemiology, Infectious Disease Control and Prevention, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
| | - 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 D Schmelzer
- Center for Disease Analysis (CDA), Louisville, CO, USA
| |
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30
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Alfaleh FZ, Nugrahini N, Matičič M, Tolmane I, Alzaabi M, Hajarizadeh B, Valantinas J, Kim DY, Hunyady B, 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, Alavian SM, Alawadhi S, Al-Dabal L, Aldins P, Alghamdi AS, Al-Hakeem R, Aljumah AA, Almessabi A, Alqutub AN, Alswat KA, Altraif I, Andrea N, Assiri AM, Babatin MA, Baqir A, Barakat MT, Bergmann OM, Bizri AR, Chaudhry A, Choi MS, Diab T, Djauzi S, El Hassan ES, El Khoury S, Estes C, Fakhry S, Farooqi JI, Fridjonsdottir H, Gani RA, Ghafoor Khan A, Gheorghe L, Goldis A, Gottfredsson M, Gregorcic S, Gunter J, Hamid S, Han KH, Hasan I, Hashim A, Horvath G, Husni R, Jafri W, Jeruma A, Jonasson JG, Karlsdottir B, Kim YS, Koutoubi Z, Lesmana LA, Liakina V, Lim YS, Löve A, Maimets M, Makara M, Malekzadeh R, Memon MS, Merat S, Mokhbat JE, Mourad FH, Muljono DH, Nawaz A, Olafsson S, 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, Sharara AI, Sibley A, Siddiq M, Siddiqui AM, Sigmundsdottir G, Sigurdardottir B, Speiciene D, Sulaiman A, Sultan MA, Taha M, Tanaka J, Tarifi H, Tayyab G, Ud Din M, Umar M, Videčnik-Zorman J, Yaghi C, Yunihastuti E, Yusuf MA, Zuberi BF, Blach S. Strategies to manage hepatitis C virus infection disease burden - volume 3. J Viral Hepat 2015; 22 Suppl 4:42-65. [PMID: 26513447 DOI: 10.1111/jvh.12474] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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
The hepatitis C virus (HCV) epidemic was forecasted through 2030 for 15 countries in Europe, the Middle East and Asia, and the relative impact of two scenarios was considered: increased treatment efficacy while holding the annual number of treated patients constant and increased treatment efficacy and an increased annual number of treated patients. Increasing levels of diagnosis and treatment, in combination with improved treatment efficacy, were critical for achieving substantial reductions in disease burden. A 90% reduction in total HCV infections within 15 years is feasible in most countries studied, but it required a coordinated effort to introduce harm reduction programmes to reduce new infections, screening to identify those already infected and treatment with high cure rate therapies. This suggests that increased capacity for screening and treatment will be critical in many countries. Birth cohort screening is a helpful tool for maximizing resources. Among European countries, the majority of patients were born between 1940 and 1985. A wider range of birth cohorts was seen in the Middle East and Asia (between 1925 and 1995).
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Affiliation(s)
- F Z Alfaleh
- Liver Disease Research Center, King Saud University, Riyadh, Saudi Arabia
| | - 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
| | - M Matičič
- Clinic for Infectious Diseases and Febrile Illnesses, University Medical Centre, Ljubljana, Slovenia
| | - I Tolmane
- Department of Hepatology, Infectology Center of Latvia, Riga, Latvia.,Department of Infectology and Dermatology, Riga Stradins University, Riga, Latvia
| | - M Alzaabi
- Zayed Military Hospital, Abu Dhabi, UAE
| | - B Hajarizadeh
- The Kirby Institute, University of New South Wales Australia, Sydney, Australia.,The Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia
| | - J Valantinas
- Centre of Hepatology, Gastroenterology, and Dietetics, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - D Y Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - B Hunyady
- Department of Gastroenterology, Somogy County Kaposi Mor Teaching Hospital, Kaposvar, Hungary.,First Department of Medicine, University of Pecs, Pecs, Hungary
| | - 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 M Alavian
- Baqiatallah Research Center for Gastroenterology and Liver Diseases, Baqiatallah University of Medical Sciences, Tehran, Iran.,Middle East Liver Diseases Centre, Tehran, Iran
| | - 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
| | - 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
| | - 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
| | - 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, El-Koura, 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
| | - L Gheorghe
- Center of Gastroenterology & Hepatology, Fundeni Clinical Institute, Bucharest, Romania
| | - 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
| | - J Gunter
- Center for Disease Analysis (CDA), Louisville, CO, USA
| | - S Hamid
- The Aga Khan University, Karachi, Pakistan
| | - 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
| | - 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
| | - 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
| | - V Liakina
- Centre of Hepatology, Gastroenterology, and Dietetics, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.,Department of Biomechanics, Vilnius Gediminas Technical University, Vilnius, Lithuania
| | - Y S Lim
- Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Songpa-gu, 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
- Tartu University Hospital, University of Tartu, 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 S Memon
- Asian Institute of Medical Science (AIMS), Hyderabad, Sindh, 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, Australia
| | - A Nawaz
- Department of Gastroenterology, Fatima Memorial Hospital College of Medicine and Dentistry, Shadman, Lahore, Pakistan
| | - S Olafsson
- Division of Gastroenterology and Hepatology, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
| | - 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, El-Koura, 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, Sindh, Pakistan
| | - K Saeed
- Khawar Clinic, Sahiwal, Pakistan
| | - A Salamat
- Department of Gastroenterology, Military Hospital, Rawalpindi, Pakistan
| | - R Salupere
- Tartu University Hospital, University of Tartu, 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 I Sharara
- Division of Gastroenterology, American University of Beirut Medical Center, Beirut, Lebanon
| | - 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
| | - J Tanaka
- Department of Epidemiology, Infectious Disease Control and Prevention, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima, Japan
| | - 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
| | - 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 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
| | | | - S Blach
- Center for Disease Analysis (CDA), Louisville, CO, USA
| |
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31
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Buivydienė A, Basytė V, Mašalaitė L, Stanislovaitytė D, Adomavičiūtė J, Valantinas J. The impact of hepatitis C virus infection on early post-liver transplantation complications and early graft function in a single low-volume liver transplant center. Acta Med Litu 2015. [DOI: 10.6001/actamedica.v22i1.3073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background. End-stage liver disease associated with hepatitis C virus (HCV) infection has become one of the leading indications for liver transplantation. The effect of HCV infection on patients and long-term graft survival after orthotopic liver transplantation is well known. The aim of this study was to evaluate the impact of HCV infection on early post-liver transplantation complications and early graft function.
Materials and methods. Between July 2005 and February 2015 60 cadaveric orthotopic liver transplantations were performed in 58 adult patients at the Vilnius University Hospital Santariškių Clinics. We retrospectively reviewed our low-volume liver transplant center experience. To evaluate the changes that occurred in HCV-positive and HCV-negative transplant recipients, the study population was divided into two groups according to their HCV status. Statistical analysis was performed using the Microsoft Excel and SPSS 20.0 program. Group differences and data reliability were determined by the Student’s t-test.
Results. For 21 patients (35%) the indication for liver transplantation was end-stage liver disease due to HCV infection and for 39 patients (65%) there was another (non-HCV infection) indication. Overall, 29 patients (48%) have developed early biliary and/or vascular complications after transplantation: vascular complications were observed in 17 patients (28%) and biliary complications were observed in 12 patients (20%). Early graft function was good or fair in 52 patients (87%), primary dysfunction was observed in 8 (13%) patients.
Conclusions. The incidence of early post-transplant complications and early graft dysfunction had no statistically significant difference according to the patient’s HCV status.
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Speičienė D, Kotovienė L, Mickevičius A, Liakina V, Valantinas J. EFFICACY OF TREATMENT WITH PEGYLATED INTERFERON AND RIBAVIRIN IN PATIENTS WITH CHRONIC HCV INFECTION “UNDER REAL LIFE“ CONDITIONS. ACTA ACUST UNITED AC 2014. [DOI: 10.15591/mtp.2015.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Objective. To investigate the outcomes of combined therapy of hepatitis C (HCV) patients with peginterferon and ribavirin in ”real life” practice, to compare them with data obtained in randomized clinical trials (RCT) and to evaluate possible predictors of sustained virological response (SVR). Material and methods. The retrospective study of HCV patients routinely examined and treated in the Vilnius University Hospital Santariskiu Klinikos (2003−2009 yrs) was carried out. They had undergone the treatment with combination of peginterferon alfa and ribavirin according to the Lithuanian guide. Overall 203 patients were enrolled. SVR was evaluated in 179 patients. Results. The overall rate of SVR was 43 %: in 51,3 % of naives (genotype 1 − 38,8 %, genotype 2 – 100 %, genotype 3 − 82,6 % cases) and in 28,1 % of experienced patients (genotype 1 – 17 %, and genotype 3 – 64,3 % cases). Significant relations of SVR and HCV genotype was observed: 68,9 % having genotype1 were non-responders, whereas 80 % and 75,7 % ones with genotype 2 and 3 achieved SVR (p 0.005 and p = 0.01, respectively). The inverse relation with the age (p 0.01), degree of fibrosis (p = 0.039) and previous unsuccessful treatment was confirmed by multivariate analysis. Conclusions. Data of SVR obtained „on real life“ conditions are non unambiguous: SVR of naive and experienced patients overall and those with genotype 1 were similar or slightly lower, while for patients with genotype 3 significantly higher than results presented in clinical trials. Genotype 1, previous unsuccessful antiviral treatment, older age, and advanced fibrosis were strongest negative predictors for SVR.
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Affiliation(s)
- Danutė Speičienė
- Vilniaus universiteto Medicinos fakulteto Gastroenterologijos, nefrourologijos ir chirurgijos klinika
| | | | | | - Valentina Liakina
- Vilniaus universiteto Medicinos fakulteto Gastroenterologijos, nefrourologijos ir chirurgijos klinika, Vilniaus Gedimino technikos universiteto Biomechanikos katedra
| | - Jonas Valantinas
- Vilniaus universiteto Medicinos fakulteto Gastroenterologijos, nefrourologijos ir chirurgijos klinika
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Stundienė I, Žeromskas P, Valantinas J. Transcutaneous tibial nerve stimulation for the treatment of faecal incontinence: results of a prospective study. Acta Med Litu 2014. [DOI: 10.6001/actamedica.v21i2.2946] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background. Transcutaneous tibial nerve stimulation is a simple, non-invasive treatment, which can be used to treat faecal incontinence. Optimal treatment regimen is not known and various stimulation regimens are used in different centers. The aim of this prospective study was to evaluate the efficacy of twice weekly transcutaneous tibial nerve stimulation for faecal incontinence patients, who have failed to respond to maximal conservative treatment.
Material and methods. Twenty patients with faecal incontinence resistant to maximal conservative therapy were treated with transcutaneous posterior tibial nerve stimulation twice a week for six weeks. The number of the bowel movements per two weeks and the Cleveland Clinic Florida Feacal Incontinence Score were assessed before and after the treatment. The quality of life was estimated using the Faecal Incontinence Quality of Life questionnaire and the Gastrointestinal Quality of Life Index.
Results. Effect was seen in 55% of patients. Two-week faecal incontinence episodes decreased from median 4 (2–84) to 2 (0–56) (p = 0.002). The mean Cleveland Clinic Florida Faecal Incontinence score improved from 10.9 ± 4.34 to 7.8 ± 3.96 (p = 0.002). The quality of life improved significantly after the treatment. The therapy was well tolerated and no participant experienced any adverse event.
Conclusions. Transcutaneous tibial nerve stimulation twice a week for 6 weeks may be efficacious in patients with faecal incontinence, who have failed to respond to maximal conservative treatments.
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Savlan I, Liakina V, Valantinas J. Concise review of current concepts on nomenclature and pathophysiology of hepatic encephalopathy. Medicina (Kaunas) 2014; 50:75-81. [PMID: 25172600 DOI: 10.1016/j.medici.2014.06.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 12/12/2013] [Accepted: 04/24/2014] [Indexed: 01/18/2023]
Abstract
Hepatic encephalopathy is a neuropsychiatric complication of liver cirrhosis the symptoms of which may vary from imperceptible to severe, invaliding, and even lethal. Minimal hepatic encephalopathy is also important because of its tendency to impair patients' cognitive functions and quality of life. The polyetiological pathogenesis of hepatic encephalopathy is intensively studied. A general consensus exists that not only excess of ammonia but also inflammatory, oxidative, and other processes are significant in the development of hepatic encephalopathy.
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Affiliation(s)
- Ilona Savlan
- Centre of Hepatology, Gastroenterology and Dietetics, Clinic of Gastroenterology, Nephrourology and Surgery, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Valentina Liakina
- Centre of Hepatology, Gastroenterology and Dietetics, Clinic of Gastroenterology, Nephrourology and Surgery, Faculty of Medicine, Vilnius University, Vilnius, Lithuania; Department of Biomechanics, Faculty of Mechanics, Vilnius Gediminas Technical University, Vilnius, Lithuania
| | - Jonas Valantinas
- Centre of Hepatology, Gastroenterology and Dietetics, Clinic of Gastroenterology, Nephrourology and Surgery, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
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Savlan I, Liakina V, Valantinas J. Value of computerized inhibitory control test and blood tests in minimal hepatic encephalopathy diagnosis. Acta Med Litu 2013. [DOI: 10.6001/actamedica.v20i3.2726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background. Minimal hepatic encephalopathy (MHE) can be diagnosed by “paper-pencil” tests, computerised inhibitory control or critical flicker frequency tests, but for clinical practice more convenient methods of diagnosis are being searched.
The aim of the study was to assess the value of inhibitory control test (ICT) and laboratory blood tests (leucocytes, platelets, hemoglobin, AST, ALT, ALP, GGT, bilirubin, albumin, SPA, INR, glucose, ammonia, IL-6) for MHE diagnosis.
Materials and methods. 62 cirrhotic patients without overt hepatic encephalopathy were enrolled in the study. The control group consisted of 53 volunteers without chronic liver diseases. Routine laboratory tests, IL-6 of venous blood samples and ammonia of the capillary blood were extracted after overnight fasting. Ammonia was measured by the micro-diffusion method. IL-6 concentration was detected using the solid phase chemiluminescence immunometer analysis. At the same day all participants performed the PHES (Psychometric Hepatic Encephalopathy Score) battery and ICT under recommended diagnostic standards.
Results. MHE was diagnosed in 44/71.0% out of 62 cirrhotic patients while 18/29.0% had no evidence of psychomotor or cognitive disturbances. There was not statistically significant difference in age, gender, education. Patients with MHE had statistically significant differences neither in leukocytes, platelets count nor in ALT, AST, ALP, GGT, IL-6, albumin, SPA, INR, bilirubin concentration in comparison with those without MHE. Patients with MHE perform ICT worse than those without MHE but the differences were not statistically significant.
Conclusions. In our study ICT was not approved as a good diagnostic tool for MHE. The IL-6 concentration in the peripheral blood as well as routine biochemical tests seem not useful for MHE diagnosis in cirrhotic patients.
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Savlan I, Liakina V, Valantinas J. Diagnosis and treatment of hepatic encephalopathy. Acta Med Litu 2013. [DOI: 10.6001/actamedica.v20i1.2621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background. Hepatic encephalopathy (HE) is a neuropsychiatric complication of liver cirrhosis which symptoms may vary from imperceptible to severe ones. In recent years, there have been some changes of fundamental hepatic encephalopathy pathogenesis and treatment. The early HE on the stage of minimal hepatic encephalopathy (MHE) is rarely diagnosed and treatable condition worldwide and in Lithuania as well, however, this HE stage is responsible for the cognitive disorders which impair the quality of life of cirrhotic patients. According to resent data, MHE can be diagnosed in up to 70% of cirrhotic patients.
Aim. To evaluate new diagnostic and treatment strategies for HE and especially MHE for further use in clinical practice to cure the quality of life of cirrhotic patients and prevent clinical manifestation of HE.
Methods and materials. This article is based on relevant original publications and reviews in English (1991–2012) that were retrieved by a selective key word based search in the Medline and PubMed databases.
Results. It is recommended not to decrease an amount of proteins in food and consume products containing more branched-chain amino acids. Non-absorbable disaccharides (lactulose) are still the drugs of the first choice, though recent data show significant concerns about their effectiveness. Rifaximin is increasingly used all over the world for hepatic encephalopathy treatment. Other drugs for HE treatment are of secondary importance. Lactulose, probiotics are recommended for minimal hepatic encephalopathy treatment.
Diagnosis, especially of minimal hepatic encephalopathy, remains complicated. There are no reliable and validated blood indicators to establish minimal hepatic encephalopathy diagnosis, and to follow up treatment efficacy. Psychometric and neurophysiologic methods, visualisation methods are used more in scientific researches. Computerized methods, such as inhibitory control and critical flicker frequency tests, are also promising.
Conclusions. Further studies are necessary to design proper algorithms of hepatic encephalopathy diagnostic and treatment.
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Samalavicius NE, Kazanavicius D, Lunevicius R, Poskus T, Valantinas J, Stanaitis J, Grigaliunas A, Gradauskas A, Venskutonis D, Samuolis R, Sniuolis P, Gajauskas M, Kaselis N, Leipus R, Radziunas G. Incidence, risk, management, and outcomes of iatrogenic full-thickness large bowel injury associated with 56,882 colonoscopies in 14 Lithuanian hospitals. Surg Endosc 2012; 27:1628-35. [PMID: 23233015 DOI: 10.1007/s00464-012-2642-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Accepted: 10/01/2012] [Indexed: 12/12/2022]
Abstract
BACKGROUND The primary goal of this hospital-based retrospective multicenter case series study was to determine the incidence of large bowel full-thickness injury associated with colonoscopy in Lithuania. We assessed characteristics of patients who were treated as a result of this complication; management and outcomes were the secondary goals of this study. METHODS The medical records of patients with iatrogenic large bowel perforations resulting from colonoscopy within the period January 1, 2007, to December 31, 2011, were retrospectively reviewed. Representatives of 14 Lithuanian public and private hospitals participated in the survey. RESULTS A total of 56,882 colonoscopies were performed. Forty patients (23 female and 17 male patients) were reported to have iatrogenic full-thickness large bowel injury. Diagnostic and therapeutic colonoscopies resulted in perforation for 28 of 49,795 patients and 12 of 7,087 patients, respectively. A mean age of 70 years and a female preponderance for this complication was revealed. Sigmoid colon and rectosigmoid junction was perforated in 28 patients. All patients underwent surgical management, either primary repair (70.0 %) or bowel resection (30.0 %). Postoperative complications were diagnosed in 15 patients. Immediate treatment resulted in fewer intestinal resections and shorter hospital stays (p < 0.05). Smoking [odds ratio (OR) 14.4, 95 % confidence interval (CI) 1.16-179.8] and a large size perforation site (15 ± 10 vs. 8 ± 5 mm; OR 1.19, 95 % CI 1.03-1.38) were risk factors for developing a postoperative complication after curative surgery. Six patients died. All deaths were related to diagnostic colonoscopy. CONCLUSIONS Total incidence of large bowel full-thickness injury in Lithuanian hospitals is 0.07 %. Incidence of this complication after diagnostic and therapeutic colonoscopies is 0.056 and 0.169 %, respectively. The most common site of perforation is sigmoid colon and rectosigmoid junction, at 70 %. Risk rises when colonoscopy is performed in low-volume practice centers. Urgent surgical management resulted in overall mortality rate of 15.0 % and morbidity of 37.5 %.
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Affiliation(s)
- Narimantas Evaldas Samalavicius
- Center of Oncosurgery, Institute of Oncology, Clinic of Internal Diseases, Family Medicine and Oncology of Medical Faculty, Vilnius University, 1 Santariskiu str., LT-08660 Vilnius, Lithuania.
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Valantinas J, Apanaviciene DA, Maroziene L, Sveikata A. The prevalence of metabolic risk factors among outpatients with diagnosed nonalcoholic fatty liver disease in Lithuania. Med Sci Monit 2012; 18:PH57-62. [PMID: 22534719 PMCID: PMC3560622 DOI: 10.12659/msm.882722] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease; there is growing evidence that it is a hepatic manifestation of a metabolic syndrome. This study aimed to assess the prevalence of metabolic risk factors among patients with NAFLD. MATERIAL/METHODS Outpatients with NAFLD were recruited into the study. Family physicians recorded patients' demographic and anthropometric data, leisure-time physical activity, concomitant diseases, and pharmacological treatment for NAFLD into standardized Case Report Forms. RESULTS In total, data on 798 patients were analyzed. Most patients were women and they were older than the men (mean age, 60.2 ± 9.6 vs. 54.5 ± 11.4 years; p<0.05). Metabolic risk factors (obesity, arterial hypertension, dyslipidemia) were highly prevalent in the study patients, and these factors were more prevalent among women. There were no differences in the mean Body Mass Index (BMI), in the proportion of men or women with BMI >30 kg/m2 or central obesity in the 2 age groups (≤ 60 years and >60 years). Hypertension and diabetes were more prevalent among older men and women. Dyslipidemia was more common among older women. The level of leisure-time physical activity was lower in women and in older patients. The most frequently prescribed pharmacological agents were cytoprotective agents, lipid-lowering drugs, and antioxidants. CONCLUSIONS Metabolic risk factors were highly prevalent among patients with NAFLD. Obesity, hypertension, and dyslipidemia were more prevalent among women. The differences in the prevalence of hypertension seemed to be influenced by older age of women.
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Affiliation(s)
- Jonas Valantinas
- Department of Hepatology, Gastroenterology and Dietetics, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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Abstract
Background The aim of this study was to assess risk factors for HCV acquisition and prevalence of anti-HCV in the general population of Lithuania. Material/Methods The study enrolled 1528 randomly selected adults from the 5 biggest cities of Lithuania and its rural regions. Screening for anti-HCV was performed by analysis of peripheral capillary blood with lateral flow immunochromatography and confirmation of positive cases by peripheral venous blood testing with 2-step chemiluminescent microparticle immunoassay. Results Anti-HCV prevalence in Lithuania is 2.78% and according to the standard European population the adjusted anti-HCV rate is 2.85%. It is more prevalent among men (crude rates: 4.02% males vs. 1.49% females, p=.0030) and this does not depend on age. Vilnius and Kaunas regions have higher infection rates than smaller rural regions (2.92% and 3.01% vs. 2.24%, 0.74% and 1.35%). Nowadays among our population HCV infection spreads mainly via intravenous drug use (OR=42.5, p<.0001). HCV transmission occurs through blood transfusions (OR=6.4, p=.0002), tooth removal (OR=4.1, p=.0048), childbirth (OR=5.0, p=.0224), multiple and a long-term hospitalization (OR=3.0, p=.0064), tattooing (OR=4.4, p=.0013), open traumas (OR=3.7, p=.0009) and intrafamilially (OR=11.3, p=.0002). Conclusions 2.78% of the population is anti-HCV-positive. The anti-HCV rate is higher in Vilnius and Kaunas in comparison with other regions. HCV spreads mainly through intravenous drug use, but intrafamilial and some nosocomial routes are also important. The anti-HCV prevalence did not depend on age. Despite active prevention of nosocomial HCV transmission, the incidence of HCV infection does not decrease due to virus spread mostly in “trusted networks” of intravenous drug users.
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Affiliation(s)
- Valentina Liakina
- Centre of Hepatology, Gastroenterology and Dietetics, Clinic of Gastroenterology, Nephrourology and Surgery, Faculty of Medicine, Vilnius University, Lithuania.
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Stanaitis J, Vaicekauskas R, Lipnickas V, Valantinas J, Strupas K. Significance of Interdisciplinary Cooperation in the Treatment of Upper Gastrointestinal Mucosal and Submucosal Lesions: A Single Centre Experience. Visc Med 2012. [DOI: 10.1159/000345808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
<b><i>Background: </i></b>Endoscopic submucosal dissection (ESD) was initially developed in Japan for the treatment of early gastric cancer. Meanwhile ESD has become the treatment of choice for mucosal and submucosal lesions of the oesophagus and stomach. <b><i>Method: </i></b>We retrospectively reviewed our data on ESD performed in the period from 2007 to 2011 for the treatment of 67 mucosal and 8 submucosal lesions. These procedures were applied for 60 patients (mean age 63.8 years; 37 female and 23 male). <b><i>Results: </i></b>In 4 patients, we found more than 1 lesion for which ESD was applied as a treatment procedure. In 3 patients, ESD was repeated for lesion recurrence in the same location. The ESD specimens were classified as having tumour-free margins in 64 (95.5%) cases; however, during follow-up we identified 7 (10.4%) patients with recurrent lesions, including 3 cases of recurrent hyperplastic polyps, 1 case of early gastric cancer located in the cardia region of the stomach, and 1 case of recurrent flat tubular adenoma in the antral part of the stomach. We experienced 6 cases (8.9%) of delayed post-procedural bleeding all of which were successfully controlled endoscopically. In 5 cases (7.5%), perforation complications occurred. <b><i>Conclusion: </i></b>Our first experience with ESD was not all smooth: while the complication rate did not exceed 10%, it was markedly higher than that stated in Eastern literature. We would like to put this down to the learning curve phenomenon. The close cooperation between gastroenterologists and abdominal surgeons was very important and will play a vital role for technological innovations and safety in abdominal medicine in the future.
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Barakauskienė A, Speičienė D, Liakina V, Semuchinienė T, Valantinas J. Expression of cytokeratin 7 as a histological marker of cholestasis and stages of primary biliary cirrhosis. Medicina (Kaunas) 2011; 47:31-38. [PMID: 21681009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
UNLABELLED The aim of this study was to estimate cytokeratin 7 (CK-7) expression in biopsy specimens of patients with different stages of primary biliary cirrhosis and clinicopathological patterns (cholestatic and hepatitic) and its correlation with some biochemical and pathological parameters and to examine a diagnostic value of CK-7 expression. MATERIAL AND METHODS A total of 82 biopsy specimens of patients with primary biliary cirrhosis were analyzed. CK-7 expression was graded by 4 grades depending on the extent into parenchymal areas and bile duct epithelium. The correlations of CK-7 expression grade with copper deposition, bile duct/portal tract ratio, bilirubin concentration, and activity of alkaline phosphatase and gamma-glutamyl transpeptidase were studied. CK-7 expression was evaluated as a marker of cholestasis (cholestatic pattern) and inflammation (hepatitic pattern). RESULTS A positive correlation of CK-7 expression grade with copper-binding protein grade (r=0.698, P<0.0001; OR=6.199, P<0.0001), serum bilirubin level (r=0.375, P=0.001), and alkaline phosphatase activity (r=0.276, p=0.014) was found. CK-7 expression grades correlated positively with histological stages of primary biliary cirrhosis (r=0.639, P<0.000) and negatively with granulomas (r=-0.432, P<0.0001; OR=0.173, P=0.0011). CONCLUSIONS CK-7 expression is a sensitive marker of bile duct injury, which correlated well with histological stages of primary biliary cirrhosis, copper deposits, and biochemical markers of cholestasis: serum bilirubin level and alkaline phosphatase activity. Evaluation of CK-7 expression may improve the diagnosis of this serious and progressive disease. It is recommended to evaluate copper staining together with cytokeratin 7 expression in liver biopsy specimens for more precise diagnostic evaluation of asymptomatic primary biliary cirrhosis.
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Paskonis M, Masalaite L, Buivydiene A, Sokolovas V, Jurgaitis J, Jurevicius S, Mikalauskas S, Gutauskas M, Spuras J, Sarkaite R, Samuilis A, Rutkauskaite D, Misionis N, Dukstaite A, Serpytis M, Kekstas G, Rainiene T, Barakauskiene A, Valantinas J, Strupas K. Orthotopic liver transplantation: the first experience and results of the Vilnius University Hospital Santariskiu Klinikos. Ann Transplant 2010; 15:14-24. [PMID: 20305313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2009] [Accepted: 01/30/2010] [Indexed: 05/29/2023] Open
Abstract
BACKGROUND Liver transplantation has become the treatment of choice for chronic and acute end-stage liver failure as well as for selected cases of malignancies and metabolic disorders. We report our first experience of the orthotopic liver transplantation. MATERIAL/METHODS Between 2005 and 2008 16 cadaveric orthotopic liver transplantations in 16 adults (12 males, 4 females, mean age 44 years) were performed. Main indications for orthotopic liver transplantation were cholestatic liver disease (31%), viral-induced cirrhosis (25%), alcoholic liver disease (19%), hepatocellular carcinoma associated with hepatitis virus infection (13%), autoimmune cirrhosis (6%), cryptogenic acute liver failure (6%). Mean follow-up was 15 month (range: 4 days - 43 month). RESULTS Intraabdominal haemorrhage was observed in 6 patients (37.5%). Vascular complications were observed in 3 patients (18.75%). Biliary complication were observed in 3 patients (18.75%). Overall 1 year patient survival was 87,5%. Four (25%) patients died during follow-up. All patients died because of sepsis and multiorgan system failure. CONCLUSIONS Our first results showed that secret of successful liver transplantation is perfect interdisciplinary team approach, including selection of the recipient and timing of transplantation, the operative procedure itself, prevention and treatment of complications, the perioperative anaesthesiological and intensive-care management, and careful follow up after transplantation.
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Affiliation(s)
- Marius Paskonis
- Centre of Abdominal Surgery, Vilnius University Hospital Santariskiu Klinikos, Vilnius, Lithuania.
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Liakina V, Speiciene D, Irnius A, Valantinas J. Changes in hepatitis C virus infection routes and genotype distribution in a Lithuanian cohort with chronic hepatitis C. Med Sci Monit 2009; 15:PH17-PH23. [PMID: 19333213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND We evaluated the distribution of hepatitis C virus genotypes and determined their association with routes of infection according to the sex and age of the study subjects. MATERIAL/METHODS We studied 1158 patients with chronic hepatitis C. Hepatitis C virus antibodies were detected with a microparticle enzyme immunoassay, hepatitis C virus ribonucleic acid was identified via polymerase chain reaction, and hepatitis C virus genotypes were determined with a line probe assay. An anonymous questionnaire completed by all subjects included the date of chronic hepatitis C diagnosis, the age and sex of the patient, the hepatitis C virus genotype and subtype, and possible routes of infection. RESULTS Of the patients studied, 50.9% had more than 1 possible route of infection, 41.2% had a single route of infection, and 7.9% had an unknown route of infection. The most common hepatitis C transmission routes were intravenous drug use and tattoos in younger patients and surgery or long or multiple hospitalizations in older patients. The genotype distribution was as follows: genotype 1, 65.0% of patients; genotype 2, 26.3%; and genotype 3, 8.7%. The transmission of genotype 1 was associated primarily with surgery and that of genotype 3 was linked with intravenous drug use. CONCLUSIONS Today, the main routes of hepatitis C virus transmission are intravenous drug use and tattoos. Some hepatitis C infections are associated with surgery or are acquired from a family member. The shift in transmission pathways predetermined the shift in hepatitis C virus genotypes from 1 to 3.
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Affiliation(s)
- Valentina Liakina
- Centre of Hepatology, Gastroenterology and Dietetics, Clinic of Gastroenterology, Nephrourology and Surgery, Faculty of Medicine, Vilnius University, Lithuania.
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Liakina V, Speiciené D, Irnius A, Semuchiniené T, Valantinas J. Association of the prevalence and grade of steatosis in patients with chronic hepatitis C with the host and viral factors. Acta Gastroenterol Belg 2007; 70:260-266. [PMID: 18074734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
AIM The aim of this study was to investigate the prevalence of hepatosteatosis in chronic hepatitis C patients, evaluate the potential impact of some host- and virus-related factors on its occurrence and possible influence of steatosis on the consequences of hepatitis. PATIENTS AND METHODS The case records of 387 patients with hepatitis C and cirrhosis were studied. The prevalence and grade of steatosis were investigated and evaluated by logistic regression analysis as dependent variable to age, gender, alcohol consumption, body mass index, hepatitis C virus (HCV) genotypes, liver enzymes activity, histological activity index and fibrosis. RESULTS Steatosis was found in 47.3% of the patients. It was more prevalent in males, alcohol abusers, overweight and obese patients, and in those with HCV genotypes 3 and 2. Multivariate analysis confirmed body mass index as an independent risk factor for steatosis in the overall patient cohort and in those with genotypel without any correlation with the steatosis grade. The prevalence and grade of steatosis were associated with alcohol consumption and higher fibrosis stage. The age of the patients showed converse association. CONCLUSIONS The male gender, body mass index, alcohol consumption, genotype 2 and 3 were confirmed as risk factors for hepatosteatosis. Older patients had a lesser steatosis grade. The correlation of histological activity index and fibrosis scores with the prevalence and higher grade of steatosis suggested a possibility to worsen the course of hepatitis C and to accelerate disease progression.
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Affiliation(s)
- V Liakina
- Vilnius University, Faculty of Medicine, Clinic of Gastroenterology, Nephrology, Urology and Abdominal Surgery, Centre of Hepatology, Gastroenterology and Dietetics, Lithuania.
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Nilsson B, Valantinas J, Hedin L, Friman S, Svanvik J. Acetazolamide inhibits stimulated feline liver and gallbladder bicarbonate secretion. Acta Physiol Scand 2002; 174:117-23. [PMID: 11860373 DOI: 10.1046/j.1365-201x.2002.00929.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Bile acidification is a key factor in preventing calcium carbonate precipitation and gallstone formation. Carbonic anhydrase II (CA II), that is inhibited by acetazolamide, plays a role in regulation of the acid-base balance in many tissues. This study examines the effect of acetazolamide on secretin- and vasoactive intestinal peptide (VIP)-stimulated gallbladder mucosal bicarbonate and acid secretion. Gallbladders in anaesthetized cats were perfused with a bicarbonate buffer bubbled with CO2 in air. In 20 experiments VIP (10 microg kg(-1) h(-1)) and in 10 experiments secretin (4 microg kg(-1) h(-1)) were infused continuously intravenous (i.v.). Hepatic bile and samples from the buffer before and after perfusion of the gallbladder were collected for calculation of ion and fluid transport. During basal conditions a continuous secretion of H+ by the gallbladder mucosa was seen. Intravenous infusion of vasoactive intestinal peptide (VIP) and secretin caused a secretion of bicarbonate from the gallbladder mucosa (P < 0.01). This secretion was reduced by intraluminal (i.l.) acetazolamide (P < 0.01). Bile flow was enhanced by infusion of VIP and secretin (P < 0.01) but this stimulated outflow was not affected by i.v. acetazolamide. The presence of CA II in the gallbladder was demonstrated by immunoblotting. Biliary CA activity has an important function in the regulation of VIP- and secretin-stimulated bicarbonate secretion across the gallbladder mucosa.
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Affiliation(s)
- B Nilsson
- Department of Surgery, Sahlgrenska University Hospital, S-413 45 Göteborg, Sweden
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Zimmerli B, Valantinas J, Meier PJ. Multispecificity of Na+-dependent taurocholate uptake in basolateral (sinusoidal) rat liver plasma membrane vesicles. J Pharmacol Exp Ther 1989; 250:301-8. [PMID: 2746502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
To test the hypothesis of broad specificity of the hepatocellular bile acid uptake system(s) we investigated the kinetics and substrate specificity of Na+-dependent taurocholate uptake in basolateral (sinusoidal) rat liver plasma membrane vesicles in the presence and absence of bovine serum albumin. Bovine serum albumin selectively stimulated the Na+-dependent portion of taurocholate uptake and decreased its apparent Km from 46 +/- 6 to 17 +/- 3 microM, whereas it had no effect on Vmax (4.2 +/- 0.2 nmol.mg-1.min-1). Based on complementary analysis by Dixon- and Cornish-Bowden-plots the following compounds were identified as competitive inhibitors of Na+-dependent taurocholate uptake: cholate (Ki = 140 +/- 30 microM); taurochenodeoxycholate (Ki = 9 +/- 3 microM); chenodeoxycholate (Ki = 53 +/- 6 microM); progesterone (Ki = 110 +/- 30 microM); 17-beta-estradiol-3-sulfate (Ki = 28 +/- 4 microM); bumetanide (Ki = 440 +/- 85 microns); furosemide (Ki = 460 +/- 140 microM); verapamil (Ki = 65 +/- 35 microM); and phalloidin (Ki = 850 +/- 350 microM). In contrast, noncompetitive inhibition was found with bromosulfophthalein (Ki = 12 +/- 2 microM), cyclosporin A (Ki = 3 +/- 1 microM) and 4,4'-diisothiocyano-2,2'-disulfonic acid stilbene (Ki = 45 +/- 7 microM). These results support the concept of multispecificity of the Na+-dependent basolateral bile acid uptake system with respect to different bile acids and drugs. In addition, the findings provide further evidence for bile acids and bromosulfophthalein being taken up into rat hepatocytes by different transport systems, thus supporting the assumption of multiple basolateral organic anion "carriers" with distinct, yet partially overlapping substrate specificities.
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Affiliation(s)
- B Zimmerli
- Department of Medicine, University Hospital, Zurich, Switzerland
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Abstract
The mechanism(s) and driving forces for biliary excretion of sulfate were investigated in canalicular rat liver plasma membrane vesicles (cLPM). Incubation of cLPM vesicles in the presence of an inside-to-outside (in, out) bicarbonate gradient (50 mM in, 5 mM out, pH 8.0 in and out), but not pH (pH 8.0 in, 6.0 out) or out-to-in sodium gradients, stimulated sulfate uptake 10-fold compared with the absence of bicarbonate and approximately 2-fold above sulfate equilibrium ("overshoot"). Initial rates of this bicarbonate gradient-driven sulfate uptake were saturable with increasing concentrations of sulfate (apparent Km, approximately 0.3 mM) and could be inhibited by probenecid, N-(4-azido-2-nitrophenyl)-2-aminoethylsulfonate, acetazolamide, furosemide,4-acetamido-4'-isothiocyanostilbene-2,2'-disulfonic acid, and 4,4'-diisothiocyanostilbene-2,2'-disulfonic acid (IC50, approximately 40 microM). Cisinhibition of initial bicarbonate gradient-stimulated sulfate uptake and transstimulation of sulfate uptake in the absence of bicarbonate were observed with sulfate, thiosulfate, and oxalate but not with chloride, nitrate, phosphate, acetate, lactate, glutamate, aspartate, cholate, taurocholate, dehydrocholate, taurodehydrocholate, and reduced or oxidized glutathione. These findings indicate the presence of a sulfate (oxalate)-bicarbonate anion exchange system in canalicular rat liver plasma membranes. In conjunction with the previously reported chloride-bicarbonate exchanger (J. Clin. Invest. 75: 1256-1263, 1985), these findings support the concept that bicarbonate-sensitive transport system might play an important role in bile acid-independent canalicular bile formation.
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Affiliation(s)
- P J Meier
- Department of Internal Medicine, University Hospital, Zurich, Switzerland
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