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Govil S, Satsangi S, Reddy J, Raghavaiah S, Swaminathan S. The potential liver donor with tuberculosis: A fresh look at international recommendations based on a survey of practice in Indian liver transplant centres. Natl Med J India 2022; 35:82-87. [PMID: 36461849 DOI: 10.25259/nmji_419_19] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
Background The western recommendations for the use of organs from liver donors with tuberculosis (TB) come from an environment where the burden of disease is low and cadaveric organ donation rates are high-in complete contrast to the Indian scenario, where these recommendations may be too restrictive. Methods A questionnaire relating to current practice on the use of organs from liver donors with TB was sent to all liver transplant centres in India. Results Responses were obtained from 94% of centres. Two-thirds accepted organs from deceased donors with TB in the elective setting, especially for recipients with a high MELD (Model for end-stage liver disease) score. The proportion rose by 1.5 times in the setting of acute liver failure. Two-thirds advised anti-TB treatment (ATT) for corresponding recipients, and the remaining advised isonicotinic acid hydrazide (INH) prophylaxis. Untreated living donors with TB were not accepted. Half the respondents accepted living donors after completion of ATT, and did not treat recipients postoperatively. The remainder accepted them after 8 weeks of treatment and advised INH prophylaxis or ATT for recipients. Conclusions That this practice has not impacted recipient outcomes suggests that the guidelines for management of liver donors and recipients may need to be altered for populations endemic for TB.
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Affiliation(s)
- Sanjay Govil
- Apollo Integrated Liver Care, Apollo Hospital, 154/11 Bannerghatta Road, Bengaluru 560076, Karnataka, India
| | - Sandeep Satsangi
- Apollo Integrated Liver Care, Apollo Hospital, 154/11 Bannerghatta Road, Bengaluru 560076, Karnataka, India
| | - Jayanth Reddy
- Apollo Integrated Liver Care, Apollo Hospital, 154/11 Bannerghatta Road, Bengaluru 560076, Karnataka, India
| | - Suresh Raghavaiah
- Apollo Integrated Liver Care, Apollo Hospital, 154/11 Bannerghatta Road, Bengaluru 560076, Karnataka, India
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Satsangi S, Gupta N, Kodan P. Current and New Drugs for COVID-19 Treatment and Its Effects on the Liver. J Clin Transl Hepatol 2021; 9:436-446. [PMID: 34221930 PMCID: PMC8237135 DOI: 10.14218/jcth.2020.00174] [Citation(s) in RCA: 4] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/11/2021] [Accepted: 03/18/2021] [Indexed: 12/15/2022] Open
Abstract
Corona virus disease (COVID)-19 is caused by the novel severe acute respiratory syndrome coronavirus-2 (commonly referred to as SARS-CoV-2). In March 2020, the World Health Organization declared the COVID-19 outbreak a pandemic. Though the target organ for the virus is primarily the lungs, with the recent understanding of the pathobiology of this disease and the immune dysregulation associated with it, it is now clear that COVID-19 affects multiple organ systems. Several drugs and therapies have been tried or repurposed to combat the wrath posed by this disease. On October 22, 2020, the USA Food and Drug Administration approved remdesivir for use in adults and pediatric patients (12 years of age and older). Several of the drugs being tried against COVID-19 have hepatotoxicity as their potential side effect. This review aims to provide the latest insights on various drugs being used in the treatment of COVID-19 and their effects on the liver.
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Affiliation(s)
- Sandeep Satsangi
- Department of Apollo comprehensive Liver Care, Apollo Hospital, Bangalore, Karnataka, India
- Correspondence to: Sandeep Satsangi, Consultant Hepatologist & Liver Transplant Physician, Department of Apollo comprehensive Liver Care, Apollo Hospital, Bangalore, Karnataka 560076, India. Tel: +91-7899243962, E-mail:
| | - Nitin Gupta
- Department of Infectious Diseases, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Parul Kodan
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
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Dhiman RK, Grover GS, Premkumar M, Taneja S, Duseja A, Arora S, Rathi S, Satsangi S, Roy A. Decentralized care with generic direct-acting antivirals in the management of chronic hepatitis C in a public health care setting. J Hepatol 2019; 71:1076-1085. [PMID: 31325468 DOI: 10.1016/j.jhep.2019.07.006] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [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: 02/05/2019] [Revised: 07/03/2019] [Accepted: 07/05/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS The prevalence of anti-hepatitis C virus antibody in Punjab, India is 3.6%, with 728,000 people estimated to have viremic chronic hepatitis C (CHC). The Mukh-Mantri Punjab Hepatitis C Relief Fund, launched on 18th June 2016, provides no-cost generic direct-acting antivirals (DAAs) with sofosbuvir + ledipasvir ± ribavirin or sofosbuvir + daclatasvir ± ribavirin with the goal of eliminating CHC from Punjab. We assessed the safety and efficacy of decentralized treatment of CHC in a public health care setting. METHODS Primary care providers from 3 university and 22 district hospitals were trained to provide algorithm-based DAA treatment and supervised by telehealth clinics conducted fortnightly. The diagnosis of cirrhosis was based on clinical and radiological evidence, including aspartate aminotransferase-to-platelet ratio index (APRI ≥2.0) and FIB-4 score (>3.25), or on liver stiffness measurement ≥12.5 kPa on Fibroscan®. RESULTS We enrolled 48,088 individuals with CHC (63.8% male; mean age 42.1 years; 80.5% rural; 14.8% compensated cirrhosis; 69.9% genotype [GT] 3) between 18th June 2016 to 31st July 2018. While 36,250 (75.4%) patients completed treatment, 5,497 (11.4%) had treatment interruptions and 6,341 (13.2%) patients are currently ongoing treatment. Sustained virological response at 12 weeks after treatment completion (SVR12) was achieved in 91.6% of patients per protocol, 67.6% in intention-to-treat (ITT) analysis, where all interruptions were treated as failures, and 91.2% in a modified ITT analysis where all patients with successful SVR12 in the interruptions arm were included as cured. SVR12 rates in patients with and without cirrhosis and GT3 versus non-GT3 were comparable. The SVR12 rate was 84.4% in patients who had treatment interruptions. CONCLUSION Decentralized care of patients with CHC using generic all-oral DAA regimens is safe and effective regardless of genotype or presence of cirrhosis. ClinicalTrials.gov number: NCT01110447. LAY SUMMARY We assessed the safety and efficacy of public health care using no-cost all-oral generic direct-acting antiviral drugs against hepatitis C in the state of Punjab, India. The goal is elimination of chronic hepatitis C (CHC) by 2030 and involves primary care providers at 25 sites in the state. We enrolled 48,088 individuals (63.8% male; mean age 42.1 years; 80.5% rural; 14.8% compensated cirrhotic; 69.9% genotype 3) between 18th June 2016 to 31st July 2018. Cure was achieved in 91.6% of patients, demonstrating that decentralized care of CHC with generic all-oral regimens is safe and effective.
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Affiliation(s)
- Radha K Dhiman
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India; Mukh-Mantri Punjab Hepatitis C Relief Fund (MMPHCRF), Punjab Government, Punjab, India; Technical Resource Group - National Viral Hepatitis Control Program (NVHCP), Government of India, India; Injection Safety Project, Punjab Government, Punjab, India.
| | - Gagandeep S Grover
- Hepatitis C Virus Infection State Program, Punjab, India; Mukh-Mantri Punjab Hepatitis C Relief Fund (MMPHCRF), Punjab Government, Punjab, India
| | - Madhumita Premkumar
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Sunil Taneja
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Ajay Duseja
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Sanjeev Arora
- ECHO Institute University of New Mexico, USA, New Mexico, United States
| | - Sahaj Rathi
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Sandeep Satsangi
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Akash Roy
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
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Satsangi S. Pre-Emptive Transjugular Intrahepatic Portosystemic Shunt for Acute Variceal Bleed: Choose Your Patient Well! Hepatology 2019; 69:1359-1360. [PMID: 30357875 DOI: 10.1002/hep.30328] [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: 12/07/2022]
Affiliation(s)
- Sandeep Satsangi
- Department of Global Integrated Liver Care, B.G.S Gleneagles Global Hospital, Bangalore, India
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Affiliation(s)
- Sandeep Satsangi
- Address for correspondence: Sandeep Satsangi, Hepatologist, Department of Global Integrated Liver Care, B.G.S Gleneagles Global Hospital, Kengeri, Bengaluru 560060, India. Tel.: +91 7899243962/080 30444129.
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Affiliation(s)
- Sandeep Satsangi
- Global Integrated Liver Care, BGS Gleneagles Global Hospital, Bangalore, India
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Affiliation(s)
- Sandeep Satsangi
- Department of Global Integrated Liver Care, B.G.S Gleneagles Global Hospital, Kengeri, Bangalore, India
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Satsangi S, Duseja A, Sachdeva M, Tomer S, Arora SK, Taneja S, Dhiman RK, Chawla YK. Monocyte human leukocyte antigen - Antigen D related, neutrophil oxidative burst and cytokine analysis in patients of decompensated cirrhosis with and without acute-on chronic liver failure. PLoS One 2018; 13:e0200644. [PMID: 30020985 PMCID: PMC6051623 DOI: 10.1371/journal.pone.0200644] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 06/30/2018] [Indexed: 12/13/2022] Open
Abstract
Background and aim Due to a dysregulated immune response, patients with acute-on-chronic liver failure (ACLF) have increased risk of infection and multi organ failure in comparison to compensated cirrhosis. The comparative data on the presence of ‘immune paresis’ in patients with ACLF and decompensated cirrhosis without ACLF is not available. Aim of the present study was to compare the immunological parameters in patients with decompensated cirrhosis with and without ACLF. Methodology In a prospective study, 76 patients with decompensated cirrhosis with (n = 38) and without (n = 38) ACLF and 10 healthy controls (HC) were evaluated for monocytic human leukocyte antigen–antigen D Related (HLA-DR) expression, mean density of HLA-DR expressed on the surface of these cells, neutrophil oxidative burst (NOB) capacity and serum levels of cytokines (IL-1, IL-6, IL-8, IL10, IL-12, and TNF-α). Results Patients of decompensated cirrhosis with and without ACLF demonstrated significantly lower mean percentage of monocytes expressing HLA-DR and quantitative increase in the NOB after stimulation with PMA when compared to HC. However there was no difference in mean percentage of monocytes with HLA-DR expression (43.61±26.56% vs. 43.10±20.98%) (p = 0.91), mean density of HLA-DR expression on the surface (30.34±29.32 vs. 41.71±52.13) (p = 0.42) and quantitative increase in NOB after stimulation with PMA (16.55±11.91 vs. 17.24±16.18) (p = 0.47) amongst patients with decompensated cirrhosis with and without ACLF. Patients with ACLF had significantly higher pro-inflammatory and anti-inflammatory cytokines in comparison to patients with decompensated cirrhosis without ACLF. Conclusion Patients with decompensated cirrhosis demonstrate a component of immune-paresis, however there is similar impairment in HLA–DR expression and NOB capacity in patients with and without ACLF. Both inflammatory and anti-inflammatory cytokines are increased in patients with ACLF in comparison to patients with decompensated cirrhosis without ACLF.
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Affiliation(s)
- Sandeep Satsangi
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ajay Duseja
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
- * E-mail:
| | - Meenakshi Sachdeva
- Department of Immunopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Shallu Tomer
- Department of Immunopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sunil K. Arora
- Department of Immunopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sunil Taneja
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Radha K. Dhiman
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Yogesh K. Chawla
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Nigam B, Mittal S, Prakash A, Satsangi S, Mahto PK, Swain BP. Synthesis and Characterization of Fe3O4 Nanoparticles for Nanofluid Applications-A Review. ACTA ACUST UNITED AC 2018. [DOI: 10.1088/1757-899x/377/1/012187] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Satsangi S. Response to Terlipressin in Hepatorenal Syndrome: Predict to Prognosticate! Clin Gastroenterol Hepatol 2018; 16:1173. [PMID: 29914639 DOI: 10.1016/j.cgh.2018.02.025] [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] [Received: 02/07/2018] [Revised: 02/13/2018] [Accepted: 02/19/2018] [Indexed: 02/07/2023]
Affiliation(s)
- Sandeep Satsangi
- Department of Global Integrated Liver Care, B.G.S. Gleneagles Global Hospital, Bangalore, India
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Sakpal M, Satsangi S, Mehta M, Duseja A, Bhadada S, Das A, Dhiman RK, Chawla YK. Vitamin D supplementation in patients with nonalcoholic fatty liver disease: A randomized controlled trial. JGH Open 2017; 1:62-67. [PMID: 30483536 PMCID: PMC6207029 DOI: 10.1002/jgh3.12010] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Accepted: 08/12/2017] [Indexed: 01/10/2023]
Abstract
Background and Aim Deficiency of vitamin D may be related to the pathogenesis of nonalcoholic fatty liver disease (NAFLD). The aim of the present study was to evaluate the effect of vitamin D supplementation in patients with NAFLD. Methods A total of 81 patients with NAFLD with normal or raised (n = 47) serum alanine aminotransferase (ALT) having vitamin D deficiency were randomized prospectively. Group 1 (n = 51) received lifestyle modifications and a single injection of vitamin D (600 000 U) (standard medical treatment [SMT] + vitamin D) and group 2 (n = 30) received lifestyle modifications (SMT) for 6 months. The primary objective of this study was to assess the improvement in insulin resistance (IR) and serum ALT (in patients with raised ALT) and the secondary objective was to assess the change in cytokine profile in the SMT + vitamin D group. Results After 6 months, significant improvement in serum levels of ALT was observed in the SMT + vitamin D group when compared to the SMT group (ALT [87 ± 48 and 59 ± 32 IU/mL, P < 0.001] vs [64 ± 35 and 62 ± 24 IU/mL, P = 0.70]). Mean insulin levels and homeostasis model assessment‐IR remained unchanged at 6 months in the SMT + vitamin D group while there was a significant increase in mean insulin and homeostasis model assessment‐IR in the SMT group. SMT + vitamin D group had significant increase in mean serum levels of adiponectin (836 ± 309 and 908 ± 312 (pg/mL), P = 0.018) compared with the baseline; tumor necrosis factor‐α levels decreased from baseline but the change was not significant. Conclusion Patients with NAFLD given vitamin D in addition to lifestyle modifications have significant improvement in serum ALT and serum adiponectin levels.
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Affiliation(s)
- Mallikarjun Sakpal
- Department of Hepatology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Sandeep Satsangi
- Department of Hepatology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Manu Mehta
- Department of Hepatology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Ajay Duseja
- Department of Hepatology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Sanjay Bhadada
- Department of Endocrinology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Ashim Das
- Department of Histopathology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Radha K Dhiman
- Department of Hepatology Postgraduate Institute of Medical Education and Research Chandigarh India
| | - Yogesh K Chawla
- Department of Hepatology Postgraduate Institute of Medical Education and Research Chandigarh India
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Mehta M, Satsangi S, Duseja A, Taneja S, Dhiman RK, Chawla Y. Can Alcoholic Liver Disease and Nonalcoholic Fatty Liver Disease Co-Exist? J Clin Exp Hepatol 2017; 7:121-126. [PMID: 28663676 PMCID: PMC5478941 DOI: 10.1016/j.jceh.2017.01.112] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [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: 06/24/2016] [Accepted: 01/29/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) by definition would require exclusion of significant alcohol intake. Present study was aimed to assess the prevalence of various components of metabolic syndrome (MS) in patients with alcoholic cirrhosis (AC) and to study the affect of its presence on the severity of liver disease, testing the hypothesis if alcoholic liver disease (ALD) and NAFLD could co-exist. METHODS In a retrospective analysis of 16 months data, 81 patients with AC were analysed for the prevalence of MS. The diagnosis of AC was based on the history of alcohol intake, clinical examination, serum biochemistry, hematological parameters, exclusion of other causes of chronic liver disease, imaging and upper gastrointestinal endoscopy. Severity of liver disease was assessed by Child-Turcott-Pugh (CTP) score. MS was assessed as per the ATP III criteria and the affect of MS on CTP score was evaluated. RESULTS All 81 patients with AC were male [mean age 50.9 ± 9.5, mean CTP score 8.38 ± 1.66]. But for three patients (3.7%) all other 78 patients (96.3%) with AC had at least one component of MS. Forty-three (53.0%) patients had full blown MS with three or more components of MS. Sixty-one (75.30%) patients were either overweight [22 (27.1%)] or obese [39 (48.1%)], with a mean BMI of 25.35 ± 3.86 kg/m2. Type II DM was present in 40 (25%) and 28 (34.5%) patients were hypertensive. Twenty-two (27.2%) patients had hypertriglyceridemia and 52 (64.2%) had low HDL. Eleven (13.6%) patients had Child's A cirrhosis, 46 (56.8%) had Child's B and 24 (29.6%) patients had Child's C cirrhosis. Even though not significant statistically, patients with Child's C cirrhosis (17, 70.83%) had higher presence of MS in comparison to Child's A (7, 63.6%) and B (19, 41.3%) cirrhosis. CONCLUSION MS is common in patients with AC. Presence of MS may be contributing towards severity of liver disease in these patients indirectly suggesting the co-existence of ALD and NAFLD.
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Affiliation(s)
| | | | - Ajay Duseja
- Address for correspondence: Ajay Duseja, Department of Hepatology, Sector 12, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India. Tel.: +91 172 2756336; fax: +91 0172 2744401.Department of Hepatology, Sector 12, Post Graduate Institute of Medical Education and ResearchChandigarh160012India
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Satsangi S, Mehta M, Duseja A, Taneja S, Dhiman RK, Chawla Y. Dual treatment with sofosbuvir plus ribavirin is as effective as triple therapy with pegylated interferon plus sofosbuvir plus ribavirin in predominant genotype 3 patients with chronic hepatitis C. J Gastroenterol Hepatol 2017; 32:859-863. [PMID: 27624314 DOI: 10.1111/jgh.13595] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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] [Accepted: 09/05/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIM Sofosbuvir (SOF) was the first directly acting antiviral made available for chronic hepatitis C (CHC) in India. We describe our "real life" experience of using SOF with ribavirin (RBV) with or without pegylated interferon (Peg-IFN) in predominant genotype 3 patients with CHC. METHODS A total of 158 patients (men 99 [62.6%], mean age 40.3 ± 12.8 years) with CHC treated with dual therapy (SOF + RBV) for 24 weeks or triple therapy (Peg-IFN + SOF + RBV) for 12 weeks were included prospectively. Patients with co-infection, decompensated liver disease, and post-organ transplantation were excluded. Data were analysed for the preference of treatment regimen, end of treatment response (ETR), sustained virological response at 12 weeks, and side effects. RESULTS Genotype 3 was the predominant genotype (105 [66.4%]) followed by genotype 1 (40 [25.3%]) and genotype 4 (13[8.2%]). Forty-eight (30.37%) patients had cirrhosis (LSM ≥ 13 kPa), and 30 (19%) were treatment experienced with Peg-IFN + RBV. A total of 103 (65.18%) patients received dual therapy, and 55 (34.81%) received triple therapy. Resentment to receive injections, inaccessibility to a facility, fear of injection or its side effects, and financial constraints were the reasons to refuse triple therapy. All patients in triple therapy group and all but two patients (98%) in the dual therapy group attained ETR. All those who achieved ETR achieved sustained virological response at 12 weeks in both groups. But for anemia in three patients (two in triple, one in dual therapy), there were no major side effects. CONCLUSIONS Most patients with CHC prefer an oral treatment with directly acting antivirals. Both oral and interferon-based regimens achieve high response rate.
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Affiliation(s)
- Sandeep Satsangi
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Manu Mehta
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ajay Duseja
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sunil Taneja
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Radha K Dhiman
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Yogesh Chawla
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Dhiman R, Satsangi S. Autoimmune diseases of the liver. Indian J Med Res 2017. [PMCID: PMC5460567 DOI: 10.4103/0971-5916.207248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Affiliation(s)
- Sandeep Satsangi
- Department of Hepatology, Postgraduate Institute of Medical Education & Research, Chandigarh 160 012, India
| | - Radha K Dhiman
- Department of Hepatology, Postgraduate Institute of Medical Education & Research, Chandigarh 160 012, India
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Abstract
Hepatitis C virus (HCV) is a globally prevalent pathogen and is a major cause of healthcare burden in India. HCV poses a significant problem in the state of Punjab, India owing to the higher prevalence of risk factors like unsafe medical practices (including unsafe injections and dental procedures) and intravenous drug use. The reported prevalence of HCV in this part of the country was 5.2% in 2012, while a recent study has shown the prevalence to be 3.2% in 2016. Similar to the other geographic belts in India, genotype 3 predominates in the state of Punjab. Control of HCV infection in Punjab requires focusing on several strategies. There is a need to formulate a health educational curriculum targeting not only the high-risk population but also the general population regarding the transmission of HCV. Training of family physicians who form the first link to patients in the community is imperative in the success of healthcare programmes. Adopting the dual approach of treating the old cases (decreasing the reservoir pool of HCV) and decreasing the incidence of new ones would help curtail the disease and decrease liver related mortality. A commendable initiative has been launched by the Punjab state government to eliminate HCV from Punjab. However, besides the initiative by the government, a concerted effort by all other stakeholders in managing the HCV burden in India, namely the doctors, the drug companies and the non-government organizations is required for control of HCV.
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Key Words
- BPL, below poverty line
- DNDi, drugs for neglected diseases initiative
- ECHO, Extension for Community Healthcare Outcomes
- HBV, hepatitis B virus
- HCC, hepatocellular carcinoma
- HCV, hepatitis C virus
- HCW, health care worker
- HD, hemodialysis
- INASL, Indian National Association for study of the Liver
- IVDU, intravenous drug user
- MMPHCRF, Mukh Mantri Punjab Hepatitis-C Relief Fund
- NAT, nucleic acid testing
- NGO, non-government organization
- PSACS, Punjab State AIDS Control Society
- Punjab
- control
- hepatitis C
- prevalence
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Affiliation(s)
- Radha K. Dhiman
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India,Address for correspondence: Radha K. Dhiman, Professor, Department of Hepatology, PGIMER, Chandigarh 160012, India.Professor, Department of Hepatology, PGIMERChandigarh160012India
| | - Sandeep Satsangi
- Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | | | - Pankaj Puri
- Department of Internal Medicine, Armed Forces Medical College, Pune 411040, India
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Satsangi S, Acharya V, Kini H, Anupama K. An unusual cause of lung mass in a young female. Lung India 2014; 31:188-90. [PMID: 24778492 PMCID: PMC3999689 DOI: 10.4103/0970-2113.129894] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Sandeep Satsangi
- Junior resident, Department of Internal Medicine, Kasturba Medical College and Hospital, Mangalore, Karnataka, India E-mail: Sandeep satsangi:
| | - Vishak Acharya
- Associate professor, Department of Pulmonary Medicine, Kasturba Medical College and Hospital, Mangalore, Karnataka, India
| | - Hema Kini
- Professor and Head of Department of Pathology, Kasturba Medical College and Hospital, Mangalore, Karnataka, India
| | - Kv Anupama
- Junior resident, Department of Internal Medicine, Kasturba Medical College and Hospital, Mangalore, Karnataka, India E-mail: Sandeep satsangi:
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