Yi-Hao Yen

Mutations in the interferon sensitivity-determining region (nonstructural 5A amino acid 2209-2248) in patients with hepatitis C-1b infection and correlating response to combined therapy of pegylated interferon and ribavirin

Backgroundu2002 Most reports suggest that mutations in the interferon sensitivity‐determining region (ISDR) correlate with response to conventional interferon‐based therapies in hepatitis C virus‐1b (HCV‐1b) patients. However, the correlation between ISDR region mutations and response to pegylated interferon plus ribavirin therapy in HCV‐1b patients remains unclear.

Study of hepatitis B (HB) vaccine non-responsiveness among health care workers from an endemic area (Taiwan)

Abstract: Objective: To evaluate the etiology of non‐responsiveness to hepatitis B (HB) vaccination in adults from an endemic area.

A comparison of efficacy and safety of 2-year telbivudine and entecavir treatment in patients with chronic hepatitis B: a match–control study

There are limited data comparing the clinical outcomes between telbivudine and entecavir. We consecutively enrolled 115 telbivudine-naive and 115 entecavir-naive chronic hepatitis B patients, who were matched for age, sex, hepatitis B e antigen (HBeAg) status and cirrhosis, and treated for at least 2xa0years or less than 2xa0years but had developed resistance. Except for the rate of HBeAg seroconversion, which was similar, patients in the entecavir group had better clinical outcomes than those in the telbivudine group for alanine aminotransferase normalization (85.2% vs 78.4%, pxa0<0.048), undetectable HBV DNA (96.5% vs 74.8%, pxa0<0.001), and viral resistance (0.9% vs 21.7%, pxa0<0.001) after 2xa0years of treatment, After applying roadmap or super-responders concepts, entecavir still had better outcomes than telbivudine in undetectable HBV DNA and viral resistance. The cumulative incidence of hepatocellular carcinoma development was similar between telbivudine-naive and entecavir-naive patients (pxa00.565). In renal function analysis, there were significantly more patients with estimated glomerular filtration rate (eGFR) category improvement in both the telbivudine and entecavir groups at year 1 (pxa00.006 and pxa00.047, respectively). The rate of virological improvement was significantly higher with entecavir than with telbivudine after 2xa0years of treatment, whether applying the concepts of roadmap or super-responders. The incidence of hepatocellular carcinoma was similar between telbivudine and entecavir. Both telbivudine and entecavir were associated with eGFR improvement, especially in patients with renal insufficiency.

Comparison of renal safety and efficacy of telbivudine, entecavir and tenofovir treatment in chronic hepatitis B patients: real world experience

This study aims to assess the nephrotoxicity and efficacy of tenofovir disoproxil fumarate (tenofovir), telbivudine and entecavir. A retrospective study of 587 patients with chronic hepatitis B treated with tenofovir (n = 170), telbivudine (n = 184) and entecavir (n = 233) for at least 1 year. Renal function and efficacy were assessed. The estimated glomerular filtration rate (eGFR) decreased significantly in the tenofovir group after a mean of 17 months treatment (from 92.2 to 85.6 mL/min/1.73 m(2), p < 0.001), but increased in the telbivudine group after a mean of 32 months of treatment (from 86.1 to 95 mL/min/1.73 m(2), p < 0.001). There was no significant change in eGFR in the entecavir group after a mean of 44 months. By multivariate analysis, pre-existing renal insufficiency (p = 0.003), tenofovir (p = 0.007) and diuretic treatment (p = 0.001) were independent predictors for renal function deterioration. Cumulative virological breakthrough was 0% in tenofovir after 2 years, 3.4% in entecavir after 7 years and 22.9% in telbivudine after 5 years. Liver cirrhosis (p = 0.008) and virological breakthrough (p = 0.040) were independently associated with increased risk of hepatocellular carcinoma development. Tenofovir may lead to deterioration in renal function as assessed by serial eGFR measurements. Although telbivudine appeared to be associated with an improvement in eGFR, it was associated with high rates of virological breakthrough, which was an independent risk factor for HCC development. With low rates of virological breakthrough and preservation of renal function, entecavir could be the best choice among these three agents.

Community-based screening for hepatocellular carcinoma in elderly residents in a hepatitis B- and C-endemic area

Background and Aim:u2002 The aim of the present study was to elucidate a reasonable model and the efficacy of hepatocellular carcinoma (HCC) screening on an elderly population.

Comparing the efficacy and clinical outcome of telbivudine and entecavir naïve patients with hepatitis B virus-related compensated cirrhosis.

There is limited data on the efficacy and outcome of telbivudine (LdT) therapy in patients with chronic hepatitis B and compensated cirrhosis. We evaluated LdT as first‐line therapy in these patients and compared with those treated with entecavir (ETV).

Three-year efficacy and safety of tenofovir in nucleos(t)ide analog-naïve and nucleos(t)ide analog-experienced chronic hepatitis B patients

This study compared the efficacy and safety of tenofovir disoproxil fumarate (TDF) up to 3u2009years of innucleos(t)ide analog (NA)‐naïve and NA‐experienced chronic hepatitis B (CHB) patients.

Incidence and associated risk factors of hepatocellular carcinoma in a dural hepatitis B and C virus endemic area: A surveillance study

The purposes of this study were to determine the incidence of hepatocellular carcinoma (HCC) in dual hepatitis B virus (HBV) and hepatitis C virus (HCV) endemic areas and to assess the associated risk factors of HCC development in the community. During April 2004 to November 2005, 4,127 residents of Tainan County, aged 40 years or older, had participated in a comprehensive health examination. Among them, residents with HBV or HCV infection; platelet count less than or equal to 150 × 109/L; and no hepatic tumor, by liver ultrasonography, were invited to this study. Alpha‐fetoprotein (AFP) screening and ultrasonography for HCC surveillance were performed. Once hepatic tumor was detected, the subjects were referred to medical centers for further confirmation and treatment. A total of 1,133 residents were eligible for this study, and 413 (36.5%), including 197 men and 216 women, with a mean age of 64.5 years, were enrolled. There were 21 cases with suspected HCC. Of the 21 cases, 18 (85.7%) accepted further studies and 11 (52.4%) were confirmed to be affected with HCC. All HCCs were unifocal with a diameter less than or equal to 4 cm. In the Kaplan–Meier survival analysis, the 2‐year cumulative incidence of HCC was 4.7%. Based on the same analysis with log rank test, AFP greater than or equal to 20 ng/mL (p = 0.007), platelet count less than or equal to 100 × 109/L (p < 0.001), and liver cirrhosis (p < 0.001) were found to be the associated risk factors of HCC development. In summary, the 2‐year cumulative incidence of HCC was 4.7% among adult residents with chronic HBV or HCV infection in this dual HBV and HCV endemic area. Platelet count less than 100 × 109/L, AFP level greater than 20 ng/mL, and liver cirrhosis were the associated risk factors for HCC development.

Acquirement and disappearance of HBsAg and anti-HCV in an aged population: a follow-up study in an endemic township

Background: HBsAg and anti‐hepatitis C virus (anti‐HCV) are stable markers and widely used. The seroconversion and seroclearance of HBsAg and anti‐HCV are important for disease control and prognosis of diseases.

The correlation of controlled attenuation parameter results with ultrasound-identified steatosis in real-world clinical practice

BACKGROUND/PURPOSEnControlled attenuation parameter (CAP) is a method for measuring steatosis based on FibroScan. Despite observer dependency, ultrasound (US) robustly diagnoses moderate and severe steatosis. Here, we aimed to evaluate the correlation of CAP with US-identified steatosis in real-world clinical practice.nnnMETHODSnCAP and US were performed for 1554 chronic liver disease (CLD) patients. CAP was performed by two technicians, and US was performed by 30 hepatologists. The performance of the CAP as compared with the US results was assessed using the area under the receiver operating characteristic curve (AUROC).nnnRESULTSn532 (34.2%) of the patients had hepatitis C virus (HCV) infection, 723 (46.5%) of the patients had hepatitis B virus (HBV) infection, and the rest were patients with metabolic risk factors. CAP values were significantly correlated with the steatosis grades identified by US for all the patients (ρxa0=xa00.497, Pxa0<xa00.001), for the HBV-infected patients (ρxa0=xa00.495, Pxa0<xa00.001), for the HCV-infected patients (ρxa0=xa00.343, Pxa0<xa00.001), and for the patients with metabolic risk factors (ρxa0=xa00.515, Pxa0<xa00.001). Using CAP, the AUROC values were 0.759, 0.795, 0.715, and 0.716 for ≥moderate steatosis identified by US in, respectively, all the patients, the HBV-infected patients, the HCV-infected patients, and the patients with metabolic risk factors. The AUROC values were 0.791, 0.868, 0.807 and 0.701 for severe steatosis identified by US in, respectively, all the patients, the HBV-infected patients, the HCV-infected patients, and the patients with metabolic risk factors.nnnCONCLUSIONnCAP values were well correlated with the steatosis grades assessed by US in real-world clinical practice.