93 research outputs found
Baseline characteristics by status of HCV infection.
<p>Note: Data are expressed as number (percentage) for categorical variables and mean ± standard deviation for continuous variables. Statistical comparisons between viral hepatitis categories were performed using chi-square test for categorical variables and analysis of variance for continuous variables. eGFR was calculated using the 4-variable MDRD study equation.</p><p>Conversion factors for units: hemoglobin in g/dL to g/L, x10; serum albumin in g/dL to g/L, x10; serum cholesterol in mg/dL to mmol/L, x0.02586; serum uric acid in mg/dL to µmol/L, x59.48; serum creatinine in mg/dL to µmol/L, x88.4; serum glucose in mg/dL to mmol/L, x0.05551; eGFR in mL/min/1.73m2 to mL/s/1.73m2, x0.01667; Urine protein creatinine ratio in mg/mg to mg/mmol, x1.13; no conversion is necessary for platelet levels in 103/µL and 109/L.</p><p>Abbreviations: BMI, body mass index; ALT, alanine aminotransferase; eGFR, estimated glomerular filtration rate.</p
Hepatitis C Virus Infection Increases Risk of Developing End-Stage Renal Disease Using Competing Risk Analysis
<div><p>Background</p><p>Chronic kidney disease (CKD) and hepatitis C virus (HCV) infection are closely linked and both increase patient mortality. The association of HCV and risk of developing end-stage renal disease (ESRD) has not been analyzed with competing risk model.</p><p>Method</p><p>We enrolled a prospective cohort of 4,185 patients (mean age, 62 years; 41% female) registered in the CKD integrated care program at two affiliated hospitals of Kaohsiung Medical University in Taiwan between November 11, 2002 and May 31, 2009. With competing risk model, we analyzed the association of HCV infection, defined by seropositive of anti-HCV antibody, and hepatitis B virus (HBV) infection, defined by seropositive of HBV surface antigen, with the risk of entering ESRD.</p><p>Results</p><p>The prevalence of HCV infection was 7.6% and it increased with the CKD stages (trend test, <i>P</i><0.001), while the prevalence of HBV infection was 7.4% and no specific trend among CKD stages (tend test, <i>P</i> = 0.1). During the 9,101 person-year follow-up period, there were 446 death and 1,205 patients entering ESRD. After adjusting death as the competing risk, the estimated 5-year cumulative incidence rate of ESRD among patients with and without HCV infection were 52.6% and 38.4%, respectively (modified log-rank, <i>P</i><0.001). Multivariable analysis showed that HCV infection, but not HBV infection, had higher risk of developing ESRD compared with cases without infection (HCV, HR: 1.32, 95% CI: 1.07–1.62; HBV, HR: 1.10, 95% CI: 0.89–1.35). Subgroup analyses showed consistent results.</p><p>Conclusions</p><p>With death-adjusted competing risk analysis, HCV infection is associated with an increased risk of developing ESRD in CKD cohort.</p></div
Hazard ratios by status of viral hepatitis to end-stage renal disease adjusting competing risk of death.
<p>Abbreviation: HR, hazard ratio; CI, confident interval.</p><p>Note: 3,646 patients presenting complete information were included in the multivariable analyses.</p><p># Multivariables include sex, marital status, educational status, herb use, comorbidity (mild liver disease, diabetes mellitus, severe liver disease, hypertension, and cardiovascular disease), body mass index, hemoglobin, platelets, albumin, alanine aminotransferase, cholesterol, uric acid, glucose, CKD stages and urine protein creatinine ratio; HBV infection analysis adjusted status of HCV infection, and HCV infection analysis adjusted status of HBV infection.</p
Cumulative incidence of end-stage renal disease adjusted competing for death plot showed HCV infection had higher cumulative rate of end-stage renal disease than cases without HCV infection (modified log-rank, <i>P</i><0.001).
<p>Cumulative incidence of end-stage renal disease adjusted competing for death plot showed HCV infection had higher cumulative rate of end-stage renal disease than cases without HCV infection (modified log-rank, <i>P</i><0.001).</p
Prevalence of hepatitis B virus and hepatitis C virus infection at chronic kidney disease stages.
<p>Different prevalence between various stages of chronic kidney disease was analyzed by trend test. The <i>P</i> value was <0.001 in hepatitis C infected cases, and <i>P</i> = 0.1 in hepatitis B virus infected cases.</p
Multivariable stratified subgroup analyses for the association of hepatitis C virus infection with the risk of entering end-stage renal disease.
<p>Multivariable stratified subgroup analyses for the association of hepatitis C virus infection with the risk of entering end-stage renal disease.</p
The impact of an additional extra-hepatic primary malignancy on the outcomes of patients with hepatocellular carcinoma
<div><p>Background</p><p>The impact of additional extra-hepatic primary cancer (EHPC) on the outcomes of patients with hepatocellular carcinoma (HCC) remains uncertain.</p><p>Methods</p><p>We retrospectively analyzed the cancer registration database from a tertiary hospital in Southern Taiwan. Patients who were diagnosed with HCC from 2008 to 2012 were enrolled. Overall survival (OS), HCC-specific survival and recurrence after curative therapy were analyzed and compared between the patients with and the patients without EHPC.</p><p>Results</p><p>EHPC was found in 121/1506 (8.0%) patients. HCC patients with EHPC were older, more likely to be classified as Child-Pugh A, less likely to have viral hepatitis B or C, more likely to be single, had early stage HCC and received curative therapy for HCC. The OS did not significantly differ between the patients with and without EHPC(p = 0.061). However, significantly higher HCC-specific survival was observed in patients with EHPC (p<0.001), and a higher rate of non-HCC mortality was demonstrated in patients with EHPC (54.4% vs 9.3%). The subgroup analysis revealed better OS in patients with EHPC who were older than 65, had viral hepatitis B or C, had non-stage 1 HCC, had non-early stage BCLC and received non-curative therapy. Conversely, patients with HCC stage 1 who received curative therapy exhibited worse OS if they also had EHPC. The analysis of recurrence after curative therapy showed no difference between the two groups.</p><p>Conclusions</p><p>Our results implied that EHPC did not affect OS, but HCC-related survival was better in patients with EHPC. Based on these findings, the management of additional primary cancer is warranted.</p></div
Regional differences in treatment rates for patients with chronic hepatitis C infection: Systematic review and meta-analysis
<div><p>Background & aims</p><p>Treatment rates with interferon-based therapies for chronic hepatitis C have been low. Our aim was to perform a systematic review of available data to estimate the rates and barriers for antiviral therapy for chronic hepatitis C.</p><p>Methods</p><p>We conducted a systematic review and meta-analysis searching MEDLINE, SCOPUS through March 2016 and abstracts from recent major liver meetings for primary literature with available hepatitis C treatment rates. Random-effects models were used to estimate effect sizes and meta-regression to test for potential sources of heterogeneity.</p><p>Results</p><p>We included 39 studies with 476,443 chronic hepatitis C patients. The overall treatment rate was 25.5% (CI: 21.1–30.5%) and by region 34% for Europe, 28.3% for Asia/Pacific, and 18.7% for North America (<i>p</i> = 0.008). On multivariable meta-regression, practice setting (tertiary vs. population-based, <i>p</i> = 0.04), region (Europe vs. North America <i>p</i> = 0.004), and data source (clinical chart review vs. administrative database, <i>p</i> = 0.025) remained significant predictors of heterogeneity. The overall treatment eligibility rate was 52.5%, and 60% of these received therapy. Of the patients who refused treatment, 16.2% cited side effects, 13.8% cited cost as reasons for treatment refusal, and 30% lacked access to specialist care.</p><p>Conclusions</p><p>Only one-quarter of chronic hepatitis C patients received antiviral therapy in the pre-direct acting antiviral era. Treatment rates should improve in the new interferon-free era but, cost, co-morbidities, and lack of specialist care will likely remain and need to be addressed. Linkage to care should even be of higher priority now that well-tolerated cure is available.</p></div
Comparison of overall survival and HCC-specific survival between patients with EHPC and patients without EHPC according to different parameters.
<p>Comparison of overall survival and HCC-specific survival between patients with EHPC and patients without EHPC according to different parameters.</p
Meta-regression for predictors for antiviral therapy for chronic hepatitis C.
<p>Meta-regression for predictors for antiviral therapy for chronic hepatitis C.</p
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