Characteristics of Adults in the Hepatitis B Research Network in North America Reflect Their Country of Origin and Hepatitis B Virus Genotype

Chronic hepatitis B virus (HBV) infection is an important cause of cirrhosis and hepatocellular carcinoma worldwide; populations that migrate to the US and Canada might be disproportionately affected. The Hepatitis B Research Network (HBRN) is a cooperative network of investigators from the United States and Canada, created to facilitate clinical, therapeutic, and translational research in adults and children with hepatitis B. We describe the structure of the network and baseline characteristics of adults with hepatitis B enrolled in the network

What motivates patients to remain in longitudinal observational studies?

Abstract Background: Low retention rates threaten the validity of clinical research studies and generalizability of the results. Aims: To survey Hepatitis B Research Network (HBRN) Cohort Study participants to evaluate University of Michigan retention strategies, to develop best practices, and to identify other strategies that will improve retention. Methods: 90 patients that are currently participating in the HBRN Cohort study at the University of Michigan were surveyed. Results: Participants were a good mix of male (51.2%) and female (46.5%), mostly non-Hispanic, between the age of 40 and 60 years (50%). Roughly half were Asian Chinese (50.2%), had some graduate school education or a professional degree (54.7%), and an annual income of more than $100,000 (45.4%). All the participants had medical insurance (private 87.2% vs. government 12.8%). Average participation in the study was 3.95 years. 22.1% of the participants reported they had missed at least one study visit and the main reason was they forgot the appointment. Participants reported that no co-pay to see the specialists is a better motivating factor than receiving financial compensation for staying in the study (38.4% vs. 18.6%). Participants reported that the overall experience at the visit was the main motivating factor for them to stay in the study. Eighty-nine % of participants responded they are likely to stay in the study that is currently projected to end in late 2019 and moving away from the study site is the main reason why they would discontinue participation in the study. Conclusion: Overall, participants in the HBRN study seem to be satisfied with how the study is being conducted at our site and willing to stay in the study until 2019, but the results did help us identify a few areas for improvement

Metabolic abnormalities, liver and body fat in American versus Chinese patients with non-alcoholic fatty liver disease

Background and AimNon-alcoholic fatty liver disease (NAFLD) is common in the United States and China. We compared prevalence of metabolic syndrome (MS), hepatic steatosis and fibrosis, and quantity and quality of body fat between American versus Chinese patients with NAFLD.MethodsNAFLD patients were prospectively recruited from the University of Michigan Health System (UMHS) in the United States and Peking University Health Sciences Center (PUHSC) in China. All patients had baseline computed tomography (CT), laboratory tests and Fibroscan® controlled attenuation parameter (CAP) and liver stiffness measurement (LSM). Comparisons were made for overall cohorts and matched cohorts (matched for sex, age, and body mass index [BMI] category). Logistic regression was performed to identify independent predictors of moderate and severe steatosis and lack of advanced fibrosis.ResultsOne-hundred and one American and One-hundred and sixty Chinese patients were included. UMHS patients were older, with higher prevalence of MS, had higher LSM and CAP scores, and more fat in liver, visceral, subcutaneous, and muscle compartments than PUHSC patients. Differences in LSM, visceral fat Hounsfield unit, and subcutaneous fat area (SFA) persisted in the matched cohort. NAFLD patients with MS had significantly higher LSM, and more fat in liver, visceral, subcutaneous and muscle compartments than those without. Moderate or severe steatosis was independently associated with MS, visceral fat quality, and SFA, while the absence of advanced fibrosis was associated with Asian race and not having MS.ConclusionAmerican patients with NAFLD had more liver fibrosis than Chinese patients despite having better quality visceral fat and after matching for age, sex, and BMI category.One-hundred and one American (University of Michigan Health System) and one-hundred and sixty Chinese (Peking University Health Sciences Center) patients with non-alcoholic fatty liver disease were included in this study and 64 in each cohort were matched for sex, age, and body mass index category.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/173140/1/jgh312756_am.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/173140/2/jgh312756.pd

Characteristics of Adults in the Hepatitis B Research Network in North America Reflect Their Country of Origin and Hepatitis B Virus Genotype

Background & aimsChronic hepatitis B virus (HBV) infection is an important cause of cirrhosis and hepatocellular carcinoma worldwide; populations that migrate to the United States and Canada might be affected disproportionately. The Hepatitis B Research Network (HBRN) is a cooperative network of investigators from the United States and Canada, created to facilitate clinical, therapeutic, and translational research in adults and children with hepatitis B. We describe the structure of the network and baseline characteristics of adults with hepatitis B enrolled in the network.MethodsThe HBRN collected data on the clinical characteristics of 1625 adults with chronic HBV infection who are not receiving antiviral therapy from 21 clinical centers in North America.ResultsHalf of the subjects in the HBRN are men, and the median age is 42 years; 72% are Asian, 15% are black, and 11% are white; with 82% born outside of North America. The most common HBV genotype was B (39%); 74% of subjects were negative for the hepatitis B e antigen. The median serum level of HBV DNA when the study began was 3.6 log10 IU/mL; 68% of male subjects and 67% of female subjects had alanine aminotransferase levels higher than the normal range.ConclusionsThe HBRN cohort is used to address important clinical and therapeutic questions for North Americans infected with chronic HBV and to guide health policies on HBV prevention and management in North America

Characteristics of Adults in the Hepatitis B Research Network in North America Reflect Their Country of Origin and Hepatitis B Virus Genotype

Chronic hepatitis B virus (HBV) infection is an important cause of cirrhosis and hepatocellular carcinoma worldwide; populations that migrate to the US and Canada might be disproportionately affected. The Hepatitis B Research Network (HBRN) is a cooperative network of investigators from the United States and Canada, created to facilitate clinical, therapeutic, and translational research in adults and children with hepatitis B. We describe the structure of the network and baseline characteristics of adults with hepatitis B enrolled in the network