scholarly journals Translational Research of Telecare for the Treatment of Hepatitis C

2014 ◽  
Vol 2014 ◽  
pp. 1-6
Author(s):  
Wan-Lin Chen ◽  
Wen-Ta Chiu ◽  
Ming-Shun Wu ◽  
Mei-Huang Hsu ◽  
Shin-Han Tsai
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Dropout Rate ◽  
Serum Biochemistry ◽  
Public Health Nurse ◽  
Easy Access ◽  
Communication Center ◽  
Group 2 ◽  
Program Costs ◽  
Group 1

Objective. Chronic hepatitis C virus (HCV) infection is a serious health problem in Taiwan. The high dropout rate due to side effects limits the efficacy of treatment. The objective of this study is to investigate the effectiveness of telecare for the treatment of chronic hepatitis.Material and Methods. Two hundred and ninety-eight patients randomly chose either of the two support programs. Group 1 was offered public health nurse consultation at outpatient clinic. Group 2 was offered telecare program with 24 hours of consultation services via a health communication center. All patients were treated with standard therapy and followed up for 72 weeks.Results. Normalization of serum biochemistry was noted in both Group 1 (150 patients) and Group 2 (148 patients). The most common types of side effect in both groups were influenza-like symptoms. Patient compliance was 88% (Group 1) and 94.6% (Group 2). Total dropout cases were 18 (12%) in Group 1 and 8 (5.4%) in Group 2. The program costs were 232,632 USD (Group 1) and 112,500 USD (Group 2).Conclusion. Telecare system with health care communication center model is significant in reducing dropout rate and is more effective with easy access.

Comparison of Impairment of PFT due to Plain Vs Pegylated Interferon Therapy in pts With Ch. Hepatitis C Virus Infection

2021 ◽  
Vol 15 (12) ◽  
pp. 3337-3340
Author(s):  
Umer Sohail ◽  
Zahid Hussain Shah ◽  
Sohaib Haider Zaidi ◽  
Umair Ashfaq ◽  
Salman Kazmi
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Pulmonary Function ◽  
Interferon Therapy ◽  
Pulmonary Function Tests ◽  
Pegylated Interferon ◽  
Function Tests ◽  
Before And After ◽  
Group 2 ◽  
Group 1

Aim: To compare Impairment of pulmonary function tests due to plain versus pegylated interferon therapy in the diagnosed cases of chronic Hepatitis C Methodology: In this comparative study, 71 patients fulfilling inclusion criteria were randomly included in each group. Study consisted; Group 1 (Control Group): Pulmonary Function Tests performed before and after the completion of 24 weeks of treatment with Plain/conventional Interferons and ribavirin. Group 2 (experimental Group): PFTs performed before and after the completion of 24 weeks treatment with Pegylated Interferon Therapy and ribavirin. Referred patients of both groups underwent spirometry (PFTs) at baseline and at the end of 6 months Results: Mean value observed for age was 49.86, for height 1.592 meters, for weight 62.6 kg and for BMI 24.9. Before and after therapy mean for FEV1 was 90.19 and 67.71 and it was 91.34 and 67.83 for FVC respectively. N=71 patients were enrolled in both groups. Male gender showed high prevalence 70%. Group-1 (46 vs 25) & group-2 (45 vs 26) male to female ratio seen. Adult age group hold bulk of disease (30 - 40 years of age). Patients preferred winter season for treatment (Sep to Nov). Low viral load and genotype 3a were common findings (82% and 35%). Constitutional symptoms improved after therapy (86 to 44%) as a whole. Individually, anorexia, body aches, lethargy and fever were like this (39 vs 19%, 66 vs 28%, 54 vs 30%, 19 vs 11%) pre and post therapy. Cough and dyspnea reported in 7% and 20% respectively. Conclusion: According to the present study, treatment with pegylated interferon and ribavirin is associated with impairment of pulmonary function tests similarly as treatment with plain interferon and ribavirin. Long Half-life of pegylated interferon cause more impairment in lung functions as indicated by limited available literature (Foster GR et al). Keywords: Chronic hepatitis C, Pulmonary function tests, plain/Conventional interferon therapy, Pegylated interferon therapy.

Effect of Sustained Uterine Compression versus Uterine Massage on Blood Loss after Vaginal Delivery: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Labib M. Ghulmiyyah ◽  
Alaa El-Husheimi ◽  
Ihab M. Usta ◽  
Cristina Colon-Aponte ◽  
Ghina Ghazeeri ◽  
...  
Keyword(s):  
Blood Loss ◽  
Vaginal Delivery ◽  
Postpartum Hemorrhage ◽  
Primary Outcome ◽  
Dropout Rate ◽  
Significant Difference ◽  
Uterine Massage ◽  
Secondary Outcomes ◽  
Group 2 ◽  
Group 1

Objective This study aimed to compare the effectiveness of sustained uterine compression versus uterine massage in reducing blood loos after a vaginal delivery. Study Design This was a prospective randomized trial conducted at the American University of Beirut Medical Center (AUBMC) between October 2015 and October 2017. Inclusion criteria were women with a singleton pregnancy at ≥36 weeks of gestation, with less than three previous deliveries, who were candidates for vaginal delivery. Participants were randomized into two groups, a sustained uterine compression group (group 1) and a uterine massage group (group 2). Incidence of postpartum hemorrhage (blood loss of ≥500 mL) was the primary outcome. We assumed that the incidence of postpartum hemorrhage at our institution is similar to previously published studies. A total of 545 women were required in each arm to detect a reduction from 9.6 to 4.8% in the primary outcome (50% reduction) with a one-sided α of 0.05 and a power of 80%. Factoring in a 10% dropout rate. Secondary outcomes were admission to intensive care unit (ICU), postpartum complications, drop in hemoglobin, duration of hospital stay, maternal pain, use of uterotonics, or of surgical procedure for postpartum hemorrhage. Results A total of 550 pregnant women were recruited, 273 in group 1 and 277 in group 2. There was no statistically significant difference in baseline characteristics between the two groups. Type of anesthesia, rate of episiotomy, lacerations, and mean birth weight were also equal between the groups. Incidence of the primary outcome was not different between the two groups (group 1: 15.5%, group 2: 15.4%; p = 0.98). There was no statistically significant difference in any of the secondary outcomes between the two groups, including drop in hemoglobin (p = 0.79). Conclusion There was no difference in blood loss between sustained uterine compression and uterine massage after vaginal delivery. Key Points

Patient Access to Hepatitis C Treatment After Incorporation of Pharmacists in a Hepatology Clinic

2021 ◽  
pp. 001857872110375
Author(s):  
Frank A. Fanizza ◽  
Jennifer Loucks ◽  
Angelica Berni ◽  
Meera Shah ◽  
Dennis Grauer ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Medication Adherence ◽  
Hcv Treatment ◽  
Clinical Pharmacists ◽  
The Mean ◽  
Group 2 ◽  
Cure Rates ◽  
The Impact ◽  
Mean Time ◽  
Group 1

Background: Modern hepatitis C virus (HCV) treatment regimens yield cure rates greater than 90%. However, obtaining approval for treatment through the prior authorization (PA) process can be time consuming and require extensive documentation. Lack of experience with this complex process can delay HCV medication approval, ultimately increasing the amount of time before patients start treatment and in some cases, prevent treatment altogether. Objectives: Assess the impact of incorporating clinical pharmacists into specialty pharmacy and hepatology clinic services on medication access, patient adherence, and outcomes in patients being treated for HCV. Methods: We performed a retrospective cohort exploratory study of patients seen in an academic medical center hepatology clinic who had HCV prescriptions filled between 8/1/15 and 7/31/17. Patients were categorized by whether they filled prescriptions prior to (Pre-Group) or after (Post-Group) the implementation of a pharmacist in clinic. The Post-Group was further divided according to whether the patient was seen by a pharmacist in clinic (Post-Group 2) or if the patient was not seen by the pharmacist, but had their HCV therapy evaluated by the pharmacist before seeking insurance approval (Post-Group 1). Results: The mean time from the prescription being ordered to being dispensed was longer in the Pre-Group (50.8 ± 66.5 days) compared to both Post-Groups (22.2 ± 27.8 days in Post-Group 1 vs 18.9 ± 17.7 days in Post-Group 2; P < .05). The mean time from when the prescription was ordered to when the PA was submitted was longer in the Pre-Group (41.6 ± 71.9 days) compared to both Post-Groups (6.3 ± 16 in Post-Group 1 vs 4.1 ± 9.7 in Post-Group 2; P < .05). Rates of medication adherence and sustained virologic response were similar between all groups. Conclusion: Incorporation of clinical pharmacists into a hepatology clinic significantly reduced the time patients waited to start HCV treatment. In addition to improving access to medications, implementation of the model helped to maintain excellent medication adherence and cure rates.

scholarly journals Multivariate Analysis and Geochemical Signatures of Shallow Groundwater in the Main Urban Area of Chongqing, Southwestern China

Water ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 2833
Author(s):  
Si Chen ◽  
Zhonghua Tang ◽  
Jian Wang ◽  
Jialing Wu ◽  
Chang Yang ◽  
...  
Keyword(s):  
Geochemical Modeling ◽  
Shallow Groundwater ◽  
Poor Quality ◽  
Easy Access ◽  
Multivariate Statistical ◽  
Drinking Purposes ◽  
Groundwater Samples ◽  
New Findings ◽  
Group 2 ◽  
Group 1

Hydrogeochemical processes and quality assessment for shallow groundwater are pivotal issues to be solved in many regions over the world due to the easy access of shallow groundwater. In this study, eighty-six water samples were collected from shallow aquifers of Chongqing, China, during July–September 2019. Multivariate statistical techniques, major ion ratios, and geochemical modeling were integrated to investigate hydrogeochemical characteristics and controlling factors. Afterwards, groundwater quality in spatial was classified by entropy-weighted water quality index and geographic information system (GIS) spatial analysis. Groundwater samples were alkaline and possessed high total dissolved solids (TDS) values. Two-group samples were distinguished as mix cations-HCO3-SO4 (group 1) and Ca-Mg-SO4 (group 2) facies. Hydrogeochemical compositions of group 1 samples were dominated by silicate dissolution and ion exchange, while sulfate and calcite dissolution were the main factors influencing the hydrogeochemical characteristics of group 2. The overall quality of groundwater samples varied greatly from excellent quality to extremely poor quality. Group 1 samples were found with excellent and good quality and suitable for drinking purposes. Group 2 samples were all unsuitable for direct drinking purposes as the quality varied from medium to extremely poor, but were spatially limited. Groundwaters with relatively poor quality were due to dissolution of sulfate that were locally enriched in the aquifers. The new findings of this study are expected to provide the reference for future management and sustainable exploitation of groundwater in Chongqing.

scholarly journals Ropeginterferon alfa-2b every 2 weeks as a novel pegylated interferon for patients with chronic hepatitis B

2020 ◽  
Author(s):  
Yi-Wen Huang ◽  
Chao-Wei Hsu ◽  
Sheng-Nan Lu ◽  
Ming-Lung Yu ◽  
Chien-Wei Su ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Hbeag Seroconversion ◽  
Pegylated Interferon ◽  
Preliminary Evaluation ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Background Ropeginterferon alfa-2b is a novel mono-pegylated interferon that has only one major form as opposed to 8–14 isomers of other on-market pegylated interferon, allowing injection every two or more weeks with higher tolerability. It received European Medicines Agency and Taiwan marketing authorization in 2019 and 2020, for treatment of polycythemia vera. This phase I/II study aimed to have preliminary evaluation of safety and efficacy in chronic hepatitis B. Methods Thirty-one HBeAg-positive and 31 HBeAg-negative were stratified by HBeAg status and randomized at 1:1:1 ratio to q2w ropeginterferon alfa-2b 350 μg (group 1), q2w 450 μg (group 2) or q1w PEG-IFN alfa-2a 180 μg (group 3). Each patient received 48-week treatment (TW48) and 24-week post-treatment follow-up (FW24). Results The baseline demographics were comparable among the three groups, except for mean HBeAg in HBeAg-positive patients (2.90, 2.23, 2.99 log10 S/CO, respectively). Cumulative HBeAg seroconversion rate at follow-up period was 27.3% (3/11), 36.4% (4/11), and 11.1% (1/9) with time to HBeAg seroconversion starting from TW24, TW16, and TW48 in group 1, 2, and 3, respectively. The rate of HBV DNA < 2000 IU/mL and HBsAg levels < 1500 IU/mL at FW24 were comparable in all groups. Ropeginterferon alfa-2b (group 1 & 2) had numerically lower incidence of rash (9.5% and 4.5%) as compared to PEG-IFN alfa-2a (36.8%). Ropeginterferon alfa-2b 350 μg (group 1) had more ALT elevation (38.1%), however the rate was comparable in group 2 (9.1%) and group 3 (10.5%). Conclusion In this preliminary study, ropeginterferon alfa-2b, although in only half the number of injections, is as safe and effective as pegylated interferon alfa-2a for chronic hepatitis B. Graphic abstract

scholarly journals Prior Exposure to Lamivudine Increases Entecavir Resistance Risk in Chronic Hepatitis B Patients without Detectable Lamivudine Resistance

2014 ◽  
Vol 58 (3) ◽  
pp. 1730-1737 ◽  
Author(s):  
Jeong-Hoon Lee ◽  
Yuri Cho ◽  
Dong Hyeon Lee ◽  
Minjong Lee ◽  
Jeong-ju Yoo ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Tertiary Hospital ◽  
Lamivudine Resistance ◽  
Genotypic Resistance ◽  
Resistance Risk ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

ABSTRACTThe efficacy of entecavir (ETV) treatment in chronic hepatitis B (CHB) patients who were exposed to lamivudine (LAM) but had no detectable LAM resistance (LAM-R) is not well evaluated. In this study, we aimed to evaluate whether the probability of developing genotypic resistance to ETV in LAM-exposed patients with or without LAM-R is comparable to that in antiviral-naive patients. This retrospective cohort study included 500 consecutive patients with CHB who started ETV monotherapy at a single tertiary hospital in Korea. The patients were divided into three groups: nucleos(t)ide analogue (NA)-naive patients (group 1,n= 142), patients who were previously exposed to LAM and had no currently or previously detected LAM-R (group 2,n= 233), and patients with LAM-R when starting ETV (group 3,n= 125). The overall median ETV treatment duration was 48.7 months. The probabilities of virologic breakthrough were significantly increased not only in group 3 (hazard ratio [HR] = 14.4,P< 0.001) but also in group 2 (HR = 5.0,P< 0.001) compared to group 1. Genotypic ETV resistance (ETV-R) developed more frequently in group 2 (HR = 13.0,P= 0.013) as well as group 3 (HR = 43.9,P< 0.001) than in group 1: the probabilities of developing ETV-R in groups 1, 2, and 3 were <1.0%, 8.0%, and 28.2%, respectively, at month 48. The results of this study indicate that ETV-R occurred more frequently in LAM-exposed patients, even though they had no detectable LAM-R, than in NA-naive patients. Therefore, LAM-exposed CHB patients, regardless of the presence or absence of LAM-R, should be monitored more cautiously for the development of ETV-R during ETV monotherapy.

scholarly journals Antibodies against non-structural c100/3 and structural core antigen of hepatitis C virus (HCV) in hemodialysis patients

1993 ◽  
Vol 35 (4) ◽  
pp. 315-321 ◽  
Author(s):  
C.F.T. Yoshida ◽  
Y. Takahashi ◽  
B.O.M. Vanderborght ◽  
C.D. Rouzere ◽  
M.S. França ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Blood Transfusion ◽  
Core Protein ◽  
Hemodialysis Patients ◽  
Core Antigen ◽  
Prevalence Rates ◽  
High Prevalence ◽  
Group 2 ◽  
Group 1

Two groups of patients undergoing hemodialysis (HD) maintenance were evaluated for their antibody response to non-structural c100/3 protein and structural core protein of hepatitis C virus (HCV). Forty-six patients (Group 1) never presented liver abnormalities during HD treatment, while 52 patients (Group 2) had either current or prior liver enzyme elevations. Prevalence rates of 32.6% and 41.3% were found for anti-c100/3 and anti-HCV core antibodies, respectively, in patients with silent infections (Group 1). The rate of anti-c100/3 in patients of Group 2 was 71.15% and reached 86.5% for anti-HCV core antibodies. The recognition of anti-c100/3 and anti-core antibodies was significantly higher in Group 2 than in Group 1. A line immunoassay composed of structural and non-structural peptides was used as a confirmation assay. HBV infection, measured by the presence of anti-HBc antibodies, was observed in 39.8% of the patients. Six were HBsAg chronic carriers and 13 had naturally acquired anti-HBs antibodies. The duration of HD treatment was correlated with anti-HCV positivity. A high prevalence of 96.7% (Group 2) was found in patients who underwent more than 5 years of treatment. Our results suggest that anti-HCV core ELISA is more accurate for detecting HCV infection than anti-c100/3. Although the risk associated with the duration of HD treatment and blood transfusion was high, additional factors such as a significant non-transfusional spread of HCV seems to play a role as well. The identification of infective patients by more sensitive methods for HCV genome detection should help to control the transmission of HCV in the unit under study.

Study of IL28B gene variation as a predictor of response to directly acting antiviral therapy in hepatic transplantation hepatitis C Egyptian patients

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
H M Badawy ◽  
S S Taha ◽  
Y O Abdelrahman ◽  
S H Gadallah ◽  
R Samir ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Hepatitis C ◽  
Antiviral Therapy ◽  
Il28b Genotype ◽  
Donor Liver Transplantation ◽  
Gene Variation ◽  
Significant Difference ◽  
Group 2 ◽  
Group B ◽  
Group 1

Abstract Background IL28B gene polymorphisms are associated with the response to antiviral therapy in hepatitis C patients in the non-transplant setting. Objective To determine the prevalence and impact on clinical outcomes of donor and recipient IL28B genotypes among liver transplant recipients receiving directly acting antiviral therapy compared to those of HCV non-transplant patients. Patient and Methods This study included 60 patients divided into 2 groups: group 1 included 30 patients subjected to living donor liver transplantation and group 2 included 30 patients of HCV infection. Each group was subdivided into group A and group B according to the regimen of directly acting antiviral therapy (sofosbuvir-ledibasvir, sofosbuvir-daclatasvir). Liver transplantation was done between January 2016 and April 2018. Genotyping of the polymorphism was performed on DNA collected from all donors and recipients in group 1 before and after liver transplantation and also collected from all patients of group 2. Sustained virological response was found in 28 patients in group 1 (transplanted group) and 29 patients in group 2 (non-transplanted group) with no significant difference. Results No significant difference also was found in both groups according to the type of regimen. Also the type of genotype CC, CT and TT of IL28B in donors and recipients were not significantly associated or affecting the results of SVR in both groups of patients. Conclusion Our results support no role of recipient IL28B genotype in the response to directly acting antiviral drugs for hepatitis C recurrence. Interestingly, donor genotype seems not to influence the response pattern in recipients who have different IL28B genotype.

scholarly journals The Role of Hepatic Expression of STAT1, SOCS3 and PIAS1 in the Response of Chronic Hepatitis C Patients to Therapy

2013 ◽  
Vol 27 (2) ◽  
pp. e13-e17 ◽  
Author(s):  
Sherif El-Saadany ◽  
Dina H Ziada ◽  
Hanan El Bassat ◽  
Wael Farrag ◽  
Hesham El-Serogy ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Protein Expression ◽  
Western Blotting ◽  
Liver Tissue ◽  
Negative Regulators ◽  
Group 2 ◽  
Chronic Hcv ◽  
Socs3 Protein ◽  
Group 1 ◽  
Liver Tissues

BACKGROUND: The underlying mechanisms of hepatitis C virus (HCV) resistance to treatment are unknown. Signal transducers and activators of transcription (STAT) proteins play a critical role in antiviral defense.OBJECTIVE: To explore some of the mechanisms of HCV resistance to interferon, the expression of STAT1 and its negative regulators, protein inhibitor of activated STAT (PIAS1) and suppressor of cytokine signalling (SOCS3), in liver tissues of both inteferon responders and nonresponders in chronic HCV patients.METHODS: Sixty patients were divided into the following groups: group 1a comprised 38 treatment-responder chronic HCV patients; group 1b consisted of 22 treatment-nonresponder chronic HCV patients; and group 2 consisted of six control subjects. Liver biopsies were examined for histological scoring; STAT1, SOCS3 and PIAS1 expression was analyzed using Western blotting methods.RESULTS: STAT1 expression in the liver tissue of patients in group 1 was significantly increased compared with group 2 patients (P=0.001), while no significant difference in expression was observed between group 1a and group 1b patients (P=0.747). However, phosphorylated STAT1 protein was expressed at a significantly higher level in liver tissue of patients in group 1a compared with patients in group 1b (P=0.001). Western blot analysis of PIAS1 and SOCS3 protein expression in liver tissues from groups 1 and 2 revealed significantly increased expression in group 1 compared with group 2 (P=0.001). In addition, PIAS1 and SOCS3 protein expression was significantly higher in the liver tissues of patients in group 1b compared with patients in group 1a.CONCLUSION: Levels of STAT1 and/or the protein expression of its negative regulators, PIAS1 and SOCS3, may be a good predictor of response to therapy. These could be used as biomarkers that are easily detected by Western blotting or immunostaining during standard histopathological liver biopsy analysis.

scholarly journals Persistence of Hepatitis C RNA in Liver Allografts Is Associated with Histologic Progression Independent of Serologic Viral Clearance

2009 ◽  
Vol 2009 ◽  
pp. 1-6 ◽  
Author(s):  
M. Ghabril ◽  
R. C. Dickson ◽  
M. Krishna ◽  
R. Lloyd ◽  
J. Aranda-Michel ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Treatment Duration ◽  
Sustained Viral Response ◽  
Hcv Rna ◽  
Undetectable Serum ◽  
Total Treatment ◽  
Similar Patient ◽  
Group 2 ◽  
Hepatitis C Rna ◽  
Group 1

Background. Hepatitis C virus (HCV) nondetectability in the liver may predict a sustained viral response (SVR) in patients with an end of treatment response. HCV RNA can be detected in liver tissue by in situ hybridization (ISH).Aim. To determine if HCV nondetectability in liver allografts by ISH can predict SVR in patients who cleared virus serologically on treatment.Methods. Twenty five patients with undetectable serum HCV on Interferon/Ribavirin therapy for HCV recurrence post liver transplant (LT) were studied. All had biopsies at 4 months post LT (baseline) and follow up with HCV ISH analysis performed.Results. 10 were ISH positive (group 1); 15 were ISH negative (group 2). Groups 1 and 2 had similar patient, donor, and viral characteristics at LT, as well as treatment duration at the time of the ISH assayed liver biopsy (13±16versus10±4monthsP= .24). However, group 1 had longer total treatment duration (24±10versus14±5months,P= .001). Eight (80%) group 1 and 9 (60%) group 2 patients achieved SVR. Mean grade and stage (modified Ishak score) were similar at 4 months, however, group 1 had higher grade (3±1.7versus1.6±1.3,P= .039) and stage (1.4±1.4versus0.5±0.6,P= .084) on the ISH assayed biopsy, after similar post LT intervals (23±10versus24±12months,P= .91).Conclusion. Allograft HCV ISH nondetectability does not predict SVR in treatment responsive HCV recurrence, but is associated with less severe histologic disease.

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