scholarly journals Clinical Impact of Viral Load on the Development of Hepatocellular Carcinoma and Liver-Related Mortality in Patients with Hepatitis C Virus Infection

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Ran Noh ◽  
Doo Hyuck Lee ◽  
Byoung Woon Kwon ◽  
Yong Hyun Kim ◽  
Suk Bae Kim ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Viral Load ◽  
Hepatitis C ◽  
Proportional Hazards ◽  
Significant Risk ◽  
Cox Proportional Hazards ◽  
Clinical Impact ◽  
Hcv Rna ◽  
Related Mortality

Aim. This study aimed to assess clinical impact of hepatitis C viral load on the development of hepatocellular carcinoma (HCC) and liver-related mortality in HCV-infected patients.Methods. A total of 111 subjects with chronic HCV infection who were available for serum quantitation of HCV RNA were recruited in this retrospective cohort. Cox-proportional hazards models were used to calculate hazard ratio (HR) of developing HCC and liver-related mortality according to serum HCV RNA titers.Results. HCC was developed in 14 patients during follow-up period. The cumulative risk of HCC development was higher in subjects with high HCV RNA titer (log HCV RNA IU/mL > 6) than subjects with low titer (log HCV RNA IU/mL ≦ 6) (HR = 4.63,P=0.032), giving an incidence rate of 474.1 and 111.5 per 10,000 person-years, respectively. Old age (HR = 9.71,P=0.014), accompanying cirrhosis (HR = 19.34,P=0.004), and low platelet count (HR = 13.97,P=0.009) were other independent risk factors for the development of HCC. Liver-related death occurred in 7 patients. Accompanying cirrhosis (HR = 6.13,P=0.012) and low albumin level (HR = 9.17,P=0.002), but not HCV RNA titer, were significant risk factors related to liver-related mortality.Conclusion. Serum HCV RNA titer may be considered an independent risk factor for the development of HCC but not liver-related mortality.

Prevalence and Risk Factors of Hepatitis C Virus (HCV) in Tehsil Batkhela District Malakand, KPK, Pakistan

2018 ◽  
Vol 9 (06) ◽  
pp. 20251-20256
Author(s):  
Mudassir Khan ◽  
Shahrukh Khan ◽  
Shohra Haider ◽  
Fazal Jalil ◽  
Muhsin Jamal ◽  
...  
Keyword(s):  
Risk Factors ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Skin Color ◽  
Significant Risk ◽  
Rapid Test ◽  
Prevalence Ratio ◽  
Hcv Infection ◽  
Hcv Rna ◽  
Common Symptom

Background: Prevalence of Hepatitis C viral infection and its major risk factors has been found out in population of Batkhela, Khyber Pakhtunkhwa, Pakistan by taking number of volunteers from the interested area. HCV prevalence has not been researched in recent time here in this area, so that’s why we contributed. Materials and Methods: Ab rapid test cassette serum/plasma (USA) kit has been used for the mentioned purpose following by ELISA and finally PCR to find out active infection of virus. ICT positive individuals were reconfirmed by ELISA and then ELISA positive samples were carefully investigated by RT-PCR for Hepatitis C Virus. Results: The study population was of 770 volunteers belonging to the mentioned area of research, 453 males and 317 females. The overall prevalence was found to be 5.32% of HCV in Batkhela. This prevalence ratio was 3.12% in males and 2.20 % in females. 3rd generation ELISA was used to refine ICT positive samples which showed that 37 of the ICT positive samples had antibodies detected by ELISA. To find out active HCV infection, ELISA positive samples were refined by real time PCR which showed 2.98% of prevalence of active HCV infection in Batkhela based on HCV RNA in their blood. Principle Conclusion: Overall prevalence was found 5.32%, contaminated reused syringes and blades at Barbour’s shop, blood transfusion, surgical operations and unhygienic food in stalls etc were found significant risk factors for acquiring HCV infection. Body weakness and pale yellow skin color was common symptom in HCV positive volunteers. Safe sexual activities, blood screening before donation and sterilizing surgical equipment’s can protect us from Hepatitis C Virus.

scholarly journals Risk Factors Contributing to the Occurrence and Recurrence of Hepatocellular Carcinoma in Hepatitis C Virus Patients Treated with Direct-Acting Antivirals

Biomedicines ◽  
2020 ◽  
Vol 8 (6) ◽  
pp. 175
Author(s):  
Sara Kishta ◽  
Ashraf Tabll ◽  
Tea Omanovic Kolaric ◽  
Robert Smolic ◽  
Martina Smolic
Keyword(s):  
Risk Factors ◽  
Hepatocellular Carcinoma ◽  
Hepatitis C ◽  
Dna Ploidy ◽  
Hcv Rna ◽  
Direct Acting Antivirals ◽  
Hepatic Cells ◽  
Chronic Hcv ◽  
Direct Acting

Although hepatitis C virus (HCV) RNA may be eliminated from blood circulation by direct-acting antivirals (DAA) therapy as assessed by real-time polymerase chain reaction (PCR), HCV RNA can still be present in liver tissue, and this is known as occult HCV. There has been a lot of controversy surrounding the recurrence of hepatocellular carcinoma (HCC) after DAA treatment of hepatic cells infected with chronic HCV. One of the main risk factors that leads to de novo HCC is the chronicity of HCV in hepatic cells. There are many studies regarding the progression of HCV-infected hepatic cells to HCC. However, there is a lack of research on the different molecular mechanisms that lead to the progression of chronic HCV infection to HCC, as well as on the effect of HCV on the alteration of DNA ploidy, which eventually leads to a recurrence of HCC after DAA treatment. In this review article, we will address some risk factors that could lead to the development/recurrence of HCC after treatment of HCV with DAA therapy, such as the role of liver cirrhosis, the alteration of DNA ploidy, the reactivation of hepatitis B virus (HBV), the role of cytokines and the alteration of the immune system, concomitant non- alcoholic fatty liver disease (NAFLD), obesity, alcohol consumption and also occult HCV infection/co-infection. Clinicians should be cautious considering that full eradication of hepatocarcinogenesis cannot be successfully accomplished by anti-HCV treatment alone.

scholarly journals Long-Term Follow-Up of Chronic Hepatitis C Patients Treated with Interferon-Alpha: Risk of Cirrhosis and Hepatocellular Carcinoma in a Single Center over 10 Years

Intervirology ◽  
2015 ◽  
Vol 58 (1) ◽  
pp. 14-21
Author(s):  
Hyun Jung Lee ◽  
Jong Eun Yeon ◽  
Eileen L. Yoon ◽  
Sang Jun Suh ◽  
Keunhee Kang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Antiviral Therapy ◽  
Disease Progression ◽  
Chronic Hepatitis C ◽  
Cumulative Incidence ◽  
Proportional Hazards ◽  
Antiviral Treatment ◽  
Cox Proportional Hazards

Objectives: Interferon (IFN)-based therapy for chronic hepatitis C (CHC) is cost-effective and is associated with reduced risk of disease progression. We aimed to assess the incidence of cirrhosis and hepatocellular carcinoma (HCC) and to identify risk factors associated with disease progression. Methods: We retrospectively reviewed 280 CHC patients who were registered at our hospital between 2001 and 2010. Results: About 80% of patients received antiviral treatment. The 10-year cumulative incidence of cirrhosis was significantly lower among patients who received antiviral therapy than among those who did not (8.3 vs. 44.0%; p = 0.001). Among them, patients with sustained virological response (SVR) had a significantly lower incidence of cirrhosis than those without SVR (0.6 vs. 33.9%; p < 0.001). Cox proportional hazards regression showed that SVR was the significant independent factor for reducing the risk of cirrhosis (hazard ratio, HR = 0.03; p = 0.034). The 10-year cumulative incidence of HCC was higher among patients who did not receive antiviral therapy than among those who did (43.9 vs. 6.1%; p < 0.001). Multivariate analysis showed that underlying cirrhosis was the only independent risk factor associated with HCC development (HR = 7.70; p = 0.010). Conclusions: SVR secondary to IFN-based therapy could reduce cirrhosis development in CHC patients. Underlying cirrhosis was the strongest predictor of HCC development.

scholarly journals Risk Factors for Secondary Glaucoma in Patients with Vogt-Koyanagi-Harada Disease

2021 ◽  
Author(s):  
Carlos Alvarez-Guzman ◽  
Curt Hartleben-Matkin ◽  
Raul E. Ruiz-Lozano ◽  
Alejandro Rodríguez-Garcia ◽  
Manuel E. Quiroga-Garza ◽  
...  
Keyword(s):  
Risk Factors ◽  
Proportional Hazards ◽  
Significant Risk ◽  
Cox Proportional Hazards ◽  
Secondary Glaucoma ◽  
Angle Closure ◽  
Mexican Mestizo ◽  
Peripapillary Atrophy ◽  
Clinically Significant ◽  
Recurrent Inflammation

Abstract Background: To identify the prevalence and risk factors for secondary glaucoma among Mexican-mestizo patients with Vogt-Koyanagi-Harada Disease (VKH). A retrospective cohort study was conducted to identify the risk factors for developing secondary glaucoma based on demographic, clinical, and epidemiological variables of VKH Mexican-mestizo patients. Risk estimates were calculated using a Cox proportional hazards regression model. Main text: One hundred eyes of 50 patients, 44 (88%) women and 6 men (12%) with a median age of 35.5 years (IQR 29 – 46), and a median follow-up time of 72 months (IQR 13.7 – 126.7) were included for analysis. The prevalence of glaucoma was 20%, with angle-closure glaucoma accounting for 70% of all cases. Significant clinical risk factors for glaucoma development were a chronic recurrent stage at presentation (RR 2.88 95% CI 1.11 – 12.63, p=0.037), more than two episodes of recurrent anterior uveitis (RR 8.52 95% CI 2.02 – 35.92, p<0.001), angle-closure disease (ACD, RR 7.08 95% CI 2.44 – 20.48, p<0.001), iris bombé (RR 5.0 95% CI 2.10 – 11.90, p<0.001), and peripapillary atrophy (RR 3.56 95% CI 1.43 – 8.85, p<0.001). Exposure to prednisone for more than 24 months (RR 9.33 95% CI 2.21 – 39.28, p<0.001) or topical corticosteroid drops for more than 12 months (RR 3.88 95% CI 1.31 – 11.46, p=0.007) were associated with an increased likelihood for secondary glaucoma development. Conclusions: Glaucoma is a frequent complication in patients with VKH, often attributed to mixed pathogenic mechanisms. Chronic disease at presentation, recurrent inflammation, angle-closure mechanisms, iris bombé, and peripapillary atrophy represent clinically significant risk factors for secondary glaucoma development. Prompt and aggressive steroid-spearing immunosuppressive therapy for reaching adequate control of inflammation may lower the risk of glaucoma in VKH patients.

PREVALENCE AND RISK FACTORS OF HEPATITIS C VIRUS INFECTION IN HAEMODIALYSIS PATIENTS: TESTING ANTIBODIES, RNA AND GENOTYPES

2015 ◽  
Vol 77 (25) ◽  
Author(s):  
Waqar Al-Kubaisy ◽  
Nor Aini Mohd Noor ◽  
Nik Shamsidah Nik Ibrahim ◽  
Usama Al-Nasirie
Keyword(s):  
Risk Factors ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Blood Transfusion ◽  
Enzyme Immunoassay ◽  
Significant Risk ◽  
Hcv Infection ◽  
Hcv Rna ◽  
Seropositive Rate ◽  
Hcv Transmission

Hepatitis C virus (HCV) infection is an important global public health problem affecting approximately 180 million people. Multiple risk factors are associated with HCV transmission among haemodialysis (HD) patients leading to an increased risk for liver-related mortality. Patients undergoing HD may show a decreased humoral and cellular immunity, which lowers the sensitivity of the HCV antibodies (Abs) test resulting in false negative antibody test, thus requiring HCV RNA testing. Our study is to determine the prevalence of HCV markers (antibody RNA and genotype) and risk factors of HCV infection among patients in HD unit in Baghdad. A sample of 54 patients were interviewed. HCV Abs (anti-HCV) was tested using third generation enzyme immunoassay (EIA-3) and immunoblot assay (Lia-Tek III) as screening and confirmatory test respectively. Sera of 46 patients (irrespective to anti-HCV results) were subjected to molecular analysis, using the most developed RT-PCR and DNA Enzyme immunoassay (DEIA) method. Seropositive rate of anti-HCV and HCV-RNA were (66.6%) and (60.9%) respectively. Anti-HCV seropositive rate was significantly higher in males (77.1%), and history of blood transfusion (85%). Blood transfusion acts as a significant risk for acquiring HCV (OR 44.2, 95% CI 7.6-256.9). Genotype 4 was the most prevalent (33.3%), followed by genotype 1a (25.9%) and genotype 1b (22.2%). We concluded that, the prevalence of HCV among the haemodialysis patients is high. It is significantly related to gender, duration of dialysis and number of blood transfusion. Blood transfusion acts as a significant risk factor. Molecular test for detection for HCV RNA is necessary and proper nosocomial prevention program should be implemented to prevent HCV transmission.

The Impact of Delayed Hepatitis C Viral Load Suppression on Patient Risk: Historical Evidence from the Veterans Administration

2016 ◽  
Vol 19 (2) ◽  
pp. 333-351 ◽  
Author(s):  
Tara Matsuda ◽  
Jeffrey S. McCombs ◽  
Ivy Tonnu-Mihara ◽  
Justin McGinnis ◽  
D. Steven Fox
Keyword(s):  
Viral Load ◽  
Hepatitis C ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Viral Load Suppression ◽  
Clinical Registry ◽  
Patient Risk ◽  
Viral Response ◽  
Clinical Events ◽  
The Impact

Abstract Background: The high cost of new hepatitis C (HCV) treatments has resulted in “watchful waiting” strategies being developed to safely delay treatment, which will in turn delay viral load suppression (VLS). Objective: To document if delayed VLS adversely impacted patient risk for adverse events and death. Methods: 187,860 patients were selected from the Veterans Administration’s (VA) clinical registry (CCR), a longitudinal compilation of electronic medical records (EMR) data for 1999–2010. Inclusion criteria required at least 6 months of CCR/EMR data prior to their HCV diagnosis and sufficient data post-diagnosis to calculate one or more FIB-4 scores. Primary outcome measures were time-to-death and time-to-a composite of liver-related clinical events. Cox proportional hazards models were estimated separately using three critical FIB-4 levels to define early and late viral response. Results: Achieving an undetectable viral load before the patient’s FIB-4 level exceed pre-specified critical values (1.00, 1.45 and 3.25) effectively reduced the risk of an adverse clinical events by 33–35% and death by 21–26%. However, achieving VLS after FIB-4 exceeds 3.25 significantly reduced the benefit of viral response. Conclusions: Delaying VLS until FIB-4 >3.25 reduces the benefits of VLS in reducing patient risk.

Significantly Higher Mortality Following Liver Transplantation Among Patients Aged 70 Years and Older

2017 ◽  
Vol 27 (3) ◽  
pp. 225-231 ◽  
Author(s):  
Mokshya Sharma ◽  
Aijaz Ahmed ◽  
Robert J. Wong
Keyword(s):  
United States ◽  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Hepatitis C ◽  
Proportional Hazards ◽  
The United States ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Models ◽  
Using Data ◽  
The Impact

Introduction: The age of liver transplantation recipients in the United States is steadily increasing. However, the impact of age on liver transplant outcomes has demonstrated contradictory results. Research Questions: We aim to evaluate the impact of age on survival following liver transplantation among US adults. Design: Using data from the United Network for Organ Sharing registry, we retrospectively evaluated all adults undergoing liver transplantation from 2002 to 2012 stratified by age (aged 70 years and older vs aged <70 years), presence of hepatocellular carcinoma, and hepatitis C virus status. Overall survival was evaluated with Kaplan-Meier methods and multivariate Cox proportional hazards models. Results: Compared to patients aged <70 years, those aged 70 years and older had significantly lower 5-year survival following transplantation among all groups analyzed (hepatocellular carcinoma: 59.9% vs 68.6%, P < .01; nonhepatocellular carcinoma: 61.2% vs 74.2%, P < .001; hepatitis C: 60.7% vs 69.0%, P < .01; nonhepatitis C: 62.6% vs 78.5%, P < .001). On multivariate regression, patients aged 70 years and older at time of transplantation was associated with significantly higher mortality compared to those aged <70 years (hazards ratio: 1.67; 95% confidence interval: 1.48-1.87; P < .001). Conclusion: The age at the time of liver transplantation has continued to increase in the United States. However, patients aged 70 years and older had significantly higher mortality following liver transplantation. These observations are especially important given the aging cohort of patients with chronic liver disease in the United States.

scholarly journals A Modern Cohort of Duodenal Obstruction Patients: Predictors of Delayed Transition to Full Enteral Nutrition

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Sigrid Bairdain ◽  
David C. Yu ◽  
Chueh Lien ◽  
Faraz Ali Khan ◽  
Bhavana Pathak ◽  
...  
Keyword(s):  
Risk Factors ◽  
Enteral Nutrition ◽  
Median Time ◽  
Nutritional Support ◽  
Proportional Hazards ◽  
Significant Risk ◽  
Cox Proportional Hazards ◽  
Potential Risk Factors ◽  
Cox Analysis ◽  
Delayed Transition

Background. A common site for neonatal intestinal obstruction is the duodenum. Delayed establishment of enteral nutritional autonomy continues to challenge surgeons and, since early institution of nutritional support is critical in postoperative newborns, identification of patients likely to require alternative nutritional support may improve their outcomes. Therefore, we aimed to investigate risk factors leading to delayed establishment of full enteral nutrition in these patients.Methods. 87 patients who were surgically treated for intrinsic duodenal obstructions from 1998 to 2012 were reviewed. Variables were tested as potential risk factors. Median time to full enteral nutrition was estimated using the Kaplan-Meier method. Independent risk factors of delayed transition were identified using the multivariate Cox proportional hazards regression model.Results. Median time to transition to full enteral nutrition was 12 days (interquartile range: 9–17 days). Multivariate Cox analysis identified three significant risk factors for delayed enteral nutrition: gestational age (GA) ≤ 35 weeks (P < .001), congenital heart disease (CHD) (P=.02), and malrotation (P = .03).Conclusions. CHD and Prematurity are most commonly associated with delayed transition to full enteral nutrition. Thus, in these patients, supportive nutrition should strongly be considered pending enteral nutritional autonomy.

scholarly journals History of premorbid depression is a risk factor for COVID-related mortality: Analysis of a retrospective cohort of 1,387 COVID+ patients

2020 ◽  
Author(s):  
Sean Clouston ◽  
Benjamin J Luft ◽  
Edward Sun
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Models ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
History Of ◽  
History Of Depression ◽  
Related Mortality

Background: The goal of the present work was to examine risk factors for mortality in a 1,387 COVID+ patients admitted to a hospital in Suffolk County, NY. Methods: Data were collated by the hospital epidemiological service for patients admitted from 3/7/2020-9/1/2020. Time until final discharge or death was the outcome. Cox proportional hazards models were used to estimate time until death among admitted patients. Findings: In total, 99.06% of cases had resolved leading to 1,179 discharges and 211 deaths. Length of stay was significantly longer in those who died as compared to those who did not p=0.007). Of patients who had been discharged (n=1,179), 54 were readmitted and 9 subsequently died. Multivariable-adjusted Cox proportional hazards regression revealed that in addition to older age, male sex, and heart failure, a history of premorbid depression was a risk factor for COVI-19 mortality. Interpretation: While an increasing number of studies have shown effects linking cardiovascular risk factors with increased risk of mortality in COVID+ patients, this study reports that history of depression is a risk factor for COVID mortality.

Sign in / Sign up

Export Citation Format

Share Document