Diabetes Mellitus Increases the Risk of Hepatocellular Carcinoma After Direct-Acting Antiviral Therapy: Systematic Review and Meta-Analysis

Background: Hepatitis C virus (HCV)-infected patients treated with direct-acting antivirals (DAAs) are still at risk of developing hepatocellular carcinoma (HCC) after sustained virologic response (SVR). This study aimed to investigate the role of diabetes mellitus (DM) as a potential predictive risk factor in developing de novo HCC in HCV-infected patients after DAA treatment.Methods: This study was registered on PROSPERO under registration number CRD42021230457. We performed a systematic search in four medical databases from inception through November 3rd, 2020. Studies were eligible if they reported on HCV-infected patients treated with DAAs and compared the frequency of de novo HCC in patients with and without DM. We calculated pooled odds ratios, unadjusted (UHR), and adjusted hazard ratios (AHR) with 95% confidence intervals (CIs) in meta-analysis.Results: We included 30 articles in our systematic review and meta-analysis. DM proved to be a significant risk factor of HCC in DAA-treated HCV patients in unadjusted (UHR = 1.44, CI: 1.15–1.79) and adjusted analyses (AHR = 1.31, CI: 1.06–1.62). In the group of patients achieving SVR after DAA therapy, DM increased the risk of HCC in unadjusted (UHR = 1.3, CI: 1.09–1.51) analysis; however, in adjusted results, the risk was non-significant (AHR = 1.07, CI: 0.89–1.28). In patients with advanced liver fibrosis, DM was a risk factor for HCC in adjusted (AHR = 1.36, CI: 1.03–1.8), but not in unadjusted analysis (UHR = 1.11, CI: 0.8–1.42).Conclusions: DM is an independent risk factor of de novo HCC after DAA treatment in HCV-infected patients.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=230457, identifier: CRD42021230457.

Download Full-text

Family history is a significant risk factor for pancreatic cancer: results from a systematic review and meta-analysis

Familial Cancer ◽

10.1007/s10689-008-9214-8 ◽

2008 ◽

Vol 8 (2) ◽

pp. 109-117 ◽

Cited By ~ 116

Author(s):

Jennifer Permuth-Wey ◽

Kathleen M. Egan

Keyword(s):

Systematic Review ◽

Pancreatic Cancer ◽

Risk Factor ◽

Family History ◽

Meta Analysis ◽

Significant Risk ◽

Significant Risk Factor

Download Full-text

Obesity Increases the Severity and Mortality of Influenza and COVID-19: A Systematic Review and Meta-Analysis

Frontiers in Endocrinology ◽

10.3389/fendo.2020.595109 ◽

2020 ◽

Vol 11 ◽

Author(s):

Xue Zhao ◽

Xiaokun Gang ◽

Guangyu He ◽

Zhuo Li ◽

You Lv ◽

...

Keyword(s):

Systematic Review ◽

Morbid Obesity ◽

Risk Factor ◽

Confidence Intervals ◽

Web Of Science ◽

Meta Analysis ◽

Significant Risk ◽

Significant Risk Factor ◽

Systematic Search ◽

Odds Ratios

Since December 2019, COVID-19 has aroused global attention. Studies show the link between obesity and severe outcome of influenza and COVID-19. Thus, we aimed to compare the impacts of obesity on the severity and mortality of influenza and COVID-19 by performing a meta-analysis. A systematic search was performed in MEDLINE, EMASE, ClinicalTrials.gov, and Web of Science from January 2009 to July 2020. The protocol was registered onto PROSPERO (CRD42020201461). After selection, 46 studies were included in this meta-analysis. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were analyzed. We found obesity was a risk factor for the severity and mortality of influenza (ORsevere outcome = 1.56, CI: 1.28-1.90; ORmortality = 1.99, CI: 1.15-3.46). For COVID-19, obesity was a significant risk factor only for severe outcome (OR = 2.07, CI: 1.53-2.81) but not for mortality (OR = 1.57, CI: 0.85-2.90). Compared with obesity, morbid obesity was linked with a higher risk for the severity and mortality of both influenza (OR = 1.40, CI: 1.10-1.79) and COVID-19 (OR = 3.76, CI: 2.67-5.28). Thus, obesity should be recommended as a risk factor for the prognosis assessment of COVID-19. Special monitoring and earlier treatment should be implemented in patients with obesity and COVID-19.

Download Full-text

Risk factors for Clostridium difficile infection in pediatric inpatients: A meta-analysis and systematic review

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2019.23 ◽

2019 ◽

Vol 40 (4) ◽

pp. 420-426 ◽

Cited By ~ 5

Author(s):

Scott Anjewierden ◽

Zheyi Han ◽

Charles B. Foster ◽

Chaitanya Pant ◽

Abhishek Deshpande

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Risk Factor ◽

Meta Analysis ◽

Significant Risk ◽

Female Gender ◽

Significant Risk Factor ◽

Antibiotic Exposure ◽

H2 Receptor Antagonist ◽

Increased Risk

AbstractObjective:To summarize risk factors for Clostridioides (formerly Clostridium) difficile infection (CDI) in hospitalized pediatric patients as determined by previous observational studies.Design:Meta-analysis and systematic review.Patients:Studies evaluating risk factors for CDI in pediatric inpatients were eligible for inclusion.Method:We systematically searched MEDLINE, Web of Science, Scopus, and EMBASE for subject headings and text words related to CDI and pediatrics from 1975 to 2017. Two of the investigators independently screened studies, extracted and compiled data, assessed study quality, and performed the meta-analysis.Results:Of the 2,033 articles screened, 14 studies reporting 10,531,669 children met the inclusion criteria. Prior antibiotic exposure (odds ratio [OR], 2.14; 95% confidence interval [CI], 1.31–3.52) and proton pump inhibitor (PPI) use (OR, 1.33; 95% CI, 1.07–1.64) were associated with an increased risk of CDI in children. Subgroup analyses using studies reporting only adjusted results suggested that prior antibiotic exposure is not a significant risk factor for CDI. H2 receptor antagonist (H2RA) use (OR, 1.36; 95% CI, 0.31–5.98) and that female gender (OR, 0.87; 95% CI, 0.74–1.03) did not play a significant role as a risk factor for developing CDI.Conclusion:Prior antibiotic exposure appears to be an important risk factor for CDI based on the combined analysis but not significant using adjusted studies. PPI use was associated with an increased risk of CDI. Judicious and appropriate use of antibiotics and PPIs may help reduce the risk of CDI in this vulnerable population.

Download Full-text

Epidemiology and outcomes of COVID-19 in HIV-infected individuals: a systematic review and meta-analysis

Scientific Reports ◽

10.1038/s41598-021-85359-3 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Paddy Ssentongo ◽

Emily S. Heilbrunn ◽

Anna E. Ssentongo ◽

Shailesh Advani ◽

Vernon M. Chinchilli ◽

...

Keyword(s):

Systematic Review ◽

Meta Analysis ◽

Significant Risk ◽

Significant Risk Factor ◽

Cochrane Library ◽

Random Effects Models ◽

Beneficial Effects ◽

Risk Of Mortality ◽

Immunodeficiency Syndrome ◽

Hiv Negative

AbstractSusceptibility to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the risk of mortality among people living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) (PLWHA) is largely unknown. PLWHA are unique due to their altered immune system from their history of chronic HIV infection and their use of antiretroviral therapy, some of which have been used experimentally to treat coronavirus disease 2019 (COVID-19). Therefore, we conducted a systematic review and meta-analysis to assess the epidemiology of SARS-COV-2/HIV coinfection and estimate associated mortality from COVID-19 (Prospero Registration ID: CRD42020187980). PubMed, SCOPUS, OVID and Cochrane Library databases, and medRxiv preprint repositories were searched from January 1, 2020, to December 12, 2020. Data were extracted from studies reporting COVID-19 attack and mortality rates in PLWHA compared to their HIV-negative counterparts. Pooled attack and mortality risks were quantified using random-effects models. We identified 22 studies that included 20,982,498 participants across North America, Africa, Europe, and Asia. The median age was 56 years, and 50% were male. HIV-positive persons had a significantly higher risk of SARS-CoV-2 infection [risk ratio (RR) 1.24, 95% CI 1.05–1.46)] and mortality from COVID-19 (RR 1.78, 95% CI 1.21–2.60) than HIV-negative individuals. The beneficial effects of tenofovir and protease-inhibitors in reducing the risk of SARS-CoV-2 infection and death from COVID-19 in PLWHA remain inconclusive. HIV remains a significant risk factor for acquiring SARS-CoV-2 infection and is associated with a higher risk of mortality from COVID-19. In support of the current Centers for Disease Control and Prevention (CDC) guidelines, persons with HIV need priority consideration for the SARS-CoV-2 vaccine.

Download Full-text