scholarly journals Impact of Interferon-Based Therapy on Hepatitis C-Associated Rheumatic Diseases: A Nationwide Population-Based Cohort Study

2021 ◽  
Vol 10 (4) ◽  
pp. 817
Author(s):  
Jur-Shan Cheng ◽  
Yu-Sheng Lin ◽  
Jing-Hong Hu ◽  
Ming-Yu Chang ◽  
Hsin-Ping Ku ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hepatitis C ◽  
Rheumatic Diseases ◽  
Cumulative Incidence ◽  
Population Based ◽  
Hcv Infection ◽  
Research Database ◽  
Stage Renal Disease ◽  
End Stage ◽  
Overall Mortality

Whether hepatitis C virus (HCV) infection-associated risk of rheumatic diseases is reversed by anti-HCV therapy remain elusive. A nationwide population-based cohort study of the Taiwan National Health Insurance Research Database was conducted. Of 19,298,735 subjects, 3 cohorts (1:4:4, propensity score-matched), including HCV-treated (6919 HCV-infected subjects with interferon and ribavirin therapy ≥ 6 months), HCV-untreated (n = 27,676) and HCV-uninfected (n = 27,676) cohorts, were enrolled and followed (2003–2015). The HCV-uninfected cohort had the lowest cumulative incidence of rheumatic diseases (95% confidence interval (CI): 8.416–10.734%), while HCV-treated (12.417–17.704%) and HCV-untreated (13.585–16.479%) cohorts showed no difference in the cumulative incidences. Multivariate analyses showed that HCV infection (95% CI hazard ratio (HR): 1.54–1.765), female sex (1.57–1.789), age ≥ 49 years (1.091–1.257), Charlson comorbidity index ≥ 1 (1.075–1.245), liver cirrhosis (0.655–0.916), chronic obstruction pulmonary disease (1.130–1.360), end-stage renal disease (0.553–0.98), diabetes mellitus (0.834–0.991) and dyslipidemia (1.102–1.304) were associated with incident rheumatic diseases. Among the 3 cohorts, the untreated cohort had the highest cumulative incidence of overall mortality, while the treated and un-infected cohorts had indifferent mortalities. Conclusions: HCV infection, baseline demographics and comorbidities were associated with rheumatic diseases. Although HCV-associated risk of rheumatic diseases might not be reversed by interferon-based therapy, which reduced the overall mortality in HCV-infected patients.

scholarly journals Interferon-based therapy did not attenuate hepatitis C-associated rheumatic disorder risk: A nationwide population-based cohort study

2020 ◽  
Author(s):  
Jur-Shan Cheng ◽  
Jing-Hong Hu ◽  
Yu-sheng Lin ◽  
Ming-Shyan Lin ◽  
Hsin-Ping Ku ◽  
...  
Keyword(s):  
Cohort Study ◽  
Hepatitis C ◽  
Cumulative Incidence ◽  
Population Based ◽  
Hcv Infection ◽  
Research Database ◽  
Hcv Therapy ◽  
Stage Renal Disease ◽  
End Stage ◽  
Overall Mortality

Abstract BackgroundWhether hepatitis C virus (HCV) infection increases the risk of rheumatic disorders and whether the associated risk is reversed by anti-HCV therapy remain elusive. We aimed to investigate these topics. MethodsA nationwide population-based cohort study of Taiwan National Health Insurance Research Database (TNHIRD) was conducted. ResultsOf 19,298,735 subjects, 3 TNHIRD cohorts (1:4:4, propensity score-matched), including HCV-treated (6,919 HCV-infected subjects with interferon and ribavirin therapy > 6 months), HCV-untreated (n=27,676) and HCV-uninfected (n=27,676) cohorts, were enrolled and had been followed since 2003 to 2015. HCV-uninfected cohort had the lowest 11-year cumulative incidence of rheumatic disorders [9.535%; 95% confidence interval (CI): 8.416~10.734%] (p<0.0001), while HCV-treated (14.95%; 12.417~17.704%) and HCV-untreated (14.999%; 13.585~16.479%) cohorts showed no difference in the cumulative incidences of rheumatic disorders (p=0.8316). Multivariate analyses showed, HCV infection [hazard ratio (HR):1.671; 95% CI HR: 1.562-1.788, p<0.0001], female sex (1.67; 1.565-1.782, p<0.0001), age> 49 years (1.168; 1.088-1.253, p<0.0001), Charlson comorbidity index > 1 (1.156; 1.074-1.245, p=0.0001), liver cirrhosis (0.795; 0.674-0.937, p=0.0062), chronic obstruction pulmonary disease (1.244; 1.134-1.364, p<0.0001), end stage renal disease (0.732; 0.549-0.974, p=0.0326), diabetes mellitus (0.91; 0.835-0.993, p=0.0333) and dyslipidemia (1.205; 1.108-1.31, p<0.0001) were associated with incident rheumatic disorders. Among the 3 cohorts, the untreated cohort had the highest cumulative incidence of overall mortality (29.163%; 27.218-31.133%, p<0.0001), while the treated (13.662%; 11.389-16.140%) and un-infected (9.99%; 8.548-11.559%) cohorts had indifferent mortalities (p=0.1796). ConclusionsHCV infection, baseline demographics and comorbidities were associated with the risks of rheumatic disorders. Although HCV-associated risk of rheumatic disorders might not be reversed by interferon-based anti-HCV therapy, which reduced the overall mortality in HCV-infected patients.

scholarly journals Association between Hepatitis C Virus Infection and Esophageal Cancer: An Asian Nationwide Population-Based Cohort Study

2021 ◽  
Vol 10 (11) ◽  
pp. 2395
Author(s):  
Yin-Yi Chu ◽  
Jur-Shan Cheng ◽  
Ting-Shu Wu ◽  
Chun-Wei Chen ◽  
Ming-Yu Chang ◽  
...  
Keyword(s):  
Esophageal Cancer ◽  
Cohort Study ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Cumulative Incidence ◽  
Population Based ◽  
Hcv Infection ◽  
Cancer Development ◽  
Male Sex ◽  
Overall Mortality

Background: Hepatitis C virus (HCV) infection causes many extrahepatic cancers, and whether HCV infection is associated with esophageal cancer development remains inconclusive. Methods: A nationwide population-based cohort study of the Taiwan National Health Insurance Research Database (TNHIRD) was conducted. Results: From 2003 to 2012, of 11,895,993 patients, three 1:1:1 propensity score-matched cohorts, including HCV-treated (interferon-based therapy ≥ 6 months, n = 9047), HCV-untreated (n = 9047), and HCV-uninfected cohorts (n = 9047), were enrolled. The HCV-untreated cohort had the highest 9-year cumulative incidence of esophageal cancer among the three cohorts (0.174%; 95% confidence interval (CI): 0.068–0.395) (p = 0.0292). However, no difference in cumulative incidences was identified between the HCV-treated (0.019%; 0.002–0.109%) and HCV-uninfected cohorts (0.035%; 0.007–0.133%) (p = 0.5964). The multivariate analysis showed that HCV positivity (hazard ratio (HR): 5.1, 95% CI HR: 1.39–18.51) and male sex (HR: 8.897; 95% CI HR: 1.194–66.323) were independently associated with the development of esophageal cancer. Of the three cohorts, the HCV-untreated cohort had the highest cumulative incidence of overall mortality at 9 years (21.459%, 95% CI: 18.599–24.460) (p < 0.0001), and the HCV-treated (12.422%, 95% CI: 8.653–16.905%) and HCV-uninfected cohorts (5.545%, 95% CI: 4.225–7.108%) yielded indifferent cumulative mortality incidences (p = 0.1234). Conclusion: Although HCV positivity and male sex were independent factors associated with esophageal cancer development, whether HCV infection is the true culprit or a bystander for developing esophageal cancer remains to be further investigated. Interferon-based anti-HCV therapy might attenuate esophageal risk and decrease overall mortality in HCV-infected patients.

scholarly journals Mental Disorders and Interferon Nontreatment in Hepatitis C Virus Infection-a Population Based Cohort Study

2020 ◽  
Vol 17 (3) ◽  
pp. 268-274 ◽  
Author(s):  
Wei-Che Chiu ◽  
Mong-Liang Lu ◽  
Cheng-Chen Chang
Keyword(s):  
Cohort Study ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Mental Disorders ◽  
Conditional Logistic Regression ◽  
Population Based ◽  
Hcv Infection ◽  
Chronic Obstructive ◽  
Research Database ◽  
Ifn Therapy

Objective This study investigates the association between mental disorders and interferon nontreatment in patients with chronic hepatitis C virus (HCV) infection in a large national sample.Methods Using the National Health Insurance Research Database of Taiwan, we conducted a nationwide population-based study. Each case was matched to five controls by age, sex, urbanization, and income. Conditional logistic regression was used to assess odds of HCV nontreatment in different mental disorders.Results From 1999 to 2013, we identified 92,970 subjects with HCV infection and 15,495 HCV cases (16.7%) had received IFN therapy. Other than chronic obstructive pulmonary disease, the medical diseases and mental disorders were significantly different between IFN and non-IFN treated HCV patients. After adjusting for medical diseases, depressive disorder and anxiety disorder was positively associated with receiving IFN therapy. Patients with schizophrenia, bipolar disorders and alcohol use disorders were significantly less likely to receive interferon. Antidepressant exposure (cumulative daily exposure or cumulative daily dose) was associated with lower odds of IFN treatment.Conclusion Our nationwide cohort study demonstrated that INF nontreatment rate was lower in certain mental disorders. Antidepressant exposure might lower the chance of receiving IFN treatment. Our results may help to identify and to overcome the obstacles for HCV treatment and further apply to DAAs regimen.

scholarly journals Postoperative Renal Outcomes of Patients Receiving Percutaneous Nephrolithotomy versus Pyelolithotomy: A Population-Based Cohort Study

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Fang-Ting Chen ◽  
Fu-Chao Liu ◽  
Chih-Wen Cheng ◽  
Jr-Rung Lin ◽  
Huang-Ping Yu
Keyword(s):  
Cohort Study ◽  
Hospital Stay ◽  
Percutaneous Nephrolithotomy ◽  
Perioperative Complications ◽  
Population Based ◽  
Research Database ◽  
Renal Outcomes ◽  
Artery Disease ◽  
Stage Renal Disease ◽  
End Stage

The aim of this population-based cohort study was to explore postoperative renal outcomes of patients receiving pyelolithotomy versus percutaneous nephrolithotomy (PCNL). Data were retrieved from the Taiwan National Health Insurance Research Database. During the period from Jan 1, 1998, to Dec 31, 2012, there were 2549 and 21654 patients who underwent pyelolithotomy and PCNL, respectively. The postoperative incidence of new diagnosed end stage renal disease (ESRD) was statistically analyzed and compared between the pyelolithotomy and PCNL groups. The perioperative complications of two groups were also analyzed. In comparison to pyelolithotomy, PCNL achieved lower new diagnosed ESRD (1.38% versus 2.28%, p=0.0004). Patients receiving PCNL had significantly higher rates of preoperative hypertension, diabetes mellitus, pulmonary disease, cerebrovascular disease, and coronary artery disease. The hospital stay was shorter in PCNL groups compared with pyelolithotomy groups (8.31 days versus 12.59 days, p=0.0006). In conclusion, PCNL contributed to lower rates of new diagnosed ESRD and hospital stay when compared to pyelolithotomy.

scholarly journals A Treatment-as-Prevention Trial to Eliminate Hepatitis C Among Men Who Have Sex With Men Living With Human Immunodeficiency Virus (HIV) in the Swiss HIV Cohort Study

2020 ◽  
Author(s):  
Dominique L Braun ◽  
Benjamin Hampel ◽  
Bruno Ledergerber ◽  
Christina Grube ◽  
Huyen Nguyen ◽  
...  
Keyword(s):  
Human Immunodeficiency Virus ◽  
Cohort Study ◽  
Hepatitis C ◽  
Population Based ◽  
Hcv Infection ◽  
World Health ◽  
Treatment As Prevention ◽  
Hcv Rna ◽  
Immunodeficiency Virus ◽  
Sex With Men

Abstract Background In 2016, the World Health Organization (WHO) introduced global targets for the elimination of hepatitis C virus (HCV) by 2030. We conducted a nationwide HCV micro-elimination program among men who have sex with men (MSM) living with human immunodeficiency virus (HIV) from the Swiss HIV Cohort Study (SHCS) to test whether the WHO goals are achievable in this population. Methods During phase A (10/2015–06/2016), we performed a population-based and systematic screening for HCV-RNA among MSM from the SHCS. During phase B (06/2016–02/2017) we offered treatment with HCV direct-acting antiviral (DAA) agents to MSM identified with a replicating HCV infection. During phase C (03/2017–11/2017), we offered rescreening to all MSM for HCV-RNA and initiated DAA treatment in MSM with replicating infections. Results We screened 3715/4640 (80%) MSM and identified 177 with replicating HCV infections (4.8%); 150 (85%) of whom started DAA treatment and 149 (99.3%) were cured. We rescreened 2930/3538 (83%) MSM with a prior negative HCV-RNA and identified 13 (0.4%) with a new HCV infection. At the end of the micro-elimination program, 176/190 MSM (93%) were cured, and the HCV incidence rate declined from .53 per 100 patient-years (95% CI, .35–.83) prior to the intervention to .12 (95% CI, .03–.49) by the end of 2019. Conclusions A systematic, population-based HCV micro-elimination program among MSM living with HIV was feasible and resulted in a strong decline in HCV incidence and prevalence. Our study can serve as a model for other countries aiming to achieve the WHO HCV elimination targets. Clinical Trials Registration NCT02785666.

scholarly journals Comparison of Risk for End-Stage Renal Disease Between Physicians and the General Population: A Nationwide Population-Based Cohort Study

2019 ◽  
Vol 16 (12) ◽  
pp. 2211
Author(s):  
Chin-Kai Yen ◽  
Tian-Hoe Tan ◽  
I-Jung Feng ◽  
Chung-Han Ho ◽  
Chien-Chin Hsu ◽  
...  
Keyword(s):  
Cohort Study ◽  
Peritoneal Dialysis ◽  
Renal Transplantation ◽  
General Population ◽  
Renal Disease ◽  
End Stage Renal Disease ◽  
Population Based ◽  
Easy Access ◽  
Stage Renal Disease ◽  
End Stage

Physicians experience high stress and have much responsibility during a night shift, which contributes to increased sympathetic activity, the risk factor for renal disease. The risk for end-stage renal disease (ESRD) in physicians is still unclear. Therefore, we conducted a nationwide population-based cohort study to clarify this issue. Using Taiwan’s National Health Insurance Research Database, we identified 30,268 physicians and 60,536 individuals from the general population matched with a ratio of 1:2 by age and sex. All participants who had ESRD before 2006 and residents were excluded. ESRD risk between physicians and the general population and among physician subgroups was compared by following up their medical histories until 2012. We also compared the treatments between both cohorts with ESRD. Physicians had a lower ESRD risk than the general population (adjusted odds ratio (AOR): 0.5; 95% confidence interval (CI): 0.4–0.7), particularly in the middle-age subgroup (35–64 years) (AOR: 0.4; 95% CI: 0.3–0.7); however, there was no difference in the older age subgroup (≥65 years) (AOR: 1.0; 95% CI: 0.6–1.7). More physicians received peritoneal dialysis (63.0% vs. 11.1%) and renal transplantation (5.6% vs. 1.7%) than the general population after being diagnosed with ESRD. Compared with the general population, physicians had a lower ESRD risk and higher treatment selection for peritoneal dialysis and renal transplantation after being diagnosed with ESRD. Better medical knowledge, a greater awareness of diseases and their risk factors, more rigorous implementation of preventive measures, and easy access to medical care may play a role in this aspect. Further studies are warranted for elucidating the associated mechanisms.

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