Journal of Viral Hepatitis最新文献

{"title":"Multiple Low-Level Viraemia Suggest Hindered Liver Fibrosis Regression in Chronic Hepatitis B Patients During Antiviral Therapy","authors":"Zhengzhao Lu,&nbsp;Ya-Meng Sun,&nbsp;Shuyan Chen,&nbsp;Tongtong Meng,&nbsp;Bingqiong Wang,&nbsp;Jialing Zhou,&nbsp;Xiaoning Wu,&nbsp;Xinyan Zhao,&nbsp;Xiaojuan Ou,&nbsp;Yuan-Yuan Kong,&nbsp;Jidong Jia,&nbsp;Xinyu Zhao,&nbsp;Hong You","doi":"10.1111/jvh.14012","DOIUrl":"10.1111/jvh.14012","url":null,"abstract":"<div>\u0000 \u0000 <p>Low-level viraemia (LLV) occurs in chronic hepatitis B (CHB) patients despite antiviral treatment, which may cause failed histological regression. Our study aimed to investigate the impact of different LLV types on fibrosis regression. The prospective study enrolled CHB patients with paired liver biopsies before and after 260 weeks of entecavir treatment. Fibrosis regression was defined by the Ishak score or P-I-R system. Patients were grouped as the SVR (HBV DNA &lt; 20 IU/mL persistently) or LLV (HBV DNA between 20 and 2000 IU/mL), which were further grouped as very low-level viraemia (VLLV, HBV DNA &lt; 50 IU/mL), occasionally LLV (OLLV, HBV DNA ≥ 50 IU/mL only once) and multiple LLV (MLLV, HBV DNA ≥ 50 IU/mL more than once). Logistic regression models were used to calculate the adjusted odds ratios (aORs) and 95% confidence intervals (CIs). The analysis included 111 CHB patients. In the SVR group (<i>n</i> = 54), 39 (72.2%) patients had fibrosis regression, which was higher than the LLV (56.1%, <i>p</i> = 0.080). The fibrosis regression rates for VLLV (30 patients), OLLV (17 patients) and MLLV (10 patients) were 70.0%, 52.9% and 30.0%, respectively. Compared with SVR, VLLV (aOR = 0.78; 95% CI: 0.28–2.21; <i>p =</i> 0.644) was not associated with fibrosis regression, but patients with non-VLLV (aOR = 0.27; 95% CI: 0.09–0.85; <i>p =</i> 0.025), especially with MLLV (aOR = 0.19; 95% CI: 0.04–0.97; <i>p =</i> 0.046) is significantly associated with hindered fibrosis regression. Our study suggests that patients with detectable serum HBV DNA levels higher than 50 IU/mL need to be monitored carefully, especially in those with more than once.</p>\u0000 <p><b>Trial Registration:</b> ClinicalTrials.gov identifiers NCT01938781 and NCT01938820</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"31 12","pages":"898-902"},"PeriodicalIF":2.5,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142381201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply: Regarding the Predictive Role of CXCL16 in Liver Inflammation in Chronic Hepatitis B Patients","authors":"Yawen Wan,&nbsp;Shengxia Yin,&nbsp;Chao Wu","doi":"10.1111/jvh.13996","DOIUrl":"10.1111/jvh.13996","url":null,"abstract":"&lt;p&gt;We have received your letter and thank you very much for your hard work. We are very pleased that the reader has carefully read the article, and we also greatly appreciate the valuable feedback provided by Zhang. I provide the following response to Zhang's question.&lt;/p&gt;&lt;p&gt;Firstly, we conducted an univariate logistic regression analysis to preliminarily identify the associated factors with severe liver inflammation. Considering the close relationship between these parameters and liver inflammation in univariate analysis, factors with &lt;i&gt;p&lt;/i&gt; &lt; 0.05 were adjusted for further multivariate analysis. However, we totally agree with Zhang's comments that a larger sample size is more appropriate for this analysis, but we encountered great difficulties in collecting serum samples. Due to the fact that liver puncture is an invasive examination and our inclusion criteria are strict, therefore it is difficult to obtain samples that meet the standards. I hope to gain the reader's understanding regarding this matter.&lt;/p&gt;&lt;p&gt;Secondly, how I adjust which factors to enter into multivariate logistic regression analysis and choose which factors to build the model is a key question. I would like to discuss my viewpoint and hope to receive Zhang's support. (1) This factor must have statistical significance in univariate logistic regression analysis. (2) This factor is of great significance in practical clinical work, such as alanine aminotransferase (ALT), platelet (PLT) and albumin (ALB), which can evaluate the progression of liver diseases from different aspects. (3) We have considered the correlation between factors. If there is a strong correlation between factors, it may affect the stability of the model. (4) We have done a lot of statistical work, arranging and combining these factors separately for statistical analysis. We compared the final results and came to a conclusion. We found that CXCL16, ALT, PLT and ALB were statistically significant in the multivariate logistic regression analysis, and the predictive model was the most representative. Due to the large and complex statistical information, we did not present all statistical results in the article. (5) Our mouse experiments confirmed a strong correlation between CXCL16 and liver inflammation. I apologize for the confusion caused to Zhang and other readers.&lt;/p&gt;&lt;p&gt;Thirdly, Zhang raised the issue of the impact of antiviral drugs on patients with chronic hepatitis B, which is indeed worth considering. However, we have excluded patients who underwent antiviral therapy at enrollment, as clearly indicated in exclusion criteria.&lt;/p&gt;&lt;p&gt;In future research, we will gradually expand the sample size and consider more factors that affect the outcomes of patients with chronic hepatitis B. We look forward to collaborating with Zhang and other readers. We sincerely thank you again for your valuable letter.&lt;/p&gt;&lt;p&gt;Sincerely yours,&lt;/p&gt;&lt;p&gt;Chao Wu, MD, PhD.&lt;/p&gt;&lt;p&gt;All authors reviewed this manuscript and agreed to subm","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"31 12","pages":"905-906"},"PeriodicalIF":2.5,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Disparities in the Detection, Diagnosing and Treatment of Hepatitis B Among Females","authors":"Osman Cagin Buldukoglu,&nbsp;Serkan Ocal,&nbsp;Ayhan Hilmi Cekin","doi":"10.1111/jvh.14013","DOIUrl":"10.1111/jvh.14013","url":null,"abstract":"","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"31 12","pages":"903-904"},"PeriodicalIF":2.5,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of and Risk Factors for Liver Enzyme Elevation After Hepatitis C Virologic Cure","authors":"Helen L. Zhang,&nbsp;Hayley Nemeth,&nbsp;E. Wilbur Woodhouse,&nbsp;Clemontina A. Davenport,&nbsp;Cliburn Chan,&nbsp;Nwora Lance Okeke,&nbsp;Susanna Naggie","doi":"10.1111/jvh.14009","DOIUrl":"10.1111/jvh.14009","url":null,"abstract":"<div>\u0000 \u0000 <p>A subset of patients with chronic hepatitis C virus (HCV) infection demonstrate liver enzyme elevation (LEE) after achieving sustained virologic response (SVR). Risk factors for LEE are not well characterised. We conducted a single-centre retrospective cohort study of adults with HCV infection in the Duke University Health System who received direct-acting antiviral therapy and achieved SVR. We performed multivariable logistic regression to assess the relationship between potential risk factors and LEE. We used generalised linear mixed-effects models to explore longitudinal relationships between HIV and LEE. Among 1356 patients, 556 (41.0%) had LEE after achieving SVR. Higher pretreatment alanine aminotransferase (ALT) (adjusted odds ratio [aOR] 1.08 per 10 IU/L increase; 95% confidence interval [CI] 1.05–1.11) and pretreatment cirrhosis (aOR 2.26, 95% CI 1.60–3.21) were associated with higher odds of LEE; male sex was associated with lower odds of LEE (aOR 0.28, 95% CI 0.21–0.38). There was insufficient evidence of an association between HIV and LEE (aOR 0.83, 95% CI 0.47–1.44). Pretreatment ALT, cirrhosis and female sex predicted LEE in this cohort of patients with HCV infection who achieved SVR. These findings can help to identify patients at greatest risk of post-SVR liver injury.</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"31 12","pages":"866-872"},"PeriodicalIF":2.5,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142365692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"United States Provider Experiences With Telemedicine for Hepatitis C Treatment: A Nationwide Survey","authors":"Pruthvi Patel,&nbsp;Martin T. Wells,&nbsp;Elaine Wethington,&nbsp;Martin Shapiro,&nbsp;Yasir Parvez,&nbsp;Shashi N. Kapadia,&nbsp;Andrew H. Talal","doi":"10.1111/jvh.14010","DOIUrl":"10.1111/jvh.14010","url":null,"abstract":"<div>\u0000 \u0000 <p>Hepatitis C virus (HCV) elimination requires treatment access expansion, especially for underserved populations. Telehealth has the potential to improve HCV treatment access, although data are limited on its incorporation into standard clinical practice. We conducted a cross-sectional, email survey of 598 US HCV treatment providers who had valid email addresses and (1) were located in urban areas and had written ≥ 20 prescriptions for HCV treatment to US Medicare beneficiaries in 2019–2020 or (2) were located in non-urban areas and wrote any HCV prescriptions in 2019–2020. Through email, we notified providers of a self-administered electronic 28-item survey of clinical strategies and attitudes about telemedicine for HCV. We received 86 responses (14% response rate), of which 75 used telemedicine for HCV in 2022. Of those 75, 24% were gastroenterologists/hepatologists, 23% general medicine, 17% infectious diseases and 32% non-physicians. Most (82%) referred patients to commercial laboratories, and 85% had medications delivered directly to patients. Overwhelmingly, respondents (92%) felt that telehealth increases healthcare access, and 76% reported that it promotes or is neutral for treatment completion. Factors believed to be ‘extremely’ or ‘very’ important for telehealth use included patient access to technology (86%); patients' internet access (74%); laboratory access (76%); reimbursement for video visits (74%) and audio-only visits (66%). Non-physician licensing and liability statutes were rated ‘extremely’ or ‘very’ important by 43% and 44%, respectively. Providers felt that telehealth increases HCV treatment access. Major limitations were technological requirements, reimbursement, and access to ancillary services. These findings support the importance of digital equity and literacy to achieve HCV elimination goals.</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"31 12","pages":"873-879"},"PeriodicalIF":2.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142349280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunogenicity of a Birth Dose of Hepatitis B Vaccine in Kinshasa, Democratic Republic of Congo: A Randomised, Controlled Trial","authors":"Samantha E. Tulenko,&nbsp;Patrick Ngimbi,&nbsp;Kashamuka Mwandagalirwa,&nbsp;Martine Tabala,&nbsp;Jolie Matondo,&nbsp;Sarah Ntambua,&nbsp;Nana Mbonze,&nbsp;Charles Mbendi,&nbsp;Christophe Luhata,&nbsp;Ravi Jhaveri,&nbsp;Jessie K. Edwards,&nbsp;Sylvia Becker-Dreps,&nbsp;Ann M. Moormann,&nbsp;Didine Kaba,&nbsp;Marcel Yotebieng,&nbsp;Jonathan B. Parr,&nbsp;Emily W. Gower,&nbsp;Peyton Thompson","doi":"10.1111/jvh.14003","DOIUrl":"10.1111/jvh.14003","url":null,"abstract":"<div>\u0000 \u0000 <p>The WHO recommends hepatitis B birth-dose vaccination (HepB-BD), but it is not routinely given in most sub-Saharan African countries. We aimed to assess the immunogenicity of HepB-BD in addition to the existing hepatitis B vaccine (HepB3) schedule in Kinshasa, Democratic Republic of Congo among HBV-unexposed and HBV-exposed infants. Using an open-label, randomised, controlled design, HBV-unexposed infants were randomised (1:1) to receive the standard HepB3 vaccine series (group U3), or to receive HepB-BD in addition to HepB3 (group U4). A supplemental cohort of HBV-exposed infants (group E4) received HepB-BD and HepB3. We compared the proportion of infants with protective antibodies against HBV (HBV surface antibody ≥ 10 mIU/mL) between groups U3 and U4 and groups U4 and E4 at 12 months of age. Between August 20 and October 9, 2019, we enrolled 281 mother/infant dyads; 88 (31.3%) returned at 12 months. Most infants had protective antibodies against HBV at 12 months: 92.9% (75.7%–98.2%) in group U3, 85.7% (67.5%–94.5%) in group U4 and 96.9% (95% CI: 81.2%–99.6%) in group E4. Trends held in estimates adjusted for loss-to-follow-up (LTFU) and baseline imbalance across groups. In this first randomised trial assessing the addition of HepB-BD to the hepatitis B vaccine schedule in SSA, we found that HBV-unexposed infants who received the 3-dose and 4-dose vaccine series had similar immunogenicity against HBV at 12 months. A high proportion of infants, and notably HBV-exposed infants, had protective antibodies. Though extrapolation of findings may be limited by LTFU, this study adds real-world evidence regarding HepB-BD implementation in sub-Saharan Africa.</p>\u0000 <p><b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT03897946</p>\u0000 </div>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"31 12","pages":"795-807"},"PeriodicalIF":2.5,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142308027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perspectives of People Living With Chronic Hepatitis D: Impact of Disease and Unmet Needs Along the Care Cascade","authors":"Beatrice Zovich,&nbsp;Poonum Patel,&nbsp;Thomas Tu,&nbsp;Su Wang,&nbsp;Darlene Jubah,&nbsp;Jamie Zagorski","doi":"10.1111/jvh.14005","DOIUrl":"10.1111/jvh.14005","url":null,"abstract":"<p>Hepatitis D virus leads to a severe form of viral hepatitis and affects nearly 5% of people living with chronic hepatitis B. Chronic infection with hepatitis D virus leads to more rapid progression to cirrhosis, hepatocellular carcinoma and ultimately liver disease-related death compared with hepatitis B monoinfection. Health outcomes and treatment adherence can be affected by patient perception of, engagement in, and satisfaction with care. Our objective was to better understand the experiences of people with chronic hepatitis D, identify their preferred sources of information, and recognise unmet needs from their perspectives. Sixty-seven participants from the United States and the European Union took part in monthly, online, self-guided surveys for a minimum of 3 months with an optional extension. Participants reported feeling anxious and scared at the time of diagnosis but over time came to accept living with chronic hepatitis D. They voiced a need for access to information from trusted sources, fewer barriers to care, and shorter wait times for provider visits and test results after diagnosis. Participants experienced both physical and psychological strain living with chronic hepatitis D. Although most participants reported the ability to continue their regular activities and employment, some stated such activities were done at a reduced pace. Self-reported overall health appeared to be closely linked with emotional support. Understanding patient perspectives, with concurrent clinician perspectives, is crucial when working toward developing solutions to fulfil unmet patient needs associated with chronic hepatitis D management and advancing health equity.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"31 12","pages":"820-829"},"PeriodicalIF":2.5,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvh.14005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142263788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower Serum Albumin Level: A Prospective Risk Predictor of Hepatocellular Carcinoma in Patients With Chronic Hepatitis B Virus Infection","authors":"Yusheng Song,&nbsp;Haiyan Chen,&nbsp;Jinlong Li,&nbsp;Feifei Zhong,&nbsp;Yunbing Liu,&nbsp;Hui Liu,&nbsp;Shaogui Wan","doi":"10.1111/jvh.14008","DOIUrl":"10.1111/jvh.14008","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 &lt;p&gt;Hepatocellular carcinoma (HCC) is one of the most common malignant tumours in China, at high annual incidence and mortality. Chronic hepatitis B virus infection (CHB) is considered as a leading cause to bring about HCC in China. Serum albumin (ALB) level has been adopted to verify its risk with HCC development as a combination variable with other factors. However, the predictive value of a single ALB level on HBV-related HCC risk remained unclear. The aim of this study was to evaluate the prediction ability of serum ALB concentration on the risk of HBV-related HCC development. A prospectively enrolled clinical cohort compromising 2932 cases of CHB patients with at least 1-year exclusion window was selected to explore the predictive role of serum ALB level on incident HCC risk. Baseline clinical data including host characters and laboratory test were collected at the initial period of hospitalisation. The hazard ratio of ALB level associated with HCC development was assessed by Cox proportional hazards regression model using univariate and multivariate analyses. We evaluated the discrimination accuracy of ALB level in predicting HCC development by receiver operating characteristic (ROC) curves. Dose-dependent and time-dependent effects of ALB level on HCC risk prediction were demonstrated, respectively, using a restricted cubic spline and a Fine and Grey competing risk model. Referred to patients with higher ALB level, those with lower ALB level exhibited significantly increased risk of HCC development after adjustment for host variables (dichotomised analyses: hazard ratio = 3.12, 95% confidence interval 1.63–5.97, &lt;i&gt;p&lt;/i&gt; = 8.23 × 10&lt;sup&gt;−4&lt;/sup&gt;, &lt;i&gt;p&lt;/i&gt;&lt;sub&gt;log-rank&lt;/sub&gt; = 5.97 × 10&lt;sup&gt;−4&lt;/sup&gt;; tertile analyses: hazard ratio = 2.07, 95% confidence interval 1.63–2.64, &lt;i&gt;p&lt;/i&gt; = 3.77 × 10&lt;sup&gt;−9&lt;/sup&gt;, &lt;i&gt;p&lt;/i&gt;&lt;sub&gt;log-rank&lt;/sub&gt; &lt; 2.00 × 10&lt;sup&gt;−16&lt;/sup&gt;; quartile analyses: hazard ratio = 2.10, 95% confidence interval 1.56–2.84, &lt;i&gt;p&lt;/i&gt; = 9.87 × 10&lt;sup&gt;−7&lt;/sup&gt;, &lt;i&gt;p&lt;/i&gt;&lt;sub&gt;log-rank&lt;/sub&gt; &lt; 2.00 × 10&lt;sup&gt;−16&lt;/sup&gt;). There was a statistically increasing trend on HCC risk which was found following by the decrease of ALB level (&lt;i&gt;p&lt;/i&gt;&lt;sub&gt;trend&lt;/sub&gt; &lt; 0.0001). Similar findings were present by the Kaplan–Meier analysis, cumulative incidences of HCC development were significantly higher in patients with lower ALB levels, with the &lt;i&gt;p&lt;/i&gt; value obtained from log-rank test were all &lt; 0.0001. The result of dose-dependent effect showed hazard ratio (HR) value of HCC risk was gradually decreasing as the increasing of ALB level, with non-linear correlation being statistically significant (Wald &lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt; = 20.59, &lt;i&gt;p&lt;/i&gt; = 0.000). HR value in lower ALB level remained persistently prominent by fluctuating around 2.73 in the whole follow-up time by adjusting for host variables. Sub-cohort analysis by ROC revealed that the discrimination ability of the ALB model was performed better than Child-Pu","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"31 12","pages":"857-865"},"PeriodicalIF":2.5,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dynamic Changes in ELF Score Predict Hepatocellular Carcinoma in Chronic Hepatitis B Patients Receiving Antiviral Treatment","authors":"Lilian Yan Liang,&nbsp;Terry Cheuk-Fung Yip,&nbsp;Jimmy Che-To Lai,&nbsp;Amy Shuk-Man Lam,&nbsp;Yee-Kit Tse,&nbsp;Vicki Wing-Ki Hui,&nbsp;Henry Lik-Yuen Chan,&nbsp;Vincent Wai-Sun Wong,&nbsp;Grace Lai-Hung Wong","doi":"10.1111/jvh.14004","DOIUrl":"10.1111/jvh.14004","url":null,"abstract":"<p>Enhanced liver fibrosis (ELF) score is a noninvasive assessment for liver fibrosis. We aimed to evaluate the performance of changes in ELF score 3 years apart in combination with liver stiffness measurement (LSM)-hepatocellular carcinoma (HCC) score to predict HCC in chronic hepatitis B (CHB) patients. This is a prospective cohort study. Patients who underwent transient elastography (TE) examinations and at intermediate or high risk of HCC defined by LSM-HCC score were invited to repeat the examination about 3 years later. Their serum samples at these two time points were retrieved to assess the ELF score changes. The primary endpoint was HCC. There were 445 CHB patients (males: 73.9%; mean age: 51.6 ± 10.3 years) who received two TE examinations and ELF scores. Among them, 252 (56.6%) and 193 (43.4%) patients were at intermediate and high HCC risk at first assessment defined by LSM-HCC score, respectively. Kaplan–Meier analysis showed that the changes in ELF score could stratify the HCC risk in both intermediate- and high-risk patients defined by LSM-HCC score (<i>p</i> &lt; 0.001 for intermediate-risk group; <i>p</i> = 0.011 for high-risk group). Patients remained having mild or moderate fibrosis at both assessments had the lowest risk of HCC (4.0%), followed by patients with fibrosis regressed (11.3%; <i>p</i> = 0.014) during a mean follow-up of 163 months. Patients remained having or progressed to severe fibrosis were at highest risk of HCC (&gt; 20%). Consistent findings were demonstrated in patients at both intermediate and high risk of HCC defined by LSM-HCC score. Dynamic changes in ELF score provided additional value to LSM-HCC score for stratifying HCC risk in CHB patients.</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"31 12","pages":"808-819"},"PeriodicalIF":2.5,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvh.14004","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Socioeconomic Deprivation Weighs Heavily on Liver Fibrosis and Mortality After Hepatitis C Cure (ANRS CO22 Hepather)","authors":"Tangui Barré,&nbsp;Lucia Parlati,&nbsp;Marc Bourlière,&nbsp;Clémence Ramier,&nbsp;Fabienne Marcellin,&nbsp;Camelia Protopopescu,&nbsp;Vincent Di Beo,&nbsp;Cécile Moins,&nbsp;Celine Dorival,&nbsp;Jérôme Nicol,&nbsp;Jessica Zucman-Rossi,&nbsp;Philippe Mathurin,&nbsp;Dominique Larrey,&nbsp;Jérôme Boursier,&nbsp;Fabrice Carrat,&nbsp;Patrizia Carrieri,&nbsp;the ANRS/AFEF Hepather Study group","doi":"10.1111/jvh.14006","DOIUrl":"10.1111/jvh.14006","url":null,"abstract":"<p>Although Hepatitis C virus (HCV) infection can be cured with direct-acting antivirals (DAA), some cured patients face a serious risk of advanced liver damage and early mortality. In order to avoid these two negative health outcomes, it is important to identify and assess related risk factors. Little is currently known about socioeconomic and behavioural factors in this context. Using data from the ANRS CO22 Hepather cohort, we tested for associations between socioeconomic and behavioural factors and (i) advanced liver fibrosis (defined as an FIB-4 &gt; 3.25) assessed longitudinally using a mixed-effects logistic regression model (both the whole population and stratified on advanced liver fibrosis status at the time of HCV cure) and (ii) all-cause mortality (Cox proportional hazards model), during post-HCV cure follow-up. Among 5833 participants cured of HCV, living in poverty was associated with postcure advanced liver fibrosis in participants without this diagnosis at the time of HCV cure (population attributable fraction—PAF—of 8.6%) and with mortality in the whole study population (PAF of 10.6%). The detrimental effects of unhealthy alcohol use and heavy tobacco smoking, as well as the beneficial effect of living with a stable partner were also highlighted. We highlighted the major role of poverty and behavioural factors in advanced liver fibrosis and all-cause mortality in patients cured of HCV. Encouraging linkage to social support services and healthy behaviours after successful DAA treatment could limit morbidity and increase survival in this population.</p><p><b>Clinical Trial Registration</b>: ClinicalTrials.gov: NCT01953458</p>","PeriodicalId":17762,"journal":{"name":"Journal of Viral Hepatitis","volume":"31 12","pages":"830-846"},"PeriodicalIF":2.5,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/jvh.14006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142217806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}