bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tenofovir plus lamivudine as rescue therapy for adefovir‐resistant chronic hepatitis B in hepatitis B e antigen‐positive patients with liver cirrhosis
Authors: Choe Won Hyeok , Kwon So Young , Kim Byung Kook , Ko Soon Young , Yeon Jong Eun , Byun Kwan Soo , Kim Gyun‐Hwan , Lee Chang Hong 
Published: August 2010

AbstractBackground/Aims: There is no consensus on the management of patients with adefovir (ADV)‐resistant hepatitis B virus (HBV) infection. The aim of this study was to investigate whether tenofovir disoproxil fumarate (TDF) combined with lamivudine (LMV) is effective and safe in patients with resistance to or non‐response to ADV.Methods: Six patients with HBV‐related cirrhosis, viral breakthrough during LMV therapy and viral breakthrough or non‐response during ADV therapy were treated daily with TDF plus LMV for at least 6 months. The HBV DNA level, alanine aminotransferase (ALT), the Child–Pugh score and serum creatinine were monitored. Genotypic LMV‐ or ADV‐resistant mutations were measured in stored samples.Results: In five of six patients, ADV‐resistant mutations at rt181 or rt236 were detected during ADV therapy. At 6 months of starting TDF/LMV combination, HBV DNA levels became undetectable (detection limit, 400 copies/ml) in four of six patients. Within 12 months, HBV DNA levels became undetectable in all patients, and ALT levels were normalized in four of six patients. These responses persisted up to the end of the observation period (median duration 16.5 months, range 6–21 months). The Child–Pugh scores improved in two of three patients with hepatic decompensation. No significant changes in serum creatinine were observed.Conclusion: Our data demonstrated that TDF plus LMV safely and markedly suppressed HBV replication in patients with resistance to or non‐response to ADV. This study suggests that this combination may be a promising rescue therapy for these patients, particularly those with liver cirrhosis or pre‐existing LMV resistance.
High prevalence of hepatitis C virus infection among noninjecting drug users: association with sharing the inhalation implements of crack
Authors: Macías Juan , Palacios Rosa B. , Claro Evangelina , Vargas Julio , Vergara Salvador , Mira José A. , Merchante Nicolás , Corzo Juan E. , Pineda Juan A. 
Published: August 2010

AbstractBackground: Most of the prevalent cases of hepatitis C virus (HCV) infection are attributable to intravenous drug using. However, a substantial number of individuals, particularly noninjecting drug users (NIDU), report no identifiable source of HCV exposure. This may be interpreted as inaccurate reporting of past intravenous exposure or as the presence of an unidentified source of HCV infection. Because of this, we evaluated the prevalence of and factors associated with HCV infection among NIDU.Methods: One hundred and eighty‐two individuals who were attended from 2003 to 2004 in a drug addiction facility because of noninjecting drug use were included.Results: HCV infection was detected in 23 (12.6%) participants. Sharing the inhalation tube of crack cocaine [adjusted odds ratio (AOR) 3.6, 95% confidence interval (CI) 1.3–9.8, P=0.01], presence of tattoos (AOR 3.5, 95% CI 1.3–9.1, P=0.02) and age ≥34 years (AOR 3.9, 95% CI 1.3–11.6, P=0.01) 3.9 were independently associated with HCV infection.Conclusion: The prevalence of HCV infection in NIDU is higher than in general population. HCV infection is more likely among older drug users, those with tattoos and crack cocaine users that share the inhalation implements.
Chemopreventive effect of selenium and Chinese medicinal herbs on N‐nitrosobis(2‐oxopropyl)amine‐induced hepatocellular carcinoma in Syrian hamsters
Authors: Lee Chang‐Yin , Hsu Yi‐Chao , Wang Jir‐You , Chen Chien‐Chih , Chiu Jen‐Hwey 
Published: August 2010

AbstractBackground/Aims: Oxidative DNA damage by reactive oxygen species is involved in the process of liver carcinogenesis. To test the hypothesis that a remedy containing Scutellaria baicalensis Georgi (Sb) and Bupleurum scorzonerifolfium Willd (Bs) (Sb/Bs remedy) modulates hepatic neoplastic growth, BOP (N‐nitrosobis(2‐oxopropyl)amine)‐induced liver cancers in hamsters were established.Methods: Parameters such as survival rate, tumour area, tumour foci, 8‐hydroxydeoxyguanosine (8‐OHdG), caspase‐3, transforming growth factor (TGF‐β1) and tumour necrosis factor‐α (TNF‐α) were measured after Sb/Bs remedy treatment during BOP‐induced carcinogenesis.Results: The results showed that the Sb/Bs remedy and its constituents Sb and Bs suppressed the tumour area in BOP‐induced liver tumours. Because selenium (Sel) is toxic at a high dose (10 mg/kg), with a low survival rate (0%), the combination of Sb/Bs remedy and low‐dose Sel (1 mg/kg) was found to decrease the tumour area and the number of tumour foci while increasing serum TNF‐α and TGF‐β1, but not IL‐6 levels. Besides, the Sb/Bs remedy, when combined with low‐dose Sel, not only decreased the expression of 8‐OHdG and increased caspase‐3 expression within the glutathione S‐transferase placental form‐positive tumour foci but also increased tumour apoptosis in BOP‐induced hamsters.Conclusions: We conclude that low‐dose Sel has a chemoprevention effect on BOP‐induced liver tumours and such an effect was more enhanced when combined with Sb/Bs treatment.
Hepatocellular carcinoma incidence trends in Canada: analysis by birth cohort and period of diagnosis
Authors: Pocobelli Gaia , Cook Linda S. , Brant Rollin , Lee Samuel S. 
Published: August 2010

AbstractBackground and Aims: We examined birth cohort and calendar period trends in hepatocellular carcinoma (HCC) incidence in Canada (1976–2000). We also projected HCC incidence rates through 2015.Patients and methods: Data were obtained from the Canadian Cancer Registry on all cases of HCC diagnosed among persons aged 20 years and older in Canada from 1976 to 2000 and was used to describe trends in HCC incidence rates.Results: We found that age‐adjusted HCC incidence rates increased faster in males compared with females, 3.4% per year [95% confidence interval (CI): 3.0–3.8%] vs 2.2% per year (95% CI: 1.5–2.8%). An increasing birth cohort trend accelerated among males around the 1940 birth cohort and decelerated among females around the 1935 birth cohort. For calendar period trends, the increasing HCC risk was relatively constant over time among males whereas there was an acceleration in HCC risk around 1988 among females. Age‐adjusted HCC incidence rates were projected to increase 73% in males and 28% in females from 1996 to 2015.Conclusions: Our results suggest that HCC incidence rates will continue to increase in Canada during the next decade as persons born in more recent birth cohorts, who face a relatively greater risk for HCC, age.
Usefulness of surveillance programmes for early diagnosis of hepatocellular carcinoma in clinical practice
Authors: Pascual Sonia , Irurzun Javier , Zapater Pedro , Such José , Sempere Laura , Carnicer Fernando , Palazón Jose María , De La Iglesia Pedro , Gil Santiago , De España Francisco , Perez‐Mateo Miguel 
Published: August 2010

AbstractBackground/Aims: Surveillance programmes (SPs) for hepatocellular carcinoma (HCC) in patients with cirrhosis intend to diagnose the tumour in its early stages when an effective therapy can be applied. The aims of this study have been to compare the survival of patients with HCC being diagnosed or not in SPs, and to establish a more accurate profile of the best target population.Methods: From January 1996 to June 2005, 290 patients with HCC were included. The relationship between being diagnosed or not in an SP and survival has been analysed in a univariate analysis. Pretreatment variables found to be significant predictors of survival in univariate analysis were included in a multivariate analysis.Results: The mean survival for patients diagnosed in SPs (27 months, 16.6–37.4) was significantly longer than in patients being diagnosed out of these programmes (6 months, 2.6–9.4) (P=0.001). Child–Pugh class A [β 1.4, 95% confidence interval (CI) 1.14–1.78; P=0.0002] and being diagnosed in SPs (β 0.4, 95% CI 0.3–0.6; P=0.0003) became the only independent predictive factors of longer survival.Conclusions: SPs for HCC allow the detection of small tumours and the application of intention‐to‐cure therapies, which improves survival. However, these programmes do not improve prognosis in patients with advanced cirrhosis.
Hepatic venous pressure gradient as a predictor of fibrosis in chronic liver disease because of hepatitis B virus
Authors: Kumar Manoj , Kumar Ashish , Hissar Syed , Jain Pankaj , Rastogi Archana , Kumar Deepak , Sakhuja Puja , Sarin Shiv K. 
Published: August 2010

AbstractBackground: Liver biopsy has been considered to be a gold standard for assessing hepatic fibrosis. Sample variability, interobserver variability and step‐wise evaluation limit its use. Hepatic venous pressure gradient (HVPG) correlates with hepatic fibrosis in chronic liver disease (CLD) because of hepatitis C.Aim: To evaluate the utility of HVPG for assessing hepatic fibrosis in patients with hepatitis B virus (HBV)‐related CLD.Patients and Methods: Sixty‐one patients with HBV‐related CLD who underwent both liver biopsy and hepatic haemodynamic studies were studied.Results: Forty‐nine (80.3%) patients had clinically significant portal hypertension (PHT) (HVPG≥10 mmHg), 39 (63.9%) severe PHT (i.e. HVPG≥12 mmHg), six (9.8%) HVPG≤5 mmHg and another six (9.8%) had preclinical PHT (i.e. HVPG>5 but <10 mmHg). A positive correlation between HVPG and fibrosis score was found (r=0.436, P<0.001). In patients with HVPG<10 or <12 mmHg there was a significant correlation with fibrosis score (r=0.603, P=0.029 and r=0.887, P<0.001 respectively). A positive correlation also existed in patients with HVPG≥10 mmHg and in patients with HVPG≥12 mmHg (r=0.512, P≤0.001 and r=0.543, P<0.001 respectively). Receiver operating characteristic curve of HVPG for the prediction of advanced fibrosis (stage≥3) had an area under curve of 0.906. HVPG value above 13.0 mmHg had a sensitivity of 79% and a specificity of 89% for predicting advanced fibrosis on histology.Conclusions: HVPG correlates well with the degree of histological fibrosis in patients with HBV‐related CLD.
Natural history and prognostic factors of primary biliary cirrhosis in Taiwan: a follow‐up study up to 18 years
Authors: Su Chien‐Wei , Hung Hung‐Hsu , Huo Teh‐Ia , Huang Yi‐Hsiang , Li Chung‐Pin , Lin Han‐Chieh , Lee Pui‐Ching , Lee Shou‐Dong , Wu Jaw‐Ching 
Published: August 2010

AbstractPurpose: The natural history of primary biliary cirrhosis (PBC) has been little studied in Asia. We conducted a Taiwanese cohort study on the natural history of PBC and analysed the prognostic factors.Methods: This study enrolled 96 consecutive PBC patients between 1985 and 2006 to evaluate the baseline characteristics and outcomes.Results: There were 74 females and 22 males. Eighty‐five were positive for antimitochondrial antibodies in sera, and 11 were negative. The clinical manifestations and prognosis were similar between these two groups. In a median follow‐up of 47.5±55.8 months, 27 patients died. Multivariate analysis indicated that the independent prognostic factors were serum albumin (P=0.021), creatinine (P=0.033) and ursodeoxycholic acid treatment (P=0.008). Besides, 42 patients developed adverse outcomes. Albumin (P<0.001), bilirubin (P=0.019) and prothrombin time (PT) (P=0.010) were significant factors. Moreover, a Mayo risk score <5, a Model for End‐Stage Liver Disease (MELD) score <6, a Child–Pugh stage A and early liver histology were associated with favourable outcomes.Conclusion: Serum albumin, bilirubin and PT were independent prognostic factors of adverse outcomes for Taiwanese PBC patients. Besides, the Mayo risk score, the MELD score, the Child–Pugh stage and liver histology were also validated to predict survival.
Disruption of connective tissue growth factor by short hairpin RNA inhibits collagen synthesis and extracellular matrix secretion in hepatic stellate cells
Authors: Yuhua Zhu , Wanhua Ren , Chenggang Sun , Jun Shi , Yanjun Wang , Chunqing Zhang 
Published: August 2010

AbstractPurpose: Connective tissue growth factor (CTGF) plays a key role in the pathogenesis of liver fibrosis. This study aimed at investigating that the disruption of CTGF expression by short hairpin RNA (shRNA) could modulate the production of fibrosis‐related components in hepatic stellate HSC‐T6 cells.Methods: Three plasmids expressing individual shRNA were constructed and transfected into HSC‐T6 cells respectively. The levels of CTGF and transforming growth factor β1 (TGF‐β1) expression were determined by reverse transcriptase‐polymerase chain reaction and Western blot assays. Furthermore, the production of collagens and extracellular matrix (ECM) proteins, including type III procollagen (PC III), type IV collagen (collagen IV), laminin (LN) and hyaluronic acid (HA) in the CTGF‐disrupted cells, were analysed by radioimmunoassay.Results: Following transfection with the pEGFP‐CTGFshRNA1, the expression of CTGF was disrupted in HSC‐T6 cells. While the knockdown of CTGF expression failed to modulate the expression of TGF‐β1, it did significantly reduce the production of PC III, collagen IV, LN and HA by HSC‐T6 cells.Conclusion: Our data suggest that shRNA‐mediated disruption of CTGF expression can attenuate ECM synthesis. Potentially, our findings may aid in the design of a CTGF‐based new therapy for treatment of hepatic fibrosis.
Serum levels of soluble vascular cell adhesion molecule are related to hyperdynamic circulation in patients with liver cirrhosis
Authors: Lo Iacono Oreste , Rincón Diego , Hernando Ana , Ripoll Cristina , Catalina Maria Vega , Salcedo Magdalena , Clemente Gerardo , Gomez Judith , Nuñez Oscar , Matilla Ana , Bañares Rafael 
Published: August 2010

AbstractBackground: In patients with liver cirrhosis, serum levels of soluble vascular cell adhesion molecule‐1 (sVCAM‐1) have been associated with increasing fibrosis and are related to angiogenesis.Aim: To assess the possible correlation between sVCAM‐1 and splanchnic and systemic haemodynamic and clinical staging of cirrhotic patients.Methods: We assessed, using immunoassays, the serum levels of sVCAM‐1, in the peripheral and hepatic vein, in all consecutive patients with liver cirrhosis, who underwent a haemodynamic study as part of its routine clinical work‐up.Results: We studied 86 patients [61 M/25 F; age 51.1 (8.3) years] with alcoholic (31) or viral (HBV:6, HCV:49) cirrhosis, 10 of them with hepatocellular carcinoma (Milan criteria). The mean follow‐up was 391(187) days; 29 patients died or underwent transplantion during follow‐up. A strong correlation in serum levels of sVCAM‐1 was observed between the peripheral and the hepatic vein (r=0.8; P=0.0001). There was no correlation between levels of sVCAM‐1 and hepatic venous pressure gradient. At univariate analysis, sVCAM‐1 was inversely related with mean arterial pressure (r=−0.292; P=0.007), systemic vascular resistance (SVR) (r=−0.37; P=0.005) and serum sodium levels (r=−0.326; P=0.002). In multivariate linear regression only SVR remained as an independent variable associated to sVCAM‐1. A correlation of sVCAM‐1 with Child–Pugh scores, model for end‐stage liver disease (MELD) and the clinical stage proposed in the Baveno IV consensus conference was also observed. Finally, patients who died or underwent transplantion during follow‐up had significantly greater values of sVCAM‐1 at baseline than those who did not [3505(1329) vs. 2488(1208) P=0.001].Conclusion: This study supports a potential role of sVCAM‐1 as a marker of hyperdynamic circulation, closely related to the different stage of liver cirrhosis.
Evaluating the accuracy and increasing the reliable diagnosis rate of blood tests for liver fibrosis in chronic hepatitis C
Authors: Calès Paul , De Ledinghen Victor , Halfon Philippe , Bacq Yannick , Leroy Vincent , Boursier Jérôme , Foucher Juliette , Bourlière Marc , De Muret Anne , Sturm Nathalie , Hunault Gilles , Oberti Frédéric 
Published: August 2010

AbstractBackground: The reliable diagnosis rate of diagnostic tests is provided by their intervals with acceptable accuracy (e.g. ≥90%) where a liver biopsy can be avoided.Aims: To evaluate the overall accuracy and improve the reliable diagnosis rates of blood tests for significant liver fibrosis.Methods: Five blood tests were compared with Metavir fibrosis (F) staging in 1056 patients with chronic hepatitis C.Results: Area under the receiver operating characteristics (F0‐1 vs. F2‐4) were: FibroMeter: 0.853, Fibrotest: 0.811, Fib‐4: 0.799, aspartate aminotransferase to platelet ratio index (APRI): 0.786 and Hepascore: 0.784 (P<10−3 between tests). The reliable diagnosis rates based on two traditional intervals defined by thresholds ≥90% of negative predictive values (NPV) and positive predictive values (PPV), diagnosing F0/1 and F2/3/4, respectively, were: FibroMeter: 43.5%, APRI: 19.6%, Fibrotest: 17.1%, Hepascore: 3.9%, Fib‐4: 1.7% (P<10−3). By dividing the indeterminate interval by the diagnostic cut‐off, two new intervals could be diagnosed reliably: F1/2 and F1/2/3. Accordingly, the reliable diagnosis rate was increased, e.g. FibroMeter: 75.5% (accuracy: 89.5%) with three intervals (F0/1, F1/2, F2/3/4). It was possible to further increase this rate by using the more exportable 90% sensitivity/specificity thresholds, e.g. FibroMeter: 90.2% (accuracy: 86.4%). By using the four intervals, the reliable diagnosis rate was 100% (accuracy: 89.5% with predictive value (PV) and 87.5% with sensitivity/specificity).Conclusion: Reliable diagnosis is a diagnostic index devoted to clinical practice. Its rate can be increased by creating new intervals between diagnostic cut‐off and 90% PVs or sensitivity/specificity thresholds. This increased the overall accuracy from 78.1 to 89.5% and reduced the need for a liver biopsy from 56.5 to 0% with the most accurate test.
Adult liver transplant survey: policies towards eligibility criteria in Canada and the United States 2007
Authors: Kroeker Karen I. , Bain Vincent G. , Shaw‐Stiffel Thomas , Fong Tse‐Ling , Yoshida Eric M. 
Published: August 2010

AbstractGoals:To assess the current practice patterns of liver transplant centres in Canada and the USA regarding transplant eligibility.Background:Liver transplantation is an evolving field and today remains the only life‐sustaining treatment for end‐stage liver disease. Issues of allocation and transplant eligibility are important factors in the ethical practice of medicine.Study:Questionnaires were mailed to liver transplant programme directors in Canada and the USA inquiring about current practices regarding recipient eligibility.Results:This study demonstrates that there is consensus in the use of other eligibility criteria, including non‐compliance, social status, abstinence from alcohol and methadone and cocaine use. Interestingly, literature is lacking to support the use of these parameters as eligibility criteria with the exception of alcohol. There is a lack in consensus regarding marijuana use, human immunodeficiency virus status, ability to accept blood transfusions and prisoner status. The literature suggests that liver transplantation in select patients who refuse blood transfusions results in good outcomes.Conclusions:Important decisions regarding transplant eligibility still have to be made empirically in the absence of scientific literature about various social issues. While consensus among transplant programmes is useful, it is important that we continue to use the evidence in the literature to revise these eligibility criteria, keeping in mind ethical principles applied to the access and allocation of a scarce resource.
Bacterial translocation increases phagocytic activity of polymorphonuclear leucocytes in portal hypertension: priming independent of liver cirrhosis
Authors: Neugebauer Hermann , Hartmann Pia , Krenn Sebastian , Glück Thomas , Schölmerich Jürgen , Straub Rainer , Wiest Reiner 
Published: August 2010

AbstractAim: Bacterial translocation (BT) to mesenteric lymph nodes (MLN) in cirrhosis has been linked to impaired host defence. Phagocytosis by polymorphonuclear leucocytes (PMNLs) is the primary event in the killing of bacteria but has not been investigated in relation to the presence of BT.Methods: Mesenteric lymph nodes were harvested sterile and assessed for BT by culture techniques. Study groups included ascitic cirrhotic rats (LC), healthy controls (Con) as well as portal‐vein‐ligated (PVL) rats 2 days (acute PVL with and without norfloxacin) or 3 weeks after surgery (chronic PVL). PMNLs were isolated from systemic blood and the capacity to phagocytose opsonized Escherichia coli was evaluated by FACS analysis.Results: No BT was observed in Con and chronic PVL animals but 11/20 LC (55%) and six out of six acute PVL (100%) presented with BT. In the presence of BT, PMNL from PVL as well as LC rats showed significantly increased phagocytic activity as compared with controls. In contrast, PMNL from animals without BT, whether PVL or LC, exhibited phagocytic activity similar to those from control rats. The number of PMNLs involved in the phagocytic process was significantly increased only in portal‐hypertensive rats with but not without BT as compared with controls. Norfloxacin did prevent BT in acute PVL animals, thereby correcting the increase in phagocytic capacity in PMNL.Conclusions: Cirrhosis per se is not associated with alterations of the phagocytic capacity of PMNL. The occurrence of BT, however, increases the phagocytic capacity of PMNL, being observed likewise in prehepatic portal hypertension, indicating an in vivo‘priming’ of PMNL by BT independent of cirrhosis.
Disease progression and the risk factor analysis for chronic hepatitis C
Authors: Sinn Dong Hyun , Paik Seung Woon , Kang Pung , Kil Jae Sook , Park Sang Un , Lee So‐Young , Song Soon Mi , Gwak Geum‐Youn , Choi Moon Seok , Lee Joon Hyoek , Koh Kwang Cheol , Yoo Byung Chul 
Published: August 2010

AbstractBackground/Aims:The present study aimed to assess the incidence of advanced cirrhotic complications and to identify the risk factors associated with such complications in chronic hepatitis C.Methods:The data of 1137 chronic hepatitis C patients were retrospectively reviewed. We analysed the incidence rate and risk factors for ‘disease progression’, as defined by the occurrence of an increase of at least 2 points in the Child–Pugh score, oesophageal/gastric variceal bleeding, spontaneous bacterial peritonitis, hepatic encephalopathy, death related to liver disease or development of hepatocellular carcinoma (HCC).Results:Of the 1137 patients enrolled for analysis, 490 patients received antiviral treatment. The overall annual incidence rate of disease progression was 0.8 and 3.7% for patients with and without antihepatitis C virus (anti‐HCV) therapy respectively. The development of HCC was the most common cause of disease progression. In patients with anti‐HCV therapy, treatment response, platelet level and aspartate aminotranferase:platelet ratio index (APRI) were independent factors associated with disease progression. For those without anti‐HCV therapy, older age, male sex, diabetes, platelet level and APRI were independent factors for disease progression. APRI was strongest predictor for disease progression.Conclusions:The present study demonstrated that the development of HCC was the most common cause of disease progression, and we also identified the risk factors associated with disease progression. Thus, patients at such risks need close monitoring for disease progression, and especially for detecting HCC. Moreover, the active application of antiviral therapy and efforts to improve the antiviral response are required.