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1دورية أكاديمية
المؤلفون: Mondher Toumi, Jack Wallace, Chari Cohen, Chris Marshall, Helen Kitchen, Jake Macey, Hannah Pegram, Ashley F. Slagle, Robert G. Gish, Qin Ning, Hiroshi Yatsuhashi, Markus Cornberg, Maurizia Brunetto, Florian van Bömmel, Qing Xie, Dee Lee, Noriyuki Habuka, Urbano Sbarigia, Maria Beumont-Mauviel, Angelina Villasis Keever, Yasushi Takahashi, Yiwei Lu, Ao Liu, Qiaoqiao Chen, Tetsuro Ito, Olaf Radunz, Anna Puggina, Gudrun Hilgard, Eric K.H. Chan, Su Wang
المصدر: BMC Public Health, Vol 24, Iss 1, Pp 1-14 (2024)
مصطلحات موضوعية: Hepatitis B virus, Chronic Hepatitis B, Functional cure, Qualitative research, Self-stigma, Social impact, Public aspects of medicine, RA1-1270
الوصف: Abstract Background People with chronic hepatitis B (CHB) commonly experience social and self-stigma. This study sought to understand the impacts of CHB-related stigma and a functional cure on stigma. Methods Adults with CHB with a wide range of age and education were recruited from 5 countries and participated in 90-minute qualitative, semi-structured interviews to explore concepts related to CHB-associated stigma and its impact. Participants answered open-ended concept-elicitation questions regarding their experience of social and self-stigma, and the potential impact of reduced CHB-related stigma. Results Sixty-three participants aged 25 to 71 years (15 from the United States and 12 each from China, Germany, Italy, and Japan) reported emotional, lifestyle, and social impacts of living with CHB, including prejudice, marginalization, and negative relationship and work experiences. Self-stigma led to low self-esteem, concealment of CHB status, and social withdrawal. Most participants stated a functional cure for hepatitis B would reduce self-stigma. Conclusions CHB-related social and self-stigma are widely prevalent and affect many aspects of life. A functional cure for hepatitis B may reduce social and self-stigma and substantially improve the health-related quality of life of people with CHB. Incorporating stigma into guidelines along with infectivity considerations may broaden the patient groups who should receive treatment.
وصف الملف: electronic resource
Relation: https://doaj.org/toc/1471-2458
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2دورية أكاديمية
المؤلفون: Young-Suk Lim, Henry L.Y. Chan, Sang Hoon Ahn, Wai Kay Seto, Qin Ning, Kosh Agarwal, Harry L.A. Janssen, Calvin Q. Pan, Wan Long Chuang, Namiki Izumi, Scott Fung, Shalimar, Maurizia Brunetto, Aric Josun Hui, Ting-Tsung Chang, Seng Gee Lim, Frida Abramov, John F. Flaherty, Hongyuan Wang, Leland J. Yee, Jia-Horng Kao, Edward Gane, Jinlin Hou, Maria Buti
المصدر: JHEP Reports, Vol 5, Iss 10, Pp 100847- (2023)
مصطلحات موضوعية: REACH-B, aMAP, mPAGE-B, incidence, antiviral therapy, Diseases of the digestive system. Gastroenterology, RC799-869
الوصف: Background & Aims: Antiviral therapy may attenuate the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). We aimed to explore how tenofovir alafenamide (TAF) and tenofovir disoproxil fumarate (TDF) affect HCC risk in patients with CHB. Methods: The REACH-B, aMAP, and mPAGE-B models were utilized to assess HCC risk in patients with CHB from two global randomized-controlled trials evaluating the impact of TAF vs. TDF treatment. Standard incidence ratios (SIRs) were calculated using data from the REACH-B model as a ratio of observed HCC cases in the TAF- or TDF-treated patients vs. predicted HCC cases for untreated historical controls. Proportions of treated patients shifting aMAP and mPAGE-B risk categories between baseline and Week 240 were calculated. Results: Of the 1,632 patients (TAF, n = 1,093; TDF, n = 539) followed for up to 300 weeks, 22 HCC cases developed. Those receiving TAF had an SIR that was lower compared to the SIR of individuals receiving TDF: 0.32 (p
وصف الملف: electronic resource
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3دورية أكاديمية
المؤلفون: Pietro Lampertico, Elisabetta Degasperi, Lisa Sandmann, Heiner Wedemeyer, Cihan Yurdaydin, Dominique Roulot, Fabien Zoulim, Florin Alexandru Caruntu, Helenie Kefalakes, Julie Lucifora, Kosh Agarwal, Laurent Castera, Maria Buti, Mario Rizzetto, Markus Cornberg, Maura Dandri, Maurizia Brunetto, Nancy Reau, Robert Gish, Saeed Hamid, Soo Aleman, Stephan Urban, Tarik Asselah, Thomas Berg, Victor de Lédinghen
المصدر: JHEP Reports, Vol 5, Iss 9, Pp 100818- (2023)
مصطلحات موضوعية: Chronic hepatitis Delta, HDV, HDV RNA, cirrhosis, Entry Inhibitor, Bulevirtide, Diseases of the digestive system. Gastroenterology, RC799-869
الوصف: Summary: Chronic infection with hepatitis delta virus (HDV) affects between 12-20 million people worldwide and represents the most severe form of viral hepatitis, leading to accelerated liver disease progression, cirrhosis and its complications, such as end-stage-liver disease and hepatocellular carcinoma. From the discovery of HDV in 1977 by Prof. Mario Rizzetto, knowledge on the HDV life cycle and mechanisms of viral spread has expanded. However, little is still known about the natural history of the disease, host-viral interactions, and the role of the immune system in HDV persistence. Diagnosis of HDV is still challenging due to a lack of standardised assays, while accurate viral load quantification is needed to assess response and endpoints of antiviral treatment. Until recently, interferon has represented the only treatment option in patients with chronic hepatitis delta; however, it is associated with low efficacy and a high burden of side effects. The discovery of the entry inhibitor bulevirtide has represented a breakthrough in HDV treatment, by demonstrating high rates of viral suppression in phase II and III trials, results which have been confirmed in real-world settings and in patients with compensated advanced liver disease. In the meantime, other compounds (i.e. lonafarnib, new anti-hepatitis B virus drugs) are under development to provide alternative or combined strategies for HDV cure. The first international Delta Cure meeting was organised in Milan in October 2022 with the aim of sharing and disseminating the latest data; this review summarises key takeaway messages from state-of-the-art lectures and research data on HDV.
وصف الملف: electronic resource
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4دورية أكاديمية
المؤلفون: Milan J. Sonneveld, Shao-Ming Chiu, Jun Yong Park, Sylvia M. Brakenhoff, Apichat Kaewdech, Wai-Kay Seto, Yasuhito Tanaka, Ivana Carey, Margarita Papatheodoridi, Piero Colombatto, Florian van Bömmel, Thomas Berg, Fabien Zoulim, Sang Hoon Ahn, George N. Dalekos, Nicole S. Erler, Maurizia Brunetto, Heiner Wedemeyer, Markus Cornberg, Man-Fung Yuen, Kosh Agarwal, Andre Boonstra, Maria Buti, Teerha Piratvisuth, George Papatheodoridis, Chien-Hung Chen, Benjamin Maasoumy
المصدر: JHEP Reports, Vol 5, Iss 8, Pp 100790- (2023)
مصطلحات موضوعية: HBV DNA, HBsAg, HBcrAg, HBsAg loss, Entecavir, Tenofovir, Diseases of the digestive system. Gastroenterology, RC799-869
الوصف: Background & Aims: Pretreatment predictors of finite nucleo(s)tide analogue (NUC) therapy remain elusive. We studied the association between pretreatment HBV DNA levels and outcomes after therapy cessation. Methods: Patients with chronic hepatitis B who were HBeAg negative at the start of NUC treatment were enrolled from sites in Asia and Europe. We studied the association between pretreatment HBV DNA levels and (1) clinical relapse (defined as HBV DNA >2,000 IU/ml + alanine aminotransferase >2 × the upper limit of normal or retreatment) and (2) HBsAg loss after NUC withdrawal. Results: We enrolled 757 patients, 88% Asian, 57% treated with entecavir, with a median duration of treatment of 159 (IQR 156–262) weeks. Mean pretreatment HBV DNA levels were 5.70 (SD 1.5) log IU/ml and were low (20,000 IU/ml) in 607 (80%). The cumulative risk of clinical relapse at 144 weeks after therapy cessation was 22% among patients with pretreatment HBV DNA levels 20,000 IU/ml, whereas the cumulative probabilities of HBsAg loss were 17.5% vs. 5% (p
وصف الملف: electronic resource
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5دورية أكاديمية
المؤلفون: Valentina D Mangano, Daniela Campani, Andrea Cacciato Insilla, Barbara Coco, Maria Angeles Gomez Morales, Maurizia Brunetto, Giuseppe La Rosa, Alessandra Ludovisi, Paolo De Simone, Fabrizio Bruschi
المصدر: Pathogens, Vol 12, Iss 8, p 1003 (2023)
مصطلحات موضوعية: Opistorchis, liver transplant, parasitic infection, Medicine
الوصف: A man with hepatitis B infection was admitted to Pisa University Hospital for hepatological evaluation, which revealed multiple cystic lesions and suggested a cirrhotic evolution. Treatment with Entecavir 0.5 mg/day was started, resulting in rapid viral load suppression and alanine aminotransferase normalization. After 10 years, imaging documented a single nodule of hepatocellular carcinoma (HCC), and a robot-assisted nodule resection was performed. One year later, HCC recurrence prompted orthotopic liver transplantation, during which the patient died because of the sudden rupture of the donor’s organ and rapid multiorgan deterioration before retransplantation. During post-mortem liver examination, adult worms were evidenced within large biliary ducts, suggesting infection with Opisthorchis or Clonorchis spp. flukes. Sequencing of the ITS2 locus, following PCR amplification of DNA extracted from liver tissue, revealed 100% identity with the reference sequence of O. felineus. Infection of the patient with O. felineus was confirmed by the presence of specific IgG detected by ELISA in the patient’s sera. Two major alkaline phosphatase serum levels peaks observed during the first two years of antiviral therapy support the hypothesis that O. felineus infection worsened liver function. This case report highlights the importance of a very careful screening of parasitic infections in solid organ transplantation candidates.
وصف الملف: electronic resource
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6دورية أكاديمية
المؤلفون: Carla Rognoni, Maria Rosa Barcellona, Irene Bargellini, Maria Grazia Bavetta, Marilena Bellò, Maurizia Brunetto, Patrizia Carucci, Roberto Cioni, Laura Crocetti, Fabio D’Amato, Mario D’Amico, Simona Deagostini, Désirée Deandreis, Paolo De Simone, Andrea Doriguzzi, Monica Finessi, Paolo Fonio, Serena Grimaldi, Salvatore Ialuna, Fabio Lagattuta, Gianluca Masi, Antonio Moreci, Daniele Scalisi, Roberto Virdone, Rosanna Tarricone
المصدر: Frontiers in Oncology, Vol 12 (2022)
مصطلحات موضوعية: trans-arterial radioembolisation, cost-effectiveness, cost-utility, personalised dosimetry, tailored treatment, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
الوصف: AimsTo perform a cost-effectiveness analysis (CEA) comparing personalised dosimetry with standard dosimetry in the context of selective internal radiation therapy (SIRT) with TheraSphere for the management of adult patients with locally advanced hepatocellular carcinoma (HCC) from the Italian Healthcare Service perspective.Materials and methodsA partition survival model was developed to project costs and the quality-adjusted life years (QALYs) over a lifetime horizon. Clinical inputs were retrieved from a published randomised controlled trial. Health resource utilisation inputs were extracted from the questionnaires administered to clinicians in three oncology centres in Italy, respectively. Cost parameters were based on Italian official tariffs.ResultsOver a lifetime horizon, the model estimated the average QALYs of 1.292 and 0.578, respectively, for patients undergoing personalised and standard dosimetry approaches. The estimated mean costs per patient were €23,487 and €19,877, respectively. The incremental cost-utility ratio (ICUR) of personalised versus standard dosimetry approaches was €5,056/QALY.ConclusionsPersonalised dosimetry may be considered a cost-effective option compared to standard dosimetry for patients undergoing SIRT for HCC in Italy. These findings provide evidence for clinicians and payers on the value of personalised dosimetry as a treatment option for patients with HCC.
وصف الملف: electronic resource
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7دورية أكاديمية
المؤلفون: Ondrej Podlaha, Edward Gane, Maurizia Brunetto, Scott Fung, Wan-Long Chuang, Calvin Q. Pan, Zhaoshi Jiang, Yang Liu, Neeru Bhardwaj, Prasenjit Mukherjee, John Flaherty, Anuj Gaggar, Mani Subramanian, Namiki Izumi, Shalimar, Young-Suk Lim, Patrick Marcellin, Maria Buti, Henry L. Y. Chan, Kosh Agarwal
المصدر: Scientific Reports, Vol 9, Iss 1, Pp 1-9 (2019)
الوصف: Abstract Despite the high global prevalence of chronic hepatitis B (CHB) infection, datasets covering the whole hepatitis B viral genome from large patient cohorts are lacking, greatly limiting our understanding of the viral genetic factors involved in this deadly disease. We performed deep sequencing of viral samples from patients chronically infected with HBV to investigate the association between viral genome variation and patients’ clinical characteristics. We discovered novel viral variants strongly associated with viral load and HBeAg status. Patients with viral variants C1817T and A1838G had viral loads nearly three orders of magnitude lower than patients without those variants. These patients consequently experienced earlier viral suppression while on treatment. Furthermore, we identified novel variants that either independently or in combination with precore mutation G1896A were associated with the transition from HBeAg positive to the negative phase of infection. These observations are consistent with the hypothesis that mutation of the HBeAg open reading frame is an important factor driving CHB patient’s HBeAg status. This analysis provides a detailed picture of HBV genetic variation in the largest patient cohort to date and highlights the diversity of plausible molecular mechanisms through which viral variation affects clinical phenotype.
وصف الملف: electronic resource
Relation: https://doaj.org/toc/2045-2322
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8دورية أكاديمية
المؤلفون: Calvin Q Pan, Ting-Tsung Chang, Si Hyun Bae, Maurizia Brunetto, Wai-Kay Seto, Carla S Coffin, Susanna K Tan, Shuyuan Mo, John F Flaherty, Anuj Gaggar, Mindie H Nguyen, Mustafa Kemal Çelen, Alexander Thompson, Edward J Gane
المصدر: PLoS ONE, Vol 16, Iss 5, p e0251552 (2021)
الوصف: Background/purposeUse of tenofovir disoproxil fumarate (TDF) improves patient outcomes in preventing mother-to-child transmission (pMTCT) of the hepatitis B virus (HBV) in mothers with chronic HBV and high viral loads. Given the lack of data for tenofovir alafenamide (TAF) in pMTCT, rates of early viral suppression with TAF and TDF were evaluated in women of childbearing potential (WOCBP) participating in 2 randomized, double-blind, Phase 3 studies in chronic HBV.MethodsIn a patient subset meeting WOCBP criteria and with baseline HBV DNA >200,000 IU/mL, rates of viral suppression with TAF or TDF in achieving the target of HBV DNA ResultsIn 275 of 1298 (21%) patients meeting WOCBP criteria with high viral load, 93% and 96% had HBV DNA ConclusionsIn WOCBP with high VL, no differences were found between TAF and TDF in reducing HBV DNA to levels associated with lower transmission risk. These data support ongoing studies of TAF for pMTCT.
وصف الملف: electronic resource
Relation: https://doaj.org/toc/1932-6203
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9دورية أكاديمية
المؤلفون: Danila Germanese, Sara Colantonio, Mario D’Acunto, Veronica Romagnoli, Antonio Salvati, Maurizia Brunetto
المصدر: Sensors, Vol 19, Iss 17, p 3656 (2019)
مصطلحات موضوعية: electronic noses, gas sensors, data processing, breath analysis, liver impairment, hepatic encephalopathy, Chemical technology, TP1-1185
الوصف: Biologically inspired to mammalian olfactory system, electronic noses became popular during the last three decades. In literature, as well as in daily practice, a wide range of applications are reported. Nevertheless, the most pioneering one has been (and still is) the assessment of the human breath composition. In this study, we used a prototype of electronic nose, called Wize Sniffer (WS) and based it on an array of semiconductor gas sensor, to detect ammonia in the breath of patients suffering from severe liver impairment. In the setting of severely impaired liver, toxic substances, such as ammonia, accumulate in the systemic circulation and in the brain. This may result in Hepatic Encephalopathy (HE), a spectrum of neuro−psychiatric abnormalities which include changes in cognitive functions, consciousness, and behaviour. HE can be detected only by specific but time-consuming and burdensome examinations, such as blood ammonia levels assessment and neuro-psychological tests. In the presented proof-of-concept study, we aimed at investigating the possibility of discriminating the severity degree of liver impairment on the basis of the detected breath ammonia, in view of the detection of HE at its early stage.
وصف الملف: electronic resource
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10دورية أكاديمية
المؤلفون: Sergio Iannazzo, Barbara Coco, Maurizia Brunetto, Francesca Rossetti, Antonietta Caputo, Maria De Francesco, Ferruccio Bonino
المصدر: Farmeconomia: Health Economics and Therapeutic Pathways, Vol 14, Iss 3, Pp 111-118 (2013)
مصطلحات موضوعية: chronic hepatitis b, peg-interferon, markov model, Medicine (General), R5-920
الوصف: BACKGROUND AND OBJECTIVE: Pharmacological approaches available in chronic hepatitis B (CHB) are based on 48-weeks finite course of peg-interferon (PEG-IFN) or continuous administration of nucleoside analogues. Recent studies gave way to early identification of non-responders to peg-interferon with a stopping rule based on virologic/serologic markers at week 12. A pharmacoeconomic simulation model was developed to support the economic evaluation of HBeAg-negative CHB treatment strategies, which either involve first line peg-interferon with stopping rule and switch to current most effective analogue entecavir or tenofovir, or nucleosides analogues in first line treatment. This model showed a good cost-effectiveness profile of the first line treatment with peg-interferon. Aim of the present study was the estimation of the impact of a wide adoption of a first line with PEG-IFN and the stopping rule on total overall cost related to CHB over the lifetime of patients in Italy. METHODS: The Markov model was developed to perform a lifetime simulation of the disease progression considering the following health-related states: active CHB, virologic response, HBsAg clearance, compensated cirrhosis with active CHB, compensated cirrhosis with virologic response, decompensated cirrhosis, hepatocellular carcinoma, liver transplant, post-liver transplant and death. The outcomes provided by the model were average survival, quality-adjusted life years (QALY) and costs, calculated from the Italian National Health Service (SSN) perspective. A “current” mix of treatments, where 80% patients received ETV or TDF in first-line, was compared with an “hypothetical” mix defined by a 100% adoption of a PEG-IFN first-line with the stopping rule, to estimate the impact on total lifetime CHB-related costs for a cohort of 100 HBeAg-negative CHB patients in Italy. RESULTS: Results obtained from the evaluation of overall total treatment cost over patients’ lifetime appeared to confirm the cost-effectiveness of peg-interferon previously assessed. Lifetime overall total cost resulted significantly lower with the “hypothetical” treatment mix as compared to the “current” mix.. In fact, estimated lifetime overall total costs for the former and latter scenario were equal to €7,239,050 and €9,060,150 respectively, thus generating a saving of approximately 20% associated to CHB treatment with first-line peg-interferon. CONCLUSION: Based on the results obtained from the economic evaluation of the CHB treatment strategies, first-line peg-interferon associated with the stopping rule and switch to nucleoside analogues consistently represents a convenient strategy on both the clinical and economic perspective.
وصف الملف: electronic resource
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