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Treatment responses in Asians and Caucasians with chronic hepatitis C infection

World Journal of Gastroenterology 2008年第21期14卷 3416-3420页

作者： Kenneth K Yan Marianne Guirgis Amany Zekry Thuy Dinh anouk dev Jacob George Alice Lee Department of Hepatology St George HospitalKogarahSydney 2217NSWAustralia Department of Gastroenterology Monash Medical CentreMelbourne 3168VictoriaAustralia Storr Liver Unit Westmead Millennium InstituteUniversity of Sydney and Westmead HospitalSydney 2217NSWAustralia Department of Gastroenterology and Hepatology Concord Repatriation HospitalConcordSydney 2217NSWAustralia

AIM：To conduct a multicentre retrospective review of virological response rates in Asians infected with genotype 1 chronic hepatitis C（CHC） treated with combination interferon and ribavirin and then to compare their responses to that among Caucasians.METHODS：Asian patients infected with genotype 1 CHC treated at 4 Australian centres between 2001 to 2005 were identified through hospital *** demographic characteristics,biochemical,virological and histological data and details of treatment were *** virological responses（SVR） in this cohort were then compared to that in Caucasian subjects,matched by genotype,age,gender and the stage of hepatic fibrosis.RESULTS：A total of 108 Asians with genotype 1 CHC were *** end of treatment response（ETR） for the cohort was 79% while the SVR was 67%.Due to the relatively advanced age of the Asian cohort,only sixty-four subjects could be matched with *** ETR among matched Asians and Caucasians was 81% and 56% respectively（P=0.003）,while the SVR rates were 73% and 36%（P 〈0.001） *** difference remained significant after adjusting for other predictive variables. CONCLUSION： Genotype 1 CHC in Asian subjects is associated with higher rates of virological response compared to that in Caucasians.

关键词： Hepatitis C Treatment Asians Retro-spective studies Comparative study Interferon Ribavirin Statistical data analysis

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Hepatitis C virus treatment with glecaprevir and pibrentasvir in patients co-prescribed carbamazepine:Three case reports

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2023年第4期14卷 33-38页

作者： Michael Braude Dilip T Ratnam Louise Marsh Joshua H Abasszade anouk T dev Department of Gastroenterology and Hepatology Monash HealthClayton 3168VICAustralia General Practice Margaret River Medical CentreMargaret River 6285Australia

BACKGROUND Highly effective and well-tolerated direct-acting antiviral(DAA)therapies have revolutionised the management of hepatitis C virus(HCV);however,niche populations face treatment *** co-prescribed with several firstgeneration anti-epileptic drugs(AEDs)are contraindicated due to drug-drug interactions.A common example is carbamazepine whereby steady-state carbamazepine reduces the maximum concentration and area under the curve of velpatasvir,glecaprevir and pibrentasvir due to potent cytochrome P450(CYP)3A4 *** also induces P-glycoprotein which reduces glecaprevir and pibrentasvir’s area under curve to infinite *** and glecaprevir-pibrentasvir are contraindicated in patients who are co-prescribed carbamazepine due to the risk of reduced DAA therapeutic effect and consequently,virological treatment *** presents a challenge for patients in whom carbamazepine substitution is medically unfeasible,impractical or ***,the properties of current generation DAA therapies,including high-potency non-structural protein 5A inhibitory effect,may be sufficient to overcome reduced bioavailability arising from carbamazepine related CYP 3A4 and P-glycoprotein *** SUMMARY We present a case series of three patients with non-cirrhotic,treatment-naïve,genotype 1a,1b,and 3a HCV who were treated with a 12 wk course of glecaprevir-pibrentasvir,while co-prescribed carbamazepine for seizure ***-pibrentasvir combination therapy was chosen due to its potent in vitro activity and low barrier to pan-genotypic resistance associated *** therapy was dose-separated from carbamazepine to maximise time to peak concentration,and taken with meals to improve *** virological response at 12 wk was achieved in each patient with no adverse *** DAA therapies,including glecaprevir-pibrentasvir,warrant consideration as a therapeutic agent in people with HCV w

关键词： Antiepileptic drugs Drug interactions Hepatitis C virus Sustained virological response Health care access Case repor

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Clinical outcomes of patients with two small hepatocellular carcinomas

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World Journal of Hepatology 2021年第10期13卷 1439-1449页

作者： Anh Duy Pham Karl Vaz Zaid S Ardalan Marie Sinclair Ross Apostolov Sarah Gardner Ammar Majeed Gauri Mishra Ning Mao Kam Kurvi Patwala Numan Kutaiba Niranjan Arachchi Sally Bell anouk T dev John S Lubel Amanda J Nicoll Siddharth Sood William Kemp Stuart K Roberts Michael Fink Adam G Testro Peter W Angus Paul J Gow The Victorian Liver Transplant Unit Austin HealthHeidelberg 3084VictoriaAustralia Department of Gastroenterology Alfred HealthMelbourne 3000VictoriaAustralia The Melbourne Liver Group Melbourne 3000VictoriaAustralia The University of Melbourne Parkville 3010VictoriaAustralia Central Clinical School Monash UniversityMelbourne 3004VictoriaAustralia Department of Gastroenterology and Hepatology Monash HealthClayton 3168VictoriaAustralia Department of Radiology Austin HealthHeidelberg 3084VictoriaAustralia Department of Radiology Eastern HealthBox Hill 3128VictoriaAustralia Department of Gastroenterology Western HealthFootscray 3011VictoriaAustralia Department of Gastroenterology Eastern HealthBox Hill 3128VictoriaAustralia Department of Gastroenterology Royal Melbourne HospitalParkville 3050VictoriaAustralia

BACKGROUND Management of single small hepatocellular carcinoma(HCC)is straightforward with curative outcomes achieved by locoregional therapy or *** transplantation is often considered for multiple small or single large *** of two small HCC whether presenting synchronously or sequentially is less *** To define the outcomes of patients presenting with two small *** Retrospective review of HCC databases from multiple institutions of patients with either two synchronous or sequential HCC≤3 cm between January 2000 and March *** outcomes were overall survival(OS)and transplant-free survival(TFS).RESULTS 104 patients were identified(male n=89).Median age was 63 years(interquartile range 58-67.75)and the most common aetiology of liver disease was hepatitis C(40.4%).59(56.7%)had synchronous HCC and 45(43.3%)had sequential.36 patients died(34.6%)and 25 were transplanted(24.0%).1,3 and 5-year OS was 93.0%,66.1% and 62.3% and 5-year post-transplant survival was 95.8%.1,3 and 5-year TFS was 82.1%,45.85% and 37.8%.When synchronous and sequential groups were compared,OS(1,3 and 5 year synchronous 91.3%,63.8%,61.1%,sequential 95.3%,69.5%,64.6%,P=0.41)was similar but TFS was higher in the sequential group(1,3 and 5 year synchronous 68.5%,37.3% and 29.7%,sequential 93.2%,56.6%,48.5%,P=0.02)though this difference did not remain during multivariate *** TFS in patients presenting with two HCC≤3 cm is poor regardless of the timing of the second *** patients presenting with two small HCC should be considered for transplantation.

关键词： Hepatocellular carcinoma Liver cancer Prognosis Transplantation Transplant-free survival

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