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Effect of Treatment for CHC on Liver Disease Progression and Hepatocellular Carcinoma Development in African Americans

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Journal of Clinical and Translational Hepatology 2015年第3期3卷 163-168页

作者： Naveen Reddy Paul Naylor Zaher Hakim Redwan Asbahi Karthik Ravindran Elizabeth May murray ehrinpreis milton mutchnick Department of Internal Medicine/Division of Gastroenterology Wayne State University School of MedicineHarper University Hospital Detroit MI USA

Background and Aims:African Americans (AA) historically have a low response rate to hepatitis C therapies,and there is limited information available for this patient population regarding the development and treatment of chronic hepatitis C (CHC).The aim of this study was to evaluate liver disease progression and hepatocellular carcinoma (HCC) development in AA with ***:Between 1995 and 2008,246 AA patients with CHC were identified from a database of patients and followed until 2012-2013 (average 8 years)or the development of HCC after ***:Viral clearance (intent to treat;sustained virus response (SVR)) was achieved in 15% of patients with interferon based therapies with or without *** patients who achieved an SVR (n=22) did not develop HCC or new onset cirrhosis,whereas the HCC incidence in untreated AA patients was 23% (51/203).Patients who achieved an SVR also had improved fibrosis,as defined by the AST Platelet Ratio Index (APRI) and Fibrosis-4 (FIB-4) score,relative to nonresponders and untreated ***:The severity of liver disease at the first visit (except for cirrhosis) correlated with the development of HCC,but because of the overlap in values between patients,these measurements were not useful for predicting individual *** cirrhosis at the first visit was not a predictive factor,treatment with newer antiviral therapies is the best option for reducing the incidence of advanced liver disease and its harmful outcomes in the AA population.

关键词： Hepatitis C Cirrhosis Hepatocellular carcinoma APRI Fib-4

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Latent hepatitis B is a risk factor for hepatocellular carcinoma in patients with chronic hepatitis C

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World Journal of Gastroenterology 2013年第48期19卷 9328-9333页

作者： Arvind Reddy Elizabeth May murray ehrinpreis milton mutchnick Division of Gastroenterology Wayne State University Detroit MI 48201 United States

AIM:To study the potential association between hepatocellular carcinoma(HCC)in patients with chronic hepatitis C(CHC),cirrhosis and latent hepatitis B(LHB)infection,defined as the absence of detectable serum hepatitis B surface antigen(HBsAg)and the presence of hepatitis B core antibody(HBcAb).METHODS:This retrospective analysis is comprised of 185 cirrhotic patients with HCC who were hepatitis C virus antibody(HCV Ab)(+)and HBsAg(-)at Wayne State University between 1999 and *** these,108 patients had HCV polymerase chain reaction confirmation of viremia while the remaining(77)were considered to have CHC on the basis of a positive HCV Ab and the absence of any other cause of liver *** were drawn from our institutional database from the same time period and consisted of 356 HBsAg(-)age,race and gender matched patients with HCV RNA-confirmed CHC and without evidence of HCC.A subgroup of controls included 118matched patients with liver cirrhosis.χ2test and t test were used for data ***:Seventy-seven percent of patients in all3 groups were African *** with HCC had a significantly higher body mass index(P=0.03),a higher rate of co-infection with human immunodeficiency virus(HIV)(P=0.05)and a higher prevalence of alcohol abuse(P=0.03)than the *** patients with HCC had LHB than controls(78%vs39%,P=0.01).Sixty three percent of patients with HCC were both hepatitis B surface antigen(HBsAb)(-)and HBcAb(+)compared to 23%of controls(P<0.01).When compared to cirrhotic controls,the frequency of HBcAb(+)remained higher in patients with HCC(78%vs 45%,P=0.02).Patients with HCC were more likely to be both HBsAb(-)and HBcAb(+)than the cirrhotic controls(63%vs 28%,P=0.01).Although not statistically significant,100%of CHC and HIV coinfected patients with HCC(n=11)were HBcAb(+)when compared to controls(44%;n=9).CONCLUSION:These data suggest that LHB occurs at a significantly increased frequency in patients with CHC and HCC than in

关键词： Hepatocellular carcinoma Chronic hepatitis C Latent hepatitis B Hepatitis C virus

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Overestimate of Fibrosis by FIBROSpect(R) Ⅱ in African Americans Complicates the Management of their Chronic Hepatitis C

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Journal of Clinical and Translational Hepatology 2016年第1期4卷 12-19页

作者： Maher Tama Paul Naylor Suhag Patel Johnny Altawil Dhiraj Gulati Fadi Antaki milton G.mutchnick murray ehrinpreis Wayne State University School of Medicine Department of Internal Medicine Division of Gastroenterology Detroit MI USA

Background:Evaluation of advanced fibrosis in patients with hepatitis C virus (HCV) infection is used to facilitate decisions on treatment strategy and to initiate additional screening ***,most studies have predominately Caucasian (Cau) patients and may not be as relevant for African Americans (AA).Aims:This study specifically addresses the issue of defining minimal *** fibrosis in African Americans (AA) with chronic hepatitis C (CHC) using noninvasive ***:All patients (n =319) seen between 1 January 2008 and 30 June 2013 for whom a FibroSpect II(R) (FSII) assay was performed and had data for calculation of aspartate aminotransferase (AST)platelet ratio index (APRI) and Fibrosis-4 (FIB-4) were identified using the medical ***:When liver biopsy score and FSII assay results for the AA patients with CHC were compared,31% of AA had advanced FSII fibrosis scores (F2-F4) despite a biopsy score of *** contrast,10% of Cau *** AA false positive rate was 14% for APRI and 34% for *** FSII with either APRI (7% false positive) or FIB-4 (10% false positive) improved the false positive rate in AA to 7% (FSII + APRI) and 10%(FSII + FIB-4) but reduced the sensitivity for significant ***:The FSII assay overestimates fibrosis in AA and should be used with caution since these patients may not have significant *** the APRI or FIB-4 assay is combined with the FSII assay,minimal fibrosis in AA can be defined without subjecting the patients to a subsequent biopsy.

关键词： Hepatitis c Fibrosis African Americans Fibrospect

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