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Changes in hepatic fibrosis and incidence of HCC following direct-acting antiviral treatment of F3 chronic hepatitis c patients:a prospective observational study

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Hepatoma Research 2022年第1期8卷 340-351页

作者： Gamal Shiha reham soliman Ayman AHassan Nabiel N.H.Mikhail Egyptian Liver Research Institute and Hospital(ELRIAH) SherbinMansoura 35111Egypt Hepatology and Gastroenterology Unit Internal Medicine DepartmentFaculty of MedicineMansoura UniversityMansoura 35516Egypt Tropical Medicine Department Faculty of MedicinePort Said UniversityPort Said 42526Egypt Biostatistics and Cancer Epidemiology Department South Egypt Cancer InstituteAssiut UniversityAssiut 71515Egypt

Aim:Studies of clinical outcomes in chronic hepatitis C(CHC)patients with pretreatment advanced liver fibrosis(F3)after sustained virologic response(SVR)are scarce,and most studies are of small cohorts and retrospective in *** aim was to assess the clinical outcomes following direct acting antiviral(DAA)treatment among hepatitis C F3 patients after ***:This study included 1517 chronic hepatitis C patients with F3 fibrosis receiving DAAs in the out-patient clinics at the Egyptian Liver Research Institute and Hospital(ELRIAH).We included patients 18 years or older with HCV who received DAAs,have F3 by transient elastography,and have no history of hepatocellular carcinoma(HCC).Patients were followed up every six months after end of treatment using ultrasonography and ***:Significant improvement of fibrosis occurred with decreases in LSM,FIB-4,APRI,and *** changes in LSM were categorized depending on delta LSM,873 patients(57.5%)showed regression,454(29.9%)were stable,and 190 patients(12.5%)showed progression of ***,33 cases developed HCC during follow-up with incidence rate of 0.915/100 py(95%CI:0.64-1.27).Incidence was high with progression of liver fibrosis(6.17/100 py)compared to patients with stable fibrosis(1.09/100 py)and regression of liver fibrosis(0.75/100 py).There were no significant differences as regards fibrosis indicators at baseline(LSM,FIB-4,APRI,and FIB-6)between those who developed HCC and those who did ***:CHC Patients with F3 fibrosis showed a high rate of regression of fibrosis and decreased HCC incidence after achieving SVR following DAAs.

关键词： HCC fibrosis changes F3 DAAs

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Correlation between corneal demarcation line depth in epithelium-off and trans-epithelium accelerated corneal cross linking and keratoconus progression

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International Journal of Ophthalmology(English edition) 2020年第6期13卷 907-912页

作者： Mahmoud Abdel-Radi Zeiad Eldaly Hazem Abdelmotaal reham Abdelrahman Mohamed Sayed Kamel soliman Department of Ophthalmology Assiut UniversityAssiut 71516Egypt

AIM:To compare corneal demarcation line(DL)depth in both accelerated epithelium-off and trans-epithelium cross linking(CXL)using anterior segment optical coherence tomography(AS-OCT)and its relation to maximum keratometry(Kmax)progression in both ***:A prospective comparative interventional study where patients with mild to moderate keratoconus(KC)were classified into two groups:accelerated epitheliumoff and trans-epithelium CXL based on corneal *** of corneal DL depth was carried out after 3mo by *** readings were evaluated after one year follow up using the Scheimpflug imaging ***:Study included 74 eyes of 44 *** A underwent epithelium-off CXL(41 eyes),while Group B underwent trans-epithelium CXL(33 eyes).At 3mo follow up,mean corneal DL depth in Group A was 219.9±58.4μm while in Group B was 127.2±7.8μm(P0.05).In addition,no significant change in corneal pachymetry was found in both groups(meanchange at 1y:6.4±4.7 and-10.1±2.3μm in Groups A and B respectively).CONCLUSION:Despite a significantly deeper corneal DL depth created by accelerated epithelium-off CXL technique compared to accelerated trans-epithelium CXL,there is no significant impact on keratoconus progression.

关键词： anterior segment optical coherence tomography cross linking demarcation line keratoconus

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