Publications by authors named "Man-fung Yuen"
Background: Plasma pregenomic hepatitis B virus RNA (pgRNA) is a novel biomarker in chronic hepatitis B infection (CHB). We aimed to describe the longitudinal profile of pgRNA and factors influencing its levels in CHB patients on nucleoside analogue (NUC).
Methods: Serial plasma samples from 1354 CHB patients started on first-line NUC were evaluated.
Article Synopsis
- Hepatocellular carcinoma (HCC) has a high mortality rate, and current diagnostic methods like LI-RADS often lead to indeterminate results, complicating accurate diagnosis.
- Researchers developed four deep learning models using CT scans, finding that the Spatio-Temporal 3D Convolution Network (ST3DCN) performed best, significantly outperforming standard radiological interpretation in identifying HCC.
- The ST3DCN model demonstrated strong diagnostic accuracy in both internal validation (AUCs up to 0.919) and external testing (AUC of 0.901), indicating its potential as an effective tool for HCC diagnosis.
Functional cure of chronic hepatitis B (CHB)-defined as sustained seroclearance of hepatitis B surface antigen (HBsAg) with unquantifiable hepatitis B virus (HBV) DNA at 24 weeks off treatment, is an optimal treatment endpoint. Nonetheless, it cannot be consistently attained by current treatment modalities. RNA interference (RNAi) is a novel treatment strategy using small-interfering RNA (siRNA) or antisense oligonucleotide (ASO) to target HBV post-transcriptional RNA, in turn suppressing viral protein production and replication.
View Article and Find Full Text PDFBackground And Aims: HCC recurrence frequently occurs after curative surgery. Histological microvascular invasion (MVI) predicts recurrence but cannot provide preoperative prognostication, whereas clinical prediction scores have variable performances.
Approach And Results: Recurr-NET, a multimodal multiphasic residual-network random survival forest deep-learning model incorporating preoperative CT and clinical parameters, was developed to predict HCC recurrence.
Chronic hepatitis B (CHB) poses a major global public health challenge and is a leading cause of cirrhosis and liver cancer. Hepatic steatosis is common in individuals with CHB compared to the non-CHB population and is particularly prevalent in HBV-endemic regions, affecting about one-third of CHB patients. The interaction between hepatic steatosis and CHB-related disease progression is complex and still under debate.
View Article and Find Full Text PDFFunctional cure, defined as sustained hepatitis B surface antigen (HBsAg) seroclearance with unquantifiable hepatitis B virus (HBV) DNA at 24 weeks off treatment, is a favorable treatment endpoint in chronic hepatitis B (CHB). Nonetheless, functional cure is rarely attained with the current treatment modalities of nucleos(t)ide analogues (NUCs) and pegylated interferon alpha (Peg-IFNα). Multiple novel virus-targeting agents and immunomodulators are under development for HBV with functional cure as the treatment goal.
View Article and Find Full Text PDFArticle Synopsis
- The study investigates the effects of combining pioglitazone, GLP1RA, and SGLT2i on metabolic dysfunction-associated steatohepatitis (MASH) in patients with type 2 diabetes.
- Results from 888 patients showed that using more of these medications correlated with significant improvements in liver health, as measured by changes in the FAST score over a median follow-up of 3.9 years.
- Specifically, the combination of SGLT2i and pioglitazone was associated with the highest likelihood of achieving better FAST score outcomes, suggesting a promising approach for managing MASH in diabetic patients.
VIR-2218 (elebsiran) plus pegylated interferon-alfa-2a in participants with chronic hepatitis B virus infection: a phase 2 study.
Lancet Gastroenterol Hepatol
December 2024
Article Synopsis
- Chronic hepatitis B virus (HBV) is a significant global health concern, with existing treatments yielding low rates of HBsAg seroclearance; VIR-2218 (elebsiran) is being studied for its potential to reduce HBsAg levels.
- This phase 2 open-label study involved participants aged 18-65 from various countries who had chronic HBV but no cirrhosis, assessing the safety and effectiveness of VIR-2218 alone and in combination with pegylated interferon-alpha-2a.
- The study aimed to measure adverse events and clinical outcomes, including the reduction of HBsAg and long-term seroclearance rates among those receiving different treatment regimens over a period ranging from
Article Synopsis
- - The study aimed to create and validate a prognostic model for assessing the risk of hepatocellular carcinoma (HCC) in noncirrhotic adults with chronic hepatitis B, focusing on those without significant alanine aminotransferase (ALT) elevation.
- - Researchers analyzed data from over 13,000 patients across several cohorts in Taiwan, Korea, and Hong Kong, finding that baseline HBV DNA levels were key predictors of HCC risk, especially at moderate viral loads.
- - The new model, called Revised REACH-B, showed strong predictive accuracy and was more beneficial compared to other strategies in predicting HCC risk, though its applicability to other racial groups remains a limitation.
Background And Aims: RNA interference has been extensively explored in patients with chronic hepatitis B (CHB) infection. We aimed to characterise the long-term efficacy of small interfering RNA (siRNA) on hepatitis B surface antigen (HBsAg) suppression.
Methods: We prospectively followed up participants with CHB who received siRNA, either ARC-520 or JNJ-73763989 (JNJ-3989), in combination with nucleoside analogue (NUC) in our centre.
Background: Optimal glycaemic control has well-established health benefits in patients with diabetes mellitus (DM). It is uncertain whether optimal glycaemic control can benefit liver-related outcomes.
Aims: To examine the association of optimal glycaemic control with hepatocellular carcinoma (HCC) and liver-related mortality.
Cigarette smoking is associated with worse clinical outcomes in patients with chronic hepatitis B (CHB) infection, but the effects on hepatitis B surface antigen (HBsAg) seroclearance are unclear. This study aimed to investigate the effect of active smoking on HBsAg seroclearance (SC) and its impact on peripheral blood lymphocytes in patients with CHB infection. Longitudinal follow-up data was retrieved in 7833 antiviral-treated CHB subjects identified from a centralised electronic patient record database (Part 1).
View Article and Find Full Text PDFBackground: Although the general seroprevalence of hepatitis C virus (HCV) infection in Hong Kong is <0.5 %, Hong Kong is still striving for HCV elimination owing to barriers in care cascade encompassing linkage-to-care (LTC), treatment initiation and adherence. We aimed to evaluate the feasibility of a pilot model of micro-elimination to strengthen the HCV care cascade for high-risk groups in Hong Kong.
View Article and Find Full Text PDFBackground And Aim: We assessed the effect of hepatitis B surface antigen (HBsAg) seroclearance (HBsAg-loss) on liver fibrosis regression in patients with chronic hepatitis B (CHB) infection.
Method: CHB patients with recent documented HBsAg-loss were age- and gender-matched with treatment-naïve HBeAg-negative CHB infection. Paired assessment with transient elastography and enhanced liver fibrosis (ELF) measurements were performed and repeated at 3 years.
Background And Aim: We aimed to investigate the effect of metabolic dysfunction-associated steatotic liver disease (MASLD) on three-dose BNT162b2 immunogenicity to the omicron variant.
Methods: Adult recipients of three doses of BNT162b2 were prospectively recruited between May and December 2021. The serology of the neutralizing antibody by live virus microneutralization (vMN) to the omicron variant was measured at baseline, day 180, and day 360 after the first dose.
Objective: Type 2 diabetes mellitus and metabolic dysfunction-associated steatotic liver disease (diabetic MASLD) frequently coexist and worsen liver and non-liver outcomes, but effective pharmacological therapies are limited. We aimed to evaluate the long-term effect of sodium-glucose cotransporter-2 inhibitor (SGLT-2i) on liver and non-liver outcomes among patients with diabetic MASLD.
Design: This population-based cohort study retrieved patients with diabetic MASLD from Merative Marketscan Research Databases (April 2013 and December 2021).
Background And Aims: Accurate biomarkers to predict outcomes following discontinuation of nucleos(t)ide analogue (NA) therapy are needed. We evaluated serum hepatitis B core-related antigen (HBcrAg) level as a biomarker for predicting outcomes after NA discontinuation.
Methods: Patients with HBeAg-negative chronic hepatitis B (CHB) without cirrhosis were enrolled in a prospective trial evaluating clinical outcomes until 96 weeks after NA discontinuation.
Article Synopsis
- The study aimed to evaluate the effectiveness and tolerability of direct-acting antiviral (DAA) treatments for hepatitis C virus (HCV) across different genotypes (GTs) in a global, real-world context, focusing particularly on GT3 and GT6.
- Researchers analyzed data from 15,849 chronic hepatitis C patients across Asia, North America, and Europe over a seven-year period, noting demographic factors such as age, sex, and prior treatment history.
- Results showed a high sustained virological response (SVR12) rate of 96.9% overall, with variances by genotype, highlighting that independent factors like advanced age, cirrhosis, and previous treatment failures affected treatment outcomes, while being
Article Synopsis
- Oral antiviral therapy for chronic hepatitis B (CHB) is effective and well-tolerated, but real-world data on how well patients are evaluated and treated is limited, prompting this study.
- In a cross-sectional analysis of 12,566 adult patients from 25 centers across 9 countries, it was found that 73.3% received adequate evaluation, with only 32.6% of those deemed treatment-eligible actually starting antiviral therapy.
- Factors influencing evaluation and treatment included gender, with females more likely to be evaluated but less likely to start treatment, and geographical differences, particularly among Asian patients from Western regions showing lower rates of evaluation and treatment.
Article Synopsis
- Advanced hepatocellular carcinoma (HCC) historically had limited treatment options and poor outcomes, but the introduction of sorafenib in 2007 marked a significant development in systemic therapy for this cancer.
- Recent innovations in the past five years, including combinations of immunotherapies and targeted therapies like atezolizumab plus bevacizumab, have shown improved survival rates and led to updated treatment guidelines.
- While new treatments show promise, uncertainties remain regarding their effectiveness in specific patient subgroups, emphasizing the need for further research to tailor personalized treatment approaches based on individual patient characteristics and liver disease factors.