Synergistic effects of family history of hepatocellular carcinoma and hepatitis B virus infection on risk for incident hepatocellular carcinoma.

Background & Aims: Little is known about the effects of family history of hepatocellular carcinoma (HCC) on hepatitis B progression or risk of HCC. We examined how family HCC history and presence or stage of hepatitis B virus (HBV) infection affect risk for HCC.

Methods: We performed a population-based cohort study of 22,472 participants from 7 townships in Taiwan who underwent evaluation for liver disease from 1991 through 1992.

Prediction models of long-term cirrhosis and hepatocellular carcinoma risk in chronic hepatitis B patients: risk scores integrating host and virus profiles.

Unlabelled: Integrating host and HBV characteristics, this study aimed to develop models for predicting long-term cirrhosis and hepatocellular carcinoma (HCC) risk in chronic hepatitis B virus (HBV) patients. This analysis included hepatitis B surface antigen (HBsAg)-seropositive and anti-HCV-seronegative participants from the Risk Evaluation of Viral Load Elevation and Associated Liver Disease/Cancer in HBV (R.E.

A predictive scoring system for the seroclearance of HBsAg in HBeAg-seronegative chronic hepatitis B patients with genotype B or C infection.

Background & Aims: Seroclearance of hepatitis B surface antigen (HBsAg) is the most ideal end point in the treatment of chronic hepatitis B. This study develops a predictive scoring system to assess whether the addition of serum levels HBsAg may improve the predictability of HBsAg loss.

Methods: This study included 2491 untreated participants with genotype B or C HBV infection, who were HBsAg-seropositive, HBeAg-seronegative, anti-HCV-seronegative, and cirrhosis free at study entry.

Natural history of chronic hepatitis B: what exactly has REVEAL revealed?

Chronic hepatitis B virus (HBV) infection is a serious public health problem because of its worldwide prevalence and potential to cause adverse consequences. The Risk Evaluation of Viral Load Elevation and Associated Liver Disease/Cancer-Hepatitis B Virus (REVEAL-HBV) study carried out in Taiwan was used to investigate the natural history of chronic hepatitis B. The REVEAL-HBV study has established an HBV viral load paradigm in the natural history of chronic hepatitis B (CHB).

Incidence and determinants of spontaneous seroclearance of hepatitis B e antigen and DNA in patients with chronic hepatitis B.

Background & Aims: The spontaneous seroclearance of hepatitis B e antigen (HBeAg) and hepatitis B virus (HBV) DNA are important markers of progression of chronic HBV infection. We performed a long-term cohort study to elucidate the incidence and determinants of HBeAg and HBV DNA seroclearance in patients with chronic hepatitis B.

Methods: A total of 1289 participants with a serum HBV DNA level of 10,000 copies/mL or more and without cirrhosis when the study began (1991-1992) were followed up until June 2004.

Absenteeism and productivity among employees being treated for hepatitis C.

Objectives: To compare productivity, absence days, and absence costs for treated (HCV-Tx) and untreated (HCV-NoTx) US employees with hepatitis C virus (HCV) infection.

Study Design: Retrospective database study.

Methods: Employee records from multiple large employers in the United States with data about demographics, jobs, and healthcare use in the Human Capital Management Services database were assessed.

Lifetime risk and sex difference of hepatocellular carcinoma among patients with chronic hepatitis B and C.

Purpose: Both hepatitis B (HBV) and C viruses (HCV) are causes of hepatocellular carcinoma (HCC), but lifetime risk and sex difference remain unclear. This study aimed to assess the lifetime risk and sex difference of HCC among patients with chronic HBV and/or HCV.

Methods: A prospective cohort of 23,820 residents of Taiwan age 30 to 65 years were enrolled from 1991 to 1992, with 477 instances of HCC occurring subsequently.

Changes in serum levels of HBV DNA and alanine aminotransferase determine risk for hepatocellular carcinoma.

Background & Aims: It is not clear whether risk for hepatocellular carcinoma can be accurately determined from long-term changes in serum levels of hepatitis B virus (HBV) DNA or alanine aminotransferase (ALT).

Methods: We measured serum levels of HBV DNA and ALT at enrollment and during follow-up analysis of 3160 participants in the REVEAL-HBV study. Development of hepatocellular carcinoma was determined from follow-up examinations and computerized linkage with National Cancer Registry and National Death Certification profiles.

Incidence and determinants of spontaneous hepatitis B surface antigen seroclearance: a community-based follow-up study.

Background & Aims: Seroclearance of hepatitis B surface antigen (HBsAg) is one of the most important clinical outcomes for chronic hepatitis B treatment trials. Few studies have explored the incidence and determinants of spontaneous seroclearance using a long-term follow-up study. This study aimed to examine the natural history and predictors of HBsAg seroclearance.

Nomograms for risk of hepatocellular carcinoma in patients with chronic hepatitis B virus infection.

Purpose: Counseling patients with chronic hepatitis B virus (HBV) on their individual risk of liver disease progression is challenging. This study aimed to develop nomograms for predicting hepatocellular carcinoma risk in patients with chronic hepatitis B.

Patients And Methods: Two thirds of the Risk Evaluation of Viral Load Elevation and Associated Liver Disease/Cancer-Hepatitis B Virus (REVEAL-HBV) study cohort was allocated for model derivation (n = 2,435), and the remaining third was allocated for model validation (n = 1,218).

Carriers of inactive hepatitis B virus are still at risk for hepatocellular carcinoma and liver-related death.

Background & Aims: The risk and the predictors of liver disease progression in carriers of inactive hepatitis B virus (HBV) are unclear.

Methods: Participants in the Risk Evaluation of Viral Load Elevation and Associated Liver Disease/Cancer-Hepatitis B Virus (REVEAL-HBV) study who were seronegative for hepatitis B e antigen; had serum levels of HBV DNA <10,000 copies/mL; and did not have cirrhosis, hepatocellular carcinoma, or increased serum levels of alanine aminotransferase were classified as carriers of inactive HBV (n = 1932). Study participants who were seronegative for HB surface antigen and antibodies against hepatitis C virus, yet had similar clinical liver features, were the controls (n = 18,137).

96-week efficacy and safety of atazanavir, with and without ritonavir, in a HAART regimen in treatment-naive patients.

This study assesses virologic response, safety, tolerability, and changes in health-related quality of life (HRQoL) in antiretroviral (ARV)-naive patients treated with 2 atazanavir (ATV)-based regimens over 96 weeks. Treatment-naive adult patients (n = 200) were randomized to receive either ATV 300 mg with ritonavir (RTV) 100 mg (ATV300/r, n = 95) or ATV 400 mg (ATV400; n = 105). At week 96, 75% of ATV300/r-treated and 70% of ATV400-treated patients achieved viral loads <400 copies/mL (difference estimate [95% confidence interval, CI] = 5.

Risk of pancreatic cancer in chronic hepatitis B virus infection: data from the REVEAL-HBV cohort study.

Background And Aims: The relationship between the hepatitis B virus (HBV) and pancreatic cancer remains unclear. Because HBV has been isolated from pancreatic tissue, we hypothesized that HBV may play a role in the development of pancreatic carcinoma.

Methods: This cohort was recruited between 1991 and 1992.

Hepatitis B virus DNA levels and outcomes in chronic hepatitis B.

Serum hepatitis B virus (HBV) DNA levels can fluctuate markedly during the course of chronic HBV infection. Both case-control and cohort studies have shown a significant, dose-response association between serum HBV DNA levels measured at the time of initial evaluation and the subsequent risk of cirrhosis. A similar direct relationship has been shown for the risk of hepatocellular carcinoma (HCC) in cross-sectional, case-control, and cohort studies.

Associations between hepatitis B virus genotype and mutants and the risk of hepatocellular carcinoma.

Background: The risk of hepatocellular carcinoma (HCC) increases with increasing level of hepatitis B virus (HBV) in serum (viral load). However, it is unclear whether genetic characteristics of HBV, including HBV genotype and specific genetic mutations, contribute to the risk of HCC. We examined the HCC risk associated with HBV genotypes and common variants in the precore and basal core promoter (BCP) regions.

Evaluation of the cost-effectiveness of entecavir versus lamivudine in hepatitis BeAg-positive chronic hepatitis B patients.

Background: As new treatment options for chronic hepatitis B virus (HBV) become available, evaluations of cost-effectiveness become important. Entecavir is a deoxyguanine nucleoside analogue approved by the U.S.

Long-term outcomes in hepatitis B: the REVEAL-HBV study.

This article reviews results from the REVEAL-HBV study, which found that hepatitis B virus DNA across a biologic gradient is very strongly predictive of the risk of disease progression and remains a strong predictor of risk after accounting for other important factors.

Risk and predictors of mortality associated with chronic hepatitis B infection.

Background & Aims: The study objective was to determine the risk of all-cause and cause-specific mortality as well as to examine the predictors of mortality in chronic hepatitis B infection.

Methods: We performed a prospective cohort study of 23,820 persons (age, 30-65 y) recruited between 1991 and 1992 and followed up through 2004 from 7 townships in Taiwan. The main outcomes were all-cause and liver-related mortality rates.

Past HBV viral load as predictor of mortality and morbidity from HCC and chronic liver disease in a prospective study.

Background And Aims: In a prospective cohort study with 11 yr of follow-up, we assessed the relationship between past hepatitis B virus (HBV) viral load and mortality. Surviving cohort members were evaluated for current liver disease.

Methods: We measured HBV viral load by real-time polymerase chain reaction on stored samples from cohort entry (1992-1993) in 2,763 hepatitis B surface antigen (HBsAg)-positive adults.

Predicting cirrhosis risk based on the level of circulating hepatitis B viral load.

Background & Aims: Cirrhosis develops as a result of hepatic inflammation and subsequent fibrosis in chronic hepatitis B infection. We report on the relationship between hepatitis B viremia and progression to cirrhosis in chronic hepatitis B infection.

Methods: This was a population-based prospective cohort study of 3582 untreated hepatitis B-infected patients established in Taiwan from 1991 to 1992.

Risk of hepatocellular carcinoma across a biological gradient of serum hepatitis B virus DNA level.

Context: Serum hepatitis B virus (HBV) DNA level is a marker of viral replication and efficacy of antiviral treatment in individuals with chronic hepatitis B.

Objective: To evaluate the relationship between serum HBV DNA level and risk of hepatocellular carcinoma.

Design, Setting, And Participants: Prospective cohort study of 3653 participants (aged 30-65 years), who were seropositive for the hepatitis B surface antigen and seronegative for antibodies against the hepatitis C virus, recruited to a community-based cancer screening program in Taiwan between 1991 and 1992.

Changes in lipids over twelve months after initiating protease inhibitor therapy among persons treated for HIV/AIDS.

Background: Protease inhibitors are known to alter the lipid profiles in subjects treated for HIV/AIDS. However, the magnitude of this effect on plasma lipoproteins and lipids has not been adequately quantified.

Objective: To estimate the changes in plasma lipoproteins and triglycerides occurring within 12 months of initiating PI-based antiretroviral therapy among HIV/AIDS afflicted subjects.

Chronic hepatitis B virus infection and mortality from non-liver causes: results from the Haimen City cohort study.

Background: Studies of chronic hepatitis B virus (HBV) infection in endemic populations have rarely documented causes of mortality other than liver disease and hepatocellular carcinoma (HCC).

Methods: We analysed all-cause mortality related to HBV infection, focusing on the deaths not related to liver disease in a prospective cohort of adults living in Haimen City, China, who were followed from 1992 to 2002. Death certificate data from 4590 deaths among 83 794 individuals were analysed.

Treatment costs in Canada of health conditions resulting from chronic hepatitis B infection.

Goals: To estimate resource use and expected annual cost of care for subjects with chronic hepatitis B and resulting complications in Canada.

Background: Patients chronically infected with hepatitis B virus are at an increased risk of progressing to complications from deteriorating liver function.

Study: The direct medical costs for six disease states associated with chronic hepatitis B virus infection were estimated for the year 2001.

Cost of chronic hepatitis B infection in China.

Goals: The objective of this study was to estimate the direct medical costs associated with the treatment of chronic hepatitis B (CHB) infection and its complications in China.

Background: CHB infection is a major health problem in China, with an estimated 112 million chronic carriers. However, the economic burden associated with CHB and its complications has not been well characterized.