Publications by authors named "Wan-Long Chuang"
Article Synopsis
- This study examines the link between air pollution and the development of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB) who are treated with nucleotide/nucleoside analogues.
- The research involved 1,298 patients over a follow-up period, finding that liver cirrhosis, male sex, age, and body mass index were key risk factors for HCC.
- It concludes that long-term exposure to nitrogen oxides (NO) significantly increases the risk of HCC, especially in CHB patients with cirrhosis.
Article Synopsis
- * Recent advancements in targeted therapy and immune-checkpoint inhibitors are now becoming available for treating unresectable HCC and preventing recurrence after curative procedures.
- * This clinical practice guideline aims to provide updated recommendations from Asia-Pacific experts on systemic therapy for HCC, addressing key questions about patient selection, effective treatments, and management strategies for immunotherapy.
Background And Aims: Early detection of hepatocellular carcinoma (HCC) is crucial for improving survival in patients with chronic hepatitis. The GALAD algorithm combines gender (biological sex), age, α-fetoprotein (AFP), agglutinin-reactive fraction of AFP (AFP-L3), and protein induced by vitamin K absence or antagonist-II (PIVKA-II) for HCC detection. Similarly, the GAAD algorithm incorporates gender (biological sex), age, AFP, and PIVKA-II.
View Article and Find Full Text PDFBackground And Aims: Direct-acting antiviral agents (DAAs) achieve high sustained virologic response (SVR) in chronic hepatitis C patients; yet a proportion of patients still experience de novo liver complications after SVR. Identification of risk factors is clinically important. FIB-4 index is a useful noninvasive tool to assess fibrosis, while neutrophil-to-lymphocyte ratio (NLR) is a biomarker for systemic inflammation.
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- - MASLD is a widespread chronic liver disease, affecting over 30% of people globally, and is primarily linked to metabolic issues like insulin resistance and type 2 diabetes.
- - There is a significant two-way relationship between MASLD and diabetes, influencing each other's progression and treatment outcomes.
- - Collaborative efforts from Taiwanese health organizations have led to new guidelines aimed at improving patient care for those with both diabetes and MASLD, focusing on surveillance and management strategies.
The role of artificial intelligence in the management of liver diseases.
Kaohsiung J Med Sci
November 2024
Universal neonatal hepatitis B virus (HBV) vaccination and the advent of direct-acting antivirals (DAA) against hepatitis C virus (HCV) have reshaped the epidemiology of chronic liver diseases. However, some aspects of the management of chronic liver diseases remain unresolved. Nucleotide analogs can achieve sustained HBV DNA suppression but rarely lead to a functional cure.
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- - Omicron, a variant of SARS-CoV-2, was first detected in Taiwan at the end of 2021, leading the government to end its strict "zero-COVID" policy in March 2022, after which COVID-19 outbreaks began.
- - Researchers conducted a study using nasopharyngeal swabs and medical records from Kaohsiung Medical University Hospital to track Omicron subvariant replacements and identify factors affecting hospitalization risk.
- - Findings indicated that older age, comorbidities, and male sex heightened the risk of hospitalization and mortality, while COVID-19-related cases and deaths generally decreased over time from August 2022 to October 2023.
Background: In two phase 3 studies, tenofovir alafenamide (TAF) showed non-inferior efficacy versus tenofovir disoproxil fumarate (TDF), with more favourable renal and bone safety in patients with chronic hepatitis B (CHB).
Aims: Here, we report the studies' final 8-year results.
Methods: CHB patients (hepatitis B e antigen [HBeAg]-negative and HBeAg-positive) were randomised (2:1) to double-blind TAF 25 mg/day or TDF 300 mg/day for up to 3 years, followed by open-label (OL) TAF through year 8.
Introduction: Metabolic dysfunction-associated steatotic liver disease (MASLD) and type 2 diabetes mellitus (DM) are the most prevalent metabolic disorders globally. The numbers affected in both disorders are also rapidly increasing with alarming trends in children and young adults.
Areas Covered: Insulin resistance (IR) and the subsequent metabolic dysregulation are the fundamental pathogenesis pathways of the prevalent metabolic disorders.
Background/aims: Steatotic liver disease (SLD) is a common manifestation in chronic hepatitis C (CHC). Metabolic alterations in CHC are associated with metabolic dysfunction-associated steatotic liver disease (MASLD). We aimed to elucidate whether hepatitis C virus (HCV) eradication mitigates MASLD occurrence or resolution.
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- 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
The prevalence of overweight and obesity is increasing, leading to metabolic-associated fatty liver disease (MAFLD) characterized by excessive accumulation of liver fat and a risk of developing hepatocellular carcinoma (HCC). The driver gene mutations may play the roles of passengers that occur in single 'hotspots' and can promote tumorigenesis from benign to malignant lesions. We investigated the impact of high body weight and BMI on HCC survival using The Cancer Genome Atlas Liver Hepatocellular Carcinoma (TCGA-LIHC) dataset.
View Article and Find Full Text PDFBackground And Aims: We aimed to explore the risk factors associated with virological and clinical relapse, as well as their impact on overall mortality, in hepatitis B virus (HBV)-infected patients receiving nucleos(t)ide analogues (NUCs) therapy prior to chemotherapy initiation.
Methods: From 2010 to 2020, we conducted a prospective cohort study involving patients with HBV infection undergoing cytotoxic chemotherapy. We utilized the Kaplan-Meier method and Cox proportional hazard regression models to assess risk factors.
Viral hepatitis moderates the impact of TGFB1 on neurocognitive impairment.
Kaohsiung J Med Sci
September 2024
Recent studies have identified a correlation between chronic viral hepatitis and cognitive impairment, yet the underlying mechanisms remain unclear. This study investigated the influence of TGFB1 genetic polymorphisms on cognitive function in individuals with and without hepatitis infections, hypothesizing that these polymorphisms and the viral hepatitis-induced inflammatory environment interact to affect cognitive abilities. Participants (173 with viral hepatitis and 258 healthy controls) were recruited.
View Article and Find Full Text PDFBackground: Chronic hepatitis C (CHC) increases the risk of liver cirrhosis (LC) and hepatocellular carcinoma (HCC). This nationwide cohort study assessed the effectiveness of viral eradication of CHC.
Methods: The Taiwanese chronic hepatitis C cohort and Taiwan hepatitis C virus (HCV) registry are nationwide HCV registry cohorts incorporating data from 23 and 53 hospitals in Taiwan, respectively.
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.
Background: Phase 3 studies in patients with chronic hepatitis B have shown tenofovir alafenamide to have non-inferior efficacy to tenofovir disoproxil fumarate, with improved renal and bone safety. We conducted this study to evaluate the safety and efficacy of switching to tenofovir alafenamide in participants with chronic hepatitis B and renal or hepatic impairment.
Methods: This open-label, multicentre, phase 2 study was done in eight countries or territories at 30 sites.
Chronic Hepatitis C Related Steatotic Liver Disease Is More Than "Miscellaneous Steatotic Liver Disease".
Clin Gastroenterol Hepatol
October 2024
The terminology and definition of fatty liver disease has evolved significantly. Recently, the overarching term of steatotic liver disease (SLD) has been endorsed by international societies. SLD further encompasses individuals with cardiometabolic risk factors (CMRFs), namely, metabolic dysfunction-associated steatotic liver disease (MASLD).
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- This study explored the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) and its impact on mortality related to cardiometabolic risks, involving over 343,000 adults aged 30 and older.
- The findings revealed that 36.4% of participants had MASLD, with a notable association between abnormal liver enzymes and higher cardiometabolic comorbidities among these individuals.
- Patients with MASLD faced a significantly increased risk of dying from all causes, as well as from cardiovascular and diabetes-related issues, emphasizing the need for monitoring and lifestyle guidance for those affected.
Lifestyle modification is the standard of care for nonalcoholic fatty liver disease (NAFLD) patients. We aimed to investigate the efficacy of a short-term lifestyle modification program in the disease course of Taiwanese nonalcoholic steatohepatitis (NASH) patients with paired biopsies. All patients received a 6-month, strict multidisciplinary program of lifestyle modifications led by physicians, dieticians, and nursing staff.
View Article and Find Full Text PDFIntroduction: The prospective study aimed to investigate the long-term associated risks of cirrhosis and hepatocellular carcinoma (HCC) across various subtypes of steatotic liver disease (SLD).
Methods: We enrolled 332,175 adults who participated in a health screening program between 1997 and 2013. Participants were categorized into various subtypes, including metabolic dysfunction-associated SLD (MASLD), MASLD with excessive alcohol consumption (MetALD), and alcohol-related liver disease (ALD), based on ultrasonography findings, alcohol consumption patterns, and cardiometabolic risk factors.
Background/aims: Oral EDP-514 is a potent core protein inhibitor of hepatitis B virus (HBV) replication, which produced a >4-log viral load reduction in HBV-infected chimeric mice with human liver cells. This study evaluated the safety, pharmacokinetics, and antiviral activity of three doses of EDP-514 in treatment-naive viremic patients with HBeAgpositive or -negative chronic HBV infection.
Methods: Patients with HBsAg detectable at screening and at least 6 months previously were eligible.
Background And Aim: The benefits of entecavir (ETV) versus tenofovir disoproxil fumarate (TDF) in reducing the development of chronic hepatitis B (CHB)-related hepatocellular carcinoma remain controversial. Whether mortality rates differ between patients with CHB treated with ETV and those treated with TDF is unclear.
Methods: A total of 2542 patients with CHB treated with either ETV or TDF were recruited from a multinational cohort.