M F Yuen

Queen Mary Hospital, Hong Kong, Hong Kong

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Publications (74)323.83 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Background We investigated the differences in HBsAg kinetics at different levels of viremia in hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB). Methods We compared HBsAg levels among HBeAg-negative CHB patients with persistently undetectable HBV DNA (≤20 IU/mL; Group A, n = 100), HBV DNA 20–2,000 IU/mL (Group B, n = 100), and HBV DNA >2,000 IU/mL (Group C, n = 100). HBsAg and HBV DNA levels were measured at three consecutive time points during follow-up (median 21.4 months). Results Median HBsAg levels were significantly lower in Group A than in Groups B and C at all time points (p < 0.001). HBV DNA and HBsAg levels were weakly correlated (r = 0.180 and 0.151 for Groups B and C, respectively). Among patients with HBsAg <100 IU/mL, Group A patients had the greatest median serum HBsAg reduction (0.341 log IU/mL/year; Group B, 0.122 log IU/mL/year; Group C, 0.057 log IU/mL/year; p = 0.002). Among Group A patients with HBsAg <100 IU/mL, baseline HBsAg achieved an AUROC of 0.876 in predicting >1 log annual HBsAg reduction; 10–100 IU/mL HBsAg was the optimal level for prediction (sensitivity 90 %; specificity 74.6 %). Serum HBsAg/HBV DNA ratios were significantly higher in Group B than in Groups A and C (p < 0.05). Conclusions HBV DNA and HBsAg were weakly correlated. Only patients with undetectable HBV DNA showed decline in HBsAg levels during follow-up. The greatest reduction in HBsAg levels occurred in patients with baseline HBsAg <100 IU/mL.
    Hepatology International 01/2013; 7(1):119-126. · 2.64 Impact Factor
  • Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine 12/2011; 17 Suppl 6:41-3.
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    ABSTRACT: For patients with chronic hepatitis B (CHB) infection, changes in liver stiffness measurement (LSM) over time are not known. We examined changes longitudinally in a cohort of patients. Four hundred and twenty-six patients with CHB underwent transient elastography. Patients were followed regularly, and repeat elastography was performed at 3 years. Hepatitis serology, viral load and routine liver biochemistry were monitored. Of the 426 patients, 38 (9%) were hepatitis B e-antigen (HBeAg)-positive, 293 (69%) were HBeAg-negative and 95 (22%) were patients with prior hepatitis B surface antigen (HBsAg) seroclearance. A total of 110 patients received oral antiviral therapy. There was a significant decline of LSMs at the follow-up measurement compared to baseline (6.1 vs 7.8 kPa respectively, P = 0.002) in treated patients who had elevated alanine aminotransferase (ALT) at baseline and subsequent normalization after 3 years (normal ALT limit being 30 U/L for males and 19 U/L for females). In nontreated patients, only the patients with persistently normal ALT at both time points had significantly lower LSMs at the follow-up measurement compared to baseline: 4.9 vs 5.3 kPa, respectively, in patients who remained positive for HBsAg (P = 0.005) and 5.1 vs. 5.4 kPa, respectively, in patients who had HBsAg seroclearance (P = 0.026). In patients who remained positive for HBsAg, independent factors associated with a significant decline in LSM of ≥1 kPa included antiviral therapy (P = 0.011) and the ALT levels at the follow-up time point (P = 0.024). Thus, in patients with CHB, a significant decline in LSM after 3 years was observed in treated patients with ALT normalization and in untreated patients who had persistently normal ALT. Antiviral therapy and follow-up ALT levels were independent significant factors associated with a decline in LSM.
    Journal of Viral Hepatitis 07/2011; 18(7):e200-5. · 3.08 Impact Factor
  • Journal of Hepatology - J HEPATOL. 01/2011; 54.
  • Journal of Hepatology - J HEPATOL. 01/2011; 54.
  • Journal of Hepatology - J HEPATOL. 01/2011; 54.
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    ABSTRACT: Few studies have evaluated the health-related quality of life (HRQOL) of Southern Chinese with chronic hepatitis B (CHB) infection. To evaluate the HRQOL of Chinese patients at different stages of CHB infection and to find out factors associated with HRQOL. 520 Chinese adult CHB patients of whom 156 were uncomplicated, 102 had impaired liver function, 139 had cirrhosis and 123 had hepatocellular carcinoma (HCC) were interviewed with a structured questionnaire, the SF-36 Health Survey version 2 (SF-36v2), and the Chronic Liver Disease Questionnaire (CLDQ). The differences in SF-6D health preference values and SF-36v2 scores between each CHB group and Hong Kong population norms were assessed by t-test. ANOVA was used to compare the mean SF-6D health preference, SF-36v2 scores, and CLDQ scores among CHB groups. Multiple linear regressions were performed to identify determinants of HRQOL. CHB patients had significantly lower SF-36v2 scores than the population norm. The SF-6D values of CHB patients with uncomplicated disease, impaired liver function, HCC and cirrhosis were 0.755, 0.745, 0.720 and 0.701, respectively, all significantly lower than the population norm of 0.787. Advanced stage of CHB illness, anti-viral treatment, bilirubin level, psychological co-morbidity, younger age and female were associated with poorer HRQOL. CHB infection had a negative impact on HRQOL. There was a progressive decrease in health preference values with CHB disease progression. The results can be used for the estimation of quality adjusted life years (QALYs) for CHB patients in cost effectiveness or cost utility studies. http://www.hkclinicaltrials.com; HKCTR-151.
    Health and Quality of Life Outcomes 02/2009; 7:52. · 2.27 Impact Factor
  • Journal of Hepatology - J HEPATOL. 01/2009; 50.
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    C.-L. Lai, M.-F. Yuen
    ISBT Science Series 01/2009; 4:347-351.
  • Journal of Hepatology - J HEPATOL. 01/2009; 50.
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    ABSTRACT: Chest pain is common and data regarding noncardiac chest pain (NCCP) in Asia are lacking. To determine the differences in clinical presentations, psychologic impact, and quality of life between patients with NCCP and cardiac chest pain (CCP), and to identify any factors that impacted on these patients. Consecutive patients undergoing coronary angiography for the evaluation of chest pain were recruited in Hong Kong and Wuhan, China. One hundred and forty patients with abnormal and 141 patients with normal angiography were included in the study. The validated gastroesophageal reflux disease questionnaire, the Hospital Anxiety-Depression Scale, and the 12-item Short Form Health Survey (SF-12) were used for assessment. NCCP patients reported similar days-off work and impairment of their social life compared with those with CCP. No difference was found in the anxiety and depression scores between the 2 groups. NCCP patients with reflux symptoms had higher anxiety score (7.19 vs. 5.74, P=0.044), reported more interruption of their social life (26% vs. 5%, P<0.0001), and had taken more sick leaves (17% vs. 5%, P=0.018) compared with those without gastroesophageal reflux disease. The quality of life and psychologic impact of patients with NCCP were as significant as those with CCP. NCCP patients with reflux symptoms were more anxious and were impaired in their productivity and social life.
    Journal of clinical gastroenterology 08/2008; 43(1):13-8. · 2.21 Impact Factor
  • Journal de Chirurgie. 05/2008; 145(3):295–296.
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    ABSTRACT: Helicobacter pylori infection is a major cause of gastritis and gastric carcinoma. Aspirin has anti-inflammatory and antineoplastic activity. The aim of the present study was to determine the effects of aspirin on H. pylori-induced gastritis and the development of heterotopic proliferative glands. H. pylori strain SS1 was inoculated into the stomachs of Mongolian gerbils. Two weeks after inoculation, the animals were fed with the powder diets containing 0 p.p.m. (n = 10), 150 p.p.m. (n = 10), or 500 p.p.m. (n = 10) aspirin. Mongolian gerbils were killed after 36 weeks of infection. Uninfected Mongolian gerbils (n = 10) were used as controls. Histologic changes, epithelial cell proliferation and apoptosis, and prostaglandin E(2) (PGE(2)) levels of gastric tissue were determined. H. pylori infection induced gastric inflammation. Administration of aspirin did not change H. pylori-induced gastritis, but alleviated H. pylori-induced hyperplasia and the development of heterotopic proliferative glands. Administration of aspirin accelerated H. pylori-associated apoptosis but decreased H. pylori-associated cell proliferation. In addition, the increased gastric PGE(2) levels due to H. pylori infection were suppressed by treatment with aspirin, especially at the dose of 500 p.p.m. Aspirin alleviates H. pylori-induced hyperplasia and the development of heterotopic proliferative glands. Moreover, aspirin increases H. pylori-induced apoptosis. We demonstrated the antineoplastic activities of aspirin in H. pylori-related gastric carcinogenesis.
    Helicobacter 03/2008; 13(1):20-9. · 3.51 Impact Factor
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    ABSTRACT: The incidence of esophageal adenocarcinoma was increasing in the Western Europe and United States, but not in East Asian countries. Population based study on the trend of esophageal adenocarcinoma in Hong Kong was not available. Population-based data of Hong Kong Cancer Registry from 1984 to 2003 were used. Cases were grouped into four 5-year periods. Average age standardized rate (WSR) of each period was calculated by averaging the WSR of the 5 years in each period, basing on the world standard population, with adjustment made for cases with missing histology. 10,751 new cases of esophageal neoplasm were studied (8,637 males and 2,114 females). Esophageal adenocarcinoma declined among both males and females, with the total number decreased from 224 in 1984 to 1988 to 131 in 1998 to 2003. WSR decreased from 1.10 of 100,000 in 1984 to 1988 to 0.34 of 100,000 in 1998 to 2003. The decline was faster than that for esophageal squamous cell carcinoma so that the relative ratio of esophageal adenocarcinoma decreased from 11.7% in 1984 to 1988 to 6.4% in 1998 to 2003. The incidence of esophageal adenocarcinoma and ratio of esophageal adenocarcinoma versus esophageal squamous cell carcinoma decreased in Hong Kong.
    Cancer Epidemiology Biomarkers &amp Prevention 01/2008; 16(12):2637-40. · 4.56 Impact Factor
  • Journal of Hepatology - J HEPATOL. 01/2008; 48.
  • Journal of Hepatology - J HEPATOL. 01/2008; 48.
  • Journal of Hepatology - J HEPATOL. 01/2008; 48.
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    ABSTRACT: The efficacy of levofloxacin-based quadruple therapy in resistant Helicobacter pylori infection is not known. To test the efficacy of levofloxacin-based quadruple therapy and traditional quadruple therapy in resistant H. pylori infection. One hundred and two patients with resistant H. pylori infection were randomized to 1 week of either EBAL (esomeprazole 40 mg b.d., bismuth subcitrate 240 mg b.d., amoxicillin 1 g b.d. and levofloxacin 500 mg b.d.) or EBMT (esomeprazole 40 mg b.d., bismuth subcitrate 240 mg b.d., metronidazole 400 mg t.d.s. and tetracycline 500 mg q.d.s.). (13)C-urea breath test was performed at week 12 to assess post-treatment H. pylori status. In intention-to-treat analysis H. pylori eradication was achieved in 37 of 51 (73%) subjects in EBAL and 45 of 51 (88%) subjects in EBMT groups, respectively (P = 0.046). Per-protocol eradication rates of EBAL and EMBT groups were 78% and 94%, respectively (P = 0.030). The intention-to-treat eradication rate was statistically lower for EBAL than EMBT (56% vs. 90%, P = 0.013) among those who had failed more than one course of eradication therapy. Previous levofloxacin triple therapy did not affect the efficacy of either protocol significantly. Levofloxacin-based quadruple therapy was inferior to traditional quadruple therapy for resistant H. pylori infection.
    Alimentary Pharmacology & Therapeutics 11/2007; 26(7):1063-7. · 4.55 Impact Factor
  • C.‐L. Lai, M.‐F. Yuen
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    ABSTRACT:   The natural history of chronic hepatitis B is dependent on the age of acquiring the hepatitis B infection. Those who are infected at adolescence or adulthood (including most of the Caucasians) tend to have stable disease after hepatitis B e antigen seroconversion with normal serum alanine aminotransaminase (ALT) and hepatitis B virus (HBV) DNA levels <105 copies/mL (20 000 IU/mL). In contrast, those who are infected at birth or early childhood (including the majority of the world’s hepatitis B carriers, i.e. Asians) have a prolonged immune tolerance phase followed by a prolonged immune clearance phase. A proportion of these patients have progressive disease after HBeAg seroconversion with HBV DNA <104 copies/mL (<2000 IU/mL) and ALT between 0.5 and 2× upper limit of normal. Core promoter mutations may play a part in the development of cirrhosis-related complications. However, continuing viral replication, even at a relatively low level of <104 copies/mL (<2000 IU/mL), is probably the most important factor for the development of complications.
    Journal of Viral Hepatitis 10/2007; 14(s1):6 - 10. · 3.08 Impact Factor
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    ABSTRACT: Clinical observation showed that there is family aggregation in constipated subjects, but formal data are lacking. This prompted us to conduct a formal family study in constipated subjects. Constipated subjects (probands) were identified according to the Rome II and Chinese constipation questionnaire criteria, healthy subjects were chosen as controls. Living first-degree relatives (parents, siblings, and children) and spouses (as internal controls) from both groups were identified. The questionnaire on Rome II criteria was given to the relatives either through the index subjects or by mail. The questionnaire was received by mailing back or through the index subjects. Any nonresponders were chased. There were 132 probands with constipation and 114 controls. The Rome II questionnaire was sent to a total of 677 relatives of the probands and 591 of the controls. Relatives were comparable in mean age, sex distribution, family size, and marital status in the two groups. Constipation prevalence was 16.4% in probands' relatives versus 9.1% in controls' relatives, i.e., 13% in the relatives from both proband and controls. Among the constipated relatives, 6.3%versus 9.3% of the relatives were spouses of the probands and controls (P = 0.5). Subjects with more family members having constipation will have higher risk of constipation: OR 2.02, CI 1.14-3.65, P = 0.0177 for at least one family member; OR 3.99, CI 1.86-9.23, P = 0.0006 for at least two family members. Familial aggregation of constipation occurs, supporting a genetic or intrafamilial environment component.
    The American Journal of Gastroenterology 02/2007; 102(1):149-52. · 7.55 Impact Factor

Publication Stats

2k Citations
323.83 Total Impact Points

Institutions

  • 2000–2013
    • Queen Mary Hospital
      Hong Kong, Hong Kong
  • 1999–2011
    • The University of Hong Kong
      • • Department of Medicine
      • • Department of Surgery
      Hong Kong, Hong Kong
  • 2008
    • Sun Yat-Sen University of Medical Sciences
      Shengcheng, Guangdong, China
  • 2006
    • Peking University
      Peping, Beijing, China
  • 2003
    • Kwong Wah Hospital
      Hong Kong, Hong Kong
  • 2001
    • Tuen Mun Hospital
      Hong Kong, Hong Kong