-
Chung-Feng Huang,
Chia-Yen Dai,
Wan-Long Chuang,
Chi-Kung Ho,
Ta-Chung Wu,
Nai-Jen Hou,
Chao-Ling Wang,
Ming-Yen Hsieh,
Jee-Fu Huang,
Zu-Yau Lin,
Shinn-Cherng Chen,
Ming-Yuh Hsieh,
Liang-Yen Wang, Jun-Fa Tsai,
Wen-Yu Chang,
Ming-Lung Yu
[show abstract]
[hide abstract]
ABSTRACT: Hepatitis B virus infection is hyperendemic in Taiwan. In the past, the infection rate has been higher in indigenous villages. The prevalence of chronic HBV infection among indigenous children after immunization remains unknown.
A total of 843 indigenous children were checked for the hepatitis B seromarker. Another 606 metropolitan children were enrolled for comparison in 2005.
The seroprevalences (%) of HBsAg, (hepatitis B surface antigen) anti-HBs, (antibody to hepatitis B surface antigen) and anti-HBc (antibody to hepatitis B core antigen) among indigenous and metropolitan children were 3.2 vs. 0.17 (p<0.001), 47.4 vs. 51.2 (p=0.164), and 10.7 vs. 1.7 (p<0.001), respectively. Among the indigenous children, who were divided into three age groups, the prevalences of HBsAg and anti-HBc increased with age, while anti-HBs decreased significantly (p=0.025, 0.002, and <0.001, respectively). Children with positive HBsAg had a significantly higher mean (SD) age (10.2 (2.2) vs. 9.2 (2.1) years, p=0.024) and a higher ALT value (16.4 (8.0) vs. 10.6 (8.3) IU/L, p=0.001). In a multivariable analysis, indigenous residency, older age group and abnormal ALT value were independent factors associated with positive HBsAg.
The seroprevalence of hepatitis B infection has obviously declined among indigenous children 20 years after mass immunization programs launched in Taiwan. However, it is still higher than that of metropolitan children. Higher rates of chronic HBV infection in the mothers might be one important explanation for this finding.
Preventive Medicine 02/2009; 48(4):397-400. · 3.22 Impact Factor
-
Chia-Yen Dai,
Wan-Long Chuang,
Chi-Kung Ho,
Ming-Yen Hsieh,
Jee-Fu Huang,
Li-Po Lee,
Nai-Jen Hou,
Zu-Yau Lin,
Shinn-Cherng Chen,
Ming-Yuh Hsieh,
Liang-Yen Wang, Jun-Fa Tsai,
Wen-Yu Chang,
Ming-Lung Yu
[show abstract]
[hide abstract]
ABSTRACT: To evaluate the association of virologic status with serum cholesterol and triglyceride levels in individuals with hepatitis C virus (HCV) infection.
We conducted a large scale community-based study enrolling 11,239 residents in an area endemic for hepatitis B virus (HBV) and HCV infection in southern Taiwan. Overall, 703 (6.3%), 1,536 (13.7%), 84 (0.7%) and 9,084 (80.8%) subjects were sero-positive for anti-HCV antibody (anti-HCV), hepatitis B surface antigen (HBsAg), and both anti-HCV and HBsAg, and negative for anti-HCV and HBsAg, respectively.
By multivariate logistic analyses, the independent factors significantly associated with elevated serum cholesterol level were older age, female, negative for diabetes, anti-HCV or HBsAg and elevated triglyceride levels. The independent factors significantly associated with elevated serum triglyceride level were male, positive for diabetes, negative for anti-HCV or HBsAg, higher body mass index (BMI) and elevated cholesterol levels. Of 642 anti-HCV-positive subjects that have HCV RNA tested by standardized automated qualitative PCR assay, 478 (74.5%) were positive for HCV RNA. By multivariate logistic analyses, the independent factors associated with elevated serum cholesterol level were female, elevated serum triglyceride levels, negative for diabetes or HCV RNA. The independent factors associated with elevated serum triglyceride levels were elevated serum cholesterol levels, positive for diabetes, higher BMI and negative for HCV RNA. Diabetes, lower cholesterol and triglyceride levels were independent factors associated with positive HCV RNA.
Based on the result of this large scale community study, HCV viremia appears to be associated with lower serum cholesterol and triglyceride levels which implies that HCV itself might play a significant role on serum lipid profile of patients with chronic HCV infection.
Journal of Hepatology 08/2008; 49(1):9-16. · 9.26 Impact Factor
-
Chia-Yen Dai,
Ming-Lung Yu,
Ming-Yen Hsieh,
Li-Po Lee,
Nai-Jen Hou,
Jee-Fu Huang,
Shinn-Cherng Chen,
Zu-Yau Lin,
Ming-Yuh Hsieh,
Liang-Yen Wang, Jun-Fa Tsai,
Wen-Yu Chang,
Wan-Long Chuang
[show abstract]
[hide abstract]
ABSTRACT: This study aimed to elucidate the rate and predictors of early (6 months) therapeutic responses to lamivudine, the rate of early mortality and the use of the model for end-stage liver disease (MELD) and Index in predicting the survival in patients with a clinical diagnosis of non-cirrhotic chronic hepatitis B with decompensation. Ninety-eight patients with lamivudine therapy were enrolled and MELD and Index scores were calculated. Surviving patients were treated with lamivudine for more than 6 months. Four (4.1%) of the 98 patients died after initiation of lamivudine therapy. After a 6-month lamivudine therapy, 80 (85.1%) patients and 71 (75.5%) patients had normal alanine aminotransferase (ALT) values and negative hepatitis B virus (HBV) DNA (<200 copies/mL), respectively, and hepatitis B e antigen (HBeAg)-negative patients had a significantly higher rate of negative HBV DNA than HBeAg-positive patients (P=0.002). The rates of HBeAg seroconversion and negative HBV DNA were 28.8 and 63.5%, respectively, and patients with HBeAg seroconversion had a significantly higher rate of negative HBV DNA (P=0.004). By multivariate analyses, older age, HBV nongenotype B infection, negative HBeAg and higher ALT levels were factors associated with negative HBV DNA, and a higher ALT level was associated with HBeAg seroconversion at month 6 after lamivudine therapy. MELD score and Index score were significantly associated with death and areas under the receiver operating characteristic curve for predicting survival were 0.936 and 0.907 respectively. We concluded that after 6-month lamivudine therapy, the patients who survived achieved favourable biochemical, virological responses and rate of HBeAg seroconversion. Both MELD and Index scoring systems are good models to predict the 6-month survival.
Liver international: official journal of the International Association for the Study of the Liver 01/2008; 27(10):1364-70. · 3.82 Impact Factor
-
Chia-Yen Dai,
Wan-Long Chuang,
Ming-Yen Hsieh,
Li-Po Lee,
Jee-Fu Huang,
Nai-Jen Hou,
Zu-Yau Lin,
Shinn-Cherng Chen,
Ming-Yuh Hsieh,
Liang-Yen Wang, Jun-Fa Tsai,
Wen-Yu Chang,
Ming-Lung Yu
[show abstract]
[hide abstract]
ABSTRACT: Adefovir dipivoxil (ADV)-resistant mutations have been identified in treating hepatitis B virus (HBV) infection. This study aimed to analyze the response, the incidence of ADV resistance and the virologic characteristics of ADV therapy. A total of 29 CHB patients with confirmed lamivudine (LAM)-resistant HBV were treated with ADV for more than 52 weeks. Serum HBV DNA, HBV genotypes and sequences of HBV polymerase reverse-transcriptase domain were determined. Rates for the biochemical response, HBeAg loss, HBeAg seroconversion and virologic response (< 200 copies/mL of HBV DNA) were 82.8, 23.5, 11.8, and 48.3%, respectively, at week 52 of treatment. Lower pre-treatment mean HBV DNA level was the only significant factor associated with negative HBV DNA after ADV therapy. Six (20.7%) patients had clearance of LAM-resistant YMDD variants with replacement by the wild type HBV at week 52. The rtN236T, rtA181V/T and rtI233V were not identified before ADV therapy and the genotypic mutation of rtN236T was detected in one (3.4%) patient. In conclusion, the 52-week ADV treatment for patients with LAM-resistant HBV variants significantly achieved normalization of ALT levels, reduced serum HBV DNA levels and induced HBeAg loss and seroconversion. The emergence of ADV-resistant mutations seemed rare at weeks 52.
Antiviral Research 08/2007; 75(2):146-51. · 4.30 Impact Factor
-
Chia-Yen Dai,
Wan-Long Chuang,
Nai-Jen Hou,
Li-Po Lee,
Ming-Yen Hsieh,
Zu-Yau Lin,
Shinn-Cherng Chen,
Jee-Fu Huang,
Ming-Yuh Hsieh,
Liang-Yen Wang, Jun-Fa Tsai,
Wen-Yu,
Ming-Lung Yu
[show abstract]
[hide abstract]
ABSTRACT: Both Model for End-stage Liver Disease (MELD) and Index scores have been used to predict mortality in patients with end-stage liver disease and cirrhosis in Western countries.
This study aimed to determine mortality rates, identify prognostic indicators, and determine the usefulness of these 2 scoring systems in predicting short-term (6-month) survival in Taiwanese patients with chronic hepatitis B (CHB)-related decompensation who were treated with lamivudine.
This study was conducted at the Kaohsiung Medical University Hospital and the Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan. Eligible patients were aged 18 to 85 years with CHB with related decompensation (with either serum total bilirubin level, >or=3 mg/dL or prolonged prothrombin time, >or=3 seconds) and were treatment naive. All patients were treated with lamivudine 100 mg PO (tablet) once daily; surviving patients were treated for at least 6 months. The clinical data, including hepatitis B surface antigen, hepatitis B e antigen, and hepatitis B virus (HBV) DNA, were measured before treatment. Pre-treatment MELD and Index scores were calculated for all patients.
Ninety-six patients were enrolled (79 men, 17 women; mean [SD] age, 44.5 [15.2] years). Thirteen (13.5%) patients died within 6 months. Higher international normalized ratio (INR) for prothrombin time, lower albumin level, and higher HBV DNA level (>or=10(5) copies/mL) were factors significantly associated with death. The areas under the receiver operating characteristic curve for predicting survival by the MELD and Index scores were 0.822 and 0.788, respectively. Albumin level, which was not included in the scoring systems, also was found to be a significant predictor.
: We found that with a 13.5% mortality rate, albumin, INR, and HBV DNA levels were good prognostic indicators in Taiwanese patients with CHB-related decompensation treated with lamivudine therapy. The MELD and Index scoring systems were good predictors of 6-month survival in the patients in this study.
Clinical Therapeutics 01/2007; 28(12):2081-92. · 2.32 Impact Factor
-
Chia-Yen Dai,
Wan-Long Chuang,
Ming-Yen Hsieh,
Li-Po Lee,
Nai-Jen Hou,
Shinn-Cherng Chen,
Zu-Yau Lin,
Ming-Yuh Hsieh,
Liang-Yen Wang, Jun-Fa Tsai,
Wen-Yu Chang,
Ming-Lung Yu
[show abstract]
[hide abstract]
ABSTRACT: A T-to-A polymorphic sequence at position +874 in the interferon (IFN)-gamma gene (+874 IFN-gamma) might be associated with disease susceptibilities. To investigate the influence of +874 IFN-gamma polymorphism on the hepatitis C virus (HCV) viral load and the severity of liver disease, the single nucleotide polymorphism (SNP) was determined in 302 histologically proved chronic hepatitis C (CHC) patients [M/F: 180/122, mean age: 48.8 +/- 11.6 years, HCV genotype 1b: 147 (48.7%), liver cirrhosis: 29 (9.6%)] by using a polymerase chain reaction-sequence specific primers (PCR-SSP) approach. The distribution of genotypes for +874 IFN-gamma were T/T: 12 (4.0%), T/A: 71 (23.5%), and A/A: 219 (72.5%) and 27.5% (83/302) of patients' inherited T allele. The mean age of patients without A allele was significantly lower than other patients (41.7 +/- 11.3 vs 49.2 +/- 11.5 years, P = 0.028). Patients with the T allele of +874 IFN-gamma had a significantly higher rate of liver cirrhosis than patients with homozygote A allele (15.7% vs 7.3%, P = 0.028). By multivariate logistic regression analyses, T allele of +874 IFN-gamma and age were independent factors associated with cirrhosis (odds ratio/95% confidence interval: 2.519/1.128-5.622 and 1.065 /1.025-1.107, respectively). In conclusion, the authors' findings indicate that inheritance of +847 IFN-gamma polymorphism is associated with the cirrhosis in patients with CHC.
Translational Research 10/2006; 148(3):128-33. · 2.99 Impact Factor
