Jun Hayashi

Kyushu Medical Center, Hukuoka, Fukuoka, Japan

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Publications (418)1249.6 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Coinfection with human immunodeficiency virus (HIV) and hepatitis B virus (HBV) is common worldwide. The current guidelines for the treatment of HIV infection recommend that HIV patients coinfected with HBV receive antiretoroviral therapy (ART) with two nucleoside analogs against HBV. However, an increase in liver enzymes that is usually attributed to HBV immune reconstitution inflammatory syndrome (IRIS) sometimes occurs in HBV/HIV-coinfected patients after the commencement of ART. We report a case of HBV/HIV-coinfection in which the chronic hepatitis B was successfully treated using interferon (IFN) therapy followed by ART without the development of IRIS. A Japanese man in thirties was referred to our hospital because of an acute HIV infection two months after the diagnosis of an acute HBV infection, which had progressed to a chronic HBV infection. The laboratory test results were as follows:hepatitis B surface antigen (HBsAg) positive, hepatitis B e antigen (HBeAg) positive, HBV DNA level of 8.8 Log copies/mL, HBV genotype A, alanine aminotransferase of 834 IU/L, HIV RNA level of 5 Log copies/mL, and a CD4+ T cell count of 437/microL. The initial treatment was natural IFNalpha therapy for chronic hepatitis B, and HBeAg seroclearance was achieved 20 weeks after the start of therapy. Four months after the end of IFN therapy for 24 weeks, ART including tenofovir and emtricitabine against HBV was commenced. Six months after starting ART, the patient's serum HBV DNA level had decreased and become undetectable and HBsAg seroclearance was achieved without an elevation in liver enzymes. The present case suggests that IFN therapy prior to ART contributes to a successful outcome for chronic hepatitis B patients coinfected with HIV, if the HIV status does not require the immediate start of ART.
    Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases 11/2012; 86(6):763-7. DOI:10.11150/kansenshogakuzasshi.86.763
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    ABSTRACT: BACKGROUND AND AIMS: The effects of pegylated interferon (PEG-IFN) α and ribavirin (RBV) treatment for chronic hepatitis C on the incidence of hepatocellular carcinoma (HCC) have not been well established. This study investigated the impact of treatment outcome on the development of HCC by chronic hepatitis C patients treated with PEG-IFNα2b and RBV. METHODS: This large-scale, prospective, multicenter study consisted of 1,013 Japanese chronic hepatitis C patients with no history of HCC (non-cirrhosis, n=863 and cirrhosis, n=150). All patients were treated with PEG-IFNα2b and RBV and the follow-up period started at the end of antiviral treatment (median observation period of 3.6 years). The cumulative incidence rate of HCC was estimated by the Kaplan-Meier method according to treatment outcome. RESULTS: Forty-seven patients (4.6%) developed HCC during the observation period. In the non-cirrhosis group, the 5-year cumulative incidence rates of HCC for the sustained virological response (SVR) (1.7%) and transient virological response (3.2%) (TVR: defined as relapse or breakthrough) groups were significantly lower than that of the non-virological response (NVR) group (7.6%) (P=0.003 and P=0.03, respectively). A significantly low rate of incidence of HCC by TVR patients in comparison with NVR patients was found for patients with aged 60 and over, but not for those aged under 60. In the cirrhosis group, the 5-year cumulative incidence rates of HCC for the SVR (18.9%) and TVR groups (20.8%) were also significantly lower than that of the NVR group (39.4%) (P=0.03 and P=0.04, respectively). CONCLUSIONS: SVR and complete viral suppression during treatment with relapse (TVR) were associated with a lower risk of the development of HCC when compared with NVR.
    Journal of Hepatology 10/2012; 58(3). DOI:10.1016/j.jhep.2012.10.017 · 10.40 Impact Factor
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    ABSTRACT: Background: Polymorphisms of the interleukin (IL) 28B gene have been strongly associated with the response to antiviral treatment of patients with chronic hepatitis C virus (HCV) infection. However, the IL28B gene alone is not a completely accurate predictor of the outcome. The aim of this cohort study was to determine pretreatment factors useful for predicting sustained virological response (SVR), especially IL28B polymorphism and the homeostasis model assessment of insulin resistance (HOMA-IR). Methods: This study consisted of 421 chronic hepatitis C patients with HCV genotypes 1 (n=328) and 2 (n=93) who were treated with pegulated interferon (PEG-IFN) α2b and ribavirin (RBV) for 48 and 24 weeks, respectively. Sustained virological response (SVR), by intention-to-treat analysis, was evaluated by Abbott RealTime PCR assay. Genotyping of the polymorphisms in the IL28B gene region (rs8099917) of chromosome 19 was performed on DNA collected from each patient. HOMA-IR was measured for 318 patients (HCV genotype 1; n=244, HCV genotype 2; n=74) within one week before the start of treatment. Results: SVR rates were 35.7% (117 of 328) and 73.1% (68 of 93) for HCV genotypes 1 and 2, respectively. No significant difference in IL28B genotype distribution was found according to HOMA-IR. Multivariate analysis of HCV genotype 1 identified the IL28B TT genotype (OR=5.97, P=0.0006) and HOMA-IR (OR=0.65, P=0.0044) as independent predictors of SVR. Multivariate analysis of HCV genotype 2 identified the IL28B TT genotype (OR=7.66, P=0.0126) as an independent predictor of SVR, but not HOMA-IR. Receiver operating characteristic analyses showed that the areas under the curve (AUC) were high for both the IL28B TT (AUC = 0.774, HOMA-IR cutoff value: 2.45) and IL28B TG/GG genotypes (AUC = 0.772, HOMA-IR cutoff value: 1.55) among patients with genotype 1. Although the non-SVR rate (82.2%, 69 of 84) was high in the HOMA-IR ≥ 2.45 subgroup of IL28B TT genotype, 79.7% (55 of 69) had virological relapse. Conclusion: For HCV genotype 1, both IL28B and HOMA-IR are independent predictors of SVR for patients treated with PEG-IFNα2b and RBV, unlike genotype 2 for which only IL28B was predictive. Insulin resistance undermines the advantages of IL28B polymorphism for obtaining a virological response, especially for patients with HCV genotype 1.
    IDWeek 2012 Meeting of the Infectious Diseases Society of America; 10/2012
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    ABSTRACT: The elevated serum undercarboxylated osteocalcin (ucOC) level is related to osteoporosis. In Japan, vitamin K intake is lower, and the incidence of hip fractures noticeably higher in northern Kyushu than in other areas. The study was done to determine the serum ucOC levels in a Japanese population and its association with diet and glucose metabolism. The data of 3,658 healthy adults aged 40–69 (1,373 men and 2,285 women) who lived in northern Kyushu area were analyzed. The data included anthropometric measurements and a self-reported personal interview on daily intake of foods. The serum ucOC level of each participant was measured by electrochemiluminescence immunoassay. Glycohemoglobin A1c (HbA1c), fasting plasma glucose, and serum insulin concentrations were measured. The median serum ucOC level of the women (4.65 ng/mL) was significantly higher than that of the men (3.04 ng/mL) (P = 0.0021). The age-specific ucOC levels of the men decreased significantly with age. In contrast, the ucOC levels of the women aged ≥50 were elevated, but the levels varied markedly within the other age groups. For both men and women, multivariate analysis identified a daily diet rich in vitamin K and HbA1c level as independently having a significant, negative relationship to serum ucOC level. Our study indicates that the serum ucOC decreases with age in men, increases postmenopausally in women, and correlates inversely with dietary consumption of certain foods and with fasting glucose and HbA1c level.
    Endocrine 09/2012; 43(3). DOI:10.1007/s12020-012-9803-z · 3.53 Impact Factor
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    ABSTRACT: BACKGROUND & AIMS: Early menopause in women with chronic hepatitis C virus (HCV) infection is associated with a low likelihood of a sustained virological response (SVR) in conjunction with their antiviral treatment. This is potentially related to their reduced estrogen secretion. The study was done to determine whether selective estrogen receptor modulator administration might improve the efficacy of the current standard of care (SOC) treatment, pegylated interferon (PegIFN) α2a plus ribavirin (RBV), for postmenopausal women. METHODS: One hundred and twenty-three postmenopausal women with genotype 1b chronic hepatitis C were randomly assigned to one of two treatment groups: raloxifene hydrochloride (RLX) (60mg/day) plus SOC (PegIFNα2a 180μg/week and RBV 600-1000mg/day) (n=62) or SOC only (n=61). Genotyping was performed of the polymorphism in the interleukin-28B (IL28B) gene region (rs8099917) of DNA collected from each patient. RESULTS: One RLX-treated patient discontinued RLX because of a systemic rash following 2weeks of treatment. Twenty-four weeks after treatment, the SVR rate was significantly higher for RLX plus SOC patients (61.3%) than for SOC only patients (34.4%) (p=0.0051). Further, the SVR rate was significantly higher for RLX plus SOC patients with IL28B TT (72.5%) than for SOC only patients with IL28B TT (39.2%) (p=0.0014), but no such relationship was observed in patients carrying the minor IL28B allele. CONCLUSIONS: RLX improved the efficacy of SOC in the treatment of postmenopausal women with chronic hepatitis C. RLX shows promise as an adjuvant to the standard antiviral treatment of such patients.
    Journal of Hepatology 08/2012; 57(6). DOI:10.1016/j.jhep.2012.08.003 · 10.40 Impact Factor
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    ABSTRACT: BACKGROUND: Glycated albumin (GA) is a measure of the mean plasma glucose concentration over approximately 2-3weeks. This study was done to test the hypothesis that GA can serve as a marker for atherosclerosis, similar to glycosylated hemoglobin A1c (HbA1c). METHODS: HbA1c, plasma GA and serum high-sensitivity C-reactive protein (hs-CRP) levels were measured for 1575 residents (age range 26-78years) of a suburban town in Japan. Carotid artery intima-media thickness (IMT) was measured by ultrasound for each participant. RESULTS: GA levels had significantly positive correlation coefficients with HbA1c level, hs-CRP level, and max-IMT (all P<0.001). Receiver operating characteristic curve analysis indicated a GA level of ≥15.5% to be optimal for predicting diabetes. A GA level of 15.5% corresponded to an HbA1c level of 5.8%. The hs-CRP and max-IMT values of participants with GA ≥15.5% were significantly higher than the values of those with GA <15.5% (median hs-CRP: 2.4 vs. 2.3mg/L, P=0.048; mean max-IMT 0.852 vs. 0.759mm, P=0.003, respectively). Among obese participants, the hs-CRP and max-IMT values of those with GA ≥15.5% (7.5mg/L and 1.014mm) were significantly higher than the values of those with GA <15.5% (4.7mg/dL and 0.823mm) (P=0.024 and P=0.001, respectively). CONCLUSIONS: Increased IMT and hs-CRP levels were associated with a high GA level, especially for obese participants, suggesting that GA would be as a useful biomarker for assessing the risk of atherosclerosis.
    International journal of cardiology 05/2012; 167(5). DOI:10.1016/j.ijcard.2012.05.045 · 6.18 Impact Factor
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    ABSTRACT: A simple, non-invasive medical device, using bioelectrical impedance analysis (BIA) for the evaluation of visceral fat level (VFL) was developed recently. The aim of this study was to investigate the utility of VFL by BIA in the screening of metabolic syndrome (MetS). VFL was measured by the BIA device in 1,451 Japanese residents (546 men and 905 women, age range 30-69 years). VFL had significant positive correlations with waist circumference (WC) and body mass index (r=0.772 and 0.849, all P < 0.0001). The overall MetS prevalence using Japanese Diagnosis Criteria was 19.8%: men 36.3% and women 9.8%. The mean VFL of the participants with MetS was significantly higher than those without MetS (men; 12.1 and 9.4, women; 13.3 and 8.7) (both P < 0.001). VFL significantly correlated with blood pressure, lipid profiles, fasting plasma glucose, and hemoglobin A1c (all P < 0.001). Receiver operating characteristic curve analysis for a diagnosis of two or more MetS risk factors excluding WC resulted in the same cutoff values for the VFL (10.0) of men and women. The VFL by BIA is useful for the detection of MetS because it is correlated with all metabolic parameters and shows the same normal limit in both sexes.
    Journal of atherosclerosis and thrombosis 05/2012; 19(5):462-70. · 2.77 Impact Factor
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    ABSTRACT: Recent studies have suggested that insulin resistance exerts a strong influence on chronic hepatitis C virus (HCV) infection. We analyzed pretreatment factors useful for predicting sustained virological response (SVR), especially interleukin (IL) 28B polymorphism and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR). This cohort study consisted of 328 chronic hepatitis C patients with HCV genotype 1 who were treated for 48 weeks with pegylated interferon (PegIFN) α-2b and ribavirin (RBV). Genotyping of the polymorphisms in the IL28B gene region (rs8099917) on chromosome 19 was performed on DNA collected from each patient. No significant difference in IL28B genotype distribution was found according to HOMA-IR. Multivariate analysis identified the IL28B TT genotype (OR=5.97, 95% CI 2.15-16.55, p=0.0006) and the baseline HOMA-IR (OR=0.65, 95% CI 0.48-0.87, p=0.0044) as significant, independent pretreatment predictors of SVR. Receiver operating characteristic analyses to determine the optimal threshold values of HOMA-IR for predicting SVR showed that the areas under the curve (AUC) were high for both IL28B TT (AUC=0.774, HOMA-IR cut-off value: 2.45) and IL28B TG/GG genotypes (AUC=0.772, HOMA-IR cut-off value: 1.55). For HCV genotype 1, both IL28B and baseline HOMA-IR are independent pretreatment predictors of SVR in patients treated with PegIFNα-2b and RBV. Insulin resistance undermines the advantages of IL28B polymorphism to obtain SVR.
    Journal of Hepatology 05/2012; 57(3):534-40. DOI:10.1016/j.jhep.2012.04.027 · 10.40 Impact Factor
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    ABSTRACT: The association between HCV infection and myocardial disorders remains unclear. This study aimed to assess whether or not HCV infection influences myocardial dysfunction by the use of NT-proBNP, a sensitive marker of myocardial dysfunction. A total of 198 participants [99 patients with chronic HCV infection (aged 46-68 years) and 99 anti-HCV-negative sex and age matched controls] were examined. Serum HCV-RNA level and HCV genotype were tested and liver biopsy was done only for the patient group. The NT-proBNP concentration of the HCV patients (mean 71.6 ± 79.1 pg/ml; median 46.0 pg/ml, range 5.0-400.0) was significantly higher than that of the controls (mean 39.8 ± 24.4 pg/ml; median 35.8 pg/ml, range 7.0-108.0) (P < 0.05). 20.0 % of the HCV patients and 0.6 % of the controls had high NT-proBNP (higher than 125 pg/ml; the single cut off point for patients under 75 years of age) (P < 0.05). Stepwise multiple regression analysis revealed that chronic HCV infection was independently correlated with NT-proBNP level after adjustment for parameters that might influence NT-proBNP (P = 0.005). Our data suggest that chronic HCV infection is associated with increased NT-proBNP, indicating that chronic HCV infection might induce myocardial dysfunction.
    Endocrine 05/2012; 43(1). DOI:10.1007/s12020-012-9688-x · 3.53 Impact Factor
  • Nihon Naika Gakkai Zasshi 05/2012; 101(5):1389-92. DOI:10.2169/naika.101.1389
  • Journal of Hepatology 04/2012; 56:S438. DOI:10.1016/S0168-8278(12)61124-6 · 10.40 Impact Factor
  • Journal of Hepatology 04/2012; 56:S452-S453. DOI:10.1016/S0168-8278(12)61158-1 · 10.40 Impact Factor
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    ABSTRACT: The aim of this large-scale analysis was to assess the effect of 48-week pegylated interferon (PEG-IFN) α-2b and ribavirin (RBV) therapy on virological relapse by patients infected with hepatitis C virus (HCV) genotype 1. The relationship between virological relapse and the dose of PEG-IFNα-2b and RBV was investigated in 619 patients who had once cleared HCV RNA during PEG-IFNα-2b and RBV treatment for 48 weeks. The overall virological relapse rate was 34.1% (211 of 619). The relapse rate was 59.5% (22 of 37) for patients who received <6 mg/kg/day of RBV, even if a sufficient dose of PEG-IFNα-2b (≥1.5 μg/kg/day) was received. In contrast, the relapse rate was 28.1% (16 of 57) for patients who received ≥12 mg/kg/day of RBV, irrespective of the PEG-IFNα-2b dose. The relapse rates were significantly increased with the reduction of the RBV dose for both PEG-IFNα-2b doses of ≥1.2 and <1.2 μg/kg/week (P < 0.0001 and P = 0.0006, respectively). Moreover, the relapse rate was 41.2% (35 of 85) for patients with an early virological response (EVR) who received <6 mg/kg/day of RBV. The relapse rates were significantly increased with the reduction of the RBV dose in both those patients with an EVR and those with a late virological response (P = 0.0006 and P = 0.0088, respectively). To summarize, for HCV genotype 1 patients treated with PEG-IFNα-2b and RBV, the virological relapse of HCV was RBV dose-dependent, irrespective of the dose of PEG-IFNα or the effect of early viral kinetics.
    Journal of Infection and Chemotherapy 03/2012; 18(5). DOI:10.1007/s10156-012-0396-5 · 1.38 Impact Factor
  • K Toyoda · N Furusyo · T Ihara · H Ikezaki · Y Urita · J Hayashi
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    ABSTRACT: The decreased ratio of serum pepsinogen (PG) I and II has good correlation with the presence of atrophic gastritis. A total of 1,540 residents aged 30-89 years were enrolled into this study to investigate which serum PG level of residents with Helicobacter pylori infection would represent an adjunct to the diagnosis and progression of atrophic gastritis. All participants received esophagogastroduodenoscopy. Serum antibody to H. pylori (anti-H. pylori) was measured by an enzyme-linked immunosorbent assay (ELISA). Serological atrophic gastritis was defined as serum PG I isozyme level ≤70 ng/ml and a PG I/II ratio of ≤3.0. Of the 1,540 participants, 923 (59.9%) were positive for anti-H. pylori. Serological atrophic gastritis was found significantly more often in anti-H. pylori-positive participants (40.8%) than in anti-H. pylori-negative participants (7.9%) (p ≤ 0.0001). The endoscopic findings of anti-H. pylori-positive participants with serological atrophic gastritis were significantly more frequent by 4.06 times for atrophic gastritis (p ≤ 0.0001) than anti-H. pylori-negative participants without serological atrophic gastritis. Eight anti-H. pylori-positive participants were diagnosed with gastric cancer, but no cancer was found in anti-H. pylori-negative participants without serological atrophic gastritis. Serum PG testing is clinically useful for the prediction of gastric lesions in H. pylori-infected persons.
    European Journal of Clinical Microbiology 02/2012; 31(9):2117-24. DOI:10.1007/s10096-011-1543-0 · 2.67 Impact Factor
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    ABSTRACT: Aim: A simple, non-invasive medical device, using bioelectrical impedance analysis (BIA) for the evaluation of visceral fat level (VFL) was developed recently. The aim of this study was to investigate the utility of VFL by BIA in the screening of metabolic syndrome (MetS).Methods: VFL was measured by the BIA device in 1,451 Japanese residents (546 men and 905 women, age range 30-69 years).Results: VFL had significant positive correlations with waist circumference (WC) and body mass index (r=0.772 and 0.849, all P < 0.0001). The overall MetS prevalence using Japanese Diagnosis Criteria was 19.8%: men 36.3% and women 9.8%. The mean VFL of the participants with MetS was significantly higher than those without MetS (men; 12.1 and 9.4, women; 13.3 and 8.7) (both P < 0.001). VFL significantly correlated with blood pressure, lipid profiles, fasting plasma glucose, and hemoglobin A1c (all P < 0.001). Receiver operating characteristic curve analysis for a diagnosis of two or more MetS risk factors excluding WC resulted in the same cutoff values for the VFL (10.0) of men and women.Conclusions: The VFL by BIA is useful for the detection of MetS because it is correlated with all metabolic parameters and shows the same normal limit in both sexes.
    Journal of atherosclerosis and thrombosis 01/2012; DOI:10.5551/jat.11528 · 2.77 Impact Factor
  • Nippon Shokakibyo Gakkai zasshi The Japanese journal of gastro-enterology 01/2012; 109(1):19-29.
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    ABSTRACT: Helicobacter pylori infection causes gastritis, peptic ulcers and gastric malignancies, and its eradication has been advocated by many groups. We determined the H. pylori carrier status and eradication rates of patients with chronic hepatitis C virus (HCV) infection. In total, 76 chronically HCV-infected patients were enrolled for comparison with 228 HCV-noninfected, age- and sex-matched controls. H. pylori infection was confirmed by H. pylori antibody and urea breath testing. The H. pylori infection rate was significantly higher for HCV-infected patients (67 of 76, 88.2%) than for HCV-noninfected controls (158 of 228, 69.3%). Endoscopic findings showed that the rates of gastric ulcers and gastritis were significantly higher for the 67 HCV-infected patients with H. pylori infection (34.3% and 77.6%) than for the 158 HCV-noninfected controls with H. pylori infection (15.2% and 57.6%). Treatment to eradicate H. pylori had a significantly higher success rate for HCV-infected patients (61 of 67, 91.0%) than for HCV-noninfected controls (115 of 158, 72.8%). The markedly high H. pylori eradication rate observed in this study shows that eradication of H. pylori holds promise for the improvement of the long-term health condition of patients with chronic HCV infection.
    Gut and liver 12/2011; 5(4):447-53. DOI:10.5009/gnl.2011.5.4.447 · 1.49 Impact Factor
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    ABSTRACT: Aim:  To investigate the efficacy and safety of a pegylated interferon (PEG-IFN) α-2b plus ribavirin (RBV) combination treatment for patients with chronic hepatitis C virus (HCV) infection who have persistently normal alanine aminotransferase (NALT). Methods:  This multicenter study included 989 patients with HCV genotype 1 (114 with NALT and 875 with elevated ALT) who received weight-based doses of PEG-IFN α-2b plus RBV for 48 weeks. We compared the sustained viral response (SVR) rates of patients with NALT and elevated ALT who received at least 80% or more of the target dosage of PEG-IFN α-2b and 60% or more of the target RBV (minimum acceptable dosage). Results:  No significant difference was found in the overall SVR rate between the NALT (42.1%) and elevated ALT groups (37.3%). No significant difference in the SVR rates was found between NALT (63.3%) and elevated ALT group (61.6%) patients who received minimum acceptable dosage. Multivariate analysis showed that age (<65 years old) and total cholesterol (≧220 mg/dL) were significantly independent positive factors associated with an SVR in the NALT group. Twenty-four weeks after treatment, an ALT increase above the normal range was observed for 34.0% (18 of 53) of the non-responsive group of NALT patients. Conclusions:  The efficacy and safety of PEG-IFN α-2b plus RBV combination therapy for patients with chronic HCV infection are similar for patients with NALT and those with elevated ALT levels. These results indicate that patients with NALT should be considered for treatment with PEG-IFN α-2b plus RBV.
    Hepatology Research 11/2011; 42(1):33-41. DOI:10.1111/j.1872-034X.2011.00907.x · 2.22 Impact Factor
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    ABSTRACT: Pegylated interferon (PEG-IFN) α-2b and ribavirin (RBV) treatment of chronic hepatitis C virus (HCV) infection is associated with a substantially elevated risk of discontinuation. The aim of this study is to evaluate the reason for premature discontinuation during PEG-IFN α-2b and RBV treatment due to adverse effects in patients with chronic HCV infection. A total of 2871 Japanese patients who had chronic HCV infection treated with PEG-IFN α-2b and RBV were screened. We prospectively investigated the reasons for premature discontinuation of treatment classified by sex and age, and analyzed the timing of discontinuation. Of the 2871 patients, 250 (8.7%) discontinued treatment because of adverse effects. The main reasons for premature discontinuation were neurovegetative symptoms (n = 77, 30.8%), depression-related syndrome (n = 46, 18.4%), hematologic effects (n = 41, 16.4%) and dermatologic effects (n = 27, 10.8%). The rate of discontinuation of treatment for patients aged ≥ 65 years was significantly higher than for patients aged < 65 years, for both men (P < 0.0001) and women (P = 0.0121). Moreover, the frequency of discontinuation due to neurovegetative symptoms, depression-related syndrome, and hematologic effects for men aged ≥ 65 years was significantly higher than for those aged < 65 years (P = 0.0001, P = 0.0016, and P = 0.0170, respectively), but not for women. Premature discontinuation due to the adverse effects of PEG-IFN α-2b and RBV treatment by patients with chronic HCV infection is mainly due to neuropsychiatric symptoms and is more common for older than for younger patients.
    Journal of Gastroenterology and Hepatology 11/2011; 27(7):1233-40. DOI:10.1111/j.1440-1746.2011.06965.x · 3.63 Impact Factor
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    ABSTRACT: An outbreak of Bacillus cereus (B. cereus) bacteremia occurred in our neonatal intensive care unit (NICU) in July 2005. Many strains of B. cereus were cultured from patient specimens, as well as from environmental samples such as the surfaces of instruments and air in the NICU. Some of these strains were analyzed by pulsed field gel electrophoresis, and several were confirmed to be identical. We speculated that the bacterial load in the environment had initially increased and then possibly spread throughout the NICU facility via the airflow of the ventilation system. For this reason, besides maintaining standard precautions, we performed a vigorous clean of the NICU, and covered the vents to prevent dust falling from them. These protective measures ended the outbreak. In the hospital environment, adequate ventilation is important, especially in single-occupancy isolation rooms and operating theaters. However, the criteria for the adequate ventilation of multioccupancy rooms for acute care environments such as the NICU have not yet been defined. We need to pay more attention to these environmental factors in order to avoid cross contamination and infectious outbreaks.
    Journal of Infection and Chemotherapy 10/2011; 18(3):303-7. DOI:10.1007/s10156-011-0326-y · 1.38 Impact Factor

Publication Stats

4k Citations
1,249.60 Total Impact Points

Institutions

  • 2001–2015
    • Kyushu Medical Center
      Hukuoka, Fukuoka, Japan
  • 2003–2014
    • Japan Red Cross Fukuoka Hospital
      Hukuoka, Fukuoka, Japan
  • 1982–2013
    • Kyushu University
      • • Faculty of Medical Sciences
      • • Graduate School of Medical Sciences
      • • Division of Internal Medicine
      Hukuoka, Fukuoka, Japan
  • 2004
    • Shin Kokura Hospital
      Kitakyūshū, Fukuoka, Japan
  • 1996
    • Fukuoka University
      Hukuoka, Fukuoka, Japan