Nicole J Kim

University of Washington Seattle | UW · Division of Gastroenterology

Background & Aims Hepatocellular carcinoma (HCC) surveillance rates are suboptimal in clinical practice. We aimed to elicit providers’ opinions on the following aspects of HCC surveillance: preferred strategies, barriers and facilitators, and the impact of a patient’s HCC risk on the choice of surveillance modality. Methods We conducted a web-base...

Introduction: We aimed to assess rates and predictors of hepatocellular carcinoma (HCC) screening among patients with cirrhosis. Methods: We reviewed electronic health records of 11,361 patients with cirrhosis from 11 U.S. Veterans Health Administration facilities for receipt of HCC screening in the 6 months preceding October 1, 2019. Results: Ne...

Objectives To determine how self-reported level of exposure to patients with novel coronavirus 2019 (COVID-19) affected the perceived safety, training and well-being of residents and fellows. Methods We administered an anonymous, voluntary, web-based survey to a convenience sample of trainees worldwide. The survey was distributed by email and so...

Recent hepatitis C virus (HCV) guidelines recommend disease monitoring and hepatocellular carcinoma (HCC) screening in patients with advanced fibrosis after a sustained virologic response (SVR) with direct‐acting antiviral (DAA) therapy. However, data on practice patterns in this setting is lacking. We aimed to characterize disease monitoring and H...

Background Birth cohort screening is recommended for hepatitis C virus (HCV) and underserved populations are disproportionally affected by HCV. Little is known about the influence of race on the HCV care continuum in this population. Objective To assess the cascade of HCV care in a large racially diverse and underserved birth cohort. Design Retro...

HCC, the most common form of primary liver cancer, is the fastest rising cause of cancer-related death in the United States. HCC disproportionately affects racial and ethnic minorities in the United States. A practical framework is needed to organize the complex patient, provider, health system, and societal factors that drive these racial and ethn...

Objective There is an unmet need for optimizing hepatic allograft allocation from nondirected living liver donors (ND-LLD).Materials and methodUsing OPTN living donor liver transplant (LDLT) data (1/1/2000-12/31/2019), we identified 6328 LDLTs (4621 right, 644 left, 1063 left-lateral grafts). Random forest survival models were constructed to predic...

Importance: A high proportion of underserved patients with cirrhosis receive care at safety-net hospitals (SNHs). While liver transplant (LT) can be a life-saving treatment for cirrhosis, data on referral patterns from SNHs to LT centers are lacking. Objective: To identify factors associated with LT referral within the SNH context. Design, sett...

Background: Among cirrhosis patients, it remains unclear whether there are racial/ethnic differences in cirrhosis complications and mortality. We examined the associations between race/ethnicity and risk for hepatocellular carcinoma (HCC), cirrhosis decompensation, and all-cause mortality overall and by cirrhosis etiology. Methods: US Veterans d...

Background Hepatitis C (HCV) screening remains suboptimal. We assessed the efficacy of a mobile application and provider alert in enhancing HCV screening among Asian Americans. Methods A secondary analysis of a cluster randomized clinical trial was performed during the birth cohort screening era to assess the efficacy of a Hepatitis App (intervent...

Objectives The use of extended-release naltrexone (XR-NTX) as treatment for alcohol use disorder (AUD) has been limited by a prior black box warning for hepatotoxicity. We performed a secondary analysis of data from a randomized clinical trial to compare serum liver enzyme levels for those randomized to XR-NTX versus placebo. Methods The parent...

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Background Nonalcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease. Particulate matter air pollution <2.5 μm in diameter (PM2.5) is a ubiquitous exposure primarily produced from fossil fuel combustion. Previous epidemiologic studies have been mixed. The objective of this study was to examine the association betwee...

Background and Aims: Hepatitis C virus (HCV) eradication with direct-acting antivirals (DAA) reduces hepatocellular carcinoma (HCC) risk. Pooled HCC incidence rates by cirrhosis status and fibrosis stage have not been estimated using meta-analysis. Methods: We searched PubMed, Web of Science, Embase, and Cochrane Library from 1/1/2014-12/31/2020 t...

Background There are few studies to date of interventions to increase viral hepatitis screening among Asian Americans, who have high rates of chronic hepatitis B (HBV) infection. Objective To develop, implement, and test the efficacy of a mobile application (Hepatitis App) delivered in four languages to increase HBV screening among Asian Americans...

Introduction: We evaluated the COVID-19 pandemic’s impact on HCC screening and diagnosis among patients with cirrhosis in the Veterans Health Administration. Methods: Rates and predictors of screening and diagnosis were reviewed 9/1/2019-2/29/2020 (“pre-COVID-19”,N=94,612) and 4/1/2020-9/30/2020 (“post-COVID-19”,N=88,073). Results: Screenin...

Alcohol use can cause hepatic necroinflammation and worsening portal hypertension in patients with cirrhosis. We aimed to evaluate the associations between degree of alcohol use and clinical liver-related outcomes according to etiol- ogy of cirrhosis. In this retrospective cohort analysis, 44,349 U.S. veterans with cirrhosis from alcohol-associated...

Background: Fibroscan-derived liver stiffness decreases after anti-viral treatment for hepatitis C virus (HCV) infection, which may affect the associations and interpretation of liver stiffness. Aims: To assess whether liver stiffness pre- or post-anti-viral therapy is associated with the development of decompensated cirrhosis, hepatocellular ca...

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Outcomes related to alcohol use after hepatitis C virus (HCV) treatment are unknown in the direct‐acting antiviral (DAA) era. We assessed levels of alcohol use before and after HCV treatment and their association with long‐term outcomes in a cohort of U.S. veterans. In this retrospective cohort analysis, 29,037 patients who initiated DAA regimens b...

Adenovirus is an infrequent but challenging viral complication of transplantation that is rarely reported after autologous stem cell transplant. We present a case of disseminated adenovirus infection in a woman who received an autologous stem cell transplant for treatment of multiple sclerosis. After presenting with post‐transplant episodic diarrhe...

The opioid epidemic has recently increased the rates of hepatitis C virus (HCV) infection among young women. We therefore aimed to characterize the cascade of HCV care in a cohort of underserved women of reproductive age. Medical records of 19,121 women between the ages of 15 and 44 years, receiving primary care in the San Francisco safety-net heal...

Introduction: Adherence to hepatitis C (HCV) care was suboptimal in the interferon era among underserved African Americans (AA), but adherence data in the era of direct acting antivirals (DAA) is lacking in this population. We aimed to evaluate the impact of DAA on HCV care in underserved AA. Material and methods: Clinical records of AAs undergo...

Early childhood development plays a key role in a child's future health, educational success, and economic status. However, suboptimal early development remains a global challenge. This study examines the influences of quality of the home learning environment (HOME) and child stunting in the first year of life on child development. We used data col...

Background Vulnerable populations are disproportionately affected by hepatitis C virus (HCV) infection and experience high rates of health disparity. There are no data on real-world experience with highly efficacious direct-acting anti-HCV treatment in this population. AimsWe aimed to evaluate the real-world experience with sofosbuvir-based regimen...

The purpose of this study was to understand Mexican women farmworkers’ perceptions of workplace sexual harassment, its related factors and consequences, and potential points of intervention. This Community-Based Participatory Research study conducted focus groups with 20 women farmworkers in rural Washington. Four coders analyzed and gleaned interp...