Clinical and Molecular Hepatology

"Sang Uk Lee"

Original Articles

Viral hepatitis

Barriers to treatment of failed or interferon ineligible patients in the era of DAA: single center study: Kwang Il Seo, Byung Chul Yun, Weiquan James Li, Sang Uk Lee, Byung Hoon Han, Eun Taek Park; Clin Mol Hepatol 2017;23(1):74-79.
Published online March 3, 2017; DOI: https://doi.org/10.3350/cmh.2016.0052

Abstract
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Background/Aims
Interferon-based treatment is not appropriate for a large number of patients with chronic hepatitis C for various medical and social reasons. Newly developed directly acting antivirals (DAAs) have been used to treat chronic hepatitis C without severe adverse effects and have achieved a sustained viral response (SVR) rate of 80-90% with short treatment duration. We were interested to determine whether all patients who failed to respond to or were ineligible for interferon-based therapy could be treated with DAAs.
Methods
Medical records of patients with positive serum anti-hepatitis C virus (HCV) or HCV RNA between January 2009 and December 2013 were reviewed. Demographic, clinical, and treatment data were collected for analysis.
Results
A total of 876 patients were positive for both anti-HCV and HCV RNA. Of these, 244 patients were eligible for interferon, although this was associated with relapse in 39 (16%) of patients. In total, 130 patients stopped interferon therapy (67% adverse effects, 28% non-adherent, 4% malignancy, 1% alcohol abuse) and 502 patients were ineligible (66% medical contraindications, 25% non-adherent, 5% socioeconomic problems). Among 671 patients who were ineligible for or failed to respond to interferon therapy, more than 186 (27.7%) could not be treated with DAA due to financial, social, or cancer-related conditions.
Conclusions
Newly developed DAAs are a promising treatment for patients with chronic hepatitis C who are ineligible for or failed to respond to interferon-based therapy. Nevertheless, not all chronic hepatitis C patients can be treated with DAAs due to various reasons.

Citations

Citations to this article as recorded by

Chronic Hepatitis C Infection Treated with Direct-Acting Antiviral Agents and Occurrence/Recurrence of Hepatocellular Carcinoma: Does It Still Matter?
Carlo Smirne, Maria Grazia Crobu, Irene Landi, Nicole Vercellino, Daria Apostolo, David James Pinato, Federica Vincenzi, Rosalba Minisini, Stelvio Tonello, Davide D’Onghia, Antonio Ottobrelli, Silvia Martini, Christian Bracco, Luigi Maria Fenoglio, Mauro
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Outcomes of Direct-Acting Antivirals Versus Interferon-Based Therapy in Chronic Hepatitis C Infection
Ratna Chowdhury, Wardah Rashid, Taranpreet Singh, Abdur Rehman, Nida F Daterdiwala, Varaidzo Mkosi, Bhumikala Limbu, Syeda Alliza Bukhari, Afif Ramadhan, Muath M Dabas, Abdullah Shehryar, Ramadan Khan
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Direct acting antiviral treatment of chronic hepatitis C in Denmark: factors associated with and barriers to treatment initiation
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World Journal of Hepatology.2017; 9(33): 1239. CrossRef

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Viral hepatitis

Hepatitis C virus (HCV) genotypes and the influence of HCV subtype 1b on the progression of chronic hepatitis C in Korea: a single center experience: Eun Ju Cho, Su Hyeon Jeong, Byung Hoon Han, Sang Uk Lee, Byung Chul Yun, Eun Taek Park; Korean J Hepatol 2012;18(2):219-224.
Published online June 26, 2012; DOI: https://doi.org/10.3350/cmh.2012.18.2.219

Abstract
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Background/Aims

There is some controversy regarding whether or not hepatitis C virus (HCV) subtype 1b is more influential than non-1b subtypes on the progression of chronic hepatitis (CH) C to liver cirrhosis (LC) and hepatocellular carcinoma (HCC).

Methods

We retrospectively analyzed 823 patients with chronic HCV infection, including 443 CH patients, 264 LC patients, and 116 HCC patients, who were HCV RNA positive and HBsAg negative. These patients had not received any prior treatment with either interferon alone or a combination of interferon and ribavirin.

Results

HCV subtypes 1b (51.6%) and 2a/2c (39.5%) were the two most common genotypes. The proportions of genotypes 2 (2a/2c, 2b, and 2) and 3 were 45.8% and 1.1%, respectively. One case of genotype 4 was found. HCV subtype 1b (47.3%) was less common than the non-1b subtypes (52.7%) in non-LC patients, but its proportion (56.9%) was higher than that of non-1b subtypes (43.1%) in LC patients (P=0.006). The proportions of patients with HCV subtype 1b did not differ significantly between the LC (55.3%) and HCC (60.3%) groups. Older age, male gender, and the relative progression of liver damage (non-LC vs. compensated LC vs. decompensated LC) were significant risk factors for HCC, with odds ratios of 1.081 (95% confidence interval [CI], 1.056-1.106), 5.749 (95% CI, 3.329-9.930), and 2.895 (95% CI, 2.183-3.840), respectively. HCV subtype 1b was not a significant risk factor for HCC (odds ratio, 1.423; 95% CI, 0.895-2.262).

Conclusions

HCV subtypes 1b and 2a/2c were the two most common HCV genotypes. HCV subtype 1b seemed to be more influential than non-1b subtypes on the progression of CH to LC, but not on the development of HCC from LC.

Citations

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