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Hepatitis b treatment adherence

Frank Tacke, Daniela C Kroy
Persistent hepatitis B virus (HBV) infections affect about 240 million patients worldwide that are at risk of developing liver cirrhosis or hepatocellular carcinoma. HBV is a small, partially double stranded DNA virus with four overlapping genes and a unique life cycle, which involves the generation of an RNA template for replication via reverse transcription. Mutations occur frequently during chronic infection, and particular selection pressures select distinct mutants. Nucleoside and nucleotide analogues like lamivudine (LMV), entecavir (ETV), telbivudine (LdT), adefovir dipivoxil (ADV) and tenofovir (TDF) are used to achieve long-term suppression of viral replication...
September 2016: Annals of Translational Medicine
Hanan H Balkhy, Aiman El-Saed, Faisal M Sanai, Mohammad Alqahtani, Mashael Alonaizi, Nermeen Niazy, Abdulrahman Aljumah
BACKGROUND: Non-adherence with recommended follow-up visits is a major barrier for completing treatment of viral hepatitis and is consequently associated with unfavorable outcomes of health services. OBJECTIVES: To estimate the magnitude and identify perceived reasons and patient characteristics associated with loss to follow-up in a tertiary care setting. METHODS: A two-step cross-sectional study design was used, including a chart review (2011) followed by phone survey (2012)...
October 6, 2016: Journal of Infection and Public Health
Kali Zhou, Thomas Fitzpatrick, Nick Walsh, Ji Young Kim, Roger Chou, Mellanye Lackey, Julia Scott, Ying-Ru Lo, Joseph D Tucker
BACKGROUND: Advances in therapy for hepatitis B virus (HBV) and hepatitis C virus (HCV) have ushered in a new era in chronic hepatitis treatment. To maximise the effectiveness of these medicines, individuals must be engaged and retained in care. We analysed operational interventions to enhance chronic viral hepatitis testing, linkage to care, treatment uptake, adherence, and viral suppression or cure. METHODS: We did a systematic review of operational interventions, and did meta-analyses for sufficiently comparable data...
September 5, 2016: Lancet Infectious Diseases
N Allard, A Dev, J Dwyer, G Srivatsa, A Thompson, B Cowie
Antiviral therapy for hepatitis B is effective and reduces the risk of progression to cirrhosis and liver cancer but is often required for an indefinite duration. Treatment adherence is important to prevent the development of resistance and optimize outcomes. Pharmacy adherence measures can be used to assess treatment adherence, with the medication possession ratio being less susceptible to bias than physician- or self-reported adherence. The aim of this study was to measure adherence in public hospital outpatients over a 3-year period and to examine factors associated with nonadherence...
August 9, 2016: Journal of Viral Hepatitis
Alexandre Pierre Benechet, Matteo Iannacone
Antigen-specific effector CD8(±) T cells play a critical role in controlling hepatic infections, such as the one caused by hepatitis B virus (HBV). We review here recent results where we coupled advanced dynamic imaging with dedicated mouse models of HBV pathogenesis to show that circulating effector CD8(±) T cells aimed at viral clearance initially arrest in liver sinusoids by preferentially docking onto platelets that have previously adhered to liver sinusoids. Upon detachment from platelets, effector CD8(±) T cells crawl intrasinusoidally irrespective of bloodstream direction, and probe underlying hepatocytes for the presence of antigen by extending filopodia-like protrusions through the sinusoidal fenestrae...
July 13, 2016: Journal of Hepatology
Karoline Aebi-Popp, Christian Kahlert, Andri Rauch, Beatrice Mosimann, David Baud, Nicola Low, Daniel Surbek
QUESTION: Detection and treatment of infections during pregnancy are important for both maternal and child health. The objective of this study was to describe testing practices and adherence to current national guidelines in Switzerland. METHODS: We invited all registered practicing obstetricians and gynaecologists in Switzerland to complete an anonymous web-based questionnaire about strategies for testing for 14 infections during pregnancy. We conducted a descriptive analysis according to demographic characteristics...
2016: Swiss Medical Weekly
Lai Wei, Ji-Dong Jia, Xin-Hua Weng, Xiao-Guang Dou, Jia-Ji Jiang, Hong Tang, Qin Ning, Qing-Qing Dai, Run-Qin Li, Jie Liu
AIM: To investigate Chinese physicians' awareness of the 2010 guidelines on the treatment of chronic hepatitis B virus (HBV) infection. METHODS: This was a quantitative survey that investigated the characteristics and practices of physicians who were treating patients with hepatitis B, the profile of their patients and physician practices regarding the diagnosis and treatment of HBV at the time of the survey. Participants were randomly selected from available databases of Chinese physicians and requested to complete either an online or paper-based survey...
June 28, 2016: World Journal of Hepatology
Derek Ems, Patrick Racsa, Chris Anderson, Fran Gregory, Karen Worley, Joel V Brill, Worthe Holt
BACKGROUND: Chronic hepatitis C virus (HCV) is the primary cause of liver failure leading to transplantation, and medication adherence is essential to the therapeutic efficacy of HCV treatments. While there is evidence linking poor adherence with increased utilization and cost, published literature lacks examination of the association between medication adherence and risk of liver transplant. In addition, the impact of HCV treatment on total costs of liver transplantation is not well documented...
July 2016: Journal of Managed Care & Specialty Pharmacy
Timothy Na Archampong, Ceejay L Boyce, Margaret Lartey, Kwamena W Sagoe, Adjoa Obo-Akwa, Ernest Kenu, Jason T Blackard, Awewura Kwara
BACKGROUND: The presence of hepatitis B virus (HBV) resistance mutations upon initiation or during antiretroviral therapy (ART) in HIV co-infected patients is an important determinant of treatment response. The main objective of the study was to determine the prevalence of HBV resistance mutations in antiretroviral treatment-naïve and treatment-experienced HBV-HIV co infected Ghanaian patients with detectable HBV viremia. METHODS: HBV-HIV co-infected patients who were ART-naïve or had received at least 9 months of lamivudine (3TC)-containing ART were enrolled in a cross-sectional study...
May 11, 2016: Antiviral Therapy
Adeline M Nyamathi, Sheldon X Zhang, Sarah Wall, Elizabeth A Hall, Benissa E Salem, David Farabee, Mark Faucette, Kartik Yadav
BACKGROUND: Transitioning into society after release from incarceration presents real challenges for male offenders; in California, up to 60% return to prison within 3 years after release. The risk for ongoing drug use and having sex with multiple partners is a significant challenge for ex-offenders preparing to enter the community. OBJECTIVES: The aims are to describe drug use and sexual behavior (sex with multiple partners) prior to incarceration and 6 and 12 months after study enrollment using data obtained as part of a randomized controlled trial...
May 2016: Nursing Research
Leandro N da Silva, Divânia D da Silva França, Nativa H A Del-Rio, Megmar A Dos Santos Carneiro, Regina M B Martins, Rafael A Guimarães, Raquel S Pinheiro, Ana L N Junqueira, Karlla A A Caetano, Sheila A Teles
Crack cocaine users represent a target group for hepatitis B vaccination. We evaluate the HBV epidemiology, immunization status and compliance with a super-accelerated vaccination schedule among in-treatment crack cocaine users in central Brazil. Six hundred in-treatment crack cocaine users were interviewed, and serum samples were tested for HBV markers. A super-accelerated vaccination schedule of HBV vaccine was offered to all susceptible crack cocaine users. In total, 7.0% of those tested had at least one positive marker of HBV exposure...
March 22, 2016: Journal of Infection and Public Health
Heng Chi, Pauline Arends, Jurriën G P Reijnders, Ivana Carey, Ashley Brown, Massimo Fasano, David Mutimer, Katja Deterding, Ye H Oo, Jörg Petersen, Florian van Bommel, Robert J de Knegt, Teresa A Santantonio, Thomas Berg, Tania M Welzel, Heiner Wedemeyer, Maria Buti, Pierre Pradat, Fabien Zoulim, Bettina Hansen, Harry L A Janssen
BACKGROUND AND AIM: The incidence and consequences of flares during first-line nucleos(t)ide analogue therapy are largely unknown. We aimed to investigate the incidence and outcome of ALT flares during long-term entecavir (ETV) in chronic hepatitis B (CHB). METHODS: CHB patients treated with ETV monotherapy from 11 European centers were studied. Flare was defined as >3x increase in ALT compared with baseline or lowest on-treatment level, and an absolute ALT >3x upper limit of normal...
March 24, 2016: Journal of Gastroenterology and Hepatology
Cuong Minh Duong, Mary-Louise McLaws
BACKGROUND: Hepatitis C virus (HCV) is a risk for all hemodialysis patients. Over a 2-month period in 2013, there were 11 HCV seroconversions at a satellite hemodialysis unit in Vietnam. We report the epidemiologic investigation of the transmission mode in the absence of unavailable phylogenetic analysis. METHODS: The outbreak occurred during a 2-year dynamic cohort study. All patients were tested every 2 months, and staff was tested annually for hepatitis B virus surface antigen and HCV core antigen...
May 1, 2016: American Journal of Infection Control
A Kološová, J Gašparovič
The Regional Public Health Authority was notified about four cases of viral hepatitis (B and C) among patients with pre-event history of hospitalization at an oncological ward. An outbreak investigation was commenced in response. Forty-seven cases of viral hepatitis B and C in 39 patients hospitalized during the period from September 2009 to July 2010 were registered. We found an association between parenteral treatment and disease (hepatitis B: χ(2) = 49.53; P < 0.001; hepatitis C: χ(2) = 22.42; P < 0...
June 2016: Journal of Hospital Infection
Adeel A Butt, Peng Yan, Obaid S Shaikh, Raymond T Chung, Kenneth E Sherman
BACKGROUND & AIMS: Role of non-adherence upon virological success with newer oral regimens is unknown. We sought to determine the impact of treatment adherence upon virological outcomes in hepatitis C virus (HCV) infected persons on sofosbuvir (SOF)-based regimens, using pharmacy prescription data as a measure of adherence. METHODS: We analysed HCV infected persons in Electronically Retrieved Cohort of HCV Infected Veterans, who were initiated on SOF-based regimens, excluding those with human immunodeficiency virus, positive hepatitis-B surface antigen, hepatocellular carcinoma and missing HCV RNA...
September 2016: Liver International: Official Journal of the International Association for the Study of the Liver
Vincent L Chen, An K Le, Nathan G Kim, Lily H Kim, Nghia H Nguyen, Pauline P Nguyen, Changqing Zhao, Mindie H Nguyen
BACKGROUND & AIMS: Hepatitis B virus (HBV) is the most common cause of hepatocellular carcinoma (HCC) worldwide. Unlike other liver diseases, HBV can cause HCC in the absence of cirrhosis. We investigated whether features of HCC in patients with HBV infection without cirrhosis and survival times differ from those of patients who develop HCC after cirrhosis. METHODS: We performed a retrospective cohort study of 487 consecutive cases of HBV-related HCC who were seen from 2000 through 2014 at a tertiary care center...
June 2016: Clinical Gastroenterology and Hepatology
Rodrigo Martins Abreu, Camila da Silva Ferreira, Aline Siqueira Ferreira, Eduardo Remor, Paulo Dominguez Nasser, Flair José Carrilho, Suzane Kioko Ono
INTRODUCTION: Evidence shows that treatment for hepatitis B virus (HBV) can suppress viral load. Among the factors directly linked to therapeutic success is adherence to the treatment. Several instruments to assess adherence are available, but they are not validated for use in chronic hepatitis B. The purpose of this paper was to adapt and validate the "Assessment of Adherence to Antiretroviral Therapy Questionnaire-HIV" (CEAT-VIH) for patients with chronic hepatitis B (referred to herein as CEAT-HBV)...
March 2016: Infectious Diseases and Therapy
Sahar Saeed, Erin C Strumpf, Sharon L Walmsley, Kathleen Rollet-Kurhajec, Neora Pick, Valerie Martel-Laferrière, Mark Hull, M John Gill, Joseph Cox, Curtis Cooper, Marina B Klein
BACKGROUND: Direct-acting antivirals (DAAs) against hepatitis C virus (HCV) have been described as revolutionary. However, it remains uncertain how effective these drugs will be for individuals coinfected with human immunodeficiency virus (HIV)-HCV. Bridging this gap between efficacy and effectiveness requires a focus on the generalizability of clinical trials. METHODS: Generalizability of DAA trials was assessed by applying the eligibility criteria from 5 efficacy trials: NCT01479868, PHOTON-1 (NCT01667731), TURQUOISE-I (NCT01939197), ION-4 (NCT02073656), and ALLY-2 (NCT02032888) that evaluated simeprevir; sofosbuvir; ombitasvir, paritaprevir/ritonavir/dasabuvir; sofosbuvir/ledipasvir; and daclatasvir/sofosbuvir, respectively, to the Canadian Coinfection Cohort, representing approximately 23% of the total coinfected population in care in Canada...
April 1, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Andy Liu, Ryan B Perumpail, Radhika Kumari, Zobair M Younossi, Robert J Wong, Aijaz Ahmed
Hepatic encephalopathy (HE) is a major complication of cirrhosis resulting in significant socioeconomic burden, morbidity, and mortality. HE can be further subdivided into covert HE (CHE) and overt HE (OHE). CHE is a subclinical, less severe manifestation of HE and requires psychometric testing for diagnosis. Due to the time consuming screening process and lack of standardized diagnostic criteria, CHE is frequently underdiagnosed despite its recognized role as a precursor to OHE. Screening for CHE with the availability of the Stroop test has provided a pragmatic method to promptly diagnose CHE...
December 18, 2015: World Journal of Hepatology
Vanessa Romero Díaz-Maroto, Marina Sánchez Cuervo, Miguel Ángel Rodríguez Sagrado, Teresa Bermejo Vicedo
PURPOSE: to evaluate adherence of patients with chronic hepatitis B initiated on entecavir as first-line treatment and to correlate adherence with effectiveness. METHODS: observational retrospective study performed between January 2007 and June 2013. Patients treated with entecavir for at least one year were included. A patient was considered to be adherent if median adherence was ≥ 95%. Virological response (HBV DNA < 20UI/ml by Polymerase Chain Reaction), biochemical response (normalized level of alanine amino transferase [AAT]) and serological response (loss of hepatitis B surface antigen [HBsAg]) was assessed at month 12...
November 2015: Farmacia Hospitalaria
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