Most Read Articles
06 Dec 2018
A strong belief in the necessity of medication is associated with better adherence to oral disease-modifying antirheumatic drugs (DMARDs) or prednisone, while higher self-efficacy correlates with poor adherence, in a diverse cohort of patients with rheumatoid arthritis (RA), suggests a study.
Pearl Toh, Yesterday
First-line therapy with the BTK* inhibitor ibrutinib plus the anti-CD20 immunotherapy rituximab confers significant survival advantage over the current gold-standard regimen of fludarabine, cyclophosphamide, and rituximab (FCR) for young, fit patients with treatment-naïve chronic lymphocytic leukaemia (CLL), according to the E1912 trial, a large cooperative group study supported by the US National Cancer Institute.
6 days ago
Low-dose administrations of haloperidol after thoracic surgery does not appear to prevent postoperative delirium, according to a new study.
4 days ago
Percutaneous coronary intervention (PCI) displays comparable rates of mortality and serious composite outcomes but a higher rate of target-vessel revascularization at 10 years relative to coronary artery bypass grafting (CABG) in patients with significant left main coronary artery (LMCA) disease, reports a study. On the other hand, CABG delivers lower mortality and serious composite outcome rates compared with PCI with drug-eluting stents after 5 years.

HCC, mortality risks elevated in immune-tolerant phase of chronic hepatitis B

11 Nov 2017

The risks of hepatocellular carcinoma (HCC) and death/transplantation in chronic hepatitis B virus (HBV) infection appear to be greater in untreated immune-tolerant (IT)-phase patients than in treated immune-active (IA)-phase patients, a study has found.

Researchers examined 1,910 chronic HBV patients with HBV DNA levels ≥20 000 IU/mL and no evidence of cirrhosis. They evaluated the clinical outcomes in untreated IT-phase patients (n=413) with normal alanine aminotransferase (ALT) levels (females, <19 IU/mL; males, <30 IU/mL) against those in IA-phase patients (n=1,497) with elevated ALT levels (≥80 IU/mL) and treated with nucleos(t)ide analogues.

Compared with the IA group, the IT group was significantly younger (mean age at baseline, 38 vs 40 years; p=0.04). Moreover, the IT group had significantly higher 10-year estimated cumulative incidences of HCC (12.7 vs 6.1 percent; p=0.001) and death/transplantation (9.7 vs 3.4 percent; p<0.001).

On Cox analysis, the IT phase was associated with markedly greater risks of HCC (hazard ratio [HR], 2.54; 95 percent CI, 1.54 to 4.18) and death/transplantation (HR, 3.38; 1.85 to 6.16). The elevation in the said risks was consistently identified through inverse probability treatment weighting, propensity score-matched and competing risks analyses.

Factors predictive of clinical events included older age (year; HR, 1.07), male sex (HR, 2.30), lower HBV DNA levels (log10 IU/mL; HR, 0.62) and lower platelet counts (×109 /L; HR, 0.99).

The present data suggest that “many unnecessary deaths could be prevented by earlier antiviral intervention in the IT phases before the appearance of clinically active liver disease,” researchers said.

Additional studies should be conducted to explore the potential of new emerging biomarkers for HBV infection in stratifying the patients for the risk of clinical events, as well as to evaluate the long-term clinical outcomes of the IT-phase patients with or without antiviral treatment, researchers added.

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Most Read Articles
06 Dec 2018
A strong belief in the necessity of medication is associated with better adherence to oral disease-modifying antirheumatic drugs (DMARDs) or prednisone, while higher self-efficacy correlates with poor adherence, in a diverse cohort of patients with rheumatoid arthritis (RA), suggests a study.
Pearl Toh, Yesterday
First-line therapy with the BTK* inhibitor ibrutinib plus the anti-CD20 immunotherapy rituximab confers significant survival advantage over the current gold-standard regimen of fludarabine, cyclophosphamide, and rituximab (FCR) for young, fit patients with treatment-naïve chronic lymphocytic leukaemia (CLL), according to the E1912 trial, a large cooperative group study supported by the US National Cancer Institute.
6 days ago
Low-dose administrations of haloperidol after thoracic surgery does not appear to prevent postoperative delirium, according to a new study.
4 days ago
Percutaneous coronary intervention (PCI) displays comparable rates of mortality and serious composite outcomes but a higher rate of target-vessel revascularization at 10 years relative to coronary artery bypass grafting (CABG) in patients with significant left main coronary artery (LMCA) disease, reports a study. On the other hand, CABG delivers lower mortality and serious composite outcome rates compared with PCI with drug-eluting stents after 5 years.