Abstract No. 522 Outcomes of TACE for hepatocellular carcinoma in patients with HIV infection
Elizabeth H. PhillipsRyan KohlbrennerAisha True‐YasakiNicholas FidelmanAndrew TaylorEvan LehrmanMaureen P. KohiK. KolliRobert K. KerlanNeil Mehta
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Hepatitis B
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Liver disease
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Foreword. Preface. 1. The background to hepatocellular carcinoma and the liver. 2. Premalignant lesions of hepatocellular carcinoma. 3. Pathomorphologic characteristics of early-stage small hepatocellular carcinoma. 4. Morphologic evolution of hepatocellular carcinoma: from early to advanced. 5. Angioarchitecture of hepatocellular carcinoma. 6. Advanced hepatocellular carcinoma. 7. Multicentric occurrence of hepatocellular carcinoma. 8. Combined hepatocellular carcinoma and cholangiocarcinoma. 9. Nodular lesions mimicking hepatocellular carcinoma. 10. Biopsy diagnosis of tumorous lesions of the liver. 11. Chemoprevention of hepatocellular carcinoma. Index
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Despite utilizing different actions to render blood safe for transfusions, we continue to have the risk of transmitting some viral infections. For this reason, it is important to determine prevalence of infections due to HIV and hepatitis B and hepatitis C viruses in blood donors. Previous studies from Mexico indicate that HIV prevalence is 0.01 to 0.13%, while it is 0.11 to 1.22% for hepatitis B, and for hepatitis C, prevalence is 0.47 to 1.47%. We are checking the results of the screening tests (ELISA 3rd generation and chemiluminescent immunoassays) from blood donors studied at the Central Blood Bank (Banco Central de Sangre) at the Mexican Institute of Social Security's (IMSS) Twentieth First Century National Medical Center in Mexico City from 1995 to 2002. Reactive results were studied by confirmatory tests, Western Blot for HIV, AgHBs neutralization test for hepatitis B, and RIBA-HCV3.0 for hepatitis C. Reactive results from 513,062 blood donors confirmed for HV were 0.07%, reactive results and confirmation of hepatitis B from 511,733 blood donors were 0.13%, and reactive results and confirmation of hepatitis C from 511,115 blood donors were 0.31%. Rates obtained are low when compared with results of previous studies in Mexico for HIV, hepatitis B, and hepatitis C. It may be possible than these low rates indicate the positive impact obtained from preventive actions, better strategies of detection of blood donors with high risk, and the advantage of working with a fully automated test system with state-of-the-art technology.
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There is a distinct spectrum of infectious diseases in prisons, known as desmoteric infections. We investigated the incidence of HIV, hepatitis A, B, and C in a group of 539 prisoners and compared them with the incidences of these infections in the normal population. The incidence of HIV was 928 out of 100,000. This figure is similar to that of the normal population. Hence, HIV infection does not seem to be a desmoteric disease. In contrast to AIDS the incidences of hepatitis A, B, and C among prisoners were 2968, 1670, and 20,000, respectively. Of course, hepatitis A, B, and C occur 100-200 times more often among prisoners and thus seem to be desmoteric infections. Moreover, especially hepatitis C is correlated strongly with intravenous drug abuse. About 80% of drug abusers were HCV positive and 50% of the total of HC infections are due to drug abusers.
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INTRODUCTION: The aim of this project is to evaluate coinfection of hepatitis A, B, C in Southeast Appalachian, Kentucky. METHODS: Clinical data on 152 hepatitis cases between January and April of 2019 were collected retrospectively and analyzed by age, sex, risk factors, and coinfections. RESULTS: For hepatitis A, 56.25% were male, hepatitis B 58.3% male, and C 70.24% male. The median ages for males with hepatitis A was 43, females 56; hepatitis B 50, female 52; and C 43, female 40.5. Most (79.6%) patients were diagnosed with hepatitis C and of those, 70% were male. Five (13.2%) patients had more than one type of hepatitis; A and B 3.3%, A and C (3.3%), B and C (3.3%), and A, B, C (3.3%). Patients with hepatitis A, B and C were all male. Risk behaviors among the patients included reported IV drug use (35%), and alcohol abuse (12.5%). There was a low incidence of confections (13.2%). Tattoo users had a higher incidence of hepatitis B and hepatitis C than hepatitis A. Approximately 33% of drug users were associated with hepatitis A, B, and C. CONCLUSION: In our findings, the incidence of hepatitis C (79.6%) was higher than A (10.5%) or B (7.9%). Incidence was higher in males than female; strikingly for hepatitis C. Further study with a higher number of patients might give more insight. Counseling and vaccination may prevent future incidents of hepatitis.
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The aim of this study was to determine the characteristics of hepatocellular carcinoma at a major health center in southern Turkey. Computed tomography was compared to the combination of ultrasonography and serum alpha-fetoprotein determination in the diagnosis of hepatocellular carcinoma.Of 226 patients with liver cirrhosis, 35 were diagnosed with hepatocellular carcinoma on first admission or during follow-up in the period between 1999 and 2002. The features investigated were, age at time of hepatocellular carcinoma diagnosis, etiology of cirrhosis, severity of cirrhosis at presentation, tumor pattern, stage of hepatocellular carcinoma, serum alpha-fetoprotein level, and dynamic computed tomography findings. Results were compared to previous findings in Turkey and elsewhere.In the hepatocellular carcinoma patients, the male:female ratio was 4:1 and the mean age at presentation was 61 years. Chronic hepatitis B virus infection (65.7%) and chronic hepatitis C virus infection (28.6%) were the most frequently identified risk factors for hepatocellular carcinoma. Forty percent of the patients had Child-Pugh A cirrhosis when they were diagnosed with hepatocellular carcinoma. Sixty-seven percent of patients had fewer than three hepatocellular carcinoma nodules in the liver at the time of diagnosis. Only three of the hepatocellular carcinoma cases were Okuda stage I. The combination of ultrasonography and serum alpha-fetoprotein >20 ng/ml identified hepatocellular carcinoma in 32 of the 35 total cases.The results indicate that hepatitis B virus infection in patients with cirrhosis is still the leading risk factor for the development of hepatocellular carcinoma. Also, early-stage hepatocellular carcinoma is rarely diagnosed in cirrhosis patients from this region of Turkey. Surveillance with computed tomography for early diagnosis of hepatocellular carcinoma seems not to be mandatory.
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Aims. To assess prevalence of, and behavioural risk factors for, hepatitis B and C in drug users both in and out of contact with drugs services. Design. Cross‐sectional survey of hepatitis B and C prevalence using blood samples and self‐completed risk factor questionnaires. Participants. Three hundred and sixty injecting drug users (IDUs) in treatment for their drug use, attending syringe exchange schemes (SES), and not in contact with any services in Wirral and Manchester between 1997 and 1999, for whom test results were available for 334 (hepatitis B) and 341 (hepatitis C). Findings. Hepatitis B prevalence differed between groups, from 19% of those not in contact to 41% of those presenting to request a test ( p = 0.040). Prevalence of hepatitis C ranged from 48% (SES) to 62% among those presenting for a test ( p = 0.233). After multivariate adjustment, hepatitis B was predicted by prison stays ( p = 0.030) and injecting for longer ( p = 0.003). For hepatitis C, length of injecting career ( p = 0.036), having been to prison ( p = 0.034), having injected more than one drug type ( p < 0.001) and being female ( p = 0.037) predicted infection. Overall, 38% had shared some form of injecting equipment in the previous 4 weeks. People recently starting injecting were more likely to share, and sharing was more likely to occur when injecting with only one other user rather than in larger groups. Those who had previously presented for a hepatitis C test, regardless of the result, were less likely to have recently shared injecting equipment. Conclusions. Behaviours associated with transmission of hepatitis B and C are common among IDUs. In particular, sharing of injecting equipment was more likely in small groups and in those recently beginning injecting. More broadly, chaotic drug use and time in prison were also risk factors for hepatitis infections. When assessing prevalence of hepatitis B and C, our results suggest that figures cannot be extrapolated from those in service contact to those in the wider drug‐using population.
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