Citations 2
Racial and ethnic disparities in untreated patients with hepatitis C virus‐related hepatocellular carcinoma but not in those with sustained virologic response
Park, Jung Eun , Nguyen, Vy H. , Tsai, Pei‐Chien , Toyoda, Hidenori , Leong, Jennifer , Guy, Jennifer , Huang, Chung‐Feng , Yasuda, Satoshi , Abe, Hiroshi , Hsu, Yao‐Chun , Tseng, Cheng‐Hao , Liu, Joanne, Chen, Yao‐Li , Lin, Ping‐Yi , Yoshimaru, Yoko , Ishigami, Masatoshi , Enomoto, Masaru , Tamori, Akihiro , Uojima, Haruki , Wang, Xiao Zhong, Xu, Qiang , Takahashi, Hirokazu , Eguchi, Yuichiro , Inoue, Kaori , Zhao, Wen , Barnett, Scott D. , Maeda, Mayumi , Cheung, Ramsey , Landis, Charles , Tanaka, Yasuhito , Roberts, Lewis R. , Schwartz, Myron , Yu, Ming‐Lung , Nguyen, Mindie H. , Yeh, Ming-Lun , Huang, C-F , Tseng, Cheng-Hao , Jun, D W , Ogawa, Eiichi , Huang, Daniel Q , Dai, Chia-Yen , Kumada, Takashi , Yu, M-L , Nguyen, Mindie H , Roberts, Lewis R , Huang, Daniel Q. , Chuang, Wan‐Long , Huang, Jee‐Fu
Alimentary Pharmacology & Therapeutics | January 4, 2024 | Volume: 59 | Issue: 6 | Pages: 742-751
SummaryBackgroundRacial and ethnic disparities exist for hepatitis C virus (HCV) treatment and hepatocellular carcinoma (HCC) survival.AimTo evaluate the impact of HCV treatment on such disparities.MethodsIn a retrospective cohort study, we analysed 6069 patients with HCV‐related HCC (54.2% Asian, 30.1% White, 8.5% Black, and 7.3% Hispanic) from centres in the United States and Asia.ResultsThe mean age was 61, 60, 59 and 68, respectively, for White, Black, Hispanic and Asian patients. Black patients were most likely to have Barcelona Clinic Liver Cancer stage D, vascular invasion and distant metastasis (23% vs. 5%–15%, 20% vs. 10%–17% and 10% vs. 5%–7%, respectively; all p < 0.0001). Treatment rate with direct‐acting antiviral agents (DAA) was 35.9% for Asian, 34.9% for White, 30.3% for Hispanic (30.3%), and 18.7% for Black patients (p < 0.0001). Among those untreated or without sustained virologic response (SVR), 10‐year survival rates were 35.4, 27.5, 19.3 and 14.0, respectively, for Asian, Hispanic, White and Black patients (p < 0.0001). There were no statistically significant differences among those with SVR (p = 0.44). On multivariable analysis adjusted for relevant confounders, there was no statistically significant association between survival and being Hispanic (aHR: 0.68, p = 0.26) or Black (aHR: 1.18, p = 0.60) versus White. There was a significant association between being Asian American and survival (aHR: 0.24, p = 0.001; non‐U.S. Asian: aHR: 0.66, p = 0.05), and for SVR (aHR: 0.30, p < 0.0001).ConclusionDAA treatment rates were suboptimal. Racial and ethnic disparities resolved with HCV cure. Early diagnosis and improved access to HCV treatment is needed for all patients with HCV infection.
Differentiation of Idiopathic Pulmonary Fibrosis from Connective Tissue Disease-Related Interstitial Lung Disease Using Quantitative Imaging
Adegunsoye, Ayodeji , Cannon, Brenna, Vij, Rekha, King, Christopher S. , Montner, Steven M. , Thirkateh, Prahasit , Barnett, Scott D. , Karwoski, Ronald A., Bartholmai, Brian J. , Strek, Mary E. , Nathan, Steven D. , Karwoski, Ronald, Bartholmai, Brian J , Chung, Jonathan Hero , Oldham, Justin M
Journal of Clinical Medicine | June 17, 2021 | Volume: 10 | Issue: 12 | Pages: 2663
A usual interstitial pneumonia (UIP) imaging pattern can be seen in both idiopathic pulmonary fibrosis (IPF) and connective tissue disease-related interstitial lung disease (CTD-ILD). The purpose of this multicenter study was to assess whether quantitative imaging data differ between IPF and CTD-ILD in the setting of UIP. Patients evaluated at two medical centers with CTD-ILD or IPF and a UIP pattern on CT or pathology served as derivation and validation cohorts. Chest CT data were quantitatively analyzed including total volumes of honeycombing, reticulation, ground-glass opacity, normal lung, and vessel related structures (VRS). VRS was compared with forced vital capacity percent predicted (FVC%) and percent predicted diffusing capacity of the lungs for carbon monoxide (DLCO%). There were 296 subjects in total, with 40 CTD-ILD and 85 IPF subjects in the derivation cohort, and 62 CTD-ILD and 109 IPF subjects in the validation cohort. VRS was greater in IPF across the cohorts on univariate (p < 0.001) and multivariable (p < 0.001–0.047) analyses. VRS was inversely correlated with DLCO% in both cohorts on univariate (p < 0.001) and in the derivation cohort on multivariable analysis (p = 0.003) but not FVC%. Total volume of normal lung was associated with DLCO% (p < 0.001) and FVC% (p < 0.001–0.009) on multivariable analysis in both cohorts. VRS appears to have promise in differentiating CTD-ILD from IPF. The underlying pathophysiological relationship between VRS and ILD is complex and is likely not explained solely by lung fibrosis.