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No‐touch ablation in hepatocellular carcinoma has the potential to prevent intrasubsegmental recurrence to the same degree as surgical resection

Kawamura, Yusuke ; Ikeda, Kenji ; Shindoh, Junichi ; [weitere]

Wiley ; 2019

In: Hepatology Research Vol. 49, No. 2 ( 2019-02), p. 164-176

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In: Hepatology Research, Wiley, Vol. 49, No. 2 ( 2019-02), p. 164-176

Kurzfassung: The aim of this study was to clarify the utility of a no‐touch pincer ablation procedure that uses bipolar electrodes to prevent intrasubsegmental tumor recurrence after radiofrequency ablation (RFA) for patients with hepatocellular carcinoma (HCC) compared to surgical resection. Methods We evaluated 175 consecutive patients with HCC (single nodule, tumor diameter ≤ 30 mm) who underwent surgical resection (146 received partial resection) and 313 patients who received RFA; 277 patients received touch ablation using a monopolar or bipolar RFA device, and 36 received no‐touch ablation using a bipolar RFA device. Pretreatment arterial and portal phase dynamic computed tomography (CT) or magnetic resonance imaging (MRI) images were classified into four enhancement patterns: Type 1 and Type 2 are homogeneous enhancement patterns without or with increased arterial blood flow, respectively; Type 3 is a heterogeneous enhancement pattern with a septum‐like structure; and Type 4 is an irregularly shaped ring structure enhancement pattern. Results Cumulative recurrence rates significantly differed between procedures (surgical resection, 7.5%; no‐touch ablation, 2.9%; and touch ablation, 17.7% at the third year; P = 0.005). Multivariate Cox proportional hazards analysis revealed that enhancement pattern type (Type 3: hazard ratio [HR], 2.95; P = 0.002; and Type 4: HR, 3.88, P = 0.002), treatment procedure (touch ablation: HR, 3.36; P 〈 0.001), and serum α‐fetoprotein level (≥30 μg/L: HR, 1.87; P = 0.009) were significant predictors of intrasubsegmental recurrence. No significant differences between no‐touch ablation and surgical resection were observed. Conclusion The no‐touch pincer ablation procedure has the potential to prevent intrasubsegmental recurrence after RFA for patients with HCC to the same degree as partial resection.

Materialart: Online-Ressource

ISSN: 1386-6346 , 1872-034X

URL: Issue

URL: Article

DOI: 10.1111/hepr.v49.2

DOI: 10.1111/hepr.13254

Sprache: Englisch

Verlag: Wiley

Publikationsdatum: 2019

ZDB Id: 2006439-1

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Potential of ultra‐highly sensitive immunoassays for hepatitis B surface and core‐related antigens in patients with or without development of hepatocellular carcinoma after hepatitis B surface antigen seroclearance

Suzuki, Fumitaka ; Hosaka, Tetsuya ; Imaizumi, Masayasu ; [weitere]

Wiley ; 2021

In: Hepatology Research Vol. 51, No. 4 ( 2021-04), p. 426-435

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In: Hepatology Research, Wiley, Vol. 51, No. 4 ( 2021-04), p. 426-435

Kurzfassung: Hepatitis B surface antigen (HBsAg) seroclearance indicates a “functional cure” in chronic hepatitis B (CHB) virus infection. However, several cases of hepatocellular carcinoma (HCC) development have been reported after HBsAg seroclearance. We evaluated the potential of HBsAg and hepatitis B core‐related antigen (HBcrAg), measured by the ultra‐highly sensitive assays, in cases with HCC development after HBsAg seroclearance. Methods We enrolled 17 patients with CHB who achieved HBsAg seroclearance, defined by the conventional assay using Architect HBsAg QT kit (five HCC patients and 12 non‐HCC patients). HBsAg and HBcrAg were measured in their stored serum samples using ultra‐highly sensitive assays featuring “immunoassay for total antigen including complex via pretreatment (iTACT)” technology. Results All five patients who developed HCC were positive for HBsAg or HBcrAg by iTACT‐HBsAg or iTACT‐HBcrAg at all follow‐up points. HBcrAg levels in the HCC group, using iTACT‐HBcrAg, were significantly higher than those in the non‐HCC group at HBsAg seroclearance (3.6 LogU/ml (2.8–4.2) versus 2.6 ( 〈 2.1–3.8), p = 0.020). The best cutoff value of iTACT‐HBcrAg for predicting HCC development was 2.7 LogU/ml by receiver operating characteristic curve analysis. The prevalence of HBcrAg ≥2.7 in the HCC group was significantly higher than that in non‐HCC group (100% [5/5] versus 33% [4/12] , p = 0.029). Conclusions Residual low viral antigen might predict HCC development even if HBsAg seroclearance was achieved according to a conventional assay. The results suggest that iTACT assays of HBsAg and HBcrAg would be useful for monitoring CHB patients.

Materialart: Online-Ressource

ISSN: 1386-6346 , 1872-034X

URL: Issue

URL: Article

DOI: 10.1111/hepr.v51.4

DOI: 10.1111/hepr.13602

Sprache: Englisch

Verlag: Wiley

Publikationsdatum: 2021

ZDB Id: 2006439-1

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Clinical and virological characteristics of untreated patients with chronic hepatitis C who develop serum alanine aminotransferase flare‐up

Hiraga, Nobuhiko ; Suzuki, Fumitaka ; Akuta, Norio ; [weitere]

Wiley ; 2005

In: Journal of Medical Virology Vol. 75, No. 2 ( 2005-02), p. 240-248

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In: Journal of Medical Virology, Wiley, Vol. 75, No. 2 ( 2005-02), p. 240-248

Kurzfassung: Among patients with chronic hepatitis C virus (HCV) infection, serum alanine aminotransferase (ALT) rarely increases above 500 IU/L. We examined the clinical and virological features of untreated patients with serum ALT ≥ 500 IU/L. One thousand seven hundred and sixty adult patients with chronic HCV infection were followed‐up. Among these patients, 22 developed ALT flare‐up (M:F = 13:9, median age, 50.5 years). We evaluated liver function tests, genotype, and viral titer in these patients and 44 randomly selected age‐ and sex‐matched control without ALT flare‐up. In four patients with ALT flare‐up, we examined changes in viral loads and sequential changes in amino acid sequences of the core region, hypervariable region 1 (HVR1), and interferon sensitivity determining region (ISDR) before and after ALT flare‐up. Multivariate analysis identified genotype 2 as the only significant determinant of ALT flare‐up. ALT flare‐up occurred in three of four patients without increase in viral load. Several alterations in amino acids were noted in HVR1 before and within 6 months of ALT flare‐up. One or two alterations in the core region and many alterations in HVR1 were noted after ALT flare‐up in some patients. Genotype 2 is an important factor for ALT flare‐up. However, we could not directly relate ALT flare‐up to these alterations in amino acids of the core region, HVR1, and ISDR. J. Med. Virol. 75:240–248, 2005. © 2004 Wiley‐Liss, Inc.

Materialart: Online-Ressource

ISSN: 0146-6615 , 1096-9071

URL: Issue

URL: Article

DOI: 10.1002/jmv.v75:2

DOI: 10.1002/jmv.20263

RVK:

XA 10000

Sprache: Englisch

Verlag: Wiley

Publikationsdatum: 2005

ZDB Id: 752392-0

ZDB Id: 1475090-9

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4

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The efficacy and safety of dual oral therapy with daclatasvir and asunaprevir for genotype 1b in Japanese real‐life settings

Sezaki, Hitomi ; Suzuki, Fumitaka ; Hosaka, Tetsuya ; [weitere]

Wiley ; 2017

In: Liver International Vol. 37, No. 9 ( 2017-09), p. 1325-1333

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In: Liver International, Wiley, Vol. 37, No. 9 ( 2017-09), p. 1325-1333

Kurzfassung: It is important to investigate the treatment outcomes in patients excluded from clinical trials ( CTR ). The aims of this study were to evaluate the efficacy and safety of a 24‐week daclatasvir ( DCV ) and asunaprevir ( ASV ) therapy for patients with chronic hepatitis C virus ( HCV )‐1b infection. Methods A total of 651 HCV ‐1b patients started dual oral therapy with DCV and ASV for 24 weeks in Toranomon Hospital, Tokyo. Among them, 276 patients met phase III CTR inclusion criteria. The sustained virological response ( SVR ) rate after treatment and the adverse events during therapy were compared between CTR ‐met (patients who met the inclusion criteria) and CTR ‐unmet (patients who did not meet the inclusion criteria) groups. Results SVR 12 was achieved in 87.0% (240/276) and 86.7% (325/375) in CTR ‐met and CTR‐unmet patients respectively. SVR 12 rate in simeprevir‐experienced patients was 52.9% (9/17). SVR 12 rate in patients without resistance‐associated variant ( RAV ) of NS 3 or NS 5A loci was 93.7% (416/444). However, the SVR 12 rates in patients with NS 3‐D168, NS 5A‐L31 and Y93 single RAV at baseline were 55.0% (11/20), 73.9% (17/23) and 65.6% (63/96) respectively. The safety profiles in both CTR ‐met and CTR‐unmet patients were similar. The discontinuation rate as a result of alanine aminotransferase ( ALT ) elevation was only 2.9%. Seven (2.5%) patients in CTR ‐met group and 20 (5.3%) in CTR ‐unmet group discontinued therapy because of adverse events other than the ALT elevation. Conclusions Dual oral therapy with DCV and ASV in real‐life settings was well tolerated with a similar safety profile and achieved similar SVR 12 rates as that of CTR .

Materialart: Online-Ressource

ISSN: 1478-3223 , 1478-3231

URL: Issue

URL: Article

DOI: 10.1111/liv.2017.37.issue-9

DOI: 10.1111/liv.13384

Sprache: Englisch

Verlag: Wiley

Publikationsdatum: 2017

ZDB Id: 2124684-1

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5

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Correlation between hepatitis B virus surface antigen level and alpha‐fetoprotein in patients free of hepatocellular carcinoma or severe hepatitis

Akuta, Norio ; Suzuki, Fumitaka ; Kobayashi, Mariko ; [weitere]

Wiley ; 2014

In: Journal of Medical Virology Vol. 86, No. 1 ( 2014-01), p. 131-138

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In: Journal of Medical Virology, Wiley, Vol. 86, No. 1 ( 2014-01), p. 131-138

Kurzfassung: Alfa‐fetoprotein (AFP) is used as a marker of early hepatocarcinogenesis. However, the impact of hepatitis B virus surface antigen (HBsAg) on this relationship in patients with HBV infection is not clear. The present study evaluated the relation between HBsAg and AFP levels at the initial visit in 1,610 untreated HBV patients, free of hepatocellular carcinoma (HCC) or severe hepatitis. The cumulative rate of HCC was significantly lower in patients with a low AFP level (≤10 µg/L; below the upper limit of normal) than in those with a high AFP level (≥11 µg/L) at the initial visit. In patients with HBsAg levels more than 500 IU/ml, HBsAg levels correlated significantly and negatively with AFP levels, and significantly with platelet count. Multivariate analysis of data of patients with HBsAg more than 500 IU/ml identified HBsAg ( 〈 7,000 IU/ml), albumin ( 〈 3.9 g/dl), platelet count ( 〈 20.0 × 10 4 /mm 3 ), gamma‐glutamyl transpeptidase (≥50 IU/L), aspartate aminotransferase (≥34 IU/L), HBeAg (positive), and HBV core‐related antigen (≥3.0 log U/ml) as determinants of a high AFP. Especially, in patients with HBsAg more than 500 IU/ml and low transaminase levels (below the upper limit of normal), HBsAg was identified as significant determinant of a high AFP. On the other hand, in patients with HBsAg less than 500 IU/ml, multivariate analysis identified albumin, gamma‐glutamyl transpeptidase, and HBV core‐related antigen as determinants of a high AFP. The results indicated that HBsAg level seems to affect, at least in part, the AFP levels, and that it can be used as a surrogate marker of early hepatocarcinogenesis. J. Med. Virol. 86:131–138, 2014 . © 2013 Wiley Periodicals, Inc.

Materialart: Online-Ressource

ISSN: 0146-6615 , 1096-9071

URL: Issue

URL: Article

DOI: 10.1002/jmv.v86.1

DOI: 10.1002/jmv.23790

RVK:

XA 10000

Sprache: Englisch

Verlag: Wiley

Publikationsdatum: 2014

ZDB Id: 752392-0

ZDB Id: 1475090-9

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Favorable efficacy of glecaprevir plus pibrentasvir as salvage therapy for HCV failures to prior direct‐acting antivirals regimens

Akuta, Norio ; Sezaki, Hitomi ; Suzuki, Fumitaka ; [weitere]

Wiley ; 2019

In: Journal of Medical Virology Vol. 91, No. 1 ( 2019-01), p. 102-106

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In: Journal of Medical Virology, Wiley, Vol. 91, No. 1 ( 2019-01), p. 102-106

Kurzfassung: The overall rate of SVR12, with glecaprevir and pibrentasvir (G/P) as salvage therapy in failures to prior direct‐acting antivirals (DAAs) regimens, was 100%. All patients could achieve SVR12 with G/P, regardless of emergence of NS5A RAVs, accompanied by failure to prior NS5A regimens more than once. G/P was a potentially useful salvage treatment for patients who fail prior DAAs regimens more than once.

Materialart: Online-Ressource

ISSN: 0146-6615 , 1096-9071

URL: Issue

URL: Article

DOI: 10.1002/jmv.v91.1

DOI: 10.1002/jmv.25278

RVK:

XA 10000

Sprache: Englisch

Verlag: Wiley

Publikationsdatum: 2019

ZDB Id: 752392-0

ZDB Id: 1475090-9

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7

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Evolution of simeprevir‐resistant variants in virological non‐responders infected with HCV genotype 1b

Akuta, Norio ; Suzuki, Fumitaka ; Sezaki, Hitomi ; [weitere]

Wiley ; 2015

In: Journal of Medical Virology Vol. 87, No. 4 ( 2015-04), p. 609-618

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In: Journal of Medical Virology, Wiley, Vol. 87, No. 4 ( 2015-04), p. 609-618

Kurzfassung: The present study was designed to assess the evolution of simeprevir‐resistant variants (amino acid substitutions of aa80, aa155, aa156, and aa168 positions in HCV NS3 region) over time in virological non‐responders (patients with positive HCV‐RNA during and at end of treatment). The study enrolled 136 patients infected with HCV genotype 1b who received 12‐week simeprevir‐PEG‐IFN‐ribavirin therapy, and data of 87 patients were available for analysis. Twelve patients (14%) were considered virological non‐responders, including 9 (75%) who showed absolute no‐response (HCV RNA: ≥3.0 log IU/ml at 12 weeks after start of therapy). Multivariate analysis of these patients identified lack of response to prior treatment, use of low ribavirin dose, and old age as independent and significant determinants of virological non‐response. Using ultra‐deep sequencing, de novo variants of D168 were detected in all of 9 absolute non‐responders. The majority of these variants emerged within 5 weeks of triple therapy. In comparison, de novo variants of Q80 were detected in only 3 of 9 absolute non‐responders and emerged at 6–12 weeks. Variants of Q80 detected at baseline increased during the course of treatment in 5 of 9 absolute non‐responders, while no such increase was noted in variants of R155 and/or A156 detected at baseline during the 12‐week course. De novo variants of R155 and/or A156 were not detected in this study. The results demonstrated the emergence of simeprevir‐resistant variants during the early stage of triple therapy. J. Med. Virol. 87:609–618, 2015 . © 2015 Wiley Periodicals, Inc.

Materialart: Online-Ressource

ISSN: 0146-6615 , 1096-9071

URL: Issue

URL: Article

DOI: 10.1002/jmv.v87.4

DOI: 10.1002/jmv.24113

RVK:

XA 10000

Sprache: Englisch

Verlag: Wiley

Publikationsdatum: 2015

ZDB Id: 752392-0

ZDB Id: 1475090-9

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Amino acid substitutions in the hepatitis C virus core region predict hepatocarcinogenesis following eradication of HCV RNA by all‐oral direct‐acting antiviral regimens

Ogata, Fumihiro ; Akuta, Norio ; Kobayashi, Masahiro ; [weitere]

Wiley ; 2018

In: Journal of Medical Virology Vol. 90, No. 6 ( 2018-06), p. 1087-1093

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In: Journal of Medical Virology, Wiley, Vol. 90, No. 6 ( 2018-06), p. 1087-1093

Kurzfassung: Impact of substitution of aa70 in the core region (Core aa70) in HCV genotype 1b (HCV‐1b) on hepatocarcinogenesis following eradication of HCV RNA by direct‐acting antiviral therapy is not clear. In a retrospective study, 533 patients with HCV‐related chronic liver disease, with sustained virological response defined as negative HCV RNA at 12 weeks after cessation of direct‐acting antiviral therapy, were examined to evaluate the relationship between Core aa70 substitution and hepatocarcinogenesis. Twelve patients developed hepatocellular carcinoma during the follow‐up period. The cumulative hepatocarcinogenesis rates were 1.7% and 2.4% at the end of 1 and 2 years, respectively. Overall, multivariate analysis identified HCV subgroup (HCV‐1b with Gln70(His70); P = 0.003) and age ( 〉 65 years; P = 0.049), as pretreatment predictors of hepatocarcinogenesis. In HCV‐1b patients, multivariate analysis identified post‐treatment Wisteria floribunda agglutinin positive Mac‐2 binding protein ( 〉 1.8 COI; P = 0.042) and HCV subgroup (HCV‐1b with Gln70(His70); P = 0.071), as predictors of hepatocarcinogenesis, including post‐treatment parameter. In conclusion, Core aa70 substitution in HCV‐1b at the start of direct‐acting antiviral therapy is an important predictor of hepatocarcinogenesis following eradication of HCV RNA. This study emphasizes the importance of detection of Core aa70 substitution before initiating antiviral therapy.

Materialart: Online-Ressource

ISSN: 0146-6615 , 1096-9071

URL: Issue

URL: Article

DOI: 10.1002/jmv.v90.6

DOI: 10.1002/jmv.25047

RVK:

XA 10000

Sprache: Englisch

Verlag: Wiley

Publikationsdatum: 2018

ZDB Id: 752392-0

ZDB Id: 1475090-9

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Detection of TERT promoter mutation in serum cell‐free DNA using wild‐type blocking PCR combined with Sanger sequencing in hepatocellular carcinoma

Akuta, Norio ; Suzuki, Fumitaka ; Kobayashi, Mariko ; [weitere]

Wiley ; 2020

In: Journal of Medical Virology Vol. 92, No. 12 ( 2020-12), p. 3604-3608

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In: Journal of Medical Virology, Wiley, Vol. 92, No. 12 ( 2020-12), p. 3604-3608

Kurzfassung: We developed a highly sensitive method for detection of TERT promoter mutation using WTB‐PCR combined with Sanger sequencing and demonstrated its clinical usefulness in the measurement of TERT C228T in serum cfDNA.

Materialart: Online-Ressource

ISSN: 0146-6615 , 1096-9071

URL: Issue

URL: Article

DOI: 10.1002/jmv.v92.12

DOI: 10.1002/jmv.25724

RVK:

XA 10000

Sprache: Englisch

Verlag: Wiley

Publikationsdatum: 2020

ZDB Id: 752392-0

ZDB Id: 1475090-9

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A matched case-controlled study of 48 and 72 weeks of peginterferon plus ribavirin combination therapy in patients infected with HCV genotype 1b in Japan: amino acid substitutions in HCV core region as predictor of sustained virological response

Akuta, Norio ; Suzuki, Fumitaka ; Hirakawa, Miharu ; [weitere]

Wiley ; 2009

In: Journal of Medical Virology Vol. 81, No. 3 ( 2009-03), p. 452-458

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In: Journal of Medical Virology, Wiley, Vol. 81, No. 3 ( 2009-03), p. 452-458

Materialart: Online-Ressource

ISSN: 0146-6615 , 1096-9071

URL: Issue

URL: Article

DOI: 10.1002/jmv.v81:3

DOI: 10.1002/jmv.21400

RVK:

XA 10000

Sprache: Englisch

Verlag: Wiley

Publikationsdatum: 2009

ZDB Id: 752392-0

ZDB Id: 1475090-9

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