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Aims: This study aimed to elucidate the epidemiological and clinical characteristics of chronic hepatitis C (CHC) patients in South Korea from 2007 to 2017 and to compare the treatment patterns between two periods before and after the first approval of direct-acting antivirals (DAA) in South Korea in 2015. Methods: This prospective, multicenter cohort enrolled 2,758 patients with hepatitis C virus (HCV) viremia at seven tertiary centers, and clinical data were prospectively collected with questionnaire surveys focused on lifetime risk factors related to HCV infection. Results: The HCV patients had a mean age of 57.3 years (50.8% male). Among them, 14.3% showed a positive history of transfusion before HCV screening and 5.6% reported intravenous drug use (IVDU), with significant differences in these risk factors between men and women. The proportions of patients with chronic hepatitis, liver cirrhosis and hepatocellular carcinoma (HCC) were 69.5%, 18.9%, and 11.5%, respectively. The mean alanine aminotransaminase level was within the upper normal limit at 49.9%, and the major genotypes were 1b (48.2%) and 2 (46.4%). The overall treatment rate was 53.8%, showing a rapid transition from interferon-based therapy to DAA therapy. In the post-DAA-approval era, the untreated group was older, had a higher prevalence of HCC, and had less education than the treated group. Conclusions: More than 90% of CHC patients were over 40 years old, the major genotypes were 1b and 2, and IVDU was observed in less than 6% of CHC patients. Approximately half of the patients underwent antiviral therapy even in the DAA era, showing an unmet need with regard to HCV elimination. [ABSTRACT FROM AUTHOR]

Background/Aims: Patients with Hansen's disease are the most vulnerable to hepatitis C. However, no data on the treatment efficacy of direct-acting antiviral agents (DAAs) are available in this group. Therefore, we elucidated the prevalence and clinical outcomes of hepatitis C in persons affected by leprosy in Sorokdo, Jeollanam-do, Korea. Methods: We retrospectively included 50 leprosy patients with positive hepatitis C virus (HCV) RNA test results (group A) hospitalized at the Sorokdo National Hospital from May 2016 to March 2018 and 73 patients with chronic hepatitis C who were treated with DAAs at the Chonnam National University Hospital (group B) from May 2016 to December 2017. Results: Overall, at the Sorokdo National Hospital, positive HCV antibody and HCV RNA rates were 18.4% and 11.0%, respectively. The mean participant age was 76.5±7 years, and 58% of participants were men. The genotypes were type 1b in 44% (22 out of 50) and type 2 in 56% (28 out of 50). Sustained virologic response was achieved at a rate of 95.5% (21/22) in genotype 1b and 92.9% (26/28) in genotype 2 patients. Ribavirin-induced hemolytic anemia occurred in 57.1% (16/28) of patients with genotype 2. Among these, 28.5% (8/28) received blood transfusions. Conclusions: Treatment efficacy was not different between the leprosy-affected population and the general population. However, severe ribavirin-induced hemolytic anemia requiring transfusion was present in 28.5% of genotype 2 patients. Therefore, we suggest ribavirin-free DAAs for the treatment of genotype 2 hepatitis C in leprosy-affected persons in the future. [ABSTRACT FROM AUTHOR]

Background/Aims With the development of treatment for colorectal cancer, stenting is used with increasing as a treatment for malignant colorectal obstruction. Compared with surgery, colorectal stent insertion shows similar result and less complications, successful colorectal stent insertion will improve quality of life in curative and palliative treatment patients. The aim of this study is to predict factors related to technical/clinical success in colorectal stent insertion for improvement of the success rate. Methods From January 2013 to December 2019, we retrospectively identified 479 patients with malignant colorectal obstruction who underwent placement of colorectal self-expandable metal stent (SEMS) at Chonnam National University Hwasun Hospital, Korea. Main outcome measures included technical success, clinical success, complications, and predictors of outcome. Results The incidence Technical success was achieved in 86.4% (414/479) and clinical success in 74.3% (356/479) of the cases. Pain and tenderness were present in 75.8% (363/479) and 44.1% (211/379), there were statistically related factor to technical failure of SEMS insertion (odds ratio [OR], 3.041; p=0.029 and OR, 2.358; p=0.012). Also, metastasis and microperforation were present in 306 of 479 (63.9%), 17 of 479 (3.6%) and it was a statistically significant factor associated with technical failure (OR, 7.128; p=0.04 and OR, 4.413; p=0.008). But there were no statistically factor associated with clinical failure in multivariate analysis. Conclusions Pain, tenderness, microperforation, and metastasis were a predict factor of technical failure of colorectal SEMS insertion in malignant colorectal obstruction. [ABSTRACT FROM AUTHOR]