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151. Diagnosis and Treatment of Colonic Diverticular Disease: Position Paper of the Romanian Society of Gastroenterology and Hepatology

Author

Trifan, Anca, primary, Gheorghe, Cristian, primary, Sabo, Cristina Marica, primary, Diculescu, Mircea, primary, Nedelcu, Laurențiu, primary, Singeap, Ana Maria, primary, Sfarti, Cătălin, primary, Gheorghe, Liana, primary, Sporea, Ioan, primary, Tanțău, Marcel, primary, Scripcariu, Viorel, primary, Goldiș, Adrian, primary, Gheonea, Dan, primary, Manuc, Mircea, primary, Stanciu, Carol, primary, Scarpignato, Carmelo, primary, and Dumitrașcu, Dan L, primary

Published
2018
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156. Gastrointestinal Endoscopy in Patients on Direct Oral Anticoagulants. A Consensus Paper of the Romanian Society of Gastroenterology and Hepatology

Author

Farcas, Andreea, primary, Bataga, Simona, primary, Cijevschi, Cristina, primary, Diculescu, Mircea, primary, Dobru, Daniela, primary, Dumitru, Eugen, primary, Goldis, Adrian, primary, Nedelcu, Laurentiu, primary, Popescu, Alina, primary, Sporea, Ioan, primary, Trifan, Anca, primary, Valean, Simona, primary, Gheorghe, Cristian, primary, and Dumitrascu, Dan Lucian, primary

Published
2018
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157. Sa1442 - Relative Adrenal Insufficiency in the Setting of Acute on Chronic Liver Failure – An Organ Dysfunction that Could Indicate Futility

Author

Chiriac, Stefan A., primary, Stanciu, Carol, additional, Singeap, Ana Maria, additional, Sfarti, Catalin, additional, Cojocariu, Camelia, additional, Girleanu, Irina, additional, Cuciureanu, Tudor, additional, Stoica, Oana, additional, Huiban, Laura, additional, Muzica, Cristina Maria, additional, Livadariu, Roxana Maria, additional, and Trifan, Anca, additional

Published
2018
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161. The relevance of oxidative stress balance (Superoxide dismutase versus malondialdehyde) in spontaneous bacterial peritonitis

Author

Stanciu Carol, Raluca Eugenia Iorga, Razvana Sorina Munteanu Danulescu, Trifan Anca, Ciobica Alin, and Ana Singeap Maria

Subjects
malondialdehyde, medicine.medical_specialty, Cirrhosis, Context (language use), medicine.disease_cause, Gastroenterology, General Biochemistry, Genetics and Molecular Biology, Superoxide dismutase, Lipid peroxidation, chemistry.chemical_compound, Spontaneous bacterial peritonitis, Internal medicine, Ascites, medicine, lcsh:QH301-705.5, biology, business.industry, Malondialdehyde, medicine.disease, superoxide dismutase, chemistry, lcsh:Biology (General), Immunology, biology.protein, medicine.symptom, General Agricultural and Biological Sciences, business, Oxidative stress
Abstract

Among bacterial infections associated with hepatic cirrhosis, the most common is spontaneous bacterial peritonitis (SBP). Despite different protective measures, such as early diagnosis, therapy with albumin and the introduction of new antibiotics, the prognosis of these patients remains poor, with a mortality rate of 20-40%. In this context, the identification of patients with increased risk of death is extremely important for improving the prognosis. Thus, there is growing interest for studying the effects and mechanisms of oxidative stress, considering the requirements for identifying new substances with hepatoprotective functions and reducing various adverse effects. In this study, we assessed oxidative stress markers, the antioxidant enzyme superoxide dismutase (SOD) and the marker of lipid peroxidation, malondialdehyde (MDA), in the serum and ascitic fluid in patients with decompensated cirrhosis and SBP, in patients diagnosed with decompensated liver cirrhosis with ascites and in patients with compensated liver cirrhosis. Increased oxidative stress, demonstrated by a significant decrease of SOD and increase in MDA levels, was observed in patients with decompensated cirrhosis and SBP, compared with those without SBS, as well as those with compensated liver cirrhosis. Measuring these oxidative stress markers could have a fundamental importance in the diagnosis, treatment and follow-up of this liver pathology.

Published
2014

162. Plasma-activated water: a new and effective alternative for duodenoscope reprocessing

Author

Bălan,Gheorghe G, Roșca,Irina, Ursu,Elena-Laura, Doroftei,Florica, Bostănaru,Andra-Cristina, Hnatiuc,Eugen, Năstasă,Valentin, Șandru,Vasile, Ștefănescu,Gabriela, Trifan,Anca, Mareș,Mihai, Bălan,Gheorghe G, Roșca,Irina, Ursu,Elena-Laura, Doroftei,Florica, Bostănaru,Andra-Cristina, Hnatiuc,Eugen, Năstasă,Valentin, Șandru,Vasile, Ștefănescu,Gabriela, Trifan,Anca, and Mareș,Mihai

Abstract

Gheorghe G Bălan,1 Irina RoÅŸca,2 Elena-Laura Ursu,2 Florica Doroftei,2 Andra-Cristina Bostănaru,3 Eugen Hnatiuc,4 Valentin Năstasă,3 Vasile Åžandru,5 Gabriela Åžtefănescu,1 Anca Trifan,1 Mihai MareÅŸ3 1Grigore T. Popa University of Medicine and Pharmacy, IaÅŸi, Romania; 2“Petru Poni” Institute of Macromolecular Chemistry, IaÅŸi, Romania; 3Ion Ionescu de la Brad University of Agricultural Sciences and Veterinary Medicine of Iasi, IaÅŸi, Romania; 4“Gheorghe Asachi” Technical University, IaÅŸi, Romania; 5Department of Gastroenterology Research, Clinical Emergency Hospital of Bucharest, Bucharest, Romania Introduction: Duodenoscopes have been widely used for both diagnostic and therapeutic endoscopic retrograde cholangiopancreatography procedures. Numerous outbreaks of duodenoscope-associated infections involving multidrug-resistant bacteria have recently been reported. Plasma activated water (PAW) has been widely considered an effective agent for surface decontamination and is increasingly used for disinfection of medical equipment. The aim of this study was to evaluate whether the duodenoscopes currently on market are suited for the repeated use of PAW and to test the efficacy of PAW for their disinfection. Materials and methods: In order to evaluate the disinfection efficacy and the required time of contact, the duodenoscope samples were contaminated by immersing them in fasted-state simulated intestinal fluid containing Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa, prior to PAW exposure. In order to test the duodenoscope polymer compatibility with PAW, a challenge test was conducted by immersing the samples in PAW for 30 minutes daily for 45 consecutive days. Results: Significant reductions in bacterial populations were achieved after 30 minutes of PAW treatment, indicating a high-level disinfection. Atomic force microscopy and scanning electron microscopy were used to demo

Published
2018

163. Portal Vein Thrombosis in Patients with Liver Cirrhosis

Author

Trifan, Anca

Subjects
Medical / Hepatology
Abstract

The myth that patients with liver cirrhosis are “auto‐anticoagulated” is outdated, and evidence shows that these patients frequently experience thrombosis. Portal vein thrombosis (PVT), although considered as rare, it gradually increases complications that are more likely to occur during late‐stage liver cirrhosis. The aim of this chapter is to perform a review of nonmalignant portal vein thrombosis in cirrhosis, in terms of prevalence, pathogenesis, diagnosis, clinical course, and management. Studies were identified by a search strategy using MEDLINE and EMBASE databases. For the MEDLINE search, we used the following terms: (“liver cirrhosis” [MeSH Terms] OR “cirrhosis” [All Fields] OR “cirrhosis” [All Fields]) AND (“portal vein” [MeSH Terms] OR “portal vein” [All Fields]) AND (“Thrombosis” [MeSH Terms]). For the EMBASE search, we used the following terms: (cirrhosis OR phrase liver cirrhosis) AND (phrase thrombosis/OR phrase vein thrombosis/OR phrase thrombosis prevention/OR phrase portal vein thrombosis/OR phrase liver vein thrombosis/OR phrase mesenteric vein thrombosis/OR thrombosis). Studies were considered eligible if they referred to any aspect of prevalence, pathophysiology, clinical presentation, diagnosis and management, or therapy of PVT in cirrhosis. We put forward possible responses to these unsettled issues starting with prevalence, pathogenesis, and treatment options.

Published
2017

166. Eosinophilic esophagitis in an octogenarian

Author

Trifan, Anca, Stoica, Oana, Chihaia, Catalin-Alexandru, Danciu, Mihai, Stanciu, Carol, and Singeap, Ana-Maria

Subjects
Aged, 80 and over, Male, food allergy, dietary therapy, dysphagia, Biopsy, Anti-Inflammatory Agents, Eosinophilic Esophagitis, corticosteroids, Esophagus, Administration, Inhalation, Fluticasone, Humans, Clinical Case Report, Esophagoscopy, Deglutition Disorders, Research Article, Follow-Up Studies
Abstract

Introduction: Eosinophilic esophagitis (EoE) is a chronic, immune/antigen-mediated disease characterized clinically by symptoms related to esophageal dysfunction and histologically by a marked eosinophilic infiltrate in the esophageal mucosa. What was once considered a rare disease has nowadays become one of the most frequent esophageal diseases in the Western countries, occupying a place just next to the gastroesophageal reflux disease. EoE etiology and pathogenesis remain largely unknown, although most studies consider that allergic and genetic factors play the most important role. Methods: We report the case of EoE in an elderly male (octogenarian), giving a brief review of the current data related to epidemiology, pathogenesis, diagnosis, and treatment of the disease. Results: Dysphagia to solid foods was the leading symptom, and endoscopic findings included white exudates, longitudinal furrows, and concentric mucosal rings, all suggestive for EoE. Diagnosis relied on histological findings in esophageal mucosal biopsies (>30 eosinophils per high power field). He was treated with topical steroids for 8 weeks, symptoms improved gradually and the patient remained in remission at the 8-month follow-up. Conclusion: This case emphasizes that EoE may occur in very old patients and gastroenterologists should have a high index of suspicion of this disorder in any elderly with dysphagia and endoscopic relevant features.

Published
2016

167. Increased liver stiffness in extrahepatic cholestasis caused by choledocholithiasis

Author

Trifan, Anca, Sfarti, Catalin, Cojocariu, Camelia, Dimache, Mihaela, Cretu, Maria, Hutanasu, Catalin, and Stanciu, Carol

Subjects
Transient elastography, Extrahepatic cholestasis, Case Report, Liver stiffness
Abstract

Background Extrahepatic cholestasis that is caused by benign and malignant diseases has been reported to increase liver stiffness (LS), as measured by transient elastography (TE). Objectives The aim of this study was to evaluate LS in patients with extrahepatic cholestasis due to choledocholithiasis before and after endoscopic sphincterotomy and stone removal. Patients and Methods LS was measured by TE (Fibroscan) in patients with extrahepatic cholestasis that was caused by choledocholithiasis before and 1 month after endoscopic sphincterotomy and successful stone removal. Results We studied 12 patients (7 females, 5 males), aged 36 to 76 years (mean age 57.1 ± 11.6 years), with extrahepatic cholestasis that was caused by choledocholithiasis. LS was increased in all patients (range: 6.2-18.4 kPa; mean: 8.9 ± 3.5 kPa) before endoscopic therapy. Successful biliary drainage was effected by sphincterotomy and stone removal in all patients, which led to a significant decline in LS to 3.9-8.1 kPa (Mean: 5.6 ± 1.2 kPa; p < 0.001) within a mean observation time of 29 days. The decrease in LS values correlated significantly with a decline in serum total bilirubin levels (r = 0.691; p < 0.0001). Conclusions Extrahepatic cholestasis due to choledocholithiasis increases LS and should be excluded before assesing liver fibrosis by transient elastography.

Published
2011

168. New Epidemiologic Data Regarding Hepatitis C Virus Infection in Romania

Author

Manuc, Mircea, primary, Preda, Carmen M., primary, Popescu, Corneliu P., primary, Baicuș, Cristian, primary, Voiosu, Theodor, primary, Pop, Corina S., primary, Gheorghe, Liana, primary, Sporea, Ioan, primary, Trifan, Anca, primary, Tanțău, Marcel, primary, Tanțău, Alina, primary, Ceaușu, Emanoil, primary, Proca, Doina, primary, Constantinescu, Ileana, primary, Ruta, Simona M., primary, Fulger, Larisa E., primary, Diculescu, Mircea, primary, and Oproiu, Alexandru, primary

Published
2017
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172. Real‐world efficacy and safety of ombitasvir, paritaprevir/r+dasabuvir+ribavirin in genotype 1b patients with hepatitis C virus cirrhosis

Author

Preda, Carmen M., primary, Popescu, Corneliu P., additional, Baicus, Cristian, additional, Voiosu, Theodor A., additional, Manuc, Mircea, additional, Pop, Corina Silvia, additional, Gheorghe, Liana, additional, Sporea, Ioan, additional, Trifan, Anca, additional, Tantau, Marcel, additional, Tantau, Alina, additional, Ceausu, Emanoil, additional, Proca, Doina, additional, Constantinescu, Ileana, additional, Ruta, Simona M., additional, Diculescu, Mircea M., additional, and Oproiu, Alexandru, additional

Published
2017
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173. Position Paper on Treatment of Hepatitis C in Romania 2017. Part Two

Author

Gheorghe, Liana, primary, Sporea, Ioan, primary, Iacob, Speranța, primary, Șirli, Roxana, primary, Trifan, Anca, primary, Diculescu, Mircea, primary, Stanciu, Carol, primary, Pascu, Oliviu, primary, Acalovschi, Monica, primary, Brisc, Ciprian, primary, Cijevschi, Cristina, primary, Gheorghe, Cristian, primary, Spârchez, Zeno, primary, Rogoveanu, Ion, primary, Dobru, Daniela, primary, and Dumitrascu, Dan L., primary

Published
2017
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174. Real-Life Use of 3 Direct-Acting Antiviral Regimen in a Large Cohort of Patients with Genotype-1b HCV Compensated Cirrhosis

Author

Gheorghe, Liana, primary, Iacob, Speranta, primary, Curescu, Manuela, primary, Brisc, Ciprian, primary, Cijevschi, Cristina, primary, Caruntu, Florin, primary, Stanciu, Carol, primary, Simionov, Iulia, primary, Sporea, Ioan, primary, Gheorghe, Cristian, primary, Iacob, Razvan, primary, Arama, Victoria, primary, Sirli, Roxana, primary, and Trifan, Anca, primary

Published
2017
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176. Metabolic Syndrome and Genotype 1 Virus C Compensated Liver Cirrhosis in the Era of Directly Acting Antiviral Therapy

Author

Mihai, Catalina, primary, Mihai, Bogdan, additional, Trifan, Anca, additional, Stanciu, Carol, additional, Gheorghe, Liana, additional, Diculescu, Mircea, additional, Curescu, Manuela, additional, Brisc, Ciprian, additional, Goldis, Adrian, additional, Bataga, Simona, additional, Sandulescu, Larisa, additional, Rogoveanu, Ion, additional, Seicean, Andrada, additional, and Cijevschi Prelipcean, Cristina, additional

Published
2017
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178. Position Paper on Treatment of Hepatitis C in Romania, 2017. Part One

Author

Gheorghe, Liana, primary, Sporea, Ioan, primary, Iacob, Speranţa, primary, Şirli, Roxana, primary, Trifan, Anca, primary, Dobru, Daniela, primary, Diculescu, Mircea, primary, Stanciu, Carol, primary, Pascu, Oliviu, primary, Acalovschi, Monica, primary, Brisc, Ciprian, primary, Cijevschi, Cristina, primary, Gheorghe, Cristian, primary, Spârchez, Zeno, primary, Rogoveanu, Ion, primary, and Dumitrascu, Dan, primary

Published
2017
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179. Predictors of Liver Stiffness Regression after SVR in Cirrhotic Patients Treated with 3D Regimen

Author

Iacob, Speranta, primary, Gheorghe, Liliana, additional, Prelipcean, Cristina Cijevschi, additional, Trifan, Anca, additional, Stanciu, Carol, additional, Sporea, Ioan, additional, Sirli, Roxana, additional, Curescu, Manuela, additional, Brisc, Ciprian, additional, Mihai, Catalina, additional, Alexandrescu, Luana, additional, Sandulescu, Larisa D., additional, Goldis, Adrian, additional, Arama, Victoria, additional, Caruntu, Florin, additional, Hara, Livia, additional, Rogoveanu, Ion, additional, Diculescu, Mircea, additional, Iacob, Razvan, additional, Gheorghe, Cristian, additional, Seicean, Andrada, additional, Simionov, Iulia I., additional, Vadan, Roxana, additional, Pirvulescu, Iuliana, additional, and Pietrareanu, Corina, additional

Published
2017
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180. A Low Incidence of Hepatocellular Carcinoma in Patients with Genotype 1B Compensated Cirrhosis Treated with Paritaprevir/Ritonavir, Ombitasvir and Dasabuvir  ± Ribavirin in a Tertiary Center: A Matter of Better Selection?

Author

Chiriac, Stefan A., primary, Trifan, Anca, additional, Stanciu, Carol, additional, Prelipcean, Cristina Cijevschi, additional, Stefanescu, Gabriela, additional, Mihai, Catalina, additional, Sfarti, Catalin, additional, Cojocariu, Camelia, additional, Cuciureanu, Tudor, additional, Mihai, Florin, additional, and Singeap, Ana Maria, additional

Published
2017
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181. Efficacy and Safety of Paritaprevir/Ritonavir, Ombitasvir and Dasabuvir Plus/Minus Ribavirin for Treatment of HCV Genotype 1B Compensated Cirrhosis in Patients Aged 70 Years or Older

Author

Trifan, Anca, primary, Prelipcean, Cristina Cijevschi, additional, Gheorghe, Liana, additional, Curescu, Manuela, additional, Brisc, Ciprian, additional, Bataga, Simona, additional, Miftode, Egidia, additional, Arama, Victoria, additional, Rogoveanu, Ion, additional, Suceveanu, Andra Iulia, additional, Singeap, Ana Maria, additional, Chiriac, Stefan A., additional, Cuciureanu, Tudor, additional, Sporea, Ioan, additional, Goldis, Adrian, additional, Popescu, Alina, additional, Iacob, Speranta, additional, Sfarti, Catalin, additional, Cojocariu, Camelia, additional, Stefanescu, Gabriela, additional, Girleanu, Irina, additional, Stoica, Oana, additional, Mihai, Catalina, additional, Ciortescu, Irina, additional, and Stanciu, Carol, additional

Published
2017
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182. Prospective Analysis of Discordant Results Between Fibromax® and Fibroscan® in Patients with HCV Compensated Liver Cirrhosis before 3D Antiviral Therapy Initiation

Author

Gheorghe, Liliana, primary, Iacob, Speranta, additional, Prelipcean, Cristina Cijevschi, additional, Trifan, Anca, additional, Stanciu, Carol, additional, Sporea, Ioan, additional, Sirli, Roxana, additional, Curescu, Manuela, additional, Brisc, Ciprian, additional, Mihai, Catalina, additional, Alexandrescu, Luana, additional, Sandulescu, Larisa D., additional, Goldis, Adrian, additional, Arama, Victoria, additional, Caruntu, Florin, additional, Hara, Livia, additional, Rogoveanu, Ion, additional, Diculescu, Mircea, additional, Gheorghe, Cristian, additional, Seicean, Andrada, additional, Iacob, Razvan, additional, Simionov, Iulia I., additional, Vadan, Roxana, additional, Pirvulescu, Iuliana, additional, and Pietrareanu, Corina, additional

Published
2017
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184. EXCELLENT NEGATIVE PREDICTIVE VALUE AND TIMEIMPROVED DIAGNOSTIC YIELD OF CAPSULE ENDOSCOPY IN SUSPECTED ISOLATED SMALL BOWEL CROHN'S DISEASE.

Author

Singeap, Ana-Maria, Trifan, Anca, Petrea, Oana, Sfarti, Catalin, Huiban, Laura, Girleanu, Irina, Muzica, Cristina, and Stanciu, Carol

Subjects
*CROHN'S disease, *SMALL intestine, *CAPSULE endoscopy, *INTESTINAL diseases, *GASTROINTESTINAL hemorrhage, *GASTROINTESTINAL system, *CELIAC disease
Abstract

Background. There is no unique diagnostic test for Crohn's disease, and the diagnosis of isolated small bowel Crohn's disease (SBCD) is even more challenging, due to non-patognomonic clinical picture and low availability of accurate exploration methods. Small bowel capsule endoscopy (SBCE) revolutionized the approach of middle gastrointestinal tract, becoming the first investigation tool when small bowel pathology is suspected. Objective of the study. The aim of our study was to assess the value of SBCE in diagnosing isolated SBCD. Materials and Methods. We retrospectively studied the patients undergoing SBCE for suspected isolated SBCD, in a six-year period, including in our analysis only the patients with a minimum one-year follow-up period. We calculated the diagnostic yield of SBCE, defined as number of capsule endoscopy exams whith positive findings, and we also assessed its yearly variation in time over the six-year period. Subsequently, analyzing follow-up data, positive and negative predictive values were assessed. Results. 78 patients were investigated by SBCE for suspected isolated SBCD. SBCE showed lesions compatible with the diagnosis of SBCD in 49 patients, corresponding to a specific diagnostic yield of 62.8%, while for the remaining 29 patients (37.2%), no CD lesions were found. Following additional investigations, three of the 49 patients initially thought as having isolated SBCD were reclassified as SB lymphoma, eosinophilic gastroenteritis and intestinal tuberculosis, respectively, corresponding to a positive predictive value of 93.8%. During followup, none of the 29 patients with negative SBCE was diagnosed with CD, corresponding to a negative predictive value of 100%. We found a progressively increase of the diagnostic yield over time (from 42.6% in the first year to 70.2% in the last year of the analyzed period), corresponding the most probably to the refinement of the indication. Conclusions. Despite a relatively low diagnostic yield, SBCE has a good positive predictive value for isolated SBCD. However, as CE is a purely visual technique with no capability of taking biopsies, final diagnosis needs confirmation by additional investigations. Nevertheless, SBCE has a 100% negative predictive value, being an excellent tool for rulling out isolated SBCD. Refinement of the indication could ensure a better diagostic yield. [ABSTRACT FROM AUTHOR]

Published
2023

185. PATHOLOGIES DISCOVERED INCIDENTALLY IN PATIENTS WITH CHRONIC VIRAL INFECTION B / D AND C DIAGNOSED IN THE SCREENING PROGRAM LIVE (RO)2 - EAST.

Author

Huiban, Laura, Trifan, Anca, Muzîca, Cristina, Nastasa, Robert, Zenovia, Sebastian, Stafie, Remus, Stratina, Ermina, Rotaru, Adrian, Sîngeap, Ana Maria, Cojocariu, Camelia, Sfarti, Catalin, Gîrleanu, Irina, Chiriac, Stefan, Nemteanu, Roxana, Cuciureanu, Tudor, and Stanciu, Carol

Subjects
*VIRUS diseases, *MEDICAL screening, *TYPE 2 diabetes, *VIRAL hepatitis, *HEPATITIS B, *HEPATORENAL syndrome
Abstract

Introduction. The overall burden of B / D and C viral hepatitis remains substantial, despite the major advances in the prevention and treatment of patients in recent years, due to comorbidities and complications associated with liver disease. In this context, the national screening program LIVE (RO) 2 aims to further assess all patients identified as positive for one of the hepatitis B / D / C viruses. Objectives. The study aimed to identify fortuitous pathologies discovered in patients with chronic viral B / D / C infection diagnosed in the LIVE (RO) screening program 2. Materials and Methods. We conducted a prospective study that included people from vulnerable groups (poor, uninsured, rural people, people in foster care, homeless, Roma population, people with disabilities, and suffering from alcohol or drug addiction) in different areas of North-Eastern Romania, between July 2021 - December 2022, during the national screening program LIVE (RO) 2-EAST. We also investigated the presence of newly discovered conditions in patients who tested positive and directed to the Institute of Gastroenterology and Hepatology in Iasi for the staging of liver disease and the establishment of antiviral treatment. Results. The study group included 1176 patients, of which 422 men (35.8%) and 754 women (64.1%), aged between 35 and 83 years, with a mean age of 56.32 years. The predominant source of origin was rural (73.1%). Of the patients with positive RDTs, 635 (53.9%) patients were detected with HBsAg, 521 (44.3%) patients with anti-HCV antibodies, and 20 (1.7%) patients with anti-HVD antibodies. Of these, 215 patients (18.2%) were diagnosed with a new pathology associated with B / D / C viral infection. The most common pathologies discovered incidentally were liver cirrhosis (94, 43.7%), liver cysts (35, 16.2%), liver hemangiomas (29, 13.4%), gallstones (24, 11.1%), type II diabetes mellitus (T2DM) (15, 6.9%), uterine fibroids (9, 4.1%), hepatocellular carcinoma (7, 3.2%), choledochal lithiasis (2, 0.9%). In addition, the presence of fortuitous pathologies was higher among patients with HBV infection than in those with HCV infection (65.3% vs. 42.1%, p = 0.012). Among the risk factors associated with hepatocellular carcinoma (HCC) are chronic alcohol consumption (43%, compared to 19% in the group of patients without HCC), and the association of T2DM in 3 patients (31%, compared to 10% in the group of patients with HCC). Conclusions. Patients with chronic B / D / C viral infection had a high prevalence of incidentally detected comorbidities, which necessitates the need for public health policies in vulnerable groups to promote access to existing health services to reduce the future burden of chronic diseases but also secondary complications of chronic liver disease. [ABSTRACT FROM AUTHOR]

Published
2023

186. COMORBIDITY ASSESSMENT IN THE VULNERABLE POPULATION DIAGNOSED WITH CHRONIC B/D AND C VIRAL INFECTION FROM THE NORTHEAST REGION OF ROMANIA - STAGE SCREENING RESULTS LIVE(RO) 2 - EAST.

Author

Huiban, Laura, Trifan, Anca, Muzîca, Cristina, Nastasa, Robert, Zenovia, Sebastian, Stafie, Remus, Stratina, Ermina, Rotaru, Adrian, Chiriac, Stefan, Nemteanu, Roxana, Cuciureanu, Tudor, and Stanciu, Carol

Subjects
*HEPATITIS B, *VIRUS diseases, *RAPID diagnostic tests, *CHRONIC hepatitis B, *MEDICAL screening, *VIRAL hepatitis
Abstract

Introduction. Chronic viral hepatitis B/D and C can be complicated by comorbid conditions that may influence treatment eligibility and outcomes. The aim of this study was to evaluate the presence of the most common comorbidities in patients diagnosed with chronic viral B/D and C infection using rapid diagnostic tests (TDR). Materials and Methods. Between July 2021 and December 2022, we performed prospective screening for chronic viral B/D and C infection in people in vulnerable groups (poor, uninsured, rural people, people in foster care, people without shelter, Roma people, people with disabilities, people suffering from alcohol and drug addiction) from different areas of North-Eastern Romania, during the national program for the elimination of viral hepatitis LIVE(RO) 2-EST using TDRs for hepatitis B virus (Wama Immuno-Rapid HBV®) and hepatitis C virus (Wama Immuno-Rapid HCV®). We also investigated the presence of comorbid conditions in patients tested positive and presented at the Institute of Gastroenterology and Hepatology in Iasi for the staging of liver disease and the establishment of antiviral treatment. Results. Our study included 1176 patients who came to a tertiary center for the staging of liver disease, of which 422 men (35.8%) and 754 women (64.1%), aged 35 to 83 years, with an average age of 56.32 years. The predominant source of origin was rural (73.1%). Of the patients with positive TDR, 635 (53.9%) of patients were detected with HBsAg, 521 (44.3%) of patients with anti-HCV antibodies, and 20 (1.7%) of patients with anti-HVD antibodies. Of these, 646 patients (54.9%) had at least one comorbid condition. The most common comorbidities were cardiovascular disease (21.5%), psychiatric disorders (11.5%), type 2 diabetes (8.9%), metabolic disorders (6%), thyroid disorders (5%) and cancer (2%). In addition, the presence of comorbidities was higher among patients with HCV infection than in those with HBV infection (64.9% vs. 48.5%, p = 0.014), while psychiatric disorders were most common in patients with HBV/HVD coinfection (42.3%), most likely due to the Interferon regimen that has been administered in the past to 19 individuals. Conclusions. Patients with chronic viral hepatitis B/D and C had a high prevalence of multiple comorbidities. Effective strategies are needed to manage these comorbid conditions as well as interdisciplinary collaboration to allow greater access to antiviral treatment and to reduce the future burden of advanced liver disease and its manifestations. [ABSTRACT FROM AUTHOR]

Published
2023

191. 100% Virological Response and Adherence in HCV Genotype 1 Liver Cirrhosis Treated with 3D Regimen in a Romanian Real-life Cohort

Author

Gheorghe, Liana, primary, Trifan, Anca, additional, Iacob, Maria Speranta, additional, Stanciu, Carol, additional, Sirli, Roxana, additional, Sporea, Ioan, additional, Cijevschi, Cristina, additional, Arama, Victoria, additional, Popescu, Cristina, additional, Brisc, Ciprian, additional, Goldis, Adrian, additional, Rogoveanu, Ion, additional, Iacob, Razvan, additional, and Gheorghe, Cristian, additional

Published
2016
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192. Dynamics of AFP in Cirrhotic Patients with Virological Response Following 3D Therapy and Severe Necro-inflammation at Fibromax

Author

Gheorghe, Liana, primary, Iacob, Maria Speranta, additional, Trifan, Anca, additional, Stanciu, Carol, additional, Sirli, Roxana, additional, Sporea, Ioan, additional, Lupusoru, Raluca, additional, Cijevschi, Cristina, additional, Arama, Victoria, additional, Brisc, Ciprian, additional, Rogoveanu, Ion, additional, Iacob, Razvan, additional, and Gheorghe, Cristian, additional

Published
2016
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193. Reply

Author

Cojocariu, Camelia, primary, Stanciu, Carol, primary, and Trifan, Anca, primary

Published
2016
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198. Real‐world efficacy and safety of ombitasvir, paritaprevir/r+dasabuvir+ribavirin in genotype 1b patients with hepatitis C virus cirrhosis.

Author

Preda, Carmen M., Manuc, Mircea, Gheorghe, Liana, Proca, Doina, Constantinescu, Ileana, Diculescu, Mircea M., Oproiu, Alexandru, Popescu, Corneliu P., Ceausu, Emanoil, Ruta, Simona M., Baicus, Cristian, Voiosu, Theodor A., Pop, Corina Silvia, Sporea, Ioan, Trifan, Anca, Tantau, Marcel, and Tantau, Alina

Subjects
HEPATITIS C vaccines, ANTIVIRAL agents, HEPATITIS C diagnosis, HEPATITIS C treatment, CIRRHOSIS of the liver
Abstract

Abstract: Background: Direct antiviral agents (DAA) showed very good results in terms of efficacy and safety in clinical trials, but real‐life data are still needed in order to confirm this profile. Material and methods: In Romania, through a nationwide government‐funded programme in 2015‐2016, approx.5800 patients with virus C cirrhosis received fully reimbursed DAA therapy with OBV/PTV/r+DSV+RBV for 12 weeks. We analysed a national prospective cohort enrolling the first 2070 patients, all with genotype 1b. The only key inclusion criteria was advanced fibrosis (Metavir stage F4) confirmed by Fibromax testing (or liver biopsy/Fibroscan). Efficacy was assessed by the percentage of patients achieving SVR 12 weeks post‐treatment (SVR12). Results: Forty patients stopped the treatment because of hepatic decompensation (1.9%), 21 stopped because of other adverse events and one was lost to follow‐up. This cohort was 51% females, mean age 60 years (25÷82), 67% pretreated, 70% associated NASH, 67% with severe necro‐inflammation (severity score 3‐Fibromax), 37% with comorbidities, 10.4% with Child Pugh A6, 0.5% B7. The median MELD score was 8.09 (6 ÷ 22). SVR by intention‐to‐treat was reported in 1999/2070(96.6%), 55/2070 failed to respond. Liver decompensation was statistically associated in multivariate analysis with platelets< 105/mm3(P = .03), increased total bilirubin (P < .001), prolonged INR (P = .02), and albumin<3.5 g/dL (P = .03). Conclusions: OBV/PTV/r+DSV+RBV proved to be highly efficient in our population of cirrhotics with a 96.6% SVR. Serious adverse events related to therapy were reported in 61/2070(2.9%), most of them liver decompensation (1.9%), related to hepatic dysfunction, and lower platelet count. [ABSTRACT FROM AUTHOR]

Published
2018
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