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201. Higher and Rising Prevalence and Incidence of Renal Impairment and Chronic Kidney Disease in Chronic Hepatitis B Patients Compared to Matched Non-Chronic Hepatitis B Controls in the United States: Results of a Real-World Analysis

Author

Nguyen, Mindie H., primary, Lim, Joseph K., additional, Liou, Iris, additional, Ozbay, A. Burak, additional, Fraysse, Jeremy, additional, Meyer, Nicole, additional, Dusheiko, Geoffrey, additional, and Gordon, Stuart C., additional

Published
2017
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208. 3 Times Higher Healthcare Cost in Chronic Hepatitis B Patients Compared to Non-Chronic Hepatitis B Controls Especially Those with Decompensated Liver Disease: United States Real World Healthcare Utilization and Cost Analysis

Author

Nguyen, Mindie H., primary, Lim, Joseph K., additional, Ozbay, A. Burak, additional, Shreay, Sanatan, additional, Liou, Iris, additional, Meyer, Nicole, additional, Dusheiko, Geoffrey, additional, and Gordon, Stuart C., additional

Published
2017
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211. American Gastroenterological Association Institute Guidelines for the Diagnosis and Management of Acute Liver Failure

Author

Flamm, Steven L., primary, Yang, Yu-Xiao, additional, Singh, Siddharth, additional, Falck-Ytter, Yngve T., additional, Flamm, Steven L., additional, Lim, Joseph K., additional, Rubenstein, Joel H., additional, Smalley, Walter E., additional, Stollman, Neil, additional, Vege, Santhi Swaroop, additional, Wani, Sachin B., additional, and Weinberg, David S., additional

Published
2017
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213. American Gastroenterological Association Institute Guideline on the Management of Crohn’s Disease After Surgical Resection

Author

Nguyen, Geoffrey C., primary, Loftus, Edward V., additional, Hirano, Ikuo, additional, Falck–Ytter, Yngve, additional, Singh, Siddharth, additional, Sultan, Shahnaz, additional, Flamm, Steven L., additional, Lim, Joseph K., additional, Rubenstein, Joel H., additional, Smalley, Walter E., additional, Stollman, Neil, additional, Vege, Santhi Swaroop, additional, Wani, Sachin B., additional, Weinberg, David S., additional, and Yang, Yu-Xiao, additional

Published
2017
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214. Risk of Acute Liver Injury With Antiretroviral Therapy by Viral Hepatitis Status

Author

Gowda, Charitha, primary, Newcomb, Craig W., additional, Liu, Qing, additional, Carbonari, Dena M., additional, Lewis, James D., additional, Forde, Kimberly A., additional, Goldberg, David S., additional, Reddy, K. Rajender, additional, Roy, Jason A., additional, Marks, Amy R., additional, Schneider, Jennifer L., additional, Kostman, Jay R., additional, Tate, Janet P., additional, Lim, Joseph K., additional, Justice, Amy C., additional, Goetz, Matthew Bidwell, additional, Corley, Douglas A., additional, and Lo Re, Vincent, additional

Published
2017
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217. Effectiveness of Ledipasvir-Sofosbuvir Combination in Patients With Hepatitis C Virus Infection and Factors Associated With Sustained Virologic Response

Author

Terrault, Norah A., primary, Zeuzem, Stefan, additional, Di Bisceglie, Adrian M., additional, Lim, Joseph K., additional, Pockros, Paul J., additional, Frazier, Lynn M., additional, Kuo, Alexander, additional, Lok, Anna S., additional, Shiffman, Mitchell L., additional, Ben Ari, Ziv, additional, Akushevich, Lucy, additional, Vainorius, Monika, additional, Sulkowski, Mark S., additional, Fried, Michael W., additional, and Nelson, David R., additional

Published
2016
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221. Lack of Evidence for Regional Brain Volume or Cortical Thickness Abnormalities in Youths at Clinical High Risk for Psychosis: Findings From the Longitudinal Youth at Risk Study

Author

Klauser Paul, Zhou Juan, Lim Joseph K W, Poh Joann S, Zheng Hui, Tng Han Ying, Krishnan Ranga, Lee Jimmy, Keefe Richard S E, Adcock Alison R, Wood Stephen J, Fornito Alex, and Chee Michael W L

Subjects
Adult, Cerebral Cortex, Male, Risk, Singapore, Adolescent, Regular Article, Magnetic Resonance Imaging, White Matter, Young Adult, Psychotic Disorders, Humans, Female, Gray Matter
Abstract

There is cumulative evidence that young people in an “at-risk mental state” (ARMS) for psychosis show structural brain abnormalities in frontolimbic areas, comparable to, but less extensive than those reported in established schizophrenia. However, most available data come from ARMS samples from Australia, Europe, and North America while large studies from other populations are missing. We conducted a structural brain magnetic resonance imaging study from a relatively large sample of 69 ARMS individuals and 32 matched healthy controls (HC) recruited from Singapore as part of the Longitudinal Youth At-Risk Study (LYRIKS). We used 2 complementary approaches: a voxel-based morphometry and a surface-based morphometry analysis to extract regional gray and white matter volumes (GMV and WMV) and cortical thickness (CT). At the whole-brain level, we did not find any statistically significant difference between ARMS and HC groups concerning total GMV and WMV or regional GMV, WMV, and CT. The additional comparison of 2 regions of interest, hippocampal, and ventricular volumes, did not return any significant difference either. Several characteristics of the LYRIKS sample like Asian origins or the absence of current illicit drug use could explain, alone or in conjunction, the negative findings and suggest that there may be no dramatic volumetric or CT abnormalities in ARMS.

Published
2015

222. Pathophysiology of Hepatic Encephalopathy

Author

Jaffe, Ariel, Lim, Joseph K., and Jakab, Sofia Simona

Abstract

Hepatic encephalopathy (HE) is one of the major clinical decompensations of cirrhosis, with a high impact on health care resource utilization and cost. For an effective and comprehensive management of HE, the clinicians need to understand the pathophysiologic mechanisms of HE. This review describes the multiorgan processes involved in HE and how several HE precipitants and treatment strategies act on ammonia production, excretion, and neurotoxicity, including the impact of diabetes and use of cannabinoids. The authors also discuss the current and future role of gut microbiome, systemic/central inflammation, and various neurotransmitters for the pathogenesis and treatment of HE.

Published
2020
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223. Determinants of Liver Complications Among HIV/Hepatitis B Virus-Coinfected Patients.

Author

Lo, Re, Vincent III MD, MSCE, Newcomb, Craig W. MS, Carbonari, Dena M. MS, Roy, Jason A. PhD, Althoff, Keri N. PhD, Kitahata, Mari M. MD, MPH, Reddy, K. Rajender MD, Lim, Joseph K. MD, Silverberg, Michael J. PhD, MPH, Mayor, Angel M. MD, MS, Horberg, Michael A. MD, MAS, Cachay, Edward R. MD, MAS, Kirk, Gregory D. MD, MPH, PhD, Hull, Mark MD, Gill, John MB, ChB, MSc, Sterling, Timothy R. MD, Kostman, Jay R. MD, Peters, Marion G. MD, Moore, Richard D. MD, and Klein, Marina B. MD, MSc

Published
2019
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224. Non-invasive Fibrosis Assessment of Patients with Hepatitis C: Application of Society Guidelines to Clinical Practice.

Author

Connolly, James C. and Lim, Joseph K.

Abstract

Purpose of Review: Chronic hepatitis C (CHC) infection remains a significant global public health burden and is associated with significant morbidity and mortality due to complications of cirrhosis, liver failure, and hepatocellular carcinoma (HCC). All oral direct-acting antivirals (DAAs) are associated with high rates of sustained virologic response (SVR). Pre-treatment assessment for liver fibrosis remains of high importance as it may impact treatment choice, treatment duration, and signal the presence of cirrhosis for which variceal screening and HCC surveillance are warranted. Recent Findings: Non-invasive fibrosis assessment tools have largely replaced gold standard liver biopsy in routine clinical practice. Herein, we review key modalities of noninvasive testing with serum and imaging biomarkers, summarize current guideline recommendations, and propose an algorithm for real-world application in clinical practice. Summary: Careful history and exam, laboratory assessment, liver imaging, and a two-test noninvasive fibrosis strategy can reliably identify cirrhosis in patients with CHC infection. [ABSTRACT FROM AUTHOR]

Published
2019
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225. Amyloid burden accelerates white matter degradation in cognitively normal elderly individuals.

Author

Vipin, Ashwati, Ng, Kwun Kei, Ji, Fang, Shim, Hee Youn, Lim, Joseph K. W., Pasternak, Ofer, and Zhou, Juan Helen

Abstract

Alterations in parietal and temporal white matter microstructure derived from diffusion tensor imaging occur in preclinical and clinical Alzheimer's disease. Amyloid beta (Aβ) deposition and such white matter alterations are two pathological hallmarks of Alzheimer's disease. However, the relationship between these pathologies is not yet understood, partly since conventional diffusion MRI methods cannot distinguish between cellular and extracellular processes. Thus, we studied Aβ‐associated longitudinal diffusion MRI changes in Aβ‐positive (N = 21) and Aβ‐negative (N = 51) cognitively normal elderly obtained from the Alzheimer's Disease Neuroimaging Initiative dataset using linear mixed models. Aβ‐positivity was based on Alzheimer's Disease Neuroimaging Initiative amyloid‐PET recommendations using a standardized uptake value ratio cut‐off of 1.11. We used free‐water imaging to distinguish cellular and extracellular changes. We found that Aβ‐positive subjects had increased baseline right uncinate fasciculus free‐water fraction (FW), associated with worse baseline Alzheimer's disease assessment scale scores. Furthermore, Aβ‐positive subjects showed faster decrease in fractional anisotropy (FW‐corrected) in the right uncinate fasciculus and faster age‐dependent right inferior longitudinal fasciculus FW increases over time. Right inferior longitudinal fasciculus FW increases were associated with greater memory decline. Importantly, these results remained significant after controlling for gray and white matter volume and hippocampal volume. This is the first study to illustrate the influence of Aβ burden on early longitudinal (in addition to baseline) white matter changes in cognitively normal elderly individuals at‐risk of Alzheimer's disease, thus underscoring the importance of longitudinal studies in assessing microstructural alterations in individuals at risk of Alzheimer's disease prior to symptoms onset. [ABSTRACT FROM AUTHOR]

Published
2019
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226. Prevention and Management of Hepatitis B in Healthcare Professionals.

Author

O'Brien, Corey R. and Lim, Joseph K.

Abstract

Purpose of Review: To review the epidemiology of hepatitis B virus (HBV) transmission in the healthcare setting and outline best practices in the prevention and management of chronic HBV in healthcare professionals. Recent Findings: Hepatitis B virus (HBV) infection remains a global public health burden and chronically infects an estimated 257 million persons worldwide. HBV represents one of the most important occupational risks for healthcare workers (HCWs) due to efficient transmission through percutaneous exposure of HBV-infected blood and blood-contaminated body fluids. Although the incidence of HCW-patient transmission of HBV has decreased significantly since 2000, ongoing deficits in HCW testing, vaccination, and confirmation of immunity, as well as post-exposure management protocols, raise concern for ongoing risk for nosocomial exposure. Summary: Established recommendations of the AASLD, CDC, and SHEA provide guidance to clinicians on the prevention and management of chronic HBV in healthcare professionals. [ABSTRACT FROM AUTHOR]

Published
2019
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227. A Comparison Between Community and Academic Practices in the USA in the Management of Chronic Hepatitis B Patients Receiving Entecavir: Results of the ENUMERATE Study.

Author

Lee, Hannah M., Ahn, Joseph, Kim, W. Ray, Lim, Joseph K., Nguyen, Mindie, Pan, Calvin Q., Kim, Donghee, Mannalithara, Ajitha, Te, Helen, Trinh, Huy, Chu, Danny, Tran, Tram, Woog, Jocelyn, and Lok, Anna S.

Subjects
CHRONIC hepatitis B, CIRRHOSIS of the liver, PATIENT monitoring, SEROCONVERSION, HEPATITIS, ANTIVIRAL agents, ACADEMIC medical centers, ASIANS, BLACK people, COMMUNITY health services, COMPARATIVE studies, DNA, LIVER tumors, RESEARCH methodology, MEDICAL cooperation, PURINES, RESEARCH, VIRAL antigens, WHITE people, VIRAL load, EVALUATION research, ALANINE aminotransferase, TREATMENT effectiveness, RETROSPECTIVE studies, THERAPEUTICS
Abstract

Background and Aims: The management of chronic hepatitis B patients is not well characterized in real-world practice. We compared baseline characteristics of CHB patients on entecavir, the frequency of on-treatment monitoring, and the effectiveness of ETV treatment between academic and community practices.Methods: Treatment-naïve CHB patients ≥18 years old, treated with ETV for ≥12 months from 2005 to 2013, in 26 community and academic practices throughout the USA were retrospectively evaluated.Results: Of 841 patients enrolled, 658 (65% male, 83% Asian, median age 47, 9% with cirrhosis) met inclusion criteria. Half of the patients (52%) were from community practices. A lower percentage of patients in community practices had cirrhosis or liver cancer (5 vs. 14%). Community practices more often treated patients with baseline ALT < 2 × ULN. Over a median follow-up of 4 years, community practices were more likely to discontinue ETV with less frequent laboratory monitoring compared to academic practices. The 5-year cumulative probability of ALT normalization was greater among patients treated in community practices (70 vs. 50%, p < 0.001), but the 5-year cumulative probability of undetectable HBV DNA was lower (45 vs. 70%, p < 0.001) than those treated in academic practices.Conclusion: Academic practices saw CHB patients with more advanced liver disease, more often followed AASLD guidelines, and monitored patients on ETV treatment more frequently than community practices. While patients in community practices were less likely to achieve undetectable HBV DNA and more likely to achieve ALT normalization, the rates of HBeAg loss and seroconversion as well as HBsAg loss were similar. [ABSTRACT FROM AUTHOR]

Published
2019
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228. Status of Direct-Acting Antiviral Therapy for Hepatitis C Virus Infection and Remaining Challenges.

Author

Baumert, Thomas F., Berg, Thomas, Lim, Joseph K., and Nelson, David R.

Abstract

Chronic infection with hepatitis C virus is a major cause of liver disease and hepatocellular carcinoma worldwide. After the discovery of hepatitis C virus 3 decades ago, the identification of the structure of the viral proteins, combined with high-throughput replicon models, enabled the discovery and development of direct-acting antivirals. These agents have revolutionized patient care, with cure rates of more than 90%. We review the status of direct-acting antiviral therapies for hepatitis C virus infection and discuss remaining challenges. We highlight licensed compounds, discuss the potential to shorten therapy even further, and review different options for treatment failure and resistance. We also provide an overview of clinical experience with generic agents and evidence for their efficacy. Finally, we discuss the need for new drugs and outline promising targets for future therapies. [ABSTRACT FROM AUTHOR]

Published
2019
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231. Antiretroviral therapy reduces the rate of hepatic decompensation among HIV- and hepatitis C virus-coinfected veterans

Author

Anderson, Jeffrey P, Tchetgen Tchetgen, Eric J, Lo Re, Vincent, Tate, Janet P, Williams, Paige L, Seage, George R, Horsburgh, C Robert, Lim, Joseph K, Goetz, Matthew Bidwell, Rimland, David, Rodriguez-Barradas, Maria C, Butt, Adeel A, Klein, Marina B, and Justice, Amy C

Subjects
Adult, Male, marginal structural model, Coinfection, Antiretroviral Therapy, HIV, HIV Infections, and over, Middle Aged, Biological Sciences, Hepatitis C, Microbiology, Medical and Health Sciences, Cohort Studies, Young Adult, hepatic decompensation, 80 and over, Humans, Highly Active, Liver Failure, Aged, Veterans
Abstract

Background Human immunodeficiency virus (HIV) coinfection accelerates the rate of liver disease outcomes in individuals chronically infected with hepatitis C virus (HCV). It remains unclear to what degree combination antiretroviral therapy (ART) protects against HCV-associated liver failure.Methods We evaluated 10 090 HIV/HCV-coinfected males from the Veterans Aging Cohort Study Virtual Cohort, who had not initiated ART at entry, for incident hepatic decompensation between 1996 and 2010. We defined ART initiation as the first pharmacy fill date of a qualifying ART regimen of ≥3 drugs from ≥2 classes. Hepatic decompensation was defined as the first occurrence of 1 hospital discharge diagnosis or 2 outpatient diagnoses for ascites, spontaneous bacterial peritonitis, or esophageal variceal hemorrhage. To account for potential confounding by indication, marginal structural models were used to estimate hazard ratios (HRs) of hepatic decompensation, comparing initiation of ART to noninitiation.Results We observed 645 hepatic decompensation events in 46 444 person-years of follow-up (incidence rate, 1.4/100 person-years). Coinfected patients who initiated ART had a significantly reduced rate of hepatic decompensation relative to noninitiators (HR = 0.72; 95% confidence interval [CI], .54-.94). When we removed individuals with HIV RNA ≤400 copies/mL at baseline from the analysis (assuming that they may have received undocumented ART at entry), the hazard ratio became more pronounced (HR = 0.59; 95% CI, .43-.82).Conclusions Initiation of ART significantly reduced the rate of hepatic decompensation by 28%-41% on average. These results suggest that ART should be administered to HIV/HCV-coinfected patients to lower the risk of end-stage liver disease.

Published
2014

232. Hepatic Safety of Buprenorphine in HIV-Infected and Uninfected Patients With Opioid Use Disorder: The Role of HCV-Infection

Author

Tetrault, Jeanette M., primary, Tate, Janet P., additional, Edelman, E. Jennifer, additional, Gordon, Adam J., additional, Re, Vincent Lo, additional, Lim, Joseph K., additional, Rimland, David, additional, Goulet, Joseph, additional, Crystal, Stephen, additional, Gaither, Julie R., additional, Gibert, Cynthia L., additional, Rodriguez-Barradas, Maria C., additional, Fiellin, Lynn E., additional, Bryant, Kendall, additional, Justice, Amy C., additional, and Fiellin, David A., additional

Published
2016
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233. Lower Observed Hepatocellular Carcinoma Incidence in Chronic Hepatitis B Patients Treated With Entecavir: Results of the ENUMERATE Study

Author

Ahn, Joseph, primary, Lim, Joseph K, additional, Lee, Hannah M, additional, Lok, Anna S, additional, Nguyen, Mindie, additional, Pan, Calvin Q, additional, Mannalithara, Ajitha, additional, Te, Helen, additional, Reddy, Rajender K., additional, Trinh, Huy, additional, Chu, Danny, additional, Tran, Tram, additional, Lau, Daryl, additional, Leduc, Truong-Sinh, additional, Min, Albert, additional, Le, Loc Trong, additional, Bae, Ho, additional, Van Tran, Sang, additional, Do, Son, additional, Hann, Hie-Won L, additional, Wong, Clifford, additional, Han, Steven, additional, Pillai, Anjana, additional, Park, James S, additional, Tong, Myron, additional, Scaglione, Steve, additional, Woog, Jocelyn, additional, and Kim, Ray W., additional

Published
2016
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236. Effectiveness and safety of sofosbuvir plus ribavirin for the treatment of HCV genotype 2 infection: results of the real-world, clinical practice HCV-TARGET study

Author

Welzel, Tania M, primary, Nelson, David R, additional, Morelli, Giuseppe, additional, Di Bisceglie, Adrian, additional, Reddy, Rajender K, additional, Kuo, Alexander, additional, Lim, Joseph K, additional, Darling, Jama, additional, Pockros, Paul, additional, Galati, Joseph S, additional, Frazier, Lynn M, additional, Alqahtani, Saleh, additional, Sulkowski, Mark S, additional, Vainorius, Monika, additional, Akushevich, Lucy, additional, Fried, Michael W, additional, and Zeuzem, Stefan, additional

Published
2016
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237. Introduction to Clinical Practice Update Committee Articles

Author

Katzka, David A., primary, Friedman, Lawrence S., additional, Inadomi, John M., additional, Kalloo, Anthony M., additional, Kim, Lawrence S., additional, Koch, Johannes, additional, Lieberman, David, additional, Lichtenstein, Gary R., additional, Lim, Joseph K., additional, Pandolfino, John E., additional, Shin, Andrea S., additional, and Siedler, Madelin R., additional

Published
2016
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239. Isolated Hepatitis B Core Antibody is Associated With Advanced Hepatic Fibrosis in HIV/HCV Infection But Not in HIV Infection Alone

Author

Bhattacharya, Debika, primary, Tseng, Chi-hong, additional, Tate, Janet P., additional, Lo Re, Vincent, additional, Gibert, Cynthia L., additional, Butt, Adeel A., additional, Brown, Sheldon T., additional, Lim, Joseph K., additional, Rodriguez-Barradas, Maria C., additional, Rimland, David, additional, Kaufman, Erica, additional, Justice, Amy C., additional, and Goetz, Matthew Bidwell, additional

Published
2016
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246. Effectiveness of Simeprevir Plus Sofosbuvir, With or Without Ribavirin, in Real-World Patients With HCV Genotype 1 Infection

Author

Sulkowski, Mark S., primary, Vargas, Hugo E., additional, Di Bisceglie, Adrian M., additional, Kuo, Alexander, additional, Reddy, K. Rajender, additional, Lim, Joseph K., additional, Morelli, Giuseppe, additional, Darling, Jama M., additional, Feld, Jordan J., additional, Brown, Robert S., additional, Frazier, Lynn M., additional, Stewart, Thomas G., additional, Fried, Michael W., additional, Nelson, David R., additional, Jacobson, Ira M., additional, Afdhal, N., additional, Alam, I., additional, Ben-Ari, Z., additional, Bredfeldt, J., additional, Brown, R.S., additional, Chung, R.T., additional, Darling, J., additional, Harlan, W., additional, Di Bisceglie, A.M., additional, Dickson, R.C., additional, Elbeshbeshy, H.A., additional, Everson, G., additional, Feld, J., additional, Fenkel, J.M., additional, Fried, M.W., additional, Galati, J., additional, Gordon, S.C., additional, Hassan, M., additional, Hawkins, T.N., additional, Hinestrosa, F., additional, Jacobson, I.M., additional, Kerr, C.A., additional, Kuo, A., additional, Kwo, P.Y., additional, Levitsky, J., additional, Lim, J., additional, Lok, A.S., additional, Mailliard, M., additional, Manns, M.P., additional, Morelli, G., additional, Muir, A.J., additional, Nelson, D., additional, O’Leary, J.G., additional, Pearlman, B.L., additional, Pockros, P., additional, Ramani, A., additional, Reau, N., additional, Reddy, K.R., additional, Schiff, E.R., additional, Sherman, K.E., additional, Shiffman, M.L., additional, Smith, C., additional, Spivey, J.R., additional, Sterling, R.K., additional, Sulkowski, M.S., additional, Szabo, G., additional, Terrault, N.A., additional, Trautwein, C., additional, Vargas, H.E., additional, Watts, K., additional, Williams, A., additional, and Zeuzem, S., additional

Published
2016
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