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( K Rajender Reddy ),( Marc Bourliere ),( Kosh Agarwal ),( Eric Lawitz ),( Leia Kim ),( Anu Osinusi ),( Kathryn Kersey ),( Gerald Crans ),( Stephanie Moody ),( Liyun Ni ),( Diana M. Brainard ),( John 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: Sustained virologic response (SVR) after interferon (IFN)-based treatment for HCV infection is associated with reduced risk of hepatocellular cancer (HCC), although the risk is not eliminated. Less is known regarding the risk of de novo HCC following SVR with IFN-free direct acting antiviral (DAA) therapy. In this analysis, a review of incident HCC in patients treated with SOF-containing regimens was performed. Methods: Data from Gilead HCV clinical trials (from treatment start to 24 weeks post-treatment) and registry studies (3 to 5 year follow-up observation) were analyzed to evaluate the incidence of de novo HCC. The clinical database was searched to identify adverse events of liver tumors; the occurrence of HCC is recorded at each visit in the registry studies. Incidence rates and exposure-adjusted incidence rates, time to development, and risk factors for development of HCC were assessed in patients with and without cirrhosis (compensated and decompensated) who received IFN- containing (Peg- IFN+RBV±SOF) vs IFN-free treatment (SOF, ledipasvir/SOF, SOF/velpatasvir ± RBV), and SVR vs no SVR. Results: In the clinical trial database, 0.3% (36 of 13,525) patients had AEs of HCC or suspected HCC while in the registry study database, 0.5% (33 of 6675) were reported to have HCC. The rate was similar in non-cirrhotic patients who achieved SVR with an IFN-containing vs IFN-free regimen (0.09 vs 0.03 per 100 patient years of follow-up, respectively); few patients with compensated cirrhosis and none with decompensated cirrhosis received IFN-containing regimens. Among subjects treated with IFN-free regimens, higher rates were observed with advanced liver disease and non SVR (see table). Conclusions: Data from the Gilead clinical trial and registry study databases show incidence of HCC in subjects treated with IFN-free regimens is similar to that reported in the IFN-era in similar populations. While SVR significantly reduces the risk of HCC, the risk is not completely eliminated, particularly among patients with decompensated cirrhosis.
( K. Rajender Reddy ),( David Roth ),( Annette Bruchfeld ),( Peggy Hwang ),( Barbara Haber ),( Bach-yen T. Nguyen ),( Eliav Barr ),( Janice Wahl ),( Wayne Greaves ),( Youngmi Eun ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: Decreased estimated glomerular filtration rate (eGFR) has been reported in patients with HCV infection receiving direct-acting antiviral agents. EBR/GZR was safe and efficacious in patients with chronic kidney disease stage 4/5 (CKD 4/5) in the C-SURFER study. The aim of this analysis was to evaluate the impact of EBR/GZR on eGFR in patients with less severe CKD. Methods: We analyzed a pooled dataset of 1689 patients who received EBR/GZR (50 mg/100 mg) with or without ribavirin (RBV) for 8 (n=91, 5%), 12 (n=1238, 73%), 16 (n=211, 12%), or 18 (n=149, 9%) weeks (656 patients [39%] received RBV). Patients were treatment-naïve or treatment-experienced, and included cirrhotics and those with HIV co-infection. Creatinine values were assessed at baseline and ≥1 post-baseline timepoint. eGFR was calculated using the Modified Diet in Renal Disease equation at baseline, end of treatment, and 12 weeks post-therapy. Results: Of the 1689 patients evaluated, 32 had CKD 3 (eGFR < 60 mL/min/1.73 m2 to ≥30 mL/min/1.73 m2) and 1657 had eGFR >60 mL/min/1.73 m2 (Table). Demographics were similar in both groups except for a higher proportion of HIV-co-infected patients in the CKD 3 group (41% vs. 17%). Patients with CKD 3 and those with eGFR >60 mL/min/1.73 m2 at baseline did not show any decrease in eGFR during treatment or follow-up. Conclusions: EBR/GZR did not affect eGFR in patients with pre-existing eGFR >60 mL/min/1.73 m2 or those with CKD3. Treatment duration, RBV co-administration, cirrhosis, or HIV coinfection did not adversely affect renal outcome.
Police, Anil Kumar Reddy,Chennaiahgari, Manvitha,Boddula, Rajender,Vattikuti, S.V. Prabhakar,Mandari, Kotesh Kumar,Chan, Byon Elsevier 2018 Materials research bulletin Vol.98 No.-
<P><B>Abstract</B></P> <P>Herein, we discuss the synthesis of reduced graphene oxide and TiO<SUB>2</SUB> (rGO-TiO<SUB>2</SUB>) nanocomposites with varying ratios of rGO to TiO<SUB>2</SUB> by hydrothermal method. Photocatalytic ability of the nanocomposites was assessed for H<SUB>2</SUB> production under natural sunlight. At 5wt% GO loading, the rGO-TiO<SUB>2</SUB> exhibited 24,880μmol/g/h H<SUB>2</SUB>, 12.9 times to commercial P25-TiO<SUB>2</SUB> (1920μmol/g/h). The symmetric supercapacitor device fabricated using rGO-TiO<SUB>2</SUB> demonstrated 160F/g specific capacitance with 99% retention. The efficient charge carrier separation and transportation between TiO<SUB>2</SUB> nanotubes and rGO resulted high photocatalytic activity. The synergistic double layer pseudo capacitor behavior of rGO-TiO<SUB>2</SUB> is the reason for improved specific capacitance.</P> <P><B>Highlights</B></P> <P> <UL> <LI> Wrinkle rGO wrapped TiO<SUB>2</SUB> nanotubes were prepared by alkanine hydrothermal method. </LI> <LI> Improved visible absorption and reduced recombination was witnessed in rGO-TiO<SUB>2</SUB>. </LI> <LI> H<SUB>2</SUB> production of 24,880μmole/g/h was achieved by rGO-TiO<SUB>2</SUB>, 12.9 folds to P25 TiO<SUB>2</SUB>. </LI> <LI> Double layer and pseudo capacitance of rGO-TiO<SUB>2</SUB> showed specific capacitance 160F/g. </LI> </UL> </P> <P><B>Graphical abstract</B></P> <P>[DISPLAY OMISSION]</P>
( Christoph Sarrazin ),( Curtis L. Cooper ),( Michael P. Manns ),( Rajender Reddy ),( Kris Kowdley ),( Sooji Lee ),( Hadas Dvory-Sobol ),( Evguenia Svarovskia ),( Ross Martin ),( Gregory Camus ),( Bri 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: The pangenotypic combination of sofosbuvir (SOF) /velpatasvir (VEL)/voxilaprevir(VOX), inhibit distinct HCV targets, the NS5B polymerase, the NS5A protein, and NS3/4A protease, respectively. In Phase 3 studies, SOF/VEL/VOX administered for 12weeks demonstrated a 96% SVR12 rate in NS5A inhibitor-experienced patients in POLARIS-1, and a 97% SVR12 rate in DAA-experienced patient who had not previously received an NS5A inhibitor in POLARIS-4. Here, we evaluate the effect of baseline resistance associated substitutions (RASs) on treatment outcome and the emergence of RASs in patients who experienced virologic failure. Methods: NS3, NS5A, and NS5B deep sequencing was performed at baseline for all patients and at the time of virologic failure. NS3 and NS5A class RASs as well as VOX or VEL-specific RASs that confer >2.5-fold changes in EC50 were evaluated. Results: In POLARIS-1, 79% of NS5A inhibitor-experienced patients (205/260) had baseline NS3 and/or NS5A class RASs. Of these, 75% (196/260) had baseline NS5A RASs, the most common RASs. The SVR12 rates were similar in subjects with or without NS3 and/or NS5A class RASs, and with or without VOX or VEL-specific RASs(Table 1). RASs at NS5A position Y93 were present in 25% of patients, of whom 63(95%) achieved SVR12; all patients with ≥2 NS5A RASs achieved SVR12 (n=77). 95%(18/19) of patients with NS5B nucleoside inhibitor(NI) RASs achieved SVR12; 2 patients had S282T at baseline and achieved SVR12. In POLARIS-4, the overall prevalence of baseline NS3 and/or NS5A class RASs was 47%(83/178) and all achieved SVR12. All patients with. Conclusions: Baseline RASs had no impact on response in DAA-experienced patients following treatment with SOF/VEL/VOX for 12 weeks. Viral relapse was not associated with emergence of viral resistance.