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Unmet needs of chronic hepatitis C in the era of direct-acting antiviral therapy
Chung-Feng Huang,Ming-Lung Yu 대한간학회 2020 Clinical and Molecular Hepatology(대한간학회지) Vol.26 No.3
The treatment of chronic hepatitis C (CHC) has been revolutionized in an era of all-oral direct-acting antivirals (DAAs) since 2014. Satisfactory treatment efficacy and tolerability can be provided by novel DAAs. Nevertheless, there are still some unmet needs and emerging issues in the treatment of CHC in the DAA era. Certain hard-to-cure populations are prone to have inferior treatment responses, including patients with severe liver decompensation, active hepatocellular carcinoma (HCC), and hepatitis C virus (HCV) genotype 3 (HCV-3) infection and those who experience multiple DAA treatment failures. Hepatitis B virus (HBV) reactivation during and after DAA treatment has raised concern regarding the use of prophylactic antivirals against HBV throughout DAA treatment. However, the standard strategy for the use of prophylactic antivirals is not uniform across regional guidelines. In the post-sustained virological response (SVR) period, HCC still occurs in a substantial proportion of patients. Due to the relatively short follow-up period, the net benefit of the achievement of an SVR by DAAs in the reduction of extrahepatic manifestations has not yet been determined. Attention must also be paid to HCV reinfection, particularly in high-risk populations. The most critical and unmet need for HCV elimination is the large gap in the HCV care cascade at the population level. To accomplish the World Health Organization (WHO)’s goal for HCV elimination by 2030, the expansion of access to HCV care requires a continuous effort to overcome practical and political challenges.
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The properties of hydrophobic concrete prepared by biomimetic mineralization method
Chung-Ho Huang,Hao-Yu Fang,Jue-Zhong Zhang 사단법인 한국계산역학회 2019 Computers and Concrete, An International Journal Vol.23 No.5
In this study, the calcium hydroxide, an inherent product of cement hydration, was treated using biomimetic carbonation method of incorporating stearic acid to generate the hydrophobic calcium carbonate on concrete surface. Carbonation reaction was carried out at various CO2 pressure and temperatures and utilizing the Scanning Electron Microscope (SEM), chloride-ion penetration test apparatus, and compression test machine to investigate the hydrophobicity, durability, and mechanical properties of the synthesized products. Experimental results indicate that the calcium stearate may change the surface property of concrete from hydrophilicity to hydrophobicity. Increasing reaction temperature can change the particles from irregular shapes to needle-rod structures with increased shear stress and thus favorable to hydrophobicity and microhardness. The contact angle against water for the concrete surface was found to increase with increasing CO2 pressure and temperature, and reached to an optimum value at around 90°C. The maximum static water contact angle of 128.7 degree was obtained at the CO2 pressure of 2 atm and temperature of 90°C . It was also found that biomimetic carbonation increased the permeability, acid resistance and chloride-ion permeability of the concrete material. These unique results demonstrate that the needle-rod structures of CaCO3 synthetized on concrete surface could enhance hydrophobicity, durability, and mechanical properties of concrete.
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Chung-Feng Huang,Ming-Lung Yu 대한간학회 2019 Clinical and Molecular Hepatology(대한간학회지) Vol.25 No.2
During the clinical trial development of directly acting antivirals (DAAs), evidence regarding the treatment efficacy in chronic hepatitis C patients with hepatocellular carcinoma (HCC) was scarce because these patients have always been excluded. Apart from the clinical trials, more HCC patients are currently being treated in daily practice, given that these treatments are highly effective and involve well-tolerated regimens. Large scale, real-world studies have demonstrated potentially suboptimal antiviral treatment efficacy in HCC patients who received DAAs. It is postulated that the impairment of the bioavailability of DAAs may account for the inferior treatment response. However, the results could not be generalized across all studies. The differing results were attributed to diverse patient characteristics, suboptimal regimens or imprecise definitions of active cancer statuses at the time of treatment initiation. Additional large-scale studies that utilize the treatment of choice in clearly defined HCC patients with different disease severities are warranted to clarify the issue.
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( Chung-feng Huang ),( Yasuhiro Asahina ),( Chun-jen Liu ),( Edward Gane ),( Yoshito Itoh ),( Norifumi Kawada ),( Yoshiyuki Ueno ),( Jin Youn ),( Chen-yu Wang ),( Joe Llewellyn ),( Anu Osinusi ),( Jen 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1
Aims: HCV genotype (GT) 2 is the second most common gen otype in several Asian countries including Taiwan and Korea. Treatment options for GT2 remain limited in these countries. The once-daily fixed-dose combination of ledipasvir/sofosbuvir (LDV/SOF) was evaluated for the treatment of GT 2, in patients with or without compensated cirrhosis, in three phase 2 and 3 studies. Methods: This was a retrospective analysis of subjects treated with LDV/SOF for 12 weeks in the GS-US-337-1655 (Taiwan), GS-US-337-1903 (Japan) and GS-US-1468 (New Zealand) stud ies. Subjects analyzed in this integrated analysis were either mono-infected with HCV GT2, or co-infected with HCV GT2 and HBV. The data was pooled and safety and efficacy were analyzed. Results: Overall 200 subjects were treated and analyzed; 88% of subjects were Asian, 46% male, 31% had prior treatment failure, 15% were cirrhotic, 25% were IL28B non-CC, 34% were 65 years or older and 22% (n=43) were co-infected with HBV. The overall SVR rate was 97% (194/200), and was 93% (27/29) among patients with cirrhosis and 97% (59/61) in pa tients who had failed previous therapy. Of the 197 patients with available testing; NS5A resistance-associated substitutions (RASs) were present in 86% (169/197) at baseline. SVR12 rate was 98% (165/169) in patients with baseline NS5A RASs com pared with 100% (28/28) in patients without NS5A RASs. No new RASs emerged in patients with virologic failure. Treatment with LDV/SOF for 12 weeks was well tolerated. Overall the most common adverse events AEs were headache and nasopharyngi tis. Few subjects experienced serious AEs, none of which were assessed as treatment related. One patient discontinued treat ment due to AE. Conclusions: Treatment with LDV/SOF for 12 weeks is highly effective and well tolerated in patients with GT2 HCV infection, including patients who are treatment experienced and/or have compensated cirrhosis, baseline NS5A RASs and with HBV/HCV coinfection.
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Huang Chung Ming,Chuang Wen Yang,Lin Wei Chih,Lin Li Jen,Chang Sheng Chang,Lee Tzu Tai 아세아·태평양축산학회 2021 Animal Bioscience Vol.34 No.3
Objective: Wheat bran (WB) was co-fermented with Aspergillus oryzae and phytase (Phy) to determine whether co-fermentation improve WB phosphorus and fiber utilization in Isa-brown layers. Methods: A total of 112 Isa brown layer were randomly divided into 7 treatments with 8 replicates per a treatment and 2 hens per a replicate. The treatments included basal diet (control), basal diet supplemented with 250 unit/kg Phy (control+Phy), diet with 10% WB (10% WB), diet with 5% WB and 250 unit/kg Phy (5% WB+Phy) diet with 10% WB and 250 unit/kg Phy (10% WB+Phy), diet with 5% fermented WB supplemented with molasses and phy (PCFWH) and 125 unit/kg Phy (5% PCFWH), and diet with 10% PCFWH (10% PCFWH). The intestinal microbial population, intestinal morphology, serum antioxidant enzyme activities, and excreta phosphorus content were assessed. Results: In PCFWH, spore counts, protease activity, xylanase activity, and ferulic acid were 8.50 log/g dry matter (DM), 190 unit/g DM, 120 unit/g DM, and 127 μg/g, respectively. Xylobiose and xylotriose were released in PCFWH, while they were not detectable in WB. Antioxidant capacity was also enhanced in PCFWH compared to WB. The 10% WB+Phy and 10% PCFWH groups produced higher egg mass, but hens fed 5% WB+Phy had the lowest amount of feed intake. Eggs from 10% PCFWH had better eggshell weight, eggshell strength, and eggshell thickness. Birds fed with 10% PCFWH also had higher serum superoxide dismutase and catalase activities. Compare to control, 10% PCFWH significantly reduced excreta phosphorus content. Conclusion: Diet inclusion of 10% PCFWH improved egg quality, antioxidant status, and excreta phosphorus content of laying hens. Objective: Wheat bran (WB) was co-fermented with Aspergillus oryzae and phytase (Phy) to determine whether co-fermentation improve WB phosphorus and fiber utilization in Isa-brown layers.Methods: A total of 112 Isa brown layer were randomly divided into 7 treatments with 8 replicates per a treatment and 2 hens per a replicate. The treatments included basal diet (control), basal diet supplemented with 250 unit/kg Phy (control+Phy), diet with 10% WB (10% WB), diet with 5% WB and 250 unit/kg Phy (5% WB+Phy) diet with 10% WB and 250 unit/kg Phy (10% WB+Phy), diet with 5% fermented WB supplemented with molasses and phy (PCFWH) and 125 unit/kg Phy (5% PCFWH), and diet with 10% PCFWH (10% PCFWH). The intestinal microbial population, intestinal morphology, serum antioxidant enzyme activities, and excreta phosphorus content were assessed.Results: In PCFWH, spore counts, protease activity, xylanase activity, and ferulic acid were 8.50 log/g dry matter (DM), 190 unit/g DM, 120 unit/g DM, and 127 μg/g, respectively. Xylobiose and xylotriose were released in PCFWH, while they were not detectable in WB. Antioxidant capacity was also enhanced in PCFWH compared to WB. The 10% WB+Phy and 10% PCFWH groups produced higher egg mass, but hens fed 5% WB+Phy had the lowest amount of feed intake. Eggs from 10% PCFWH had better eggshell weight, eggshell strength, and eggshell thickness. Birds fed with 10% PCFWH also had higher serum superoxide dismutase and catalase activities. Compare to control, 10% PCFWH significantly reduced excreta phosphorus content.Conclusion: Diet inclusion of 10% PCFWH improved egg quality, antioxidant status, and excreta phosphorus content of laying hens.
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Temperature development and cracking characteristics of high strength concrete slab at early age
Chung-Hao Wu,Yu-Feng Lin,Shu-Ken Lin,Chung-Ho Huang 국제구조공학회 2020 Structural Engineering and Mechanics, An Int'l Jou Vol.74 No.6
High-strength concrete (HSC) generally is made with high amount of cement which may release large amount of hydration heat at early age. The hydration heat will increase the internal temperature of slab and may cause potential cracking. In this study, slab specimens with a dimension of 600 × 600 × 100 mm were cast with concrete incorporating silica fume for test. The thermistors were embedded in the slabs therein to investigate the interior temperature development. The test variables include water-to-binder ratio (0.25, 0.35, 0.40), the cement replacement ratio of silica fume (RSF; 5 %, 10 %, 15 %) and fly ash (RFA; 10 %, 20 %, 30 %). Test results show that reducing the W/B ratio of HSC will enhance the temperature of first heat peak by hydration. The increase of W/B decrease the appearance time of second heat peak, but increase the corresponding maximum temperature. Increase the RSF or decrease the RFA may decrease the appearance time of second heat peak and increase the maximum central temperature of slab. HSC slab with the range of W/B ratio of 0.25 to 0.40 may occur cracking within 4 hours after casting. Reducing W/B may lead to intensive cracking damage, such as more crack number, and larger crack width and length.
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Scaling up the in-hospital hepatitis C virus care cascade in Taiwan
( Chung-feng Huang ),( Pey-fang Wu ),( Ming-lun Yeh ),( Ching-i Huang ),( Po-cheng Liang ),( Cheng-ting Hsu ),( Po-yao Hsu ),( Hung-yin Liu ),( Ying-chou Huang ),( Zu-yau Lin ),( Shinn-cherng Chen ),( 대한간학회 2021 Clinical and Molecular Hepatology(대한간학회지) Vol.27 No.1
Background/Aims: Obstacles exist in facilitating hepatitis C virus (HCV) care cascade. To increase timely and accurate diagnosis, disease awareness and accessibility, in-hospital HCV reflex testing followed by automatic appointments and a late call-back strategy (R.N.A. model) was applied. We aimed to compare the HCV treatment rate of patients treated with this strategy compared to those without. Methods: One hundred and twenty-five anti-HCV seropositive patients who adopted the R.N.A. model in 2020 and another 1,396 controls treated in 2019 were enrolled to compare the gaps in accurate HCV RNA diagnosis to final treatment allocation. Results: The HCV RNA testing rate was significantly higher in patients who received reflex testing than in those without reflex testing (100% vs. 84.8%, P<0.001). When patients were stratified according to the referring outpatient department, a significant improvement in the HCV RNA testing rate was particularly noted in patients from non-hepatology departments (100% vs. 23.3%, P<0.001). The treatment rate in HCV RNA seropositive patients was 83% (83/100) after the adoption of the R.N.A. model, among whom 96.1% and 73.9% of patients were from the hepatology and non-hepatology departments, respectively. Compared to subjects without R.N.A. model application, a significant improvement in the treatment rate was observed for patients from non-hepatology departments (73.9% vs. 27.8%, P=0.001). The application of the R.N.A. model significantly increased the in-hospital HCV treatment uptake from 6.4% to 73.9% for patients from non-hepatology departments (P<0.001). Conclusions: The care cascade increased the treatment uptake and set up a model for enhancing in-hospital HCV elimination. (Clin Mol Hepatol 2021;27:136-143)
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