Browsing by Author "Swain, Mark G"

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    A case series evaluating the impact of Hepatitis C eradication using direct acting antivirals on primary biliary cholangitis-associated autoimmunity
    (2018-06-25) Nguyen, Henry H; Khathlan, Abdullah; Fritzler, Marvin J; Swain, Mark G
    Abstract Background Chronic Hepatitis C Virus (HCV) infection has been commonly linked to the development of autoimmunity, in part through activation of B cells. B cells are also postulated to play a pathogenic role in the autoimmune liver disease Primary Biliary Cholangitis (PBC). Patients with concurrent PBC and HCV infection carry an increased risk of more progressive disease, although the mechanism underlying this effect is poorly understood. Utilizing a case series of patients with concurrent PBC and HCV, the aim of this study was to evaluate for the potential impact of HCV eradication upon autoimmunity/autoantibody production. Case presentation A case series evaluating three patients with co-existing PBC-HCV infection receiving non-interferon based HCV treatments with direct-acting antivirals (DAA). One of three patient received Ursodeoxycholic acid (UDCA; 13 mg/kg/day) during the treatment period. Sustained virological response (SVR) to DAA’s was assessed using a HCV Quantitative Nucleic Acid Test (Abbott). Autoantibodies associated with autoimmune liver diseases (including PBC) and liver biochemistry, were measured before, during and after DAA treatment (Mitogen Advanced Diagnostics Laboratory, Calgary, Canada). All patients achieved an SVR, as determined by negative HCV RNA test 12 weeks post-DAA therapy. Titres of anti-mitochondrial antibodies (AMA-M2), anti- branched-chain 2-oxo-acid dehydrogenase complex and 2-oxo glutarate dehydrogenase complex (anti-3E-BPO), and anti- tripartite motif-containing protein 21 (TRIM21/Ro52) remained unchanged, despite successful HCV eradication. Two of the three patients exhibited a transient decrease in some autoantibody titres during DAA treatment, but these returned to baseline levels post-DAA therapy. Conclusions Within the limitations of a case series, our results suggest that HCV co-infection may not be a significant driver of PBC-related autoimmunity/autoantibody production. However, a larger n-value is required to truly assess for the effect of HCV eradication on autoantibody production.
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    Treatment Outcomes with Telaprevir-Based Therapy for HIV/Hepatitis C Coinfected Patients are Comparable with Hepatitis C Monoinfected Patients
    (2015-01-01) O’Neil, Conar R; Pang, Jack XQ; Lee, Samuel S; Swain, Mark G; Burak, Kelly W; Klein, Patricia; Myers, Robert P; Kapler, Jeff; Gill, Michael J; Labrie, Martin; Coffin, Carla S
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    Worldwide Prevalence and Incidence of Non-Alcoholic Fatty Liver Disease (NAFLD) in the 21st Century: A Systematic Review and Meta-Analysis
    (2021-09-10) Riazi, Kiarash; Kaplan, Gilaad G; Shaheen, Abdel Aziz; Swain, Mark G; Congly, Stephen E
    Non-alcoholic fatty liver disease (NAFLD) is defined as the presence of lipid deposition in more than 5% of hepatocytes, also known as fatty liver, in the absence of any history of excessive alcohol use or secondary causes of fatty liver. NAFLD is the most common liver disorder worldwide and the leading cause of liver-related morbidity and mortality, mainly because of cirrhosis, end-stage liver disease, liver transplant, and an increased incidence of hepatocellular carcinoma.The prevalence of NAFLD is constantly rising. Due to a silent presentation, high prevalence, and the detrimental outcomes associated with it, NAFLD is a major global health problem. Since there are currently no approved treatments for NAFLD, disease prevention is the only available option for reducing the disease burden. Since primary epidemiological data are the crucial cornerstones for every public health and preventive medicine attempt, updated and accurate epidemiological data are of utmost importance. There are currently a few existing research publications on the prevalence and incidence of NAFLD worldwide, which are either outdated, methodologically imperfect, or geographically restricted. Therefore, there is a need to update current data and accurately estimate NAFLD's worldwide prevalence and incidence.We performed a systematic review to identify all the studies reporting on the prevalence or incidence of NAFLD among the general adult population of different world regions over the past two decades. We used a random-effects meta-analysis method to calculate overall or sex-specific pooled prevalence or incidence rates. We also created static and interactive choropleth maps of pooled data to highlight the geographic differences in NAFLD prevalence/incidence.We estimated that the overall prevalence of NAFLD is appreciably higher than what had previously been assessed and is growing at an alarming rate. Furthermore, our findings show that the epidemiological reports regarding NAFLD from many parts of the world are missing. A dramatic rise in prevalence should drive enhanced awareness of NAFLD among primary care physicians, public health specialists, and health policymakers to encourage the development of more effective preventive policies.