Publications by authors named "Robert Gish"

Polymorphonuclear neutrophils (PMNs) are critical mediators in the innate immune response, and their levels in ascitic fluid are pivotal for diagnosing spontaneous bacterial peritonitis (SBP), particularly in patients with liver cirrhosis. This retrospective study investigates the association between varying PMN counts in ascitic fluid and hospital outcomes, including mortality, 30-day readmission rates, and length of stay (LOS). We analyzed de-identified data from HCA Healthcare hospitals (July 2013-December 2023), focusing on patients aged 18 and older with a diagnosis of liver cirrhosis who underwent paracentesis.

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Viral hepatitis caused by hepatitis B virus accounts for a significant disease burden. Nucleos(t)ide analogues (NAs) are the standard of care for chronic hepatitis B (CHB) infection; however, treatment is long-term, and viral eradication resulting in cure is rare. Adherence to NAs is vital for disease control.

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Background: Chronic hepatitis D (CHD) is the most severe form of viral hepatitis, which results in accelerated progression to cirrhosis and poor prognosis compared with other hepatitis infections, impacting patients' health-related quality of life (HRQoL). To adequately capture patient perspectives of new hepatitis D virus (HDV) treatments in clinical trials, patient-reported outcome (PRO) measures that are valid and assess key concepts relevant to the patient are needed. This study aimed to explore the patient experience of CHD and evaluate the content validity of the Hepatitis Quality of Life Questionnaire (HQLQv2) and the Fatigue Severity Scale (FSS) for use in an HDV population.

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Hepatitis D virus (HDV) affects nearly 5% of people globally who are chronically infected with hepatitis B virus, according to the World Health Organisation. The prevalence of HDV in the United States is considered lower than in other countries. However, HDV seroprevalence studies of the US population are limited, and reported seroprevalences vary.

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Background: Prevalence estimates of primary biliary cholangitis (PBC) in the United States have evolved with the introduction of newer real-world data capture approaches. Little is known about the geographic distribution of PBC in the United States and the health care provider (HCP) landscape for patients with PBC. This real-world study aimed to estimate the prevalence of PBC in the United States, assess regional variability in its prevalence, and describe HCPs for patients with PBC.

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To evaluate the clinical characteristics and healthcare resource utilization for acute care and its costs for patients with primary biliary cholangitis (PBC) with or without cirrhosis. This retrospective observational cohort study was conducted using two datasets (Komodo's Healthcare Map™ [Komodo Health] and Optum Clinformatics Data Mart [CDM] database) between 2015 and 2023. Patients (≥18 years) with PBC were identified based on ≥1 inpatient or ≥2 outpatient claims.

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Objectives: GLS4 is a first-in-class hepatitis B virus (HBV) capsid assembly modulator that inhibits HBV replication by interfering with assembly and disassembly of the virus nucleocapsid, this prospective, open-label, comparative, phase 2b trial evaluated the antiviral activity and safety of GLS4/ritonavir (RTV) combined with entecavir in hepatitis B e antigen-positive patients.

Methods: 250 CHB patients were enrolled, including treatment-naïve patients and those interrupted anti-HBV drugs for ≥ 6 months (Part A, n=125), and patients who had taken ETV for ≥1 year and had achieved viral suppression (Part B, n=125). Patients were randomly allocated to receive 120 mg GLS4/100 mg RTV plus 0.

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Background: Alcohol dependence remains a significant global health issue, exacerbated by the coronavirus disease 2019 (COVID-19) pandemic. Phosphatidylethanol (PEth), a direct biomarker of recent alcohol consumption, offers improved specificity, sensitivity, and a longer detection window of 2 - 4 weeks compared to traditional biomarkers. This study evaluates the association between PEth testing and hospital outcomes in hospitalized patients by comparing outcomes among patients with positive PEth and negative PEth test results.

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Background And Aims: The aim of this systematic literature review (SLR) was to examine outcomes and associated predictors following nucleos(t)ide analog (NA) treatment cessation in adult patients with chronic hepatitis B virus infection.

Methods: The SLR was conducted according to PRISMA methodology. All included studies were quality assessed using appropriate scales or checklists.

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Article Synopsis
  • * The research analyzed data from over 14,800 patients diagnosed with NASH, categorizing them by severity levels of liver disease and calculating healthcare costs and resource utilization before and after diagnosis.
  • * Findings showed that annual healthcare costs significantly increased with disease severity, with patients who progressed from NASH to more severe states incurring notably higher expenses and hospitalizations compared to those who did not progress.
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Introduction: Non-alcoholic steatohepatitis (NASH) may progress to more advanced liver disease. This study aimed to characterize NASH progression and mortality in the Medicare population.

Methods: Patients with NASH in 100% Medicare fee-for-service claims accrued from 2015-2021 who were ≥ 66 years old at index diagnosis, continuously enrolled for ≥ 12 months prior to and ≥ 6 months following index (unless death), and had no evidence of other causes of liver disease were included.

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Chronic hepatitis B virus (HBV) infection affects about 262 million people worldwide, leading to over 820,000 deaths each year primarily due to cirrhosis and hepatocellular carcinoma. The World Health Organization has pledged to eliminate HBV as a health threat by 2030, but currently, no countries are on track to achieve this goal. One of the barriers to HBV elimination is stigma, causing shame, denial, self-isolation, self-rejection, and depression leading to those with chronic HBV less likely to get tested or seek treatment and more likely to conceal their infection.

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The epidemiology of Hepatitis B virus (HBV) has drastically changed in recent decades due to public health initiatives, including universal infant vaccination programs,urbanization driving global travel, and migration patterns. Despite screening of pregnant women and newborns significantly reducing the rate of perinatal transmission in certain parts of the world, other, perhaps more uncommon, routes (e.g.

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Background & Aims: Once-daily treatment of chronic hepatitis delta (CHD) with bulevirtide is well tolerated and associated with significant reductions in HDV RNA in the blood and in biochemical liver disease activity. This study explored the effects of 48-week bulevirtide treatment on health-related quality of life (HRQoL) in patients with CHD.

Methods: In an open-label, randomised, phase III trial, 150 patients with CHD and compensated liver disease were stratified by cirrhosis status and randomised 1:1:1 to no treatment (control), bulevirtide 2 mg/day, or bulevirtide 10 mg/day for 48 weeks.

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Background: With the implementation of the 11th edition of the International Classification of Diseases (ICD-11) and the publication of the metabolic dysfunction-associated fatty liver disease (MAFLD) nomenclature in 2020, it is important to establish consensus for the coding of MAFLD in ICD-11. This will inform subsequent revisions of ICD-11.

Methods: Using the Qualtrics XM and WJX platforms, questionnaires were sent online to MAFLD-ICD-11 coding collaborators, authors of papers, and relevant association members.

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In the past 3 decades, metabolic-associated fatty liver disease (MAFLD) has emerged as a widespread liver condition, with its global prevalence on the rise. It ranks as a leading contributor to hepatocellular carcinoma (HCC) and necessitates liver transplantation. Under the multiple parallel hits model, the pathogenesis of MAFLD stems from various liver stressors, notably nutrient overload and sedentary lifestyles.

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Article Synopsis
  • A study was conducted in Ho Chi Minh City, Vietnam, to explore barriers to HBV vaccination among adults after offering free vaccination coupons.
  • Out of 284 HBV-naïve participants, only 11.7% received the 1st dose, 10.7% the 2nd, and 8.9% the 3rd dose of the vaccine, indicating very low uptake despite no financial obstacles.
  • Initiation of the vaccine was linked to factors such as adequate knowledge of HBV transmission and severity, as well as the practice of seeking annual health check-ups.
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Foreign-born (FB) persons represent a large proportion of adults with chronic hepatitis B (CHB) in Canada due to higher prevalence rates in countries of birth for FB persons. Suboptimal awareness and low rates of hepatitis delta virus (HDV) testing contribute to underdiagnosis and gaps in accurate estimates of Canada HDV prevalence. We aim to provide an assessment of CHB and HDV prevalence in Canada using a comprehensive literature review and meta-analysis.

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Hepatitis D virus (HDV) is an RNA subvirus that infects patients with co-existing hepatitis B virus (HBV) infections. HDV burden is estimated to be approximately 15-20 million people worldwide. Despite HDV severity, screening for HDV remains inadequate.

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Article Synopsis
  • * Through a detailed literature review and meta-analysis, the researchers estimated that in 2022, around 1.971 million people were living with chronic hepatitis B (CHB), with about 75,005 individuals having HDV.
  • * The majority of those with HDV in the U.S. are foreign-born, with significant numbers coming from Asia, Africa, and Europe, emphasizing the need for improved screening and awareness efforts.
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Primary biliary cholangitis (PBC) is a chronic cholestatic liver disease. The management landscape was transformed 20 years ago with the advent of ursodeoxycholic acid. Up to 40% of patients do not, however, respond adequately to ursodeoxycholic acid and therefore still remain at risk of disease progression to cirrhosis.

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