Dataset Information

Trends in Incidences and Risk Factors for Hepatocellular Carcinoma and Other Liver Events in HIV and Hepatitis C Virus-coinfected Individuals From 2001 to 2014: A Multicohort Study.

ABSTRACT: BACKGROUND:While liver-related deaths in human immunodeficiency virus (HIV) and hepatitis C virus (HCV)-coinfected individuals have declined over the last decade, hepatocellular carcinoma (HCC) may have increased. We describe the epidemiology of HCC and other liver events in a multicohort collaboration of HIV/HCV-coinfected individuals. METHODS:We studied HCV antibody-positive adults with HIV in the EuroSIDA study, the Southern Alberta Clinic Cohort, the Canadian Co-infection Cohort, and the Swiss HIV Cohort study from 2001 to 2014. We calculated the incidence of HCC and other liver events (defined as liver-related deaths or decompensations, excluding HCC) and used Poisson regression to estimate incidence rate ratios. RESULTS:Our study comprised 7229 HIV/HCV-coinfected individuals (68% male, 90% white). During follow-up, 72 cases of HCC and 375 other liver events occurred, yielding incidence rates of 1.6 (95% confidence interval [CI], 1.3, 2.0) and 8.6 (95% CI, 7.8, 9.5) cases per 1000 person-years of follow-up, respectively. The rate of HCC increased 11% per calendar year (95% CI, 4%, 19%) and decreased 4% for other liver events (95% CI, 2%, 7%), but only the latter remained statistically significant after adjustment for potential confounders. Older age, cirrhosis, and low current CD4 cell count were associated with a higher incidence of both HCC and other liver events. CONCLUSIONS:In HIV/HCV-coinfected individuals, the crude incidence of HCC increased from 2001 to 2014, while other liver events declined. Individuals with cirrhosis or low current CD4 cell count are at highest risk of developing HCC or other liver events.

SUBMITTER: Gjærde LI

PROVIDER: S-EPMC4996136 | biostudies-literature | 2016 Sep

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Trends in Incidences and Risk Factors for Hepatocellular Carcinoma and Other Liver Events in HIV and Hepatitis C Virus-coinfected Individuals From 2001 to 2014: A Multicohort Study.

Gjærde Lars I LI Shepherd Leah L Jablonowska Elzbieta E Lazzarin Adriano A Rougemont Mathieu M Darling Katharine K Battegay Manuel M Braun Dominique D Martel-Laferriere Valerie V Lundgren Jens D JD Rockstroh Jürgen K JK Gill John J Rauch Andri A Mocroft Amanda A Klein Marina B MB Peters Lars L

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America 20160615 6

<h4>Background</h4>While liver-related deaths in human immunodeficiency virus (HIV) and hepatitis C virus (HCV)-coinfected individuals have declined over the last decade, hepatocellular carcinoma (HCC) may have increased. We describe the epidemiology of HCC and other liver events in a multicohort collaboration of HIV/HCV-coinfected individuals.<h4>Methods</h4>We studied HCV antibody-positive adults with HIV in the EuroSIDA study, the Southern Alberta Clinic Cohort, the Canadian Co-infection Coho ...[more]

PMID: 27307505

Similar Datasets

Project description:Dengue and dengue hemorrhagic pose significant burdens in many tropical countries. Dengue incidences have perpetually increased, leading to an annual (uncertain) peak. Dengue cases cause an enormous public health problem in Thailand because there is no anti-viral drug against the dengue virus. Searching for means to reduce the dengue incidences is a challenging and appropriate strategy for primary prevention in a dengue outbreak. This study constructs the best predictive model from past statistical dengue incidences at the provincial level and studies the relationships among dengue incidences and weather variables. We conducted experiments for 65 provinces (out of 77 provinces) in Thailand since there is no dengue information for the remaining provinces. Predictive models were constructed using weekly data during 2001-2014. The training set are data during 2001-2013, and the test set is the data from 2014. Collected data were separated into two parts: current dengue cases as the dependent variable, and weather variables and previous dengue cases as the independent variables. Eight weather variables are used in our models: average pressure, maximum temperature, minimum temperature, average humidity, precipitation, vaporization, wind direction, wind power. Each weather variable includes the current week and one to three weeks of lag time. A total of 32 independent weather variables are used for each province. The previous one to three weeks of dengue cases are also used as independent variables. There is a total of 35 independent variables. Predictive models were constructed using five methods: Poisson regression, negative binomial regression, quasi-likelihood regression, ARIMA(3,1,4) and SARIMA(2,0,1)(0,2,0). The best model is determined by combinations of 1-12 variables, which are 232,989,800 models for each province. We construct a total of 15,144,337,000 models. The best model is selected by the average from high to low of the coefficient of determination (R2) and the lowest root mean square error (RMSE). From our results, the one-week lag previous case variable is the most frequent in 55 provinces out of a total of 65 provinces (coefficient of determinations with a minimum of 0.257 and a maximum of 0.954, average of 0.6383, 95% CI: 0.57313 to 0.70355). The most influential weather variable is precipitation, which is used in most of the provinces, followed by wind direction, wind power, and barometric pressure. The results confirm the common knowledge that dengue incidences occur most often during the rainy season. It also shows that wind direction, wind power, and barometric pressure also have influences on the number of dengue cases. These three weather variables may help adult mosquitos to survive longer and spread dengue. In conclusion, The most influential factor for further cases is the number of dengue cases. However, weather variables are also needed to obtain better results. Predictions of the number of dengue cases should be done locally, not at the national level. The best models of different provinces use different sets of weather variables. Our model has an accuracy that is sufficient for the real prediction of future dengue incidences, to prepare for and protect against severe dengue outbreaks.

Project description:Importance:Cataract surgery is commonly performed at ambulatory surgery centers (ASCs) and hospital outpatient departments (HOPDs). These venues differ in many ways, including surgical efficiency, patient throughput, patient safety, and costs per surgery. Objective:To determine trends in use of ASCs and HOPDs for cataract surgery from 2001 to 2014 and factors affecting the site of surgery. Design, Setting, and Participants:This retrospective longitudinal cohort analysis involved individuals 40 years and older who underwent cataract surgery between January 2001 and December 2014 from a nationwide US managed care network. Data were analyzed from February 2016 to February 2017. Main Outcomes and Measures:We identified all enrollees who underwent cataract surgery and determined whether the surgery was performed at an ASC or HOPD. We calculated the proportion of surgeries performed at each site each year from 2001 to 2014. Multivariable logistic regression identified characteristics of enrollees who had cataract surgery at an ASC vs a HOPD. We also assessed geographic variation in the proportion of cataract surgeries performed at ASCs in 306 communities throughout the United States. Results:Of the 369 320 enrollees included in this study, 208 319 (56.4%) were female, and the mean (SD) age was 66.3 (10.4) years. All enrollees underwent cataract surgery (531 325 surgeries) from 2001 to 2014. Of these, 237 046 (64.2%) underwent cataract surgery at an ASC. The proportion of cataract surgeries performed at ASCs increased from 43.6% in 2001 to 73.0% in 2014. Compared with enrollees with incomes less than $40 000, those with incomes greater than $100 000 were 20% more likely to undergo cataract surgery at an ASC (odds ratio, 1.20; 95% CI, 1.12-1.29). Enrollees with better overall health were no more likely to undergo cataract surgery at an ASC (odds ratio, 1.00; 95% CI, 0.99-1.00) than at an HOPD. Enrollees who lived in communities without certificate of need laws were more than twice as likely to have surgery at an ASC (odds ratio, 2.49; 95% CI, 2.35-2.63). The proportion of cataract surgeries performed at ASCs from 2012 to 2014 varied considerably, from 1.6% in La Crosse, Wisconsin, to 98.8% in Pueblo, Colorado. Conclusions and Relevance:We observed a large shift in the site of cataract surgery from HOPDs to ASCs from 2001 to 2014. Future research is needed to assess the effect of this transition in site of surgical care on patient access to surgery, surgical outcomes, patient safety, and societal costs.

Project description:Preeclampsia, a multisystem disorder in pregnancies complicates with maternal and fetal morbidity. Early- and late-onset preeclampsia, defined as preeclampsia developed before and after 34 weeks of gestation, respectively. The early-onset disease was less prevalent but associated with poorer outcomes. Moreover, the risk factors between early -and late- onset preeclampsia could be differed owing to the varied pathophysiology. In the study, we evaluated the incidences, trends, and risk factors of early- and late- onset preeclampsia in Taiwan.This retrospective population-based cohort study included all ?20 weeks singleton pregnancies resulting in live-born babies or stillbirths in Taiwan between January 1, 2001 and December 31, 2014 (n?=?2,884,347). The data was collected electronically in Taiwanese Birth Register and National Health Insurance Research Database. The incidences and trends of early- and late-onset preeclampsia were assessed through Joinpoint analysis. Multivariate logistic regression was used to analyze the risk factors of both diseases.The age-adjusted overall preeclampsia rate was slightly increased from 1.1%(95%confidence interval [CI], 1.1-1.2) in 2001 to 1.3% (95%CI, 1.2-1.3) in 2012 with average annual percentage change (AAPC) 0.1%/year (95%CI, 0-0.2%). However, the incidence was remarkably increased from 1.3% (95%CI, 1.3-1.4) in 2012 to 1.7% (95%CI, 1.6-1.8) in 2014 with AAPC 1.3%/year (95%CI,0.3-2.5). Over the study period, the incidence trend in late-onset preeclampsia was steadily increasing from 0.7% (95%CI, 0.6-0.7) in 2001 to 0.9% (95%CI, 0.8-0.9) in 2014 with AAPC 0.2%/year (95%CI, 0.2-0.3) but in early-onset preeclampsia was predominantly increase from 0.5% (95%CI, 0.4-0.5) in 2012 to 0.8% (95%CI, 0.8-0.9) in 2014 with AAPC 2.3%/year (95%CI, 0.8-4.0). Advanced maternal age, primiparity, stroke, diabetes mellitus, chronic hypertension, and hyperthyroidism were risk factors of preeclampsia. Comparing early- and late-onset diseases, chronic hypertension (ratio of relative risk [RRR], 1.71; 95%CI, 1.55-1.88) and older age (RRR, 1.41; 95%CI 1.29-1.54) were more strongly associated with early-onset disease, whereas primiparity (RRR 0.71, 95%CI, 0.68-0.75) had stronger association with late-onset preeclampsia.The incidences of overall, and early- and late-onset preeclampsia were increasing in Taiwan from 2001 to 2014, predominantly for early-onset disease. Pregnant women with older age and chronic hypertension had significantly higher risk of early-onset preeclampsia.

Dataset Information

Trends in Incidences and Risk Factors for Hepatocellular Carcinoma and Other Liver Events in HIV and Hepatitis C Virus-coinfected Individuals From 2001 to 2014: A Multicohort Study.

Publications

Trends in Incidences and Risk Factors for Hepatocellular Carcinoma and Other Liver Events in HIV and Hepatitis C Virus-coinfected Individuals From 2001 to 2014: A Multicohort Study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets