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Tetsuhiro Chiba,1 Atsushi Hiraoka,2 Shigeru Mikami,3 Masami Shinozaki,4 Yukio Osaki,5 Masamichi Obu,6 Takamasa Ohki,7 Naoyuki Mita,8 Dianne Ledesma,8 Nariaki Yoshihara,8 Kathleen Beusterien,9 Kaitlan Amos,9 John FP Bridges,10 Osamu Yokosuka111Department of Gastroenterology and Nephrology, Chiba University Graduate School of Medicine, Chiba, Japan; 2Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Ehime Prefecture, Japan; 3Department of Internal Medicine, Kikkoman General Hospital, Noda-shi, Chiba Prefecture, Japan; 4Department of Gastroenterology, Numazu City Hospital, Shizuoka, Japan; 5Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan; 6Department of Gastroenterology, Kimitsu Chuo Hospital, Kisarazu City, Chiba Prefecture, Japan; 7Department of Gastroenterology, Mitsui Memorial Hospital, Tokyo, Japan; 8Market Access, Bayer Yakuhin, Ltd., Tokyo, Japan; 9ORS Health, Washington DC, USA; 10Department of Biomedical Informatics and Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA; 11Japan Community Health care Organization Funabashi Central Hospital, Funabashi, Chiba Prefecture, JapanPurpose: This study aimed to evaluate Japanese patient preferences regarding features of intermediate or advanced (Progressed) hepatocellular carcinoma (HCC) treatments: transarterial chemoembolization (TACE), hepatic arterial infusion chemotherapy (HAIC), and oral anti-cancer therapy.Methods: Patients with HCC, recruited from clinical sites and a patient panel in Japan, completed a cross-sectional web-based survey. Preferences were quantified using best–worst scaling, where patients identified the best and worst among 13 treatment features. Direct elicitation was used to identify preference for TACE, HAIC, or oral therapy, including the likelihood of trying each. Additional items asked for the willingness to try an oral medication that delays progression by six months but has an 8% or

Tetsuhiro Chiba,1 Atsushi Hiraoka,2 Shigeru Mikami,3 Masami Shinozaki,4 Yukio Osaki,5 Masamichi Obu,6 Takamasa Ohki,7 Naoyuki Mita,8 Dianne Ledesma,8 Nariaki Yoshihara,8 Kathleen Beusterien,9 Kaitlan Amos,9 John FP Bridges,10 Osamu Yokosuka111Department of Gastroenterology and Nephrology, Chiba University Graduate School of Medicine, Chiba, Japan; 2Gastroenterology Center, Ehime Prefectural Central Hospital, Matsuyama, Ehime Prefecture, Japan; 3Department of Internal Medicine, Kikkoman General Hospital, Noda-shi, Chiba Prefecture, Japan; 4Department of Gastroenterology, Numazu City Hospital, Shizuoka, Japan; 5Department of Gastroenterology and Hepatology, Osaka Red Cross Hospital, Osaka, Japan; 6Department of Gastroenterology, Kimitsu Chuo Hospital, Kisarazu City, Chiba Prefecture, Japan; 7Department of Gastroenterology, Mitsui Memorial Hospital, Tokyo, Japan; 8Market Access, Bayer Yakuhin, Ltd., Tokyo, Japan; 9ORS Health, Washington DC, USA; 10Department of Biomedical Informatics and Department of Surgery, The Ohio State University College of Medicine, Columbus, OH, USA; 11Japan Community Health care Organization Funabashi Central Hospital, Funabashi, Chiba Prefecture, JapanPurpose: This study aimed to evaluate Japanese patient preferences regarding features of intermediate or advanced (Progressed) hepatocellular carcinoma (HCC) treatments: transarterial chemoembolization (TACE), hepatic arterial infusion chemotherapy (HAIC), and oral anti-cancer therapy.Methods: Patients with HCC, recruited from clinical sites and a patient panel in Japan, completed a cross-sectional web-based survey. Preferences were quantified using best–worst scaling, where patients identified the best and worst among 13 treatment features. Direct elicitation was used to identify preference for TACE, HAIC, or oral therapy, including the likelihood of trying each. Additional items asked for the willingness to try an oral medication that delays progression by six months but has an 8% or

HBV reactivation could be induced under immunosuppressive conditions in patients with resolved infection. This study aimed to clarify the viral factors associated with the pathogenesis of HBV reactivation in association with the immunosuppressive status. Whole HBV genome sequences were determined from the sera of 24 patients with HBV reactivation, including 8 cases under strong immunosuppression mediated by hematopoietic stem cell transplantation (HSCT) and 16 cases without HSCT. Ultra-deep sequencing revealed that the prevalence of genotype B and the ratio of non-synonymous to synonymous evolutionary changes in the surface (S) gene were significantly higher in non-HSCT cases than in patients with HSCT. Those non-synonymous variants included immune escape (6/16 cases) and MHC class II-restricted T-cell epitope variants (6/16 cases). Furthermore, reactivated HBV in 11 of 16 (69%) non-HSCT cases possessed substitutions associated with impaired virion secretion, including E2G, L77R, L98V, T118K, and Q129H in the S region, and M1I/V in the PreS2 region. In conclusion, virologic features of reactivated HBV clones differed depending on the intensity of the immunosuppressive condition. HBV reactivation triggered by immunosuppressive conditions, especially those without HSCT, was characterized by the expansion of variants associated with immune escape, MHC class II-restricted T-cell epitope alterations, and/or impaired virion secretion.

© 2017 The Author(s).Resistance-associated variant (RAV) is one of the most significant clinical challenges in treating HCV-infected patients with direct-acting antivirals (DAAs). We investigated the viral dynamics in patients receiving DAAs using third-generation sequencing technology. Among 283 patients with genotype-1b HCV receiving daclatasvir + asunaprevir (DCV/ASV), 32 (11.3%) failed to achieve sustained virological response (SVR). Conventional ultra-deep sequencing of HCV genome was performed in 104 patients (32 non-SVR, 72 SVR), and detected representative RAVs in all non-SVR patients at baseline, including Y93H in 28 (87.5%). Long contiguous sequences spanning NS3 to NS5A regions of each viral clone in 12 sera from 6 representative non-SVR patients were determined by third-generation sequencing, and showed the concurrent presence of several synonymous mutations linked to resistance-associated substitutions in a subpopulation of pre-existing RAVs and dominant isolates at treatment failure. Phylogenetic analyses revealed close genetic distances between pre-existing RAVs and dominant RAVs at treatment failure. In addition, multiple drug-resistant mutations developed on pre-existing RAVs after DCV/ASV in all non-SVR cases. In conclusion, multi-drug resistant viral clones at treatment failure certainly originated from a subpopulation of pre-existing RAVs in HCV-infected patients. Those RAVs were selected for and became dominant with the acquisition of multiple resistance-associated substitutions under DAA treatment pressure.

Purpose: This study aimed to establish an efficient strategy for screening and surveillance for occupational cholangiocarcinoma. / Methods: We evaluated the consecutive changes in laboratory findings during regular health examinations and in abdominal ultrasonography findings before the diagnosis of occupational cholangiocarcinoma in nine patients. The results of laboratory tests and abdominal ultrasonography at the time of diagnosis were also examined....

Purpose: This study aimed to establish an efficient strategy for screening and surveillance for occupational cholangiocarcinoma. / Methods: We evaluated the consecutive changes in laboratory findings during regular health examinations and in abdominal ultrasonography findings before the diagnosis of occupational cholangiocarcinoma in nine patients. The results of laboratory tests and abdominal ultrasonography at the time of diagnosis were also examined....

This study describes the first case of biliary peritonitis after radiofrequency ablation diagnosed by magnetic resonance (MR) imaging with gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA), a hepatocyte-specific MR imaging contrast agent. The image acquired 300 minutes after the administration of Gd-EOB-DTPA was useful to make a definite diagnosis and to identify the pathway of bile leakage. It is important to decide on the acquisition timing with consideration of the predicted location of bile duct injury.