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Objectives Hepatitis C virus (HCV) infection is the leading cause of cirrhosis and hepatocellular carcinoma worldwide. Tzukuan, located in the southwestern area of Taiwan, is an HCV hyperendemic area (>30%). This study aimed to assess the changing epidemiological characteristics of HCV infection and to evaluate the long-term outcomes after the implementation of public health strategies for two decades.Design A population-based retrospective cohort study.Setting A comprehensive care programme was implemented, namely COMPACT Study, in Tzukuan since 1997.Participants A total of 10 714 residents participated the screening.Outcome measures The HCV status, demographic and clinical profiles of the participants were recorded and validated annually from 2000 through 2019.Results The HCV infection prevalence rates were 21.1% (1076/5099) in 2000–2004, 18.8% (239/1269) in 2005–2009, 14.1% (292/2071) in 2010–2014 and 10.3% (234/2275) in 2015–2019 (p for trend test

Objective The treatment outcome of direct-acting antivirals (DAAs) in chronic hepatitis C patients with hepatocellular carcinoma (HCC) is controversial. The current study aimed to address the treatment efficacy and safety of DAAs in patients with curative or active HCC, compared with those of patients without HCC. Design A prospective cohort study Setting A medical centre and two regional hospitals in Taiwan Participants A total of 713 Taiwanese patients (601 non-HCC, 74 curative HCC and 38 active HCC patients) who received standard-of-care DAAs were consecutively enrolled in the study. Main outcome measurement The primary objective was to determine treatment efficacy, defined as undetectable hepatitis C virus RNA throughout 12 weeks of the posttreatment follow-up period (sustained virological response 12 [SVR12]). Results The overall SVR12 rate was 96.9%. The SVR12 rate was similar between the patients with HCC and those without HCC (95.5% vs 97.2%, p=0.37). The HCC patients were divided into two groups, those with curative HCC and those with viable HCC; a substantially but not significantly lower SVR rate, 92.1% (35/38), was observed in the patients with viable HCC compared with the SVR rate, 97.3% (72/74), in those with curative HCC (p=0.33). Compared with the patients with curative HCC, the patients with viable HCC had a significantly higher proportion of serious adverse events (10.5% vs 1.0%, p=0.002), early treatment discontinuation (10.5% vs 2.8%, p=0.03) and mortality (5.3% vs 0.1%, p=0.008). Conclusions An equivalently high SVR rate was observed in patients with either past or active HCC compared with those without HCC. The safety concerns in the HCC patients did not compromise treatment efficacy. [ABSTRACT FROM AUTHOR]

Background: The recommended treatment for patients infected with hepatitis C virus genotype 2 (HCV2) is pegylated interferon (peginterferon) and ribavirin for 24 weeks. Aim: To assess whether a shorter 1 6-week treatment is as effective as a standard 24-week treatment. Methods: Patients with HCV2 infection were randomised in a 1:2 ratio to either 16 weeks (n=50) or 24 weeks (n = 100) of treatment with peginterferon α-2a (180 µg/week) and weight-based ribavirin 1000-1200 mg/day, with a 24-week follow-up period. A rapid virological response (RVR) was defined as seronegative for HCV RNA at 4 weeks of treatment, and the primary end point, sustained virological response (SVR), as seronegative for HCV RNA at the 24-week follow-up. Results: The rate of RVR and SVR was 86% (43/50, 95% confidence interval (CI) 76% to 96%) and 94% (47/ 50, CI 87% to 100%), respectively, in the 16-week group, which was comparable to 87% (87/100, CI 80% to 94%) and 95% (95/100, CI 91% to 99%) in the 24-week group. Patients with RVR had a significantly higher SVR rate than patients without RVR in both 16-week (100% vs 57%, p = 0.015) and 24-week groups (98% vs 77%, p=0.002). Multivariate analysis showed that RYR and age were independent factors associated with SVR. Both treatment arms were equally well tolerated. The incidence of alopecia was significantly higher in the 24-week group (49%) than in the 16-week group (20%, p=0.001). Conclusion: 16 weeks and 24 weeks of peginterferon treatment with weight-based ribavirin at a dose of 1000-1200 mg/day provided equal efficacy in patients with HCV2 who achieved RVR at 4 weeks. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article concerning a study designed to find out the links between triglyceride levels, hepatitis C virus and diabetes in the 2007 issue.

A letter to the editor is presented about the role of gender on hepatitis C virus clearance rate in patients infected with the virus.

A letter to the editor is presented about the incidence and risks associated with liver biopsy in non-cirrhotic patients.

A letter to the editor is presented in response to the article "Insulin resistance and geographical origin: major predictors of liver fibrosis and response to peginterferon and ribavirin in HCV-4," by R. Moucari and colleagues in the 2009 issue is presented.

A letter to the editor in response to the article regarding the use of narrow band imaging electronic dye-spray to help in dysplasia detection at colonoscopy to avoids potential chromoendoscopy risks in the 2007 issue is presented.

A letter to the editor is presented about the usefulness of the integration value of alanine aminotransferase in predicting hepatic carcinogenesis in patients with hepatitis C virus infection.