BACKGROUND Little is known about the engagement in hepatitis C virus(HCV)care and completion of HCV treatment in people living with human immunodeficiency virus(HIV)(PLWH)who have HCV coinfection in the Asia-Pacific r...BACKGROUND Little is known about the engagement in hepatitis C virus(HCV)care and completion of HCV treatment in people living with human immunodeficiency virus(HIV)(PLWH)who have HCV coinfection in the Asia-Pacific region.Examining the HCV care cascade can identify barriers to the completion of HCV treatment and facilitate achievement of HCV micro-elimination in PLWH.AIM To investigate the care cascade of incident HCV infections among PLWH in Taiwan.METHODS PLWH with incident HCV infections,defined as HCV seroconversion,were retrospectively identified by sequential anti-HCV testing of all archived blood samples at National Taiwan University Hospital between 2011 and 2018.All PLWH with incident HCV infections were followed until December 31,2019.The care cascade of HCV examined included all incident HCV-infected patients,the percentages of anti-HCV antibodies detected by HIV-treating physicians in clinical care,plasma HCV RNA load tested,HCV RNA positivity diagnosed,referral to treatment assessment made,anti-HCV treatment initiated,and sustained virologic response achieved.Those who had HCV seroconversion during the interferon(IFN)era(2011–2016)and the direct-acting antiviral(DAA)era(2017–2018)were analyzed separately.The duration of HCV viremia—from the date of seroconversion to viral clearance by treatments or until the end of observation—and the incidence of sexually transmitted infections(STIs)during the HCV viremic period were estimated.RESULTS During the study period,287 of 3495(8.2%)PLWH(92.3%being men who have sex with men)who were HCV-seronegative at baseline developed HCV seroconversion by retrospective testing of all archived blood samples.Of the 287 incident HCV infections,277(96.5%)had anti-HCV antibodies detected by HIV-treating physicians,270(94.1%)had plasma HCV RNA determined and 251(87.5%)tested positive for HCV RNA.Of those with HCV viremia,226(78.7%)were referred to treatment assessment,215(74.9%)initiated anti-HCV treatment,and 202(70.4%)achieved viral clearance.Compared with that in the IFN era,the median interval from HCV seroconversion by retrospective testing to detection of HCV seropositivity by HIV-treating physicians was significantly shorter in the DAA era{179 d[interquartile range(IQR)87-434]vs 92 d(IQR 57-173);P<0.001}.The incidence rate of STIs in the DAA vs the IFN era was 50.5 per 100 person-years of follow-up(PYFU)and 38.5 per 100 PYFU,respectively,with an incidence rate ratio of 1.31(95%confidence interval 0.96-1.77),while the duration of HCV viremia was 380 d(IQR 274-554)and 735 d(IQR 391-1447)(P<0.001),respectively.CONCLUSION While anti-HCV therapies are effective in achieving viral clearance,our study suggests more efforts are needed to expedite the linkage of PLWH diagnosed with incident HCV infections to HCV treatment.展开更多
Considering the importance of investigating the transit timing variations(TTVs)of transiting exoplanets,we present a follow-up study of HAT-P-12 b.We include six new light curves observed between2011 and 2015 from thr...Considering the importance of investigating the transit timing variations(TTVs)of transiting exoplanets,we present a follow-up study of HAT-P-12 b.We include six new light curves observed between2011 and 2015 from three different observatories,in association with 25 light curves taken from the published literature.The sample of the data used thus covers a time span of~10.2 years with a large coverage of epochs(1160)for the transiting events of the exoplanet HAT-P-12 b.The light curves are utilized to determine the orbital parameters and conduct an investigation of possible TTVs.The new linear ephemeris shows a large value of reducedχ^(2),i.e.X_(red)^(2)(23)=7.93,and the sinusoidal fitting using the prominent frequency coming from a periodogram shows a reducedχ^(2) around 4.Based on these values and the corresponding O-C diagrams,we suspect the presence of a possible non-sinusoidal TTV in this planetary system.Finally,we find that a scenario with an additional non-transiting exoplanet could explain this TTV with an even smaller reducedχ^(2) value of around 2.展开更多
基金Supported by National Taiwan University Hospital,Taipei,Taiwan,No.NTUH106-003347(to Sun HY).
文摘BACKGROUND Little is known about the engagement in hepatitis C virus(HCV)care and completion of HCV treatment in people living with human immunodeficiency virus(HIV)(PLWH)who have HCV coinfection in the Asia-Pacific region.Examining the HCV care cascade can identify barriers to the completion of HCV treatment and facilitate achievement of HCV micro-elimination in PLWH.AIM To investigate the care cascade of incident HCV infections among PLWH in Taiwan.METHODS PLWH with incident HCV infections,defined as HCV seroconversion,were retrospectively identified by sequential anti-HCV testing of all archived blood samples at National Taiwan University Hospital between 2011 and 2018.All PLWH with incident HCV infections were followed until December 31,2019.The care cascade of HCV examined included all incident HCV-infected patients,the percentages of anti-HCV antibodies detected by HIV-treating physicians in clinical care,plasma HCV RNA load tested,HCV RNA positivity diagnosed,referral to treatment assessment made,anti-HCV treatment initiated,and sustained virologic response achieved.Those who had HCV seroconversion during the interferon(IFN)era(2011–2016)and the direct-acting antiviral(DAA)era(2017–2018)were analyzed separately.The duration of HCV viremia—from the date of seroconversion to viral clearance by treatments or until the end of observation—and the incidence of sexually transmitted infections(STIs)during the HCV viremic period were estimated.RESULTS During the study period,287 of 3495(8.2%)PLWH(92.3%being men who have sex with men)who were HCV-seronegative at baseline developed HCV seroconversion by retrospective testing of all archived blood samples.Of the 287 incident HCV infections,277(96.5%)had anti-HCV antibodies detected by HIV-treating physicians,270(94.1%)had plasma HCV RNA determined and 251(87.5%)tested positive for HCV RNA.Of those with HCV viremia,226(78.7%)were referred to treatment assessment,215(74.9%)initiated anti-HCV treatment,and 202(70.4%)achieved viral clearance.Compared with that in the IFN era,the median interval from HCV seroconversion by retrospective testing to detection of HCV seropositivity by HIV-treating physicians was significantly shorter in the DAA era{179 d[interquartile range(IQR)87-434]vs 92 d(IQR 57-173);P<0.001}.The incidence rate of STIs in the DAA vs the IFN era was 50.5 per 100 person-years of follow-up(PYFU)and 38.5 per 100 PYFU,respectively,with an incidence rate ratio of 1.31(95%confidence interval 0.96-1.77),while the duration of HCV viremia was 380 d(IQR 274-554)and 735 d(IQR 391-1447)(P<0.001),respectively.CONCLUSION While anti-HCV therapies are effective in achieving viral clearance,our study suggests more efforts are needed to expedite the linkage of PLWH diagnosed with incident HCV infections to HCV treatment.
基金supported by grants from the Ministry of Science and Technology(MOST),Taiwan,China.The grant numbers are MOST 105-2119-M-007-029-MY3,MOST 1062112-M-007-006-MY3the University Grants Commission(UGC)+6 种基金financial support through Major Research Project no.UGC-MRP 43-521/2014(SR)IUCCA,Pune,India for providing supports through the IUCCA Associateship Programmefinancially supported by the National Natural Science Foundation of China(Grant Nos.11590782 and 11421303)supported by the B-type Strategic Priority Program of the Chinese Academy of Sciences(Grant No.XDB41000000)the National Natural Science Foundation of China(Grant No.11773081)CAS Interdisciplinary Innovation TeamFoundation of Minor Planets of the Purple Mountain Observatory。
文摘Considering the importance of investigating the transit timing variations(TTVs)of transiting exoplanets,we present a follow-up study of HAT-P-12 b.We include six new light curves observed between2011 and 2015 from three different observatories,in association with 25 light curves taken from the published literature.The sample of the data used thus covers a time span of~10.2 years with a large coverage of epochs(1160)for the transiting events of the exoplanet HAT-P-12 b.The light curves are utilized to determine the orbital parameters and conduct an investigation of possible TTVs.The new linear ephemeris shows a large value of reducedχ^(2),i.e.X_(red)^(2)(23)=7.93,and the sinusoidal fitting using the prominent frequency coming from a periodogram shows a reducedχ^(2) around 4.Based on these values and the corresponding O-C diagrams,we suspect the presence of a possible non-sinusoidal TTV in this planetary system.Finally,we find that a scenario with an additional non-transiting exoplanet could explain this TTV with an even smaller reducedχ^(2) value of around 2.
