Featured Articles

Substantial gaps in evaluation and treatment of patients with hepatitis B in the US

Qing Ye, MD, Leslie Y. Kam, MD, Yee Hui Yeo, MD, Nolan Dang, MD, Daniel Q.Huang, MD, Ramsey Cheung, MD, Mindie H.

In this study, we used a national database that includes laboratory data in addition to medical and pharmacy claims data to assess the current real-world situation of chronic HBV infection care in the US. Among the 12,608 patients with chronic HBV, infection included in our study, 52.3% never had a complete laboratory and only 73% had adequate evaluation. Among those who were treatment eligible by AASLD or EASL guidelines, only 60.4% and 54.3% received treatment within 12 months, respectively


Surveillance of patients with cirrhosis remains suboptimal in the United States

Yee Hui Yeo, Jungyun Hwang, Donghak Jeong, Nolan Dang, Leslie Y. Kam, Linda Henry, Haesuk Park, Ramsey Cheung, Mindie H. Nguyen

Regular monitoring/surveillance for livercomplications is crucial to reduce morbidity and mortality in patients with cirrhosis. Recommendations from professional societies are available but adherence is not well studied, especially outside of academic centers. We aimed to determine the frequencies and factors associated with laboratory monitoring, and hepatocellular carcinoma (HCC) and esophageal varices (EV) surveillance in patients with cirrhosis.

Outcomes of Sequential Therapy With Tenofovir Alafenamide After Long-term Entecavir

Mindie H. Nguyen, MD, MAS, Masanori Atsukawa, MD, PhD, Toru Ishikawa, MD, PhD, Satoshi Yasuda, MD, PhD ,Keisuke Yokohama, MD, PhD, Huy N. Trinh, MD, Taeang Arai, MD, PhD, Shinya Fukunishi, MD, PhD, Eiichi Ogawa, MD, PhD,Yao-Chun Hsu, MD, PhD, Mayumi Maeda, MD, Hansen Dang, BS, Cheng-Hao Tseng, MD, Hirokazu Takahashi, MD, PhD, Dae Won Jun, MD, PhD, Tsunamasa Watanabe, MD, PhD, Makoto Chuma, MD, PhD, Akito Nozaki, MD, PhD,Norifumi Kawada, MD, PhD, Ramsey Cheung, MD, Masaru Enomoto, MD, PhD, Koichi Takaguchi, MD, PhDand Hidenori Toyoda, MD, PhD

Entecavir (ETV) and tenofovir alafenamide (TAF) are both first-line hepatitis B virus (HBV) therapies, but ETV-to-TAF switch outcome data are limited. We aimed to assess outcomes up to 96 weeks after ETV-to-TAF switch.

Surveillance of patients with cirrhosis remains suboptimal in the United States

Yee Hui Yeo, Jungyun Hwang, Donghak Jeong, Nolan Dang, Leslie Y. Kam, Linda Henry, Haesuk Park, Ramsey Cheung, Mindie H. Nguyen

Patients with cirrhosis should undergo health monitoring for liver complications to achieve early detection and treatment. In a large nationwide cohort of 82,427 patients with cirrhosis in the United States, we found a low rate of adherence (well less than half) to routine blood test monitoring and surveillance for liver cancer and esophageal varices (swollen blood vessels in the abdomen that could lead to fatal bleeding). Adherence has increased in the recent years, but much more improvement is needed

Initial Evaluation, Long-Term Monitoring, and Hepatocellular Carcinoma Surveillance of Chronic Hepatitis B in Routine Practice: A Nationwide US Study

Sally Tran, BS, Donghak Jeong, MS, Linda Henry, PhD, Ramsey C. Cheung, MD and Mindie H. Nguyen, MD, MAS

Previous studies, mostly small and single center, have shown gaps in the evaluation and monitoring of patients with chronic hepatitis B (CHB) virus infection. We aimed to examine the rates and predictors of adherence to guidelines for CHB care in a large nationwide cohort.

Treatment and Renal Outcomes Up to 96 Weeks After Tenofovir Alafenamide Switch From Tenofovir Disoproxil Fumarate in Routine Practice

Hidenori Toyoda, Jennifer Leong, Charles Landis , Masanori Atsukawa,Tsunamasa Watanabe, Daniel Q. Huang, Joanne Liu, Sabrina Xin Zi Quek, Toru Ishikawa, Taeang Arai, Keisuke Yokohama, Makoto Chuma, Koichi Takaguchi,Haruki Uojima, Tomonori Senoo, Hansen Dang, Mayumi Maeda, Joseph Hoang, Richard H. Le, Satoshi Yasuda,Khin N. Thin, Sally Tran, Nicholas Chien, Linda Henry, Akira Asai, Shinya Fukunishi, Ramsey Cheung,MD Seng Gee Lim, Huy N. Trinh, and Mindie H. Nguyen

Prevalence of Hepatitis B Vaccination Coverage and Serologic Evidence of Immunity Among US-Born Children and Adolescents From 1999 to 2016

Michael H. Le, MS; Yee Hui Yeo, MD, MSc; Samuel So, MD; Ed Gane, MBChB, MD; Ramsey C. Cheung, MD; Mindie H. Nguyen, MD, MAS

TheWorld Health Assembly has called for the elimination of hepatitis B and C by
2030. As hepatitis B has no cure, the US strategy to eliminate hepatitis B has focused on prevention through vaccination. However, there are limited data on the trend in vaccine-associated immunity since the US implementation of universal infant hepatitis B vaccination.

Hepatocellular carcinoma incidence with tenofovir versus entecavir in chronic hepatitis B: a systematic review and meta-analysis

Cheng-Hao Tseng*, Yao-Chun Hsu*, Tzu-Haw Chen, Fanpu Ji, I-Sung Chen, Ying-Nan Tsai, Hoang Hai, Le Thi Thanh Thuy, Tetsuya Hosaka,Hitomi Sezaki, John A Borghi, Ramsey Cheung, Masaru Enomoto, Mindie H Nguyen

It is unclear whether tenofovir disoproxil fumarate and entecavir differ in their association with risk of hepatocellular carcinoma in patients with chronic hepatitis B, and previous meta-analyses have shown conflicting conclusions with substantial

Global prevalence, incidence, and outcomes of non-obese orlean non-alcoholic fatty liver disease: a systematic review and meta-analysis

Qing Ye, Biyao Zou, Yee Hui Yeo, Jie Li, Daniel Q Huang, Yuankai Wu, Hongli Yang, Chuanli Liu, Leslie Y Kam, Xiang Xuan Eunice Tan,Nicholas Chien, Sam Trinh, Linda Henry, Christopher Donald Stave, Tetsuya Hosaka, Ramsey C Cheung, Mindie Nguyen

Although non-alcoholic fatty liver disease (NAFLD) is commonly associated with obesity, it is increasingly being identified in non-obese individuals. We aimed to characterise the prevalence, incidence, and long-term outcomes of non-obese or lean NAFLD at a global level.

Diagnosis Rates of Chronic Hepatitis B in Privately Insured Patients
in the United States

Eiichi Ogawa,MD, PhD; Yee Hui Yeo, MD, MSc; Nolan Dang, BS; Michael H. Le, MS; Donghak Jeong, MS; Sally Tran, BS; Linda Henry, PhD; Ramsey Cheung, MD; Mindie H. Nguyen, MD, MAS

To achieve the World Health Organization goal of viral hepatitis elimination by 2030,it is important to estimate current rates of chronic hepatitis B (CHB) diagnosis and treatment

Factors Associated With Rates of HBsAg Seroclearance in Adults With Chronic HBV Infection: A Systematic Review and Meta-analysis

Yee Hui Yeo, Hsiu J. Ho, Hwai-I Yang, Tai-Chung Tseng,Tetsuya Hosaka, Huy N. Trinh, Min-Sun Kwak, Young Min Park,8 James Yan Yue Fung, Maria Buti, Manuel Rodríguez, Sombat Treeprasertsuk, Carmen Monica Preda,Teerapat Ungtrakul, Phunchai Charatcharoenwitthaya,Xiangyong Li, Jiayi Li, Jian Zhang,Michael Huan Le, BinWei, Biyao Zou, An Le,  Donghak Jeong, NicholasChien, Leslie Kam, Chiao-Chin Lee, Mar Riveiro-Barciela, Doina Istratescu,Tassanee Sriprayoon, Yutian Chong,Tawesak Tanwandee,16Mariko Kobayashi,Fumitaka Suzuki, Man-Fung Yuen, Hyo-Suk Lee, Jia-Horng Kao,Anna S. Lok,Chun-Ying Wu, and Mindie H. Nguyen

Cure With Interferon-Free Direct-ActingAntiviral Is Associated With Increased Survival in Patients With Hepatitis CVirus-Related Hepatocellular Carcinoma
From Both East and West

Hansen Dang, Yee Hui Yeo,Satoshi Yasuda, Chung-Feng Huang ,Etsuko Iio, Charles Landis, Dae Won Jun ,Masaru Enomoto,Eiichi Ogawa , Pei-Chien Tsai,An Le, Matthew Liu, Mayumi Maeda, Brian Nguyen, Nathan Ramrakhiani, Linda Henry,  Ramsey Cheung, Akihiro Tamori, Takashi Kumada, Yasuhito Tanaka,Ming-Lung Yu , Hidenori Toyoda, and Mindie H. Nguyen

Survival data among patients with hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) after achieving sustained virologic response (SVR) with interferon-free direct-acting antivirals (DAAs) in both Asian and western countries are limited

Chronic Hepatitis B Prevalence Among Foreign-Born and U.S.-Born Adults in the United States, 1999-2016

Michael H. Le, Yee Hui Yeo, Ramsey Cheung, Linda Henry, Anna S. Lok, and Mindie H. Nguyen

Hepatitis B virus (HBV) infection remains a major global health problem, exacerbated by poor linkage to care. We aimed to determine the prevalence of HBV infection, exposure, self-reported vaccination, vaccine-induced immunity, disease awareness, and treatment in the United States by birthplace and race/ethnicity during 1999-2016.

Tenofovir Versus Entecavir for Hepatocellular Carcinoma Prevention in an International Consortium of Chronic Hepatitis B

Yao-Chun Hsu, MD, MSc, PhD, Grace Lai-Hung Wong, MD, Chien-Hung Chen, MD, PhD, Cheng-Yuan Peng, MD, PhD,Ming-Lun Yeh, MD, PhD, Ka-Shing Cheung, MD, PhD, Hidenori Toyoda, MD, PhD, Chung-Feng Huang, MD, PhD, Huy Trinh, MD,Qing Xie, MD, PhD, Masaru Enomoto, MD, PhD, Li Liu, MD, Satoshi Yasuda, MD, PhD, Yasuhito Tanaka, MD, PhD,Ritsuzo Kozuka, MD, PhD, Pei-Chien Tsai, PhD, Yen-Tsung Huang, PhD, Christopher Wong, MD, Rui Huang, MD, PhD,Tyng-Yuan Jang, MD, Joseph Hoang, BS, Hwai-I Yang, PhD, Jiayi Li, MD, Dong-Hyun Lee, MD, PhD,Hirokazu Takahashi, MD, PhD, Jian Q. Zhang, DNP, Eiichi Ogawa, MD, PhD, Changqing Zhao, MD, Chenghai Liu, MD, PhD, Norihiro Furusyo, MD, PhD, Yuichiro Eguchi, MD, PhD, Clifford Wong, MD, Chao Wu, MD, PhD, Takashi Kumada, MD, PhD,Man-Fung Yuen, MD, PhD, Ming-Lung Yu, MD, PhD and Mindie H. Nguyen, MD, MAS, AGAF, FAASLD

Prevalence of Undetectable Vaccine- Induced Immunity Against Hepatitis B Virus in US Adults at High Risk for Infection

Yee Hui Yeo, Michael H. Le, Ellen T. Chang, Linda Henry and Mindie H. Nguyen

In 2015, the Centers for Disease Control and Prevention reported a substantial increase in the number of acute hepatitis B virus (HBV) infections in the United States

Sustained virologic response to direct-acting antiviral therapy in patients with chronic hepatitis C and hepatocellular carcinoma: A systematic review and meta-analysis

Fanpu Ji, Yee Hui Yeo, Mike TzuhenWei, Hidenori Toyoda, Akihiro Tamori, Mindie H. Nguyen

There are now medications (direct-actingantivirals or ‘‘DAAs) that can ‘‘cure hepatitis C virus, but patients with hepatitis C and liver cancer may be less likely to achieve cure than those without liver cancer.

Prevalence, incidence, and outcome of non-alcoholic fatty liver disease in Asia, 1999–2019: a systematic review and meta-analysis

Jie Li, Biyao Zou, Yee Hui Yeo, Yuemin Feng, Xiaoyu Xie, Dong Hyun Lee, Hideki Fujii, Yuankai Wu, Leslie Y Kam, Fanpu Ji, Xiaohe Li, Nicholas Chien, Mike Wei, Eiichi Ogawa, Changqing Zhao, Xia Wu, Christopher D Stave, Linda Henry, Scott Barnett, Hirokazu Takahashi,Norihiro Furusyo, Yuichiro Eguchi, Yao-Chun Hsu, Teng-Yu Lee, Wanhua Ren, Chengyong Qin, Dae Won Jun,Hidenori Toyoda, Vincent Wai-Sun Wong, Ramsey Cheung, Qiang Zhu, Mindie H Nguyen

Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic liver disease worldwide. Asia is a large, heterogeneous area with substantial variation in socioeconomic status and prevalence of obesity. 

Healthcare resource utilization and costs by disease severity in an insured national sample of US patients with chronic hepatitis B

Mindie H. Nguyen, A. Burak Ozbay, Iris Liou, Stuart C. Gordon, Geoffrey Dusheiko,Joseph K. Lim

Hepatitis B virus can be a progressive disease leading to cirrhosis,hepatocellular carcinoma, liver transplant, and death.These progressive disease states are associated with a higher rate of hospitalizations, emergency room visits, outpatient visits, and costs compared to similar patients without hepatitis B

Advancing Age and Comorbidity in a US Insured Population-Based Cohort of Patients With Chronic Hepatitis B

Mindie H. Nguyen, Joseph K. Lim, A. Burak Ozbay, Jeremy Fraysse, Iris Liou, Nicole Meyer, Geoffrey Dusheiko, and Stuart C. Gordon

Hepatitis B virus (HBV) affects an estimated 257 million people worldwide.(1) In 2015, chronic hepatitis B (CHB) resulted in 884,000 deaths, mostly from complications of cirrhosis and hepatocellular carcinoma (HCC).

Clinical Features Associated with Survival Outcome in African-American Patients with Hepatocellular Carcinoma

Jacqueline Estevez, MD, Ju Dong Yang, MD, Jennifer Leong, MD, Pauline Nguyen,BA, Nasra H. Giama, DNP, RN,Ning Zhang, MD, Hamdi A. Ali, MD, Mei-Hsuan Lee, PhD, Ramsey Cheung, MD, Lewis Roberts, MBChB, PhD,Myron Schwartz, MD and Mindie H. Nguyen, MD, MAS

African-Americans (AA) have a higher incidence of hepatocellular carcinoma (HCC) and lower survival.We characterized survival rates and clinical features associated with survival in AA vs. Caucasians with HCC over the past two decades.

Global prevalence, treatment, and prevention of hepatitis B virus infection in 2016: a modelling study

The Polaris Observatory Collaborators*

The 69th World Health Assembly approved the Global Health Sector Strategy to eliminate viral hepatitis by 2030. Although no virological cure exists for hepatitis B virus(HBV) infection, existing therapies to control viral replication and prophylaxis to minimise mother-to-child transmission make elimination of HBV feasible. We aimed
to estimate the national, regional, and global prevalence of HBsAg in the general population and in the population aged 5 years in 2016, as well as coverage of prophylaxis, diagnosis, and treatment. Methods In this modelling study, we used a Delphi process that included a literature review

Open Label Study of 8 vs. 12 Weeks of Ledipasvir/ Sofosbuvir in Genotype 6 Treatment Naïve or Experienced Patients

Mindie H. Nguyen , MD, MAS, AGAF, FAASLD  , Huy Trinh , Son Do , Thuan Nguyen , Pauline Nguyen and Linda Henry

Hepatitis C genotype 6 (HCV-GT6) is one of the most prevalent genotypes in Southeast Asia. Ledipasvir and sofosbuvir fi xed-dose combination (LDV/SOF FDC) for 12 weeks has been shown to be effective for multiple HCV genotypes including treatment-naïve HCV-6. Our goal was to examine treatment outcomes in a diverse HCV-6 population.

HCV Genotype 6 Increased the Risk for Hepatocellular Carcinoma Among Asian Patients With Liver Cirrhosis

Mei-Hsuan Lee , PhD, Tiffany I. Hsiao , MS , Shreenidhi R. Subramaniam , An K. Le , BA , Vinh D. Vu , BA , Huy N. Trinh , MD , Jian Zhang , DNP , Mingjuan Jin , MD, PhD, Vincent Wai-Sun Wong , MD, Grace Lai-Hung Wong , MD and Mindie H. Nguyen , MD, MAS 

Hepatitis C virus (HCV) infection is a well-documented risk factor for hepatocellular carcinoma (HCC). Seven HCV genotypes have been classifi ed, and the genotypes show a great variety of geographic distribution. HCV genotype 6 is prevalent in Southeast Asia and has been less studied than the other genotypes.

Serum Alanine Aminotransferase and Hepatitis B
DNA Flares in Pregnant and Postpartum Women with Chronic Hepatitis B

Christine Y. Chang, BS, Natali Aziz,MD, MSc, Mugilan Poongkunran, MD , Asad Javaid ,MD, Huy N. Trinh , MD ,Daryl Lau , MD, MSc, MPH and Mindie H. Nguyen, MD, MAS

Alterations in the immune system during pregnancy have been associated with reactivation of hepatitis B virus (HBV) in chronic hepatitis B (CHB) women. However, the effects of pregnancy on CHB remain not well understood. The goal of this study was to examine fl ares in HBV DNA and serum alanine aminotransferase (ALT) during pregnancy and postpartum in CHB women untreated prior to pregnancy.

Discrepancies between actual weight, weight perception and weight loss intention amongst persons with NAFLD

V. H. Nguyen, Y. H. Yeo, B. Zou, M. H. Le , L. Henry, R. C. Cheung & M. H. Nguyen

Currently, weight loss remains the main management strategy for NAFLD, but the weight loss intention and methods remain poorly characterized.

Renal Dysfunction in Chronic Hepatitis B PatientsTreated with Adefovir Dipivoxil

Nghi B. Ha, Nghiem B. Ha, Ruel T. Garcia, Huy N. Trinh  Andrew A. Vu, Huy A. Nguyen, Khanh K. Nguyen, Brian S. Levitt, and Mindie H. Nguyen

Renal dysfunction has been reported in patients treated with adefovir dipivoxil (ADV);however, its incidence and clinical importance may be underappreciated given the lack oflong-term follow-up and data outside of a clinical trial setting.

Characteristics and healthcare costs in the aging hepatitis B population of Japan: A nationwide rea lworld analysis

Yotsuyanagi H, Kurosaki M, Yatsuhashi H, Lee IH, Ng A, Brooks-Rooney C, Nguyen MH. Dig Dis.

2021 Mar 15. doi: 10.1159/000515854. Online ahead of print. PMID: 33721872

 Treating Hepatitis C in Lower Income Countries

Jayasekera CR, Barry M, Roberts LR, Nguyen MH..

Just two decades after the identification of hepatitisC virus (HCV), an improved understanding of the viral lifecycle has led to several new classes of highly promising therapies

Low Proportion of Barrett’s Esophagus in Asian Americans

Khoa D. Lam, B.A.,Jeanine T. Phan, B.S.,Ruel T. Garcia, M.D.,Huy Trinh, M.D.,Huy Nguyen, M.D.,Khanh Nguyen, M.D.,George Triadafilopoulos, M.D., D.Sc.,Philip Vutien, B.A.,Long Nguyen, B.A,and Mindie H. Nguyen, M.D., M.A.S.

To determine the proportion of Barrett’s esophagus (BE) in Asians versus non-Asians and the predictors of BE in patients with upper gastrointestinal (GI) symptoms.


Randomized Controlled Trial of Pegylated Interferon-Alfa 2a and Ribavirin in Treatment-Naive Chronic Hepatitis C Genotype 6

Khoa D. Lam, Huy N. Trinh,Son T. Do, Thuan T. Nguyen, Ruel T. Garcia,Tuan Nguyen, Quang Q. Phan, Huy A. Nguyen, Khanh K. Nguyen, Long H. Nguyen, and Mindie H. Nguyen

Hepatocellular carcinoma (HCC) is a wellknown complication of chronic viral hepatitis,including hepatitis C virus (HCV) infection. It is the fourth most common cancer worldwide, and most cases are associated with chronic hepatitis B (HBV) or HCV infection

Racial Differences in Effectiveness of -Fetoprotein for Diagnosis of Hepatocellular Carcinoma in Hepatitis C Virus Cirrhosis

Mindie H. Nguyen, Ruel T. Garcia, Peter W. Simpson, Teresa L. Wright, and Emmet B. Keeffe

Hepatocellular carcinoma (HCC) is a wellknown complication of chronic viral hepatitis,including hepatitis C virus (HCV) infection. It is the fourth most common cancer worldwide, andmost cases are associated with chronic hepatitis B (HBV) or HCV infection

Ethnic Differences in Viral Dominance Patterns in Patients with Hepatitis B Virus and Hepatitis C Virus Dual Infection

Long H. Nguyen, Steve Ko, Shane S. Wong, Pelu S. Tran, Huy N. Trinh,Ruel T. Garcia,Aijaz Ahmed,Glen A. Lutchman, Emmet B. Keeffe, and Mindie H. Nguyen

Studies of hepatitis B virus (HBV)/hepatitis C virus (HCV) dual infection are limited. Most are small, conducted outside the United States, and compare dual infection with HCV monoinfection.

Higher Rate of Sustained Virologic Response in Chronic Hepatitis C Genotype 6 Treated With 48 Weeks Versus 24 Weeks of Peginterferon Plus Ribavirin

Mindie H. Nguyen, M.D., M.A.S., Huy N. Trinh, M.D.,Ruel Garcia, M.D.,Gloria Nguyen, B.A.,Khoa D. Lam, B.A.,and Emmet B. Keeffe, M.D.

Infection with hepatitis C virus (HCV) genotype 6 is common in patients from parts of China and Southeast Asia. No study to date has examined the treatment response to peginterferon and ribavirin (PEG IFN + RBV) in these patients, or the effects of treatment duration on sustained virologic response (SVR) rates

Akiko Mizuta
Research Coordinator
c: 408-431-7567

Jeff Mathews
Administrative Associate