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RISS 인기검색어
- 검색키워드
- 저자 : ( S. Munkhdemberel ) (검색결과 2 건)
- 무료
- 기관 내 무료
- 유료
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Treatment Outcomes on Chronic Hepatitis C Virus in Mongolia
( S. Munkhdemberel ),( S. Ariunaa ),( L. Undram ),( J. Oyunbileg ),( O. Baatarkhuu ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1
Aims: Chronic HCV infection is a major cause of cirrhosis, hepatocellular carcinoma HCC), and liver transplantation in Mongolia. HCV disease progression modeling was used to quantify the future disease burden. Methods: HCV infection and related sequelae were tracked between 1950 and 2030. Baseline assumptions were extracted from the literature, using Mongolian data where available. Scenarios were developed to reduce future burden of HCV infection by increasing treatment eligibility and sustained virological response (SVR) rates, and increasing the annual treated population. Results: In 2013, there were an estimated 200,000 viremic HCV infections, which is expected to decline by 17% (165,000) by 2030 due to mortality as the infected population ages and progressed to more advance stages of liver disease. In the same period, the prevalence of advanced liver disease is expected to increase by 30% while liver related deaths will increase by 25%. A scenario was modeled where SVR rates increase to 95% in 2016, with treatment restricted to individuals aged 40-59 years with fibrosis stage ≥F2. The overall impact on mortality and morbidity was less than 1% due to very low treatment rate (200 cases annually). A second scenario included increased SVR, along with increases in the annual treated population up to 25,000 treated in 2022. Over time, treatment was extended to individuals aged 15-74 years, and included all fibrosis stages. Chronic infections were reduced to 20,000 by 2025 (90% reduction). Liver-related mortality decreased by 85% (11,000 deaths averted) while cases of decompensated cirrhosis and HCC decreased 75-85% by 2025 and 85-90% by 2030. Conclusions: HCV prevalence in Mongolia will decrease by 2030, but cases of advanced liver disease will continue to rise. Increasing treatment with high SVR therapies can lead to significant reduction in total infections, mortality, and morbidity.
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Cause of Cirrhosis in Mongolia Evaluated by Non-Invasive Methods Including Fibroscan, FIB4 and APRI
( Oidov Baatarkhuu ),( Munkhchuluun Batzaya ),( D. Enkhutya ),( S. Munkhdemberel ),( S. Ariunaa ),( B. Davaakhuu ),( B. Erkhem ),( G. Egelmaral ),( J. Amarsanaa ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: Liver cirrhosis is the one of the most deadly diseases in Mongolia and in rest of the world. To determine the main cause of liver cirrhosis through using methods as AST-to-Platelet Ratio Index (APRI), Fibrosis 4 score (FIB4), and Fibroscan. Methods: We collected 2758 patients who had Fibroscan, then divided them in three groups, HBV positive, HCV positive, and virus negative. Depending on the result of the Fibro scan ,we made a cut-off point of 12kPa to separate patients with F4 stage from F0, F1, F2, and F3 patients. To compare the result of the Fibroscan with other techniques we collected other laboratory results including AST, ALT level, thrombocyte number, viral markers, and viral load. Results: Among 2758 subjects 57.7% (1591) of patients were anti-HCV positive, 35.7% (984) of patients were HBV positive and 6.6% (182) of patients were virus negative. Amongst 1590 patients who were anti-HCV positive, 62.4%(992) of patients diagnosed with F4 stage of fibrosis by Fibroscan. On the other hand, 34.7%(551) of patients with HBV positive has developed cirrhosis and 2.9% (47) of patients had cirrhosis without any evidence of virus. We randomly selected 100 patients from both HBV and HCV positive groups to determine the correlation between Fibroscan, FIB4 and APRI. The correlation between Fibroscan and other non-invasive method including APRI and FIB4 was not strong. In our further study, among 2.9% patients with cirrhosis caused by non-viral etiology, 70% were frequent alcohol consumers and only 15%t admitted that they were addicted to alcohol, and rest of the patients developed liver cirrhosis caused by other factors. Conclusions: The most common cause of liver cirrhosis is HCV, followed by HBV in Mongolia.
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