Browsing by Author "Tan S.-S."
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Publication Hepatitis C and kidney disease: An overview and approach to management(Baishideng Publishing Group Co, 2015) ;Azmi A.N. ;Tan S.-S. ;Mohamed R. ;Faculty of Medicine and Health Sciences ;Universiti Sains Islam Malaysia (USIM) ;Selayang HospitalUniversity of Malaya (UM)Hepatitis C infection and chronic kidney disease are major health burden worldwide. Hepatitis C infection is associated with a wide range of extra-hepatic manifestations in various organs including the kidneys. A strong association between hepatitis C and chronic kidney disease has come to light. Hemodialysis in supporting the end stage renal disease patients unfortunately carries a risk for hepatitis C infection. Despite much improvement in the care of this group of patients, the prevalence of hepatitis C infection in hemodialysis patients is still higher than the general population. Hepatitis C infection has a negative effect on the survival of hemodialysis and renal transplant patients. Treatment of hepatitis C in end stage renal disease patients using conventional or pegylated interferon with or without ribavirin remains a clinical challenge with low response rate, high dropout rate due to poor tolerability and many unmet needs. The approval of new direct acting antiviral agents for hepatitis C may dramatically change the treatment approach in hepatitis C infected patients with mild to moderate renal impairment. However it remains to be confirmed if the newer Hepatitis C therapies are safe in individuals with severe renal impairment. This review article discusses the relationship between hepatitis C and chronic kidney disease, describe the various types of renal diseases associated with hepatitis C and the newer as well as the existing treatments for hepatitis C in the context of this subpopulation of hepatitis C patients. � The Author(s) 2015. - Some of the metrics are blocked by yourconsent settings
Publication Practical approach in hepatitis B e antigen-negative individuals to identify treatment candidates(WJG Press, 2014) ;Azmi A.N. ;Tan S.-S. ;Mohamed R. ;Faculty of Medicine and Health Sciences ;Universiti Sains Islam Malaysia (USIM) ;Hospital SelayangUniversity of Malaya (UM)The natural history of chronic hepatitis B is characterized by different phases of infection, and patients may evolve from one phase to another or may revert to a previous phase. The hepatitis B e antigen (HBeAg)-negative form is the predominant infection worldwide, which consists of individuals with a range of viral replication and liver disease severity. Although alanine transaminase (ALT) remains the most accessible test available to clinicians for monitoring the liver disease status, further evaluations are required for some patients to assess if treatment is warranted. Guidance from practice guidelines together with thorough investigations and classifications of patients ensure recognition of who needs which level of care. This article aims to assist physicians in the assessment of HBeAg-negative individuals using liver biopsy or non-invasive tools such as hepatitis B s antigen quantification and transient elastography in addition to ALT and hepatitis B virus DNA, to identify who will remain stable, who will reactivate or at risk of disease progression hence will benefit from timely initiation of anti-viral therapy. � 2014 Baishideng Publishing Group Inc. All rights reserved.