A5005921025- Liver Disease Diagnosis and Treatment
- Hepatitis C virus research
- Liver Disease and Transplantation
- Hepatitis B Virus Studies
- Hepatocellular Carcinoma Treatment and Prognosis
- Alcohol Consumption and Health Effects
- Colorectal Cancer Treatments and Studies
- Nutrition and Health in Aging
- Global Cancer Incidence and Screening
- Primary Care and Health Outcomes
- Economic and Financial Impacts of Cancer
- Organ Transplantation Techniques and Outcomes
- Colorectal Cancer Screening and Detection
- Autoimmune and Inflammatory Disorders Research
- Public Health Policies and Education
- Systemic Lupus Erythematosus Research
- Skin Diseases and Diabetes
- HIV/AIDS drug development and treatment
- Adolescent and Pediatric Healthcare
- Diet, Metabolism, and Disease
- Neuroendocrine Tumor Research Advances
- Multiple and Secondary Primary Cancers
- Family and Disability Support Research
- Helicobacter pylori-related gastroenterology studies
- Diabetes Treatment and Management
University of California, San Francisco
2013-2025
San Francisco General Hospital
2024
San Francisco VA Medical Center
2015-2020
VA Palo Alto Health Care System
2015
Gartnavel General Hospital
2010
IMPORTANCENovel treatments for hepatitis C virus (HCV) infection are highly efficacious but costly.Thus, many insurers cover therapy only in advanced fibrosis stages.The added health benefits and costs of early treatment unknown.OBJECTIVE To assess the cost-effectiveness (1) treating all patients with HCV vs those ( 2) each stage fibrosis.DESIGN, SETTING, AND PARTICIPANTS This study used a decision-analytic model genotype 1.The lifetime horizon societal perspective was representative US 1...
Concerns related to hepatotoxicity frequently lead discontinuation or non-initiation of 3-hydroxy-3-methylglutaryl-coenzyme A reductase therapy in patients with cirrhosis despite data supporting statin use. We investigated the independent effects hyperlipidemia and exposure on mortality, hepatic decompensation, hepatocellular carcinoma development a large national cohort cirrhosis.We performed retrospective study newly diagnosed from January 1, 2008 through June 30, 2016 Veterans Health...
Hepatocellular carcinoma (HCC) is a leading cause of morbidity and mortality in cirrhosis patients. This provides an opportunity to target the highest-risk population, yet surveillance rates United States Europe range from 10% 40%. The goal this study was identify barriers HCC surveillance, using data Veterans Health Administration, largest provider liver-related health care States. We included all patients 75 years age or younger who were diagnosed with January 1, 2008, until December 31,...
Background.Incarcerated populations are at high risk for hepatitis C virus (HCV) infection, yet prisoners not routinely screened or treated HCV infection. Understanding the factors of infection among could help improve interventions. Methods.Prevalence and 469 entering California State correctional facilities were assessed using antibody screening, RNA measurement, structured interviews. Multivariate logistic regression analysis was used to identify independent correlates Results.The...
Primary care providers (PCPs) face increasing numbers of patients at risk for NAFLD and are responsible the detection decision on referral to specialists. We conducted a PCP needs assessment ascertain barriers desired supports in primary care.We designed cross-sectional study PCPs large diverse health system surveyed faculty, residents, nurse practitioners. Questions assessed knowledge, approach diagnosis fibrosis testing including use FIB-4, attitudes toward support tools.The survey was...
The Child–Turcotte–Pugh (CTP) score is a widely used and validated predictor of long-term survival in cirrhosis. However, the cutpoints for stratifying laboratory variables CTP have never been validated. objective this study was to identify evidence-based subscores improve its predictive capacity transplant-free survival. Retrospective observational study. Using cohort 30,897 cirrhotic US Veteran patients with at least 5 years follow-up, we performed Cox proportional hazard model iterations...
Aims The advent of direct-acting antivirals for hepatitis C virus (HCV) and limited effectiveness prevention have generated interest in "Treatment as Prevention" (TasP), which those most likely to transmit HCV (i.e. people who inject drugs [PWID]) are treated reduced secondary transmission. However, there scant data regarding the feasibility treating PWID at high risk transmission or optimal approach treatment delivery. Methods We conducted a 2:1 randomized trial modified directly-observed...
Background and Aims: Primary care providers need strategies to identify NAFLD patients select for specialty referral, but proposed algorithms have only been studied in established patients. Methods: We implemented an algorithm all adults with diabetes mellitus a large primary practice excluded hepatitis B C or alcohol use. Applying annual Fibrosis-4 Index Fibrosis Score 5 years, we categorized as low-risk, indeterminate-risk, high-risk advanced fibrosis. targeted messaged each provider,...