1
|
Cacoub P, Buggisch P, Carrión JA, Cooke GS, Zignego AL, Beckerman R, Younossi Z. Direct medical costs associated with the extrahepatic manifestations of hepatitis C infection in Europe. J Viral Hepat 2018; 25:811-817. [PMID: 29476572 DOI: 10.1111/jvh.12881] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 01/16/2018] [Indexed: 12/13/2022]
Abstract
Hepatitis C virus (HCV) infection is a systemic disease associated with both hepatic and extrahepatic manifestations. The burden associated with the hepatic manifestation of HCV infection has been well documented in Europe, although that of HCV extrahepatic manifestations remains unknown. In this study, we estimated the annual direct medical costs associated with HCV extrahepatic manifestations in five European countries. A previously validated economic model was used to estimate the annual direct medical cost associated with HCV extrahepatic manifestations. Global excess prevalence of extrahepatic manifestations in HCV patients relative to that in non-HCV patients was obtained from a recent meta-analysis. Per-patient per-year inpatient, outpatient and medication costs to treat each extrahepatic manifestation were from the literature, national databases or expert opinion if unavailable otherwise. All costs were adjusted to 2016 euros (€). The overall direct medical costs associated with HCV extrahepatic manifestations were calculated by multiplying the total per-patient per-year costs of each by the respective excess prevalence rates and then by the size of the HCV-infected population in each country. Treatment impact with direct-acting antivirals (DAAs) was explored using HCV extrahepatic manifestations excess prevalence rates among cured patients compared to untreated HCV patients, as sourced from a meta-analysis. The total annual direct medical cost associated with HCV extrahepatic manifestations was estimated to be 2.17 billion euro (€), with a per-HCV-patient cost ranging from €899 to €1647 annually. DAA treatment was projected to result in cost savings of €316 million per year. We find that the annual economic burden of extrahepatic manifestations is significant and may be partly mitigated by treatment with DAAs.
Collapse
Affiliation(s)
- P Cacoub
- AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Department of Internal Medicine and Clinical Immunology, F-75013, Paris, France.,Sorbonne Université, UPMC Univ Paris 06, INSERM, Immunology-Immunopathology- Immunotherapy (I3), F-75005, Paris, France
| | - P Buggisch
- IFI Institut für Interdisziplinäre Medizin, Asklepios Klinik St. Georg, Hamburg, Germany
| | - J A Carrión
- Liver Section, Gastroenterology Department, Hospital del Mar, Universitat Autònoma de Barcelona, IMIM (Institut Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - G S Cooke
- Division of Infectious diseases, Imperial College London, London, UK
| | - A L Zignego
- Interdepartmental Hepatology Center MaSVE, University of Florence, Florence, Italy
| | | | - Z Younossi
- Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, USA
| |
Collapse
|
2
|
Londoño MC, Carrión JA, Forns X. Letter: hepatitis B reactivation in patients with chronic hepatitis C during direct-acting antiviral therapy-authors' reply. Aliment Pharmacol Ther 2017; 45:1559-1560. [PMID: 28503869 DOI: 10.1111/apt.14104] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- M-C Londoño
- Liver Unit, IDIBAPS, CIBEREHD, Hospital Clínic Barcelona, Barcelona, Spain
| | - J A Carrión
- Liver Unit, Gastroenterology Department, Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - X Forns
- Liver Unit, IDIBAPS, CIBEREHD, Hospital Clínic Barcelona, Barcelona, Spain
| |
Collapse
|
3
|
Alonso S, Riveiro-Barciela M, Fernandez I, Rincón D, Real Y, Llerena S, Gea F, Olveira A, Fernandez-Carrillo C, Polo B, Carrión JA, Gómez A, Devesa MJ, Baliellas C, Castro Á, Ampuero J, Granados R, Pascasio JM, Rubín A, Salmeron J, Badia E, Planas JMM, Lens S, Turnes J, Montero JL, Buti M, Esteban R, Fernández-Rodríguez CM. Effectiveness and safety of sofosbuvir-based regimens plus an NS5A inhibitor for patients with HCV genotype 3 infection and cirrhosis. Results of a multicenter real-life cohort. J Viral Hepat 2017; 24:304-311. [PMID: 27935168 DOI: 10.1111/jvh.12648] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Accepted: 11/01/2016] [Indexed: 12/12/2022]
Abstract
Patients with HCV genotype 3 (GT3) infection and cirrhosis are currently the most difficult to cure. We report our experience with sofosbuvir+daclatasvir (SOF+DCV) or sofosbuvir/ledipasvir (SOF/LDV), with or without ribavirin (RBV) in clinical practice in this population. This was a multicenter observational study including cirrhotic patients infected by HCV GT3, treated with sofosbuvir plus an NS5A inhibitor (May 2014-October 2015). In total, 208 patients were included: 98 (47%) treatment-experienced, 42 (20%) decompensated and 55 (27%) MELD score >10. In 131 (63%), treatment was SOF+DCV and in 77 (37%), SOF/LDV. Overall, 86% received RBV. RBV addition and extension to 24 weeks was higher in the SOF/LDV group (95% vs 80%, P=.002 and 83% vs 72%, P=.044, respectively). A higher percentage of decompensated patients were treated with DCV than LDV (25% vs 12%, P=.013). Overall, SVR12 was 93.8% (195/208): 94% with SOF+DCV and 93.5% with SOF/LDV. SVR12 was achieved in 90.5% of decompensated patients. Eleven treatment failures: 10 relapses and one breakthrough. RBV addition did not improve SVR (RR: 1.08; P=.919). The single factor associated with failure to achieve SVR was platelet count <75×10E9/mL (RR: 3.50, P=.019). In patients with MELD <10, type of NS5A inhibitor did not impact on SVR12 (94% vs 97%; adjusted RR: 0.49). Thirteen patients (6.3%) had serious adverse events, including three deaths (1.4%) and one therapy discontinuation (0.5%), higher in decompensated patients (16.7% vs 3.6%, P<.006). In patients with GT3 infection and cirrhosis, SVR12 rates were high with both SOF+DCV and SOF/LDV, with few serious adverse events.
Collapse
Affiliation(s)
- S Alonso
- Gastroenterology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
| | - M Riveiro-Barciela
- Liver Unit, Internal Medicine Department, Vall d'Hebron Hospital, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - I Fernandez
- Digestive Diseases Service, Hospital 12 Octubre, Madrid
| | - D Rincón
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain.,Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Y Real
- Hospital Universitario La Princesa, Madrid, Spain
| | - S Llerena
- Gastroenterology and Hepatology Unit, Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain
| | - F Gea
- Gastroenterology and Hepatology Department, Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
| | - A Olveira
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain.,Hospital Universitario La Paz, Madrid, Spain
| | - C Fernandez-Carrillo
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain.,Liver Unit, Hospital Universitario Puerta de Hierro-Majadahonda, IDIPHIM, CIBERehd, Majadahonda, Madrid, Spain
| | - B Polo
- Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - J A Carrión
- Liver Section, Gastroenterology Department, Hospital del Mar, Universitat Autònoma de Barcelona, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - A Gómez
- Hospital Universitario Donostia, Donostia, Spain
| | - M J Devesa
- Hospital Universitario Clínico San Carlos, Madrid, Spain
| | - C Baliellas
- Hospital Universitari de Bellvitge, IDIBELL, Barcelona, Spain
| | - Á Castro
- Hospital Universitario de A Coruña, A Coruña, Spain
| | - J Ampuero
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain.,Hospital Virgen de Valme, and Institute of Biomedicine of Seville, Spain
| | - R Granados
- H. U. de Gran Canaria Dr. Negrín, Gran Canaria, Spain
| | - J M Pascasio
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain.,H. U. Virgen del Rocío, Seville, Spain
| | - A Rubín
- Hepatology Unit, Digestive Medicine Service, Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | | | - E Badia
- Hospital Universitario de Burgos, Burgos, Spain
| | | | - S Lens
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain.,Liver Unit, Hospital Clínic, Instituto de Investigaciones Biomédicas August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - J Turnes
- Department of Gastroenterology, Complejo Hospitalario Universitario de Pontevedra and IISGS, Pontevedra, Spain
| | | | - M Buti
- Liver Unit, Internal Medicine Department, Vall d'Hebron Hospital, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | - R Esteban
- Liver Unit, Internal Medicine Department, Vall d'Hebron Hospital, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
| | | |
Collapse
|
4
|
Londoño MC, Lens S, Mariño Z, Bonacci M, Ariza X, Broquetas T, Pla A, Bartres C, Adriani MV, Rodríguez-Tajes S, Costa J, Carrión JA, Pérez-Del-Pulgar S, Forns X. Hepatitis B reactivation in patients with chronic hepatitis C undergoing anti-viral therapy with an interferon-free regimen. Aliment Pharmacol Ther 2017; 45:1156-1161. [PMID: 28206681 DOI: 10.1111/apt.13985] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 08/31/2016] [Accepted: 01/23/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND A few cases of hepatitis B virus (HBV) reactivation during anti-viral therapy against hepatitis C (HCV) have been reported. However, the information regarding the real impact of this phenomenon is scarce. AIM To evaluate the risk of HBV reactivation during anti-viral therapy against HCV with an interferon-free regimen with direct-acting anti-virals (DAAs). METHODS Observational and prospective study of 352 patients receiving DAAs therapy between September 2015 and May 2016. HBV-DNA and ALT levels were monitored at baseline, at week 4 of anti-viral therapy, at end of treatment and 12 weeks after treatment discontinuation in patients with HBV surface antigen (HBsAg) positive or HBV core antibody (anti-HBc) positive before starting anti-viral therapy. RESULTS Ten (2.8%) and 64 (18%) patients were HBsAg and anti-HBc positive at baseline, respectively. Five (50%) of 10 HBsAg positive and one (1.6%) of 64 anti-HBc positive patients presented HBV virological reactivation (>1log increase in HBV-DNA levels). None of these patients presented clinical reactivation (increase in ALT levels). CONCLUSIONS HBV virological reactivation is frequent in HBsAg+ patients receiving anti-viral therapy against HCV. However, HBV-DNA elevations were modest (<20 000 IU/mL) and without clinical impact (no ALT elevation).
Collapse
Affiliation(s)
- M-C Londoño
- Liver Unit, IDIBAPS and CIBEREHD, Hospital Clínic Barcelona, Barcelona, Spain
| | - S Lens
- Liver Unit, IDIBAPS and CIBEREHD, Hospital Clínic Barcelona, Barcelona, Spain
| | - Z Mariño
- Liver Unit, IDIBAPS and CIBEREHD, Hospital Clínic Barcelona, Barcelona, Spain
| | - M Bonacci
- Liver Unit, IDIBAPS and CIBEREHD, Hospital Clínic Barcelona, Barcelona, Spain
| | - X Ariza
- Liver Unit, IDIBAPS and CIBEREHD, Hospital Clínic Barcelona, Barcelona, Spain
| | - T Broquetas
- Liver Unit, Gastroenterology Department, Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - A Pla
- Liver Unit, IDIBAPS and CIBEREHD, Hospital Clínic Barcelona, Barcelona, Spain
| | - C Bartres
- Liver Unit, IDIBAPS and CIBEREHD, Hospital Clínic Barcelona, Barcelona, Spain
| | - M V Adriani
- Liver Unit, IDIBAPS and CIBEREHD, Hospital Clínic Barcelona, Barcelona, Spain
| | - S Rodríguez-Tajes
- Liver Unit, IDIBAPS and CIBEREHD, Hospital Clínic Barcelona, Barcelona, Spain
| | - J Costa
- Microbiology Department, Hospital Clínic Barcelona, Barcelona, Spain
| | - J A Carrión
- Liver Unit, Gastroenterology Department, Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - S Pérez-Del-Pulgar
- Liver Unit, IDIBAPS and CIBEREHD, Hospital Clínic Barcelona, Barcelona, Spain
| | - X Forns
- Liver Unit, IDIBAPS and CIBEREHD, Hospital Clínic Barcelona, Barcelona, Spain
| |
Collapse
|
5
|
Perelló C, Carrión JA, Ruiz-Antorán B, Crespo J, Turnes J, Llaneras J, Lens S, Delgado M, García-Samaniego J, García-Paredes F, Fernández I, Morillas RM, Rincón D, Porres JC, Prieto M, Lázaro Ríos M, Fernández-Rodríguez C, Hermo JA, Rodríguez M, Herrero JI, Ruiz P, Fernández JR, Macías M, Pascasio JM, Moreno JM, Serra MÁ, Arenas J, Real Y, Jorquera F, Calleja JL. Effectiveness and safety of ombitasvir, paritaprevir, ritonavir ± dasabuvir ± ribavirin: An early access programme for Spanish patients with genotype 1/4 chronic hepatitis C virus infection. J Viral Hepat 2017; 24:226-237. [PMID: 27976491 DOI: 10.1111/jvh.12637] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Accepted: 10/11/2016] [Indexed: 12/16/2022]
Abstract
Over the last 5 years, therapies for hepatitis C virus (HCV) infection have improved significantly, achieving sustained virologic response (SVR) rates of up to 100% in clinical trials in patients with HCV genotype 1. We investigated the effectiveness and safety of ombitasvir/paritaprevir/ritonavir±dasabuvir in an early access programme. This was a retrospective, multicentre, national study that included 291 treatment-naïve and treatment-experienced patients with genotype 1 or 4 HCV infection. Most patients (65.3%) were male, and the mean age was 57.5 years. The mean baseline viral load was 6.1 log, 69.8% had HCV 1b genotype, 72.9% had cirrhosis and 34.7% were treatment-naïve. SVR at 12 weeks posttreatment was 96.2%. Four patients had virological failure (1.4%), one leading to discontinuation. There were no statistical differences in virological response according to genotype or liver fibrosis. Thirty patients experienced serious adverse events (SAEs) (10.3%), leading to discontinuation in six cases. Hepatic decompensation was observed in five patients. Four patients died during treatment or follow-up, three of them directly related to liver failure. Multivariate analyses showed a decreased probability of achieving SVR associated with baseline albumin, bilirubin and Child-Pugh score B, and a greater probability of developing SAEs related to age and albumin. This combined therapy was highly effective in clinical practice with an acceptable safety profile and low rates of treatment discontinuation.
Collapse
Affiliation(s)
- C Perelló
- Hospital Universitario Puerta de Hierro Majadahonda, IDIPHIM, Madrid, Spain.,CIBERehd, Madrid, Spain
| | - J A Carrión
- Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Universitat Autonoma de Barcelona, Barcelona, Spain
| | - B Ruiz-Antorán
- Hospital Universitario Puerta de Hierro Majadahonda, IDIPHIM, Madrid, Spain
| | - J Crespo
- Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander, Spain.,Facultad de Medicina, Universidad de Cantabria, Santander, Spain
| | - J Turnes
- Complejo Hospitalario Universitario de Pontevedra and IISGS, Pontevedra, Spain
| | - J Llaneras
- Hospital Universitario Vall D'Hebrón, Barcelona, Spain
| | - S Lens
- CIBERehd, Madrid, Spain.,Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - M Delgado
- Hospital Universitario A Coruña, A Coruña, Spain
| | | | | | - I Fernández
- Hospital Universitario Doce de Octubre, Madrid, Spain
| | - R M Morillas
- CIBERehd, Madrid, Spain.,Hospital Universitario Germans Trias i Pujol, Badalona, Spain
| | - D Rincón
- CIBERehd, Madrid, Spain.,Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - J C Porres
- Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain
| | - M Prieto
- CIBERehd, Madrid, Spain.,Hospital Universitari i Politècnic La Fe, Valencia, Spain
| | - M Lázaro Ríos
- Hospital Universitario Miguel Servet, Zaragoza, Spain
| | | | - J A Hermo
- Hospital Álvaro Cunqueiro, Vigo, Spain
| | - M Rodríguez
- Hospital Universitario Central de Asturias, Oviedo, Spain
| | - J I Herrero
- CIBERehd, Madrid, Spain.,Clínica Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - P Ruiz
- Hospital Universitario Basurto, Bilbao, Spain
| | | | - M Macías
- Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - J M Pascasio
- CIBERehd, Madrid, Spain.,Hospital Universitario Virgen del Rocío, Sevilla, Spain
| | - J M Moreno
- Complejo Hospitalario Albacete, Albacete, Spain
| | - M Á Serra
- Hospital Universitario Clínico Valencia, INCLIVA, Valencia, Spain.,University of Valencia, Valencia, Spain
| | - J Arenas
- Hospital Universitario Donostia, Donostia, Spain
| | - Y Real
- Hospital Universitario La Princesa, Madrid, Spain
| | - F Jorquera
- CIBERehd, Madrid, Spain.,Complejo Asistencial de León, IBIOMED, León, Spain
| | - J L Calleja
- Hospital Universitario Puerta de Hierro Majadahonda, IDIPHIM, Madrid, Spain.,CIBERehd, Madrid, Spain.,Universidad Autónoma de Madrid, Madrid, Spain
| | | |
Collapse
|
6
|
Poca M, Alvarado-Tapias E, Concepción M, Pérez-Cameo C, Cañete N, Gich I, Romero C, Casas M, Román E, Castells L, Vargas V, Carrión JA, Guarner C, Soriano G. Predictive model of mortality in patients with spontaneous bacterial peritonitis. Aliment Pharmacol Ther 2016; 44:629-37. [PMID: 27464682 DOI: 10.1111/apt.13745] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 04/27/2016] [Accepted: 07/07/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND Hospital mortality in patients with spontaneous bacterial peritonitis (SBP) is high despite albumin treatment, particularly in those with worse liver and/or renal function. AIM To determine the independent predictive factors of in-hospital mortality and to create and validate a predictive model of mortality in patients with SBP. METHODS We analysed all cirrhotic patients with high-risk SBP (serum urea ≥11 mmol/L and/or serum bilirubin ≥68 μmol/L) between 2001 and 2011. We developed a predictive model of in-hospital mortality and validated this in a different cohort. RESULTS We included 118 high-risk SBP episodes treated with antibiotics and albumin. In-hospital mortality was 33/118 (28%). The independent predictive factors of in-hospital mortality at SBP diagnosis were serum urea, blood leucocyte count, Child-Pugh score and mean arterial pressure. A predictive model including these four variables showed a discrimination accuracy (AUC) of 0.850, 95% CI 0.777-0.922. A cut-off point of 0.245 showed a sensitivity of 0.85 and specificity of 0.75. The in-hospital mortality was 28/49 (57.1%) in patients with a model value ≥0.245, and 5/69 (7.2%) in patients with a model value <0.245 (P < 0.001). The validation series included 161 patients with an in-hospital mortality of 40/161 (24.8%), 30/77 (39.0%) in patients with a model value ≥0.245, and 10/84 (11.9%) in those with a model value <0.245 (P < 0.001). CONCLUSIONS We developed and validated a predictive model of mortality that includes serum urea, blood leucocyte count, Child-Pugh score and mean arterial pressure in high-risk patients with spontaneous bacterial peritonitis. These findings may help to identify patients who would benefit from additional therapeutic strategies.
Collapse
Affiliation(s)
- M Poca
- Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,CIBERehd, Instituto de Salud Carlos III, Barcelona, Spain
| | - E Alvarado-Tapias
- Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Concepción
- Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - C Pérez-Cameo
- Department of Internal Medicine-Liver Unit, Hospital Vall d'Hebron, Barcelona, Spain
| | - N Cañete
- Liver Section, Gastroenterology Department, Hospital del Mar, Universitat Autònoma de Barcelona, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - I Gich
- Department of Clinical Epidemiology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,CIBERsam, Barcelona, Spain
| | - C Romero
- Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Casas
- Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - E Román
- Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,CIBERehd, Instituto de Salud Carlos III, Barcelona, Spain.,Escola Universitària d'Infermeria EUI-Sant Pau, Barcelona, Spain
| | - L Castells
- Department of Internal Medicine-Liver Unit, Hospital Vall d'Hebron, Barcelona, Spain.,CIBERehd, Instituto de Salud Carlos III, Barcelona, Spain
| | - V Vargas
- Department of Internal Medicine-Liver Unit, Hospital Vall d'Hebron, Barcelona, Spain.,CIBERehd, Instituto de Salud Carlos III, Barcelona, Spain
| | - J A Carrión
- Liver Section, Gastroenterology Department, Hospital del Mar, Universitat Autònoma de Barcelona, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - C Guarner
- Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,CIBERehd, Instituto de Salud Carlos III, Barcelona, Spain
| | - G Soriano
- Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,CIBERehd, Instituto de Salud Carlos III, Barcelona, Spain
| |
Collapse
|
7
|
García-Paricio R, González-Colominas E, Echeverría-Esnal D, Conde-Estevez D, De Antonio-Cuscó M, Ferrandez O, Carrión JA, Salas E, Luque S. CP-216 Factors influencing the selection of direct acting antivirals in the treatment of genotype 1 hepatitis C virus infection: Abstract CP-216 Table 1. Eur J Hosp Pharm 2016. [DOI: 10.1136/ejhpharm-2016-000875.216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
8
|
Lens S, Torres F, Puigvehi M, Mariño Z, Londoño MC, Martinez SM, García-Juárez I, García-Criado Á, Gilabert R, Bru C, Solà R, Sanchez-Tapias JM, Carrión JA, Forns X. Predicting the development of liver cirrhosis by simple modelling in patients with chronic hepatitis C. Aliment Pharmacol Ther 2016; 43:364-74. [PMID: 26582599 DOI: 10.1111/apt.13472] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 05/09/2015] [Accepted: 10/21/2015] [Indexed: 12/22/2022]
Abstract
BACKGROUND Data are scarce on the natural history of chronic hepatitis C (CHC) in patients with mild hepatitis C who did not respond to anti-viral therapy. AIM To predict the risk of progression to cirrhosis, identifying patients with the more urgent need for therapy with effective anti-virals. METHODS A cohort of 1289 noncirrhotic CHC patients treated with interferon-based therapy between 1990 and 2004 in two referral hospitals were followed up for a median of 12 years. RESULTS Overall, SVR was achieved in 46.6% of patients. Data from a randomly split sample (n = 832) was used to estimate a model to predict outcomes. Among nonresponders (n = 444), cirrhosis developed in 123 (28%) patients. In this group, the 3, 5 and 10-year cumulative probabilities of cirrhosis were 4%, 7% and 22%, respectively, compared to <1% in the SVR-group (P < 0.05). Baseline factors independently associated with progression to cirrhosis in nonresponders were: fibrosis ≥F2, age >40 years, AST >100 IU/L, GGT >40 IU/L. Three logistic regression models that combined these simple variables were highly accurate in predicting the individual risk of developing cirrhosis with areas under the receiving operating characteristic curves (AUC) at 5, 7 and 10 years of ~0.80. The reproducibility of the models in the validation cohort (n = 457, nonresponders = 244), was consistently high. CONCLUSIONS Modelling based on simple laboratory and clinical data can accurately identify the individual risk of progression to cirrhosis in nonresponder patients with chronic hepatitis C, becoming a very helpful tool to prioritise the start of oral anti-viral therapy in clinical practice.
Collapse
Affiliation(s)
- S Lens
- Liver Unit, Hospital Clinic, IDIBAPS, CIBEREHD, Barcelona, Spain
| | - F Torres
- Biostatistics and Data Management Platform, IDIBAPS, Hospital Clinic, Barcelona, Spain.,Biostatistics Unit, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - M Puigvehi
- Liver Section, Gastroenterology Department, Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Z Mariño
- Liver Unit, Hospital Clinic, IDIBAPS, CIBEREHD, Barcelona, Spain
| | - M-C Londoño
- Liver Unit, Hospital Clinic, IDIBAPS, CIBEREHD, Barcelona, Spain
| | - S M Martinez
- Liver Unit, Hospital Clinic, IDIBAPS, CIBEREHD, Barcelona, Spain
| | - I García-Juárez
- Liver Unit, Hospital Clinic, IDIBAPS, CIBEREHD, Barcelona, Spain
| | | | - R Gilabert
- CDIC, IDIBAPS, Hospital Clinic, Barcelona, Spain
| | - C Bru
- CDIC, IDIBAPS, Hospital Clinic, Barcelona, Spain
| | - R Solà
- Liver Section, Gastroenterology Department, Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), Universitat Autonoma de Barcelona, Barcelona, Spain
| | | | - J A Carrión
- Liver Section, Gastroenterology Department, Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), Universitat Autonoma de Barcelona, Barcelona, Spain
| | - X Forns
- Liver Unit, Hospital Clinic, IDIBAPS, CIBEREHD, Barcelona, Spain
| |
Collapse
|
9
|
Benaiges D, Garcia-Retortillo M, Mas A, Cañete N, Broquetas T, Puigvehi M, Chillarón JJ, Flores-Le Roux JA, Sagarra E, Cabrero B, Zaffalon D, Solà R, Pedro-Botet J, Carrión JA. Clinical Value of Thyrotropin Receptor Antibodies for the Differential Diagnosis of Interferon Induced Thyroiditis. Exp Clin Endocrinol Diabetes 2015; 124:39-44. [PMID: 26575116 DOI: 10.1055/s-0035-1565071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The clinical value of thyrotropin receptor antibodies for the differential diagnosis of thyrotoxicosis induced by pegylated interferon-alpha remains unknown. We analyzed the diagnostic accuracy of thyrotropin receptor antibodies in the differential diagnosis of thyrotoxicosis in patients with chronic hepatitis C (CHC) receiving pegylated interferon-alpha plus ribavirin. METHODS Retrospective analysis of 274 patients with CHC receiving pegylated interferon-alpha plus ribavirin. Interferon-induced thyrotoxicosis was classified according to clinical guidelines as Graves disease, autoimmune and non- autoimmune destructive thyroiditis. RESULTS 48 (17.5%) patients developed hypothyroidism, 17 (6.2%) thyrotoxicosis (6 non- autoimmune destructive thyroiditis, 8 autoimmune destructive thyroiditis and 3 Graves disease) and 22 "de novo" thyrotropin receptor antibodies (all Graves disease, 2 of the 8 autoimmune destructive thyroiditis and 17 with normal thyroid function). The sensitivity and specificity of thyrotropin receptor antibodies for Graves disease diagnosis in patients with thyrotoxicosis were 100 and 85%, respectively. Patients with destructive thyroiditis developed hypothyroidism in 87.5% of autoimmune cases and in none of those with a non- autoimmune etiology (p<0.001). CONCLUSION Thyrotropin receptor antibodies determination cannot replace thyroid scintigraphy for the differential diagnosis of thyrotoxicosis in CHC patients treated with pegylated interferon.
Collapse
Affiliation(s)
- D Benaiges
- Department of Endocrinology and Nutrition, Hospital del Mar
| | | | - A Mas
- Department of Endocrinology and Nutrition, Hospital del Mar
| | - N Cañete
- Department of Medicine, Universitat Autònoma de Barcelona
| | - T Broquetas
- Department of Medicine, Universitat Autònoma de Barcelona
| | - M Puigvehi
- Department of Medicine, Universitat Autònoma de Barcelona
| | - J J Chillarón
- Department of Endocrinology and Nutrition, Hospital del Mar
| | | | - E Sagarra
- Department of Endocrinology and Nutrition, Hospital del Mar
| | - B Cabrero
- Department of Medicine, Universitat Autònoma de Barcelona
| | - D Zaffalon
- Department of Medicine, Universitat Autònoma de Barcelona
| | - R Solà
- Department of Medicine, Universitat Autònoma de Barcelona
| | - J Pedro-Botet
- Department of Endocrinology and Nutrition, Hospital del Mar
| | - J A Carrión
- Department of Medicine, Universitat Autònoma de Barcelona
| |
Collapse
|
10
|
Carrión JA, Puigvehí M, Coll S, Garcia-Retortillo M, Cañete N, Fernández R, Márquez C, Giménez MD, Garcia M, Bory F, Solà R. Applicability and accuracy improvement of transient elastography using the M and XL probes by experienced operators. J Viral Hepat 2015; 22:297-306. [PMID: 25164560 DOI: 10.1111/jvh.12296] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Transient elastography (TE) is the reference method to obtain liver stiffness measurements (LSM), but no results are obtained in 3.1% and unreliable in 15.8%. We assessed the applicability and diagnostic accuracy of TE re-evaluation using M and XL probes. From March 2011 to April 2012 868 LSM were performed with the M probe by trained operators (50-500 studies) (LSM1). Measurements were categorized as inadequate (no values or ratio <60% and/or IQR/LSM >30%) or adequate. Inadequate LSM1 were re-evaluated by experienced operators (>500 explorations) (LSM2) and inadequate LSM2 using XL probe (LSMXL). Inadequate LSM1 were obtained in 187 (21.5%) patients, IQR/LSM >30% in 97 (51%), ratio <60% in 24 (13%) and TE failed to obtain a measurement in 67 (36%). LSM2 achieved adequate registers in 123 (70%) of 175 registers previously considered as inadequate. Independent variables (OR, 95%CI) related to inadequate LSM1 were body mass index (1.11, 1.04-1.18), abdominal circumference (1.03, 1.01-1.06) and age (1.03, 1.01-1.04) and to inadequate LSM2 were skin-capsule distance (1.21, 1.09-1.34) and abdominal circumference (1.05, 1.01-1.10). The diagnostic accuracy (AUROC) to identify significant fibrosis improved from 0.89 (LSM1) to 0.91 (LSM2) (P = 0.046) in 334 patients with liver biopsy or clinically significant portal hypertension. A third evaluation (LSMXL) obtained adequate registers in 41 (93%) of 44 patients with inadequate LSM2. Operator experience increases the applicability and diagnostic accuracy of TE. The XL probe may be recommended for patients with inadequate values obtained by experienced operators using the M probe. http://clinicaltrials.gov (NCT01900808).
Collapse
Affiliation(s)
- J A Carrión
- Liver Section, Gastroenterology Department, Hospital del Mar, Universitat Autònoma de Barcelona, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
11
|
Crespo G, Lens S, Gambato M, Carrión JA, Mariño Z, Londoño MC, Miquel R, Bosch J, Navasa M, Forns X. Liver stiffness 1 year after transplantation predicts clinical outcomes in patients with recurrent hepatitis C. Am J Transplant 2014; 14:375-83. [PMID: 24410892 DOI: 10.1111/ajt.12594] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 10/21/2013] [Accepted: 11/14/2013] [Indexed: 01/25/2023]
Abstract
The value of transient elastography (TE) to assess clinical outcomes in hepatitis C recurrence after liver transplantation (LT) has not been explored so far. We studied 144 hepatitis C-infected and 48 non-hepatitis C virus (HCV)-infected LT recipients and evaluated the prognostic value of TE 1 year after transplantation to predict clinical decompensations and graft and patient survival. In HCV patients, cumulative probabilities of liver decompensation 5 years after LT were 8% for patients with liver stiffness measurement (LSM) <8.7 kilopascals (kPa) versus 47% for patients with LSM ≥ 8.7 kPa (p<0.001). Five-year graft and patient cumulative survival were 90% and 92% in patients with LSM<8.7 kPa (p<0.001) and 63% and 64% in patients with LSM ≥ 8.7 kPa, respectively (p<0.001). Patients with low LSM 1 year after LT had excellent outcomes independently from receiving antiviral treatment or achieving sustained virological response (SVR). In contrast, graft survival significantly improved in patients with LSM ≥ 8.7 kPa who achieved SVR. No association between outcomes and LSM at 12 months was observed in non-HCV patients. In conclusion, LSM 1 year after LT is a valuable tool to predict hepatitis C-related outcomes in recurrent hepatitis C and can be used in clinical practice to identify the best candidates for antiviral therapy.
Collapse
Affiliation(s)
- G Crespo
- Liver Unit, Hospital Clinic, CIBEREHD, IDIBAPS, University of Barcelona, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
Coto-Llerena M, Pérez-Del-Pulgar S, Crespo G, Carrión JA, Martínez SM, Sánchez-Tapias JM, Martorell J, Navasa M, Forns X. Donor and recipient IL28B polymorphisms in HCV-infected patients undergoing antiviral therapy before and after liver transplantation. Am J Transplant 2011; 11:1051-7. [PMID: 21466653 DOI: 10.1111/j.1600-6143.2011.03491.x] [Citation(s) in RCA: 74] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
IL28B gene polymorphisms are associated with the response to antiviral therapy in hepatitis C patients. We investigated the influence of IL28B polymorphisms on the response to therapy before and after liver transplantation (LT). Genotyping of SNPs rs8099917 and rs12979860 was performed in 128 HCV-infected liver transplant recipients and in their donors; all patients underwent antiviral treatment after LT. The prevalence of genotypes rs12979860CC and rs8099917TT was higher in donors than in recipients (50% vs.19%, p < 0.001 and 67% vs. 38%, p < 0.001, respectively). Response to antiviral therapy was significantly higher for recipient genotype rs12979860CC as compared to rs12979860CT/TT both before (100% vs. 48% p = 0.013) and after LT (59% vs. 25% p = 0.002). The figures were almost identical for SNP rs8099917. Sustained virological response after LT was particularly high in patients with favorable recipient and donor genotypes (p < 0.01 for both SNPs). In a subgroup of 34 patients treated while awaiting LT, a favorable donor IL28B genotype was associated with an improved virological response after LT. Our results support a major role of recipient IL28B genotype in the response to antiviral treatment for hepatitis C recurrence. Interestingly, donor genotype also seems to influence the response pattern, especially in recipients who have a favorable IL28B genotype.
Collapse
|
13
|
Massaguer A, Ramírez S, Carrión JA, González P, Sánchez-Tapias JM, Forns X. Evolution of the NS3 and NS5B regions of the hepatitis C virus during disease recurrence after liver transplantation. Am J Transplant 2007; 7:2172-9. [PMID: 17608833 DOI: 10.1111/j.1600-6143.2007.01894.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
In patients with hepatitis C virus (HCV)-related cirrhosis, infection recurrence is universal after liver transplantation (LT). The relevance of host and virus-related factors on the outcome of hepatitis C recurrence is poorly understood. This study analyzed the relationship between the genetic evolution of the Non-Structural (NS)3 protease and NS5B polymerase regions of HCV and the severity of hepatitis C recurrence. Thirty-three patients were classified as having mild (n = 16) or severe recurrence (n = 17), according to the degree of fibrosis in liver biopsies obtained 1 year after transplantation. Viral load and consensus sequences of the NS3 and NS5B domains were determined in a pre-LT and in four post-LT sequential serum samples. At week 12 after LT, viremia was significantly higher in patients with severe recurrence. NS3 and NS5b regions evolved independently after LT. The genetic evolution of NS3 domain was not related to the severity of the recurrence. However, the diversification in the NS5B region later than 12 weeks after LT was greater in patients with mild than in those with severe recurrence, suggesting a stronger immune pressure in the first group. These observations highlight the complex interplay between viral evolution and clinical outcomes in the LT setting.
Collapse
Affiliation(s)
- A Massaguer
- Liver Unit, Institut de Malalties Digestives, Hospital Clínic, Ciberehd and Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | | | | | | | | | | |
Collapse
|
14
|
Feliu A, Carrión JA, Massaguer A, Martínez-Bauer E, García-Retortillo M, González P, Costa J, Sánchez-Tapias JM, Forns X. Sensitivity to antiviral therapy may change after liver transplantation in patients with chronic hepatitis C virus infection. J Viral Hepat 2006; 13:544-51. [PMID: 16901285 DOI: 10.1111/j.1365-2893.2006.00714.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In hepatitis C virus (HCV)-infected patients, it is generally assumed that the pattern of response to antiviral therapy remains unaltered after liver transplantation (LT). However, changes in the circulating HCV quasispecies and in the gene expression profiles of the graft might influence response to treatment after LT. We evaluated 22 HCV-infected patients who received antiviral treatment while awaiting LT and in whom HCV infection recurred. Eleven of these patients underwent a new antiviral treatment course. Our study analyses the early virological response to both treatment courses to assess the influence of the changes in HCV on the response to therapy. Patients were considered early virological responders (EVR) if viral load declined > or = 2 log10 during the first 12 weeks of therapy. The remaining individuals were considered nonresponders (NR). HCV sequences from hypervariable region 1 and nonstructural 5A (NS5A) region before both treatment regimens were compared. Of 11 patients, 8 (73%) showed identical early response to both courses of therapy (group A: five EVR-EVR, three NR-NR). Interestingly, the response changed in three patients (27%) (group B): two NR became EVR after transplantation, whereas one EVR became NR. Fixation of mutations within the NS5A occurred preferentially in group B (100%) compared with group A (37%)(P = 0.12). However, the number of fixed mutations was not significantly different between groups, suggesting that the changes in sensitivity to therapy after LT are not exclusively dependent on variations in HCV strains. In conclusion, in HCV-infected patients undergoing LT, the pattern of response to antiviral treatment may change after transplantation, and this possibility needs to be incorporated in clinical practice.
Collapse
Affiliation(s)
- A Feliu
- Liver Unit, Institut de Malalties Digestives, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | | | | | | | | | | | | | | | | |
Collapse
|
15
|
Moro C, Madrid AH, Novo L, Marín-Huerta E, Rayo I, Bustamante R, Carrión JA. [The interruption of atrioventricular conduction by cardiac fulguration in patients with supraventricular tachycardias. The mid- and long-term results]. Rev Esp Cardiol 1992; 45:36-41. [PMID: 1549759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Catheter ablation of the atrioventricular node is a therapeutic technique for the treatment of patients with drug-refractory supraventricular tachyarrhythmias. In our Arrhythmia Unit 25 patients (8 women, 17 men) aged (mean +/- DE) 56 +/- 10 years have undergone fulguration of the atrioventricular junction since 1986. The more frequent treated rhythm disturbance was atrial flutter or fibrillation, with uncontrolled rapid ventricular response. Absence of organic heart disease was diagnosed in 9 patients; the remainder had valvular heart disease (2), cor pulmonale (2), cardiomyopathy (7), hypertensive heart disease (2) and Wolff-Parkinson-White syndrome (3). Under general anesthesia 1.8 +/- 0.8 shocks/patients were delivered along 1.2 +/- 0.7 sessions/patient. In 23 of 25 patients (92%) complete atrioventricular block was achieved, and a pacemaker was implanted. There were no complications. The other 2 patients were referred to surgery for cryoablation of the atrioventricular junction. Patients were followed for an average of 21 +/- 12 months. Four patients have died: two due to congestive heart failure, which was present prior to the ablation procedure, the third because of a metastatic carcinoma, and the fourth had a sudden death 14 months after the procedure (he had dilated cardiomyopathy and Wolff-Parkinson-White syndrome). The remainder in chronic stable complete atrioventricular block are asymptomatic for arrhythmias and without antiarrhythmic medication.
Collapse
Affiliation(s)
- C Moro
- Unidad de Arritmias, Hospital Ramón y Cajal, Madrid
| | | | | | | | | | | | | |
Collapse
|
16
|
Ecenarro O, Madariaga JA, Navarro J, Santamaría CM, Carrión JA, Savirón JM. Direction of Separation and Dependence of Feed Concentration in Liquid Thermogravitational Columns. SEP SCI TECHNOL 1991. [DOI: 10.1080/01496399108050514] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
17
|
Ecenarro O, Madariaga JA, Navarro J, Santamaria CM, Carrión JA, Savirón JM. Thermogravitational Column as a Technique for Thermal Diffusion Factor Measurement in Liquid Mixtures. SEP SCI TECHNOL 1989. [DOI: 10.1080/01496398908049791] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
18
|
Santamaría CM, Savirón JM, Yarza JC, Carrión JA. Second order kinetic properties of dilute binary noble gas mixtures containing helium. J Chem Phys 1977. [DOI: 10.1063/1.433924] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
19
|
Santamaría CM, Savirón JM, Yarza JC, Carrión JA. Thermal diffusion factors for binary noble gas mixtures from column measurements. II. J Chem Phys 1976. [DOI: 10.1063/1.432296] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
20
|
Savirón JM, Santamaría CM, Carrión JA, Yarza JC. Isotopic and nonisotopic thermal diffusion factors from column measurements. J Chem Phys 1975. [DOI: 10.1063/1.431335] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
|