Displaying publications 1 - 20 of 167 in total

  1. Lee WS, Ng KP
    Singapore Med J, 2001 Mar;42(3):100-1.
    PMID: 11405558
    A pilot study to determine the seroprevalence of anti-HCV among children from Kuala Lumpur, Malaysia, was conducted using microparticle enzyme immunoassay. Serum samples were obtained randomly from children, aged between one to 16 years of age, admitted to the paediatric unit of University of Malaya Medical Centre, Kuala Lumpur for various medical reasons. Of the 179 samples assayed, only one was positive, giving the prevalence rate of 0.6%. It is reasonable to conclude that the seroprevalence of anti-HCV among children from Kuala Lumpur is low, less than 1%.
    Matched MeSH terms: Hepatitis C/blood; Hepatitis C/epidemiology*; Hepatitis C Antibodies/blood*
  2. Maaroufi A, Vince A, Himatt SM, Mohamed R, Fung J, Opare-Sem O, et al.
    J Viral Hepat, 2017 10;24 Suppl 2:8-24.
    PMID: 29105285 DOI: 10.1111/jvh.12762
    Due to the introduction of newer, more efficacious treatment options, there is a pressing need for policy makers and public health officials to develop or adapt national hepatitis C virus (HCV) control strategies to the changing epidemiological landscape. To do so, detailed, country-specific data are needed to characterize the burden of chronic HCV infection. In this study of 17 countries, a literature review of published and unpublished data on HCV prevalence, viraemia, genotype, age and gender distribution, liver transplants and diagnosis and treatment rates was conducted, and inputs were validated by expert consensus in each country. Viraemic prevalence in this study ranged from 0.2% in Hong Kong to 2.4% in Taiwan, while the largest viraemic populations were in Nigeria (2 597 000 cases) and Taiwan (569 000 cases). Diagnosis, treatment and liver transplant rates varied widely across the countries included in this analysis, as did the availability of reliable data. Addressing data gaps will be critical for the development of future strategies to manage and minimize the disease burden of hepatitis C.
    Matched MeSH terms: Hepatitis C, Chronic/diagnosis; Hepatitis C, Chronic/mortality; Hepatitis C, Chronic/epidemiology*; Hepatitis C, Chronic/therapy
  3. Locarnini S
    Med J Malaysia, 2005 Jul;60 Suppl B:116-24.
    PMID: 16108191
    Matched MeSH terms: Hepatitis C/immunology; Hepatitis C/prevention & control*
  4. Poynard T
    Med J Malaysia, 2005 Jul;60 Suppl B:77-9.
    PMID: 16108180
    Matched MeSH terms: Hepatitis C, Chronic/drug therapy*; Hepatitis C, Chronic/physiopathology
  5. Ooi BG, Sinniah M, Ismail S, Baharuddin R
    Malays J Pathol, 1996 Dec;18(2):89-93.
    PMID: 10879228
    The Serodia-HCV Particle Agglutination (HCV-PA) for the detection of HCV antibodies was compared with the Enzyme Immunoassay Test (UBI HCV EIA) for possible in-house use. A total of 150 specimens were analysed using UBI HCV EIA and Serodia-HCV PA. Of these, 80 (53.3%) were both PA and EIA positive and 59 (39.3%) were negative by both techniques. Eleven sera (7.4%) were found to be EIA-positive but PA-negative. These 11 discordant sera were further tested by the LiaTek-HCV III Immunoassay (Organon Teknika). Ten were found to be line immunoassay negative and one was line immunoassay positive. Failure of the PA to detect the HCV positive serum meant that a small proportion of HCV antibody positives may be missed by the PA test. We conclude that (i) EIA should continue to be the first line screening test in our laboratory, (ii) PA with its 100% specificity could be a useful supplementary screen for all EIA-positive sera and finally (iii) line immunoassay could be used on sera to resolve discordant results in the EIA and PA assays.
    Matched MeSH terms: Hepatitis C/blood; Hepatitis C/diagnosis*; Hepatitis C/immunology; Hepatitis C Antibodies/blood*
  6. Tan SS, Leong CL, Lee CK
    Med J Malaysia, 2015 Oct;70(5):281-7.
    PMID: 26556116
    BACKGROUND: Co-infection by human immunodeficiency and hepatitis C viruses (HIV/HCV) is common and results in significant morbidity and mortality despite effective antiretroviral therapies (ART).
    METHOD: A retrospective and prospective evaluation of the efficacy and safety of pegylated interferon alfa 2a/2b plus ribavirin (PEG-IFN/RBV) in consecutive HIV/HCV co-infected patients treated in real life clinical practice in Malaysia.
    RESULTS: Forty-five HIV/HCV co-infected patients with a median age (interquartile range, IQR) of 41 years (37; 47) were assessed for treatment with PEG-IFN/RBV. All except one are of male gender and the most common risk behaviour was injecting drug use. At baseline 75.5% was on ART and the median (IQR) CD4 count was 492 cells/μl (376; 621). The HCV genotypes (GT) were 73 % GT3 and 27% GT1. Liver biopsies in forty patients showed 10% had liver cirrhosis and another 50% had significant liver fibrosis. The treatment completion rate was 79.5% with 15.9% dropped out of treatment due to adverse effects (AE) or default and 4.6% due to lack of early virological response. The AE causing premature discontinuations were neuropsychiatric and haematological. The overall sustained virological response (SVR) was 63.6% with a trend towards higher SVR in GT3 compared with GT1 (71.9% vs. 41.7%; p=0.064). In patients with bridging fibrosis plus occasional nodules or cirrhosis on liver biopsy, the SVR was significantly lower at 20% (p=0.030) compared to those with milder fibrosis.
    CONCLUSION: HIV/HCV co-infected patients can be successfully and safely treated with PEG-IFN/RBV achieving high rates of SVR except in cirrhotic patients.

    Study site: co-infection clinics at Sungai Buloh Hospita
    Matched MeSH terms: Hepatitis C*
  7. Siti Nurul Fazlin Abdul Rahman, Hairul Aini Hamzah, Mohammed Imad Mustafa, Mohamed Hadzri Hasmoni
    The existence of new entity called occult hepatitis C virus (HCV) has
    become a raising and escalating concern among healthcare professionals worldwide. It
    is defined by the presence of viral RNA in liver and/or peripheral blood mononuclear
    cells (PBMCs) within non HCV-infected patients. Previous study had shown the occult
    HCV is infectious and capable of transmitting the virus to another host. Till today, HCV
    infection remains common among hemodialysis patients despite having the best
    preventive plans. Because of this, there is a significant concern about the source of viral
    transmission. The aim of the study was to identify and characterize occult HCV infection
    in PBMC sample of hemodialysis patients. This was an observational and cross sectional
    study. (Copied from article).
    Matched MeSH terms: Hepatitis C; Hepatitis C Antibodies
  8. McDonald SA, Mohamed R, Dahlui M, Naning H, Kamarulzaman A
    BMC Infect Dis, 2014;14:564.
    PMID: 25377240 DOI: 10.1186/s12879-014-0564-6
    Collecting adequate information on key epidemiological indicators is a prerequisite to informing a public health response to reduce the impact of hepatitis C virus (HCV) infection in Malaysia. Our goal was to overcome the acute data shortage typical of low/middle income countries using statistical modelling to estimate the national HCV prevalence and the distribution over transmission pathways as of the end of 2009.
    Matched MeSH terms: Hepatitis C/epidemiology*; Hepatitis C/prevention & control; Hepatitis C/transmission
  9. Ng KT, Lee YM, Al-Darraji HA, Xia X, Takebe Y, Chan KG, et al.
    Genome Announc, 2013 Jan;1(1).
    PMID: 23409272 DOI: 10.1128/genomeA.00168-12
    We report the full genome sequence of hepatitis C virus (HCV) subtype 6n from Kuala Lumpur, Malaysia. Phylogenetic analysis of the isolate 10MYKJ032 suggests that Southeast Asia might be the origin for the HCV subtype 6n and highlights the possible spread of this lineage from Southeast Asia to other regions.
    Matched MeSH terms: Hepatitis C
  10. Poynard T
    Med J Malaysia, 2005 Jul;60 Suppl B:70-1.
    PMID: 16108178
    Matched MeSH terms: Hepatitis C, Chronic/diagnosis; Hepatitis C, Chronic/drug therapy*; Hepatitis C, Chronic/epidemiology
  11. Suresh RL, Kananathan R, Merican I
    Med J Malaysia, 2001 Jun;56(2):243-7.
    PMID: 11771088
    An analysis of 105 consecutive patients with chronic hepatitis C at the gastroenterology outpatient's clinic in Hospital Kuala Lumpur was performed. The clinical, laboratory and virological data was prospectively recorded in the case notes and comprised of data on patient characteristics, risk factors, clinical features, laboratory features, virology screen and management. Chronic Hepatitis C cases accounted for 2.1% of the total number of cases seen at this clinic during the entire period. There were 78 (74%) males and 27 (26%) females. The ethnic breakdown consisted of Chinese (44.2%), Malays (39.4%), Indians (15.4%) and others (1%). There was higher male preponderance in all the ethnic groups. The main mode of transmission was blood transfusion comprising 51 patients (48.8%). A total of 35.2% of cases underwent treatment, of which a proportion had interferon monotherapy for 6 or 12 months and a subsequent group of naïve patients and non-responders underwent combination therapy with interferon and ribavarin.
    Matched MeSH terms: Hepatitis C, Chronic/epidemiology*; Hepatitis C, Chronic/pathology; Hepatitis C, Chronic/virology
  12. Sachithanandan S, Fielding JF
    Med J Malaysia, 1999 Mar;54(1):110-3.
    PMID: 10972013
    The aim of this study was to determine if knowledge of both the serum HCV RNA and serum anti core IgM antibody status enabled one to predict the histological severity in chronic hepatitis C. We studied 45 female patients with chronic hepatitis C infection. The presence or absence of IgM antibodies to HCV and HCV RNA by PCR in each patient's serum was determined. Liver biopsies performed were scored according to a modified Desmet's histological activity index. Negative HCV RNA patients had least histological change. HCV RNA positive patients who were also IgM antibody positive had lower scores than their IgM negative counterparts. The grade of histological severity is more accurately predictable from knowledge of both the HCV RNA and IgM anti HCV status of the patient.
    Matched MeSH terms: Hepatitis C Antibodies/analysis*; Hepatitis C, Chronic/pathology*
  13. Sinniah M
    Med J Malaysia, 1992 Sep;47(3):155-7.
    PMID: 1283439
    Matched MeSH terms: Hepatitis C/epidemiology*; Hepatitis C/transmission; Hepatitis C Antibodies
  14. McDonald SA, Azzeri A, Shabaruddin FH, Dahlui M, Tan SS, Kamarulzaman A, et al.
    Appl Health Econ Health Policy, 2018 12;16(6):847-857.
    PMID: 30145775 DOI: 10.1007/s40258-018-0425-3
    INTRODUCTION: The World Health Organisation (WHO) has set ambitious goals to reduce the global disease burden associated with, and eventually eliminate, viral hepatitis.

    OBJECTIVE: To assist with achieving these goals and to inform the development of a national strategic plan for Malaysia, we estimated the long-term burden incurred by the care and management of patients with chronic hepatitis C virus (HCV) infection. We compared cumulative healthcare costs and disease burden under different treatment cascade scenarios.

    METHODS: We attached direct costs for the management/care of chronically HCV-infected patients to a previously developed clinical disease progression model. Under assumptions regarding disease stage-specific proportions of model-predicted HCV patients within care, annual numbers of patients initiated on antiviral treatment and distribution of treatments over stage, we projected the healthcare costs and disease burden [in disability-adjusted life-years (DALY)] in 2018-2040 under four treatment scenarios: (A) no treatment/baseline; (B) pre-2018 standard of care (pegylated interferon/ribavirin); (C) gradual scale-up in direct-acting antiviral (DAA) treatment uptake that does not meet the WHO 2030 treatment uptake target; (D) scale-up in DAA treatment uptake that meets the WHO 2030 target.

    RESULTS: Scenario D, while achieving the WHO 2030 target and averting 253,500 DALYs compared with the pre-2018 standard of care B, incurred the highest direct patient costs over the period 2018-2030: US$890 million (95% uncertainty interval 653-1271). When including screening programme costs, the total cost was estimated at US$952 million, which was 12% higher than the estimated total cost of scenario C.

    CONCLUSIONS: The scale-up to meet the WHO 2030 target may be achievable with appropriately high governmental commitment to the expansion of HCV screening to bring sufficient undiagnosed chronically infected patients into the treatment pathway.

    Matched MeSH terms: Hepatitis C/economics*; Hepatitis C/epidemiology; Hepatitis C/therapy
  15. Chan HLY, Chen CJ, Omede O, Al Qamish J, Al Naamani K, Bane A, et al.
    J Viral Hepat, 2017 10;24 Suppl 2:25-43.
    PMID: 29105283 DOI: 10.1111/jvh.12760
    Factors influencing the morbidity and mortality associated with viremic hepatitis C virus (HCV) infection change over time and place, making it difficult to compare reported estimates. Models were developed for 17 countries (Bahrain, Bulgaria, Cameroon, Colombia, Croatia, Dominican Republic, Ethiopia, Ghana, Hong Kong, Jordan, Kazakhstan, Malaysia, Morocco, Nigeria, Qatar and Taiwan) to quantify and characterize the viremic population as well as forecast the changes in the infected population and the corresponding disease burden from 2015 to 2030. Model inputs were agreed upon through expert consensus, and a standardized methodology was followed to allow for comparison across countries. The viremic prevalence is expected to remain constant or decline in all but four countries (Ethiopia, Ghana, Jordan and Oman); however, HCV-related morbidity and mortality will increase in all countries except Qatar and Taiwan. In Qatar, the high-treatment rate will contribute to a reduction in total cases and HCV-related morbidity by 2030. In the remaining countries, however, the current treatment paradigm will be insufficient to achieve large reductions in HCV-related morbidity and mortality.
    Matched MeSH terms: Hepatitis C, Chronic/drug therapy; Hepatitis C, Chronic/mortality*; Hepatitis C, Chronic/epidemiology*
  16. AR Siti Nurul Fazlin, H Hairul Aini, HM Hadzri, MM Mohammed Imad
    Hepatitis C virus (HCV) genotyping is very important for the clinical management of HCV-infected patients. The aim of this study was to determine the genotypes of HCV-infected patients and to identify their risk factors and comorbidities.
    Matched MeSH terms: Hepatitis C
  17. Rehman IU, Khan TM
    J Coll Physicians Surg Pak, 2017 Nov;27(11):735.
    PMID: 29132493 DOI: 2758
    Matched MeSH terms: Hepatitis C/complications*; Hepatitis C/epidemiology; Hepatitis C/transmission*
  18. Hiebert L, Hecht R, Soe-Lin S, Mohamed R, Shabaruddin FH, Syed Mansor SM, et al.
    Value Health Reg Issues, 2019 May;18:112-120.
    PMID: 30921591 DOI: 10.1016/j.vhri.2018.12.005
    BACKGROUND: In Malaysia, more than 330 000 individuals are estimated to be chronically infected with hepatitis C virus (HCV), but less than 2% have been treated to date.

    OBJECTIVES: To estimate the required coverage and costs of a national screening strategy to inform the launch of an HCV elimination program.

    METHODS: We designed an HCV screening strategy based on a "stepwise" approach. This approach relied on targeting of people who inject drugs in the early years, with delayed onset of widespread general population screening. Annual coverage requirements and associated costs were estimated to ensure that the World Health Organization elimination treatment targets were met.

    RESULTS: In total, 6 million individuals would have to be screened between 2018 and 2030. Targeting of people who inject drugs in the early years would limit annual screening coverage to less than 1 million individuals from 2018 to 2026. General population screening would have to be launched by 2026. Total costs were estimated at MYR 222 million ($58 million). Proportional to coverage targets, 60% of program costs would fall from 2026 to 2030.

    CONCLUSIONS: This exercise was one of the first attempts to conduct a detailed analysis of the required screening coverage and costs of a national HCV elimination strategy. These findings suggest that the stepwise approach could delay the onset of general population screening by more than 5 years after the program's launch. This delay would allow additional time to mobilize investments required for a successful general population screening program and also minimize program costs. This strategy prototype could inform the design of effective screening strategies in other countries.

    Matched MeSH terms: Hepatitis C/diagnosis*; Hepatitis C/economics; Hepatitis C/epidemiology
  19. Wong XZ, Gan CC, Mohamed R, Yahya R, Ganapathy S, Tan SS, et al.
    BMC Nephrol, 2020 11 13;21(1):480.
    PMID: 33187498 DOI: 10.1186/s12882-020-02154-4
    BACKGROUND: Hepatitis C virus (HCV) infects more than 71 million people worldwide and chronic HCV infection increases the risk of liver cirrhosis and failure. Haemodialysis (HD) is one of the renal replacement therapies with risk of HCV transmission. Anti-HCV antibodies are the serological screening test for HCV infection that does not detect active phase of infection. Majority HCV infected HD patients in Malaysia do not have further HCV RNA performed due to high cost and thus HCV treatment is less frequently offered. HCV Core Antigen (HCV Ag) can potentially be used to diagnose active HCV infection in HD population in comparison to HCV RNA, at lower cost.

    METHODS: We conducted a cross-sectional study to assess the correlation between HCV Ag and HCV RNA and to identify the prevalence of active HCV infection among HCV seropositive HD patients from dialysis centres across West Malaysia from July 2019 to May 2020. Pre-dialysis blood was taken and tested for both HCV Ag and HCV RNA tests. HCV Ag was tested with Abbott ARCHITECT HCV Ag test.

    RESULTS: We recruited 112 seropositive HD patients from 17 centres with mean age of 54.04 ± 11.62 years, HD vintage of 14.1 ± 9.7 years, and male constitute 59.8% (67) of the study population. HCV Ag correlates well with HCV RNA (Spearman test coefficient 0.833, p  3000 IU/mL, HCV Ag had a higher sensitivity of 95.1% and greater correlation (Spearman test coefficient 0.897, p 

    Matched MeSH terms: Hepatitis C; Hepatitis C Antigens; Hepatitis C Antibodies; Hepatitis C, Chronic
  20. Wait S, Kell E, Hamid S, Muljono DH, Sollano J, Mohamed R, et al.
    Lancet Gastroenterol Hepatol, 2016 11;1(3):248-255.
    PMID: 28404097 DOI: 10.1016/S2468-1253(16)30031-0
    In 2015, the Coalition to Eradicate Viral Hepatitis in Asia Pacific gathered leading hepatitis experts from Bangladesh, India, Indonesia, Malaysia, Pakistan, the Philippines, and Thailand to discuss common challenges to the burden posed by hepatitis B virus (HBV) and hepatitis C virus (HCV), to learn from each other's experience, and identify sustainable approaches. In this report, we summarise these discussions. Countries differ in their policy responses to HBV and HCV; however, substantial systemic, cultural, and financial barriers to achievement of elimination of these infections persist in all countries. Common challenges to elimination include limited availability of reliable epidemiological data; insufficient public awareness of risk factors and modes of transmission, leading to underdiagnosis; high rates of transmission through infected blood products, including in medical settings; limited access to care for people who inject drugs; prevailing stigma and discrimination against people infected with viral hepatitis; and financial barriers to treatment and care. Despite these challenges, promising examples of effective programmes, public-private initiatives, and other innovative approaches are evident in all countries we studied in Asia Pacific. The draft WHO Global Health Sector Strategy on Viral Hepatitis 2016-21 provides a solid framework upon which governments can build their local strategies towards viral hepatitis. However, greater recognition by national governments and the international community of the urgency to comprehensively tackle both HBV and HCV are still needed. In all countries, strategic plans and policy goals need to be translated into resources and concrete actions, with national governments at the helm, to enable a sustainable response to the rising burden of hepatitis B and C in all countries.
    Matched MeSH terms: Hepatitis C/diagnosis; Hepatitis C/epidemiology; Hepatitis C/prevention & control*; Hepatitis C/transmission
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