Liver disease in hepatitis C virus carriers identified at blood donation and their outcomes with or without interferon treatment: Study on 1019 carriers followed for 5-10 years.

AIM: To portray liver disease and project outcomes in carriers of hepatitis C virus (HCV) in the general population. METHODS: Liver disease was evaluated in 1019 individuals who were found with HCV infection at blood donation, and they were followed for 5-10 years with or without receiving interferon (IFN). RESULTS: At baseline, chronic hepatitis was detected in 529 (51.9%) HCV carriers and more frequently in men than in women (62.6% [299/478]vs 42.5% [230/541], P < 0.01); cirrhosis was diagnosed in five (0.5% [three men included]) and hepatocellular carcinoma (HCC) in one (0.1% [man]). Of the carriers who were followed for 5 years or longer, loss of HCV-RNA from serum was achieved in 61 (31.0%) of the 197 treated with interferon (IFN) and only one of the 211 (0.5%) without IFN (P < 0.0001). HCC developed in 14 carriers including six ofthe 211 (2.8%) without IFN and eight of the 197 (4.1%) with IFN (six non-responders included). Follow ups of the 949 carriers identified age (P < 0.002), male gender (P < 0.01) and cirrhosis at the baseline (P < 0.0001) as factors contributing to the development of HCC. Cumulative incidence rates of HCC during 10 years among carriers found with chronic hepatitis increased in parallel with the age at the baseline. CONCLUSION: Identification of HCV carriers in the general population and treating those indicated with IFN would help decrease the development of HCC and lift its medical, as well as economic, burdens off society.

Improved detection of lung cancer arising in diffuse lung diseases on chest radiographs using temporal subtraction.

RATIONALE AND OBJECTIVES: The purpose of this study was to evaluate the usefulness of temporal subtraction for the detection of lung cancer arising in pneumoconiosis, idiopathic pulmonary fibrosis, and pulmonary emphysema. MATERIALS AND METHODS: Fifteen cases of lung cancer arising in diffuse lung diseases, including three cases of pneumoconiosis, six of idiopathic pulmonary fibrosis, and six of pulmonary emphysema, were evaluated. Pathologic proof was obtained by surgery or transbronchial lung biopsy. The average interval between previous and current radiographs was 356 days (range, 31-947 days). All chest radiographs were obtained with a computed radiography system, and temporal subtraction images were produced by subtracting of a previous image from a current one with a nonlinear image-warping technique. The effect of the temporal subtraction image was evaluated by observer performance study with receiver operating characteristic analysis. RESULTS: The average observer performance with temporal subtraction was significantly improved (Az = 0.935) compared with that without temporal subtraction (Az = 0.857, P < .0001). CONCLUSION: The temporal subtraction technique is useful for the detection of lung cancer arising in pneumoconiosis, idiopathic pulmonary fibrosis, and pulmonary emphysema.