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Hepatitis: HELP
Articles by Chundamannil Eapen Eapen
Based on 7 articles published since 2010
(Why 7 articles?)
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Between 2010 and 2020, Chundamannil E. Eapen wrote the following 7 articles about Hepatitis.
 
+ Citations + Abstracts
1 Review Indian National Association for the Study of the Liver-Federation of Obstetric and Gynaecological Societies of India Position Statement on Management of Liver Diseases in Pregnancy. 2019

Arora, Anil / Kumar, Ashish / Anand, Anil C / Puri, Pankaj / Dhiman, Radha K / Acharya, Subrat K / Aggarwal, Kiran / Aggarwal, Neelam / Aggarwal, Rakesh / Chawla, Yogesh K / Dixit, Vinod K / Duseja, Ajay / Eapen, Chundamannil E / Goswami, Bhabadev / Gujral, Kanwal / Gupta, Anoop / Jindal, Ankur / Kar, Premashish / Kumari, Krishna / Madan, Kaushal / Malhotra, Jaideep / Malhotra, Narendra / Pandey, Gaurav / Pandey, Uma / Puri, Ratna D / Rai, Ramesh R / Rao, Padaki N / Sarin, Shiv K / Sharma, Aparna / Sharma, Praveen / Shenoy, Koticherry T / Singh, Karam R / Singh, Shivaram P / Suri, Vanita / Trehanpati, Nirupama / Wadhawan, Manav. ·Institute of Liver, Gastroenterology, and Pancreatico-Biliary Sciences, Sir Ganga Ram Hospital, New Delhi, India. · Kalinga Institute of Medical Sciences, KIIT University, Bubaneswar, India. · Department of Hepatology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. · Department of Obstetrics and Gynecology, LHMC & Associated Hospitals, New Delhi, India. · Department of Obstetrics and Gynecology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. · Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India. · Department of Gastroenterology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India. · Department of Hepatology, Christian Medical College, Vellore, India. · Department of Gastroenterology, Guwahati Medical College, Assam, India. · Institute of Obstetrics and Gynecology, Sir Ganga Ram Hospital, New Delhi, India. · Delhi IVF and Fertility Research Centre, New Delhi, India. · Institute of Liver and Biliary Sciences, New Delhi, India. · Department of Gastroenterology and Hepatology, Max Super Speciality Hospital, Vaishali, Patparganj, New Delhi. · Max Cure Suyosha Woman & Child Hospital, Hyderabad, India. · Max Smart Super Speciality Hospital, Saket, New Delhi, India. · Rainbow Hospitals, Agra, India. · Dept of Obstetrics & Gynecology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India. · Department of Gastroenterology, NIMS Medical College and Hospital, Jaipur, India. · Department of Hepatology, Asian Institute of Gastroenterology Hospitals, Hyderabad, India. · Department of Obstetrics and Gynecology, All India Institute of Medical Sciences (AIIMS), New Delhi, India. · Sree Gokulam Medical College and Research Foundation, Venjaramoodu, Thiruvananthapuram, India. · Regional Institute of Medical Sciences (RIMS), Imphal, Manipur, India. · Department of Gastroenterology, SCB Medical College, Cuttack, India. · BLK Super Speciality Hospital, New Delhi, India. ·J Clin Exp Hepatol · Pubmed #31360030.

ABSTRACT: Liver diseases occurring during pregnancy can be serious and can progress rapidly, affecting outcomes for both the mother and fetus. They are a common cause of concern to an obstetrician and an important reason for referral to a hepatologist, gastroenterologist, or physician. Liver diseases during pregnancy can be divided into disorders unique to pregnancy, those coincidental with pregnancy, and preexisting liver diseases exacerbated by pregnancy. A rapid differential diagnosis between liver diseases related or unrelated to pregnancy is required so that specialist and urgent management of these conditions can be carried out. Specific Indian guidelines for the management of these patients are lacking. The Indian National Association for the Study of the Liver (INASL) in association with the Federation of Obstetric and Gynaecological Societies of India (FOGSI) had set up a taskforce for development of consensus guidelines for management of patients with liver diseases during pregnancy, relevant to India. For development of these guidelines, a two-day roundtable meeting was held on 26-27 May 2018 in New Delhi, to discuss, debate, and finalize the consensus statements. Only those statements that were unanimously approved by most members of the taskforce were accepted. The primary objective of this review is to present the consensus statements approved jointly by the INASL and FOGSI for diagnosing and managing pregnant women with liver diseases. This article provides an overview of liver diseases occurring in pregnancy, an update on the key mechanisms involved in its pathogenesis, and the recommended treatment options.

2 Review Pregnancy-related liver disorders. 2014

Goel, Ashish / Jamwal, Kapil D / Ramachandran, Anup / Balasubramanian, Kunissery A / Eapen, Chundamannil E. ·Department of Hepatology, Division of Gastrointestinal Sciences, Christian Medical College, Vellore 632004, Tamil Nadu, India. · Department of Wellcome Research Unit, Division of Gastrointestinal Sciences, Christian Medical College, Vellore 632004, Tamil Nadu, India. ·J Clin Exp Hepatol · Pubmed #25755551.

ABSTRACT: Pregnancy-related liver disorders accounted for 8% of all maternal deaths at our center from 1999 to 2011. Of the three pregnancy-related liver disorders (acute fatty liver of pregnancy (AFLP), HELLP (Hemolysis, elevated liver enzymes, low platelets) syndrome and pre-eclamptic liver dysfunction, which can lead to adverse maternal and fetal outcome, AFLP is most typically under - diagnosed. Risk of maternal death can be minimised by timely recognition and early/aggressive multi-specialty management of these conditions. Urgent termination of pregnancy remains the cornerstone of therapy for some of these life threatening disorders, but recent advancements in our understanding help us in better overall management of these patients. This review focuses on various aspects of pregnancy-related liver disorders.

3 Article Findings from a large Asian chronic hepatitis C real-life study. 2018

Lim, Seng Gee / Phyo, Wah Wah / Shah, Samir R / Win, Khin Maung / Hamid, Saeed / Piratvisuth, Teerha / Tan, Soek Siam / Dan, Yock Young / Lee, Yin Mei / Ahmed, Taufique / Yang, Wei Lyn / Chen, Kok Pun / Kamat, Mrunal / Wadhawan, Manav / Madan, Kaushal / Mehta, Rajiv / Shukla, Akash / Dhore, Prashant / Eapen, Chundamannil E / Abraham, Priya / Tyagi, Satyendra / Koshy, Abraham / Bwa, Aung Hlaing / Jafri, Wasim / Abid, Shahab / Arisar, Fakhar Ali Qazi / Tanwandee, Tewesak / Yin, Thing Phee / Tee, Hoi Poh / Hj Md Said, Rosaida Binti / Goh, Khean Lee / Ho, Shiaw Hooi / Mohamed, Rosmawati / Abu Bakar, Norasiah. ·National University Health System, Singapore, Singapore. · Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. · Global Hospital- Super Speciality and Transplant Center, Mumbai, India. · Yangon GI & Liver Centre, Yangon, Myanmar. · Aga Khan University, Karachi, Pakistan. · NKC Institute of Gastroenterology and Hepatology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand. · Selayang Hospital, Selangor, Malaysia. · Khoo Teck Puat Hospital, Singapore, Singapore. · Tan Tock Seng Hospital, Singapore, Singapore. · Fortis Escorts Hospital, Dehli, India. · Artemis Health Institute, Gurgaon, India. · Surat Institute of Digestive Sciences (SIDS), Surat, India. · Lokmanya Tilak Municipal Medical College and General Hospital, Mumbai, India. · Christian Medical College, Vellore, India. · Kailashi Superspeciality Hospital, Meerut, India. · Lakeshore Hospital, Kochi, India. · Faculty of Medicine Siriraj Hospital, Mahidol University. · Sime Darby Medical Centre Subang Jaya, Subang Jaya, Malaysia. · Hospital Tengku Ampuan Afzan, Kuantan, Malaysia. · Hospital Ampang, Selangor, Malaysia. · University of Malaya Medical Centre, Kuala Lumpur, Malaysia. · Hospital Raja Perempuan Zainab II, Kota Bharu, Malaysia. ·J Viral Hepat · Pubmed #30141214.

ABSTRACT: There is a paucity of information on chronic hepatitis C (CHC) patients treated with direct antiviral agents (DAAs) in Asia. We invited Asia-Pacific physicians to collate databases of patients enrolled for CHC treatment, recording baseline clinical, virologic and biochemical characteristics, sustained virologic response at week 12 (SVR12) and virologic failure. SVR12 outcome was based on intention to treat (ITT). Multivariate analysis was used to assess independent risk factors for SVR12 using SPSS version 20. A total of 2171 patients from India (n = 977), Myanmar (n = 552), Pakistan (n = 406), Thailand (n = 139), Singapore (n = 72) and Malaysia (n = 25) were collected. At baseline, mean age was 49 years, 50.2% were males, and 41.8% had cirrhosis. Overall, SVR12 was 89.5% and by genotype (GT) based on ITT and treatment completion, respectively, was 91% and 92% for GT1, 100% and 100% for GT2, 91% and 97% for GT3, 64% and 95% for GT4, 87% and 87% for GT6 and 79% and 91% for GT untested. Patients with cirrhosis had SVR12 of 85% vs 93% for noncirrhosis (P < 0.001) (RR 2.1, 95% CI 1.4-3.1, P = 0.0002). Patients with GT1 and GT3 treated with sofosbuvir/ribavirin (SR) had 88% and 89% SVR12, respectively, but those GT6 treated with sofosbuvir/ledipasvir (SL) had only 77.6% SVR12. Multivariate analysis showed absence of cirrhosis was associated with higher SVR12 (OR 2.0, 95% CI 1.3-3.1, P = 0.002). In conclusion, patients with GT1 and GT3 with/without cirrhosis had surprisingly high efficacy using SR, suggesting that Asians may respond better to some DAAs. However, poor GT6 response to SL suggests this regimen is suboptimal for this genotype.

4 Article Bone Health and Impact of Tenofovir Treatment in Men with Hepatitis-B Related Chronic Liver Disease. 2018

Sajith, Kattiparambil G / Kapoor, Nitin / Shetty, Sahana / Goel, Ashish / Zachariah, Uday / Eapen, Chundamannil E / Paul, Thomas V. ·Professor, Department of Hepatology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India. · Associate Professor, Department of Endocrinology, Diabetes and Metabolism, Christian Medical College and Hospital, Vellore, Tamil Nadu, India. · Assistant Professor, Department of Endocrinology, Diabetes and Metabolism, Christian Medical College and Hospital, Vellore, Tamil Nadu, India. · Professor & Head, Department of Hepatology, Christian Medical College and Hospital, Tamil Nadu, India. · Professor, Department of Endocrinology, Diabetes and Metabolism, Christian Medical College and Hospital, Vellore, Tamil Nadu, India. ·J Clin Exp Hepatol · Pubmed #29743793.

ABSTRACT: Background: Chronic Liver Disease (CLD) has been shown to have an adverse impact on bone health. Hepatitis-B related CLD and its treatment with tenofovir may have additional effects on skeleton. Objective: To study the impact of HBV related CLD and its treatment with Tenofovir on bone health in Indian subjects. Methods: This cross sectional study included men (18-60 years) and comprised of three groups: Group-1 was treatment naïve HBV related CLD ( Results: A significantly greater proportion ( Conclusion: The impact of hepatitis-B related CLD as well as its treatment on bone health is significant. Bone health need to be periodically evaluated in these subjects especially in older men who are lean and have a higher viral load.

5 Article Acute-on-chronic liver failure in India: The Indian National Association for Study of the Liver consortium experience. 2016

Anonymous8530861 / Saraswat, Vivek / Singh, Shivaram P / Duseja, Ajay / Shukla, Akash / Eapen, Chundamannil E / Kumar, Dharmendra / Pandey, Gaurav / Venkataraman, Jayanti / Puri, Pankaj / Narayanswami, Krishnasamy / Dhiman, Radha K / Thareja, Sandeep / Nijhawan, Sandeep / Bhatia, Shobna / Zachariah, Uday / Sonika, Ujjwal / Varghese, Thomas / Acharya, Subrat K. ·Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India. · Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India. · S.C.B Medical College, Cuttack, India. · Postgraduate Institute of Medical Education and Research, Chandigarh, India. · Seth GS Medical College and KEM Hospital, Mumbai, India. · Christian Medical College, Vellore, India. · Army Hospital Research and Referral, New Delhi, India. · Global hospital, Chennai, India. · Madras Medical College, Chennai, India. · SMS Medical College, Jaipur, India. · Medical College Hospital, Calicut, India. · Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India. subratacharya2004@yahoo.com. ·J Gastroenterol Hepatol · Pubmed #26989861.

ABSTRACT: BACKGROUND AND AIM: The aim of this study was to analyze etiologies and frequency of hepatic and extrahepatic organ failures (OFs) and outcome of acute-on-chronic liver failure (ACLF) at 10 tertiary centers in India. METHODS: In this retrospective study (2011-2014), patients satisfying Asian Pacific Association for the Study of the Liver definition of ACLF were included. Etiology of acute precipitating insult and chronic liver disease and outcomes were assessed. Occurrence and severity of OF were assessed by chronic liver failure-sequential organ failure assessment score. RESULTS: The mean (±SD) age of 1049 consecutive ACLF patients was 44.7 ± 12.2 years; Eighty-two percent were men. Etiology of acute precipitants included alcohol 35.7%, hepatitis viruses (hepatitis A, hepatitis B, and hepatitis E) 21.4%, sepsis 16.6%, variceal bleeding 8.4%, drugs 5.7%, and cryptogenic 9.9%. Among causes of chronic liver disease, alcohol was commonest 56.7%, followed by cryptogenic and hepatitis viruses. Predictors of survival were analyzed for a subset of 381 ACLF patients; OF's liver, renal, coagulation, cerebral, respiratory, and failure were seen in 68%, 32%, 31.5%, 22.6%, 14.5%, and 15%, respectively. Fifty-seven patients had no OF, whereas 1, 2, 3, 4, and 5 OFs were recorded in 126, 86, 72, 28, and 12 patients, respectively. The mortality increased progressively with increasing number of OFs (12.3% with no OF, 83.3% with five OFs). During a median hospital stay of 8 days, 42.6% (447/1049) of patients died. On multivariate analysis by Cox proportional hazard model, elevated serum creatinine (hazard ratio [HR] 1.176), advanced hepatic encephalopathy (HR 2.698), and requirement of ventilator support (HR 2.484) were independent predictors of mortality. CONCLUSIONS: Alcohol was the commonest etiology of ACLF. Within a mean hospital stay of 8 days, 42% patients died. OFs independently predicted survival.

6 Article Lamivudine monotherapy in chronic hepatitis B patients from the Indian subcontinent: antiviral resistance mutations and predictive factors of treatment response. 2014

Ismail, Ashrafali Mohamed / Samuel, Prasanna / Ramachandran, Jeyamani / Eapen, Chundamannil Eapen / Kannangai, Rajesh / Abraham, Priya. ·Department of Clinical Virology, Christian Medical College, Vellore, 632 004, Tamil Nadu, India. ·Mol Diagn Ther · Pubmed #24030850.

ABSTRACT: BACKGROUND AND OBJECTIVE: Management of chronic hepatitis B is a global public health challenge. There are several updated guidelines proposed based on treatment outcome data from the respective study populations. In this study, we aim to characterize the antiviral resistance mutations to lamivudine monotherapy in patients diagnosed with chronic hepatitis B from the Indian subcontinent. METHODS: A total of 147 lamivudine-treated patients with a median treatment duration of 13 (interquartile range 8-24) months were studied. Virological response was measured by hepatitis B virus (HBV) DNA levels. Antiviral resistance mutations were identified by sequencing HBV reverse transcriptase domains. Factors associated with virological response and antiviral resistance mutations were analyzed. RESULTS: Virological response was observed in 50 (35 %) patients while 84 (57 %) were non-responders. The virological response for the remaining 13 (9 %) patients was undetermined. Forty patients (27 %) developed lamivudine-resistant mutations. HBV genotypes, subgenotypes and hepatitis B surface antigen subtypes did not show significant association with virological response or lamivudine-resistant mutations. High HBV DNA levels and increased treatment duration were strongly associated with the development of lamivudine-resistant mutations (p = 0.002 and p < 0.001). Patients who continued to be positive for hepatitis B e antigen have an increased risk for treatment failure (p = 0.010). High baseline aspartate transaminase levels were significantly associated with subsequent lamivudine response (p = 0.037). CONCLUSION: Considering the limited potency and high resistance rates to lamivudine therapy, our study emphasizes the use of more potent drugs in the management of chronic hepatitis B in the Indian subcontinent.

7 Article Characterization of hepatitis E virus from sporadic hepatitis cases and sewage samples from Vellore, south India. 2013

Vivek, Rosario / Zachariah, Uday G / Ramachandran, Jeyamani / Eapen, Chundamannil E / Rajan, Deva P / Kang, Gagandeep. ·Wellcome Trust Research Laboratory, Division of Gastrointestinal Sciences, Christian Medical College, Vellore 632004, India. ·Trans R Soc Trop Med Hyg · Pubmed #23677583.

ABSTRACT: BACKGROUND: Hepatitis E virus (HEV) is endemic in India and causes epidemics and sporadic cases. However, the exact transmission route for sporadic hepatitis E remains unclear. This study investigated HEV in sporadic hepatitis cases and sewage samples, as sewage is the major source of contamination of water in developing countries. METHODS: Monthly sampling and testing for HEV in sewage samples from Vellore, India was carried out for 1 year (November 2009-October 2010) and plasma and/or fecal samples from sporadic hepatitis cases presenting to a hospital in Vellore during 2006-2010 were tested for HEV RNA. A total of 144 raw sewage samples and 94 samples from sporadic hepatitis cases were tested for HEV RNA using RT-PCR. RESULTS: The prevalence of HEV RNA in sewage and sporadic cases was 55.6% and 9.6%, respectively. HEV strains isolated from sewage showed 94-100% nucleotide sequence similarity with the HEV strains isolated from the sporadic hepatitis cases. HEV RNA in sewage was identified more often during the summer (81.2%) than the monsoon season (14.5%) (p < 0.001). CONCLUSION: This study indicates that sewage may be a source of contamination for sporadic hepatitis and also underscores the need for preventive measures to protect drinking water from sewage contamination, particularly in the summer. GENBANK ACCESSION NUMBERS: HEV strains isolated from this study were deposited in GenBank under accession numbers JF972766-JF972773, JN705651-JN705659 and JN705660-JN705662.