Browsing by Author "Marcellin, Patrick"
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Publication Association between ALT flares and HBeAg loss and HBsAg decline in Patients with Chronic Hepatitis B during treatment with Tenofovir Disoproxil Fumarate or Adefovir Dipivoxil(Lippincott Williams & Wilkins, 2015-10-01) Marcellin, Patrick; Gane, Edward J.; Krastev, Zahary; Gürel, Selim; Dusheiko, Geoffrey M.; Gaggar, Anuj; Massetto, Benedetta; Kim, Kyungpil; Flaherty, John F.; Subramanian, Mani; Janssen, Harry L.; Buti, Maria; GÜREL, SELİM; Uludağ Üniversitesi/Tıp Fakültesi.; HLH-8209-2023Item Efficacy and safety of tenofovir alafenamide (TAF) at 96 weeks in chronic HBV (CHB) patients with risk factors for use of tenofovir disoproxil fumarate (TDF)(Wiley, 2017-10) Buti, Maria; Stepanova, Tatjana; Celen, Mustafa K.; Flisiak, Robert; Ryder, Stephen D.; Streinu, Adrian Cercel; Flaherty, John F.; Gaggar, Anu; Suri, Vithika; Mo, Shuyuan; Subramanian, Mani; Nurmukhametova, Elena; Zoulim, Fabien; Andreone, Pietro; Marcellin, Patrick; Gürel, Selim; Uludağ Üniversitesi/Tıp Fakültesi/Dahiliye Anabilim Dalı/Gastroenteroloji Bilim Dalı.; HLH-8209-2023Publication Factors associated with a lack of viral suppression in chronic hbv (CHB) patients after 8 years of treatment with tenofovir alafenamide (TAF) or tenofovir disoproxil fumarate (TDF) followed by taf treatment(Lippincott Williams & Wilkins, 2023-10-01) Gane, Edward J.; Buti, Maria; Fung, Scott K.; Chan, Henry Lik Yuen; Izumi, Namiki; Chuang, Wan Long; Ahn, Sang Hoon; Mehta, Rajiv M.; Gürel, Selim; Abramov, Frida; Yee, Leland J.; Wang, Hongyuan; Mateo, Roberto; Flaherty, John F.; Ma, Xiaoli; Pan, Calvin Q.; Lim, Young-Suk; Marcellin, Patrick; GÜREL, SELİM; Bursa Uludağ Üniversitesi/Tıp Fakültesi/Gastroenteroloji Anabilim Dalı.; JKF-2069-2023Item A finite course of peginterferon alfa-2a results in inactive chronic hepatitis b and hbsag clearance 5 years post-treatment in patients with hbeag-negative disease: Baseline characteristics and predictive factors of long-term response(Wiley, 2009-10) Marcellin, Patrick; Piratvisuth, Teerha; Brunetto, Maurizia; Bonino, Ferruccio; Farci, Patrizia; Yurdaydın, Cihan; Kapprell, Hans Peter; Messinger, Diethelm; Batrla, Richard; Gürel, Selim; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Gastroenteroloji Bilim Dalı.Item Impact of long-term tenofovir disoproxil fumarate on incidence of hepatocellular carcinoma in patients with chronic hepatitis B(Wiley, 2015-10-15) Kim, W. Ray; Loomba, Rohit; Berg, Thomas; Schall, Raul E. Aguilar; Yee, Leland J.; Dinh, Phillip V.; Flaherty, John F.; Martins, Eduardo B.; Therneau, Terry M.; Jacobson, Ira; Fung, Scott; Buti, Maria; Marcellin, Patrick; Gürel, Selim; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Gastroenteroloji Bilim Dalı.; 7003706434BACKGROUND: Efficacy trials have shown that antiviral therapy improves the outcomes of patients with chronic hepatitis B virus (HBV) infection. However, prospective data regarding the effect of antiviral therapy on the incidence of hepatocellular carcinoma (HCC), especially among patients without cirrhosis, are limited. The authors examined the impact of tenofovir disoproxil fumarate (TDF) on the incidence of HCC using a validated prediction model. METHODS: The incidence of HCC in patients treated with TDF was obtained in the pivotal TDF registration studies after 384 weeks of follow-up. The predicted risk of HCC in individual patients was calculated using the Risk Estimation for Hepatocellular Carcinoma in Chronic Hepatitis B (REACH-B) model, which estimates HCC incidence for up to 10 years based on age, sex, alanine aminotransferase level, hepatitis B e antigen status, and HBV-DNA. Standardized incidence ratios (SIRs) were calculated comparing the observed and predicted numbers of HCC cases in the study cohort. RESULTS: Among 634 patients with evaluable baseline biopsies, 152 had cirrhosis (Ishak fibrosis score of 5 or 6) and 482 did not. During the 384 weeks of study, 14 cases of HCC were reported, with 4 occurring within the first year. The incidence of HCC was 0.37% per year in the study as a whole (0.28% among patients without cirrhosis and 0.65% among patients with cirrhosis). Among patients without cirrhosis, the observed incidence of HCC was significantly lower than predicted (SIR, 0.40; 95% confidence interval, 0.199-0.795). The last HCC case in a patient with cirrhosis occurred around week 192 with an SIR of 0.51 (95% confidence interval, 0.231-1.144) reported at week 384. CONCLUSIONS: Based on the REACH-B risk calculator, long-term therapy with TDF was associated with a reduced incidence of HCC among patients without cirrhosis who met treatment criteria.Item Increasing rates of hbsag clearance and seroconversion in patients with hbeag-negative disease treated with peginterferon alfa-2a +/- lamivudine: Results of 5-year post-treatment follow up(Elsevier, 2009) Marcellin, Patrick; Piratvisuth, Teerha; Brunetto, Maurizia; Bonino, F.; Lau, George; Farci, Patrizia; Yurdaydın, Cihan; Wu, J.; Popescu, Matei; Gürel, Selim; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Gastroenteroloji Bilim Dalı.Publication Kinetics of hepatitis B surface antigen loss in patients with HBeAg-positive chronic hepatitis B treated with tenofovir disoproxil fumarate(Elsevier, 2014-07-11) Marcellin, Patrick; Buti, Maria; Krastev, Zahari; de Man, Robert A.; Zeuzem, Stefan; Lou, Lillian; Gaggar, Anuj; Flaherty, John F.; Massetto, Benedetta; Lin, Lanjia; Dinh, Phillip; Subramanian, G. Mani; McHutchison, John G.; Flisiak, Robert; Gürel, Selim; Dusheiko, Geoffrey M.; Heathcote, E. Jenny; GÜREL, SELİM; Uludag Üniversitesi/Tıp Fakültesi.; HLH-8209-2023Background & Aims: In a study of 266 chronic hepatitis B e antigen (HBeAg)-positive patients, 23 experienced hepatitis B surface antigen (HBsAg) loss with up to 5 years of tenofovir disoproxil fumarate (TDF) treatment. HBsAg kinetics in patients with and without HBsAg loss and predictors of HBsAg loss were evaluated.Methods: HBsAg levels were quantified every 12 weeks. A multivariable regression analysis, involving prespecified baseline characteristics and on-treatment response parameters, was performed; a stepwise procedure identified independent predictors of HBsAg loss.Results: Among patients with HBsAg loss, 14 (61%), 1 (4%), 0 and 7 (30%) were genotypes A through D, respectively; 1 (4%) was genotype F. HBsAg loss was preceded by viral suppression (HBV DNA < 29 IU/ml; n = 23) and HBeAg loss (n = 19). Among treated patients the strongest independent predictors of HBsAg loss were Caucasian race with genotype A/D and 64 years of infection (HR = 14.3, 95% confidence interval [CI] 4.7-43.4; p < 0.0001) and an HBsAg decline of >= 1 log(10) IU/ml at week 24 (HR = 13.7, 95% CI 5.6-33.7; p < 0.0001). Among TDF-treated patients, a reduction in HBsAg level of >= 1-log(10) by week 12 or 24 had a positive predictive value of 35%-45%, respectively, and a negative predictive value of 94%-97%, respectively.Conclusions: HBsAg loss in HBeAg-positive patients receiving TDF involves a chronology of virologic and serologic responses; patients with HBV genotypes A or D and a rapid early decline in HBsAg are more likely to lose HBsAg.Item Long term tenofovir disoproxil fumarate for chronic hepatitis B infection is associated with sustained virological, biochemical and serological responses with no detectable resistance(Wiley, 2014-11) Chan, Alain; Marcellin, Patrick; Tsai, Naoky; Flisiak, Robert; Petersen, Jorg; Kotzev, Iskren; Flaherty, John; Gaggar, Anuj; Kitrinos, Kathryn; Mchutchison, John; George, Jacob; Buti, Maria; Gane, Edward; Gürel, Selim; Uludağ Üniversitesi/Tıp Fakültesi.; HLH-8209-2023Publication Long term treatment with tenofovir disoproxil fumarate for chronic hepatitis b infection is safe and well tolerated and associated with durable virologic response with no detectable resistance: 8 year results from two phase 3 trials(Wiley, 2014-01-01) Marcellin, Patrick; Gane, Edward J.; Flisiak, Robert; Trinh, Huy N.; Petersen, Joerg; Gürel, Selim; Kaita, Kelly D.; Kotzev, Iskren A.; Tsai, Naoky; Flaherty, John F.; Schall, Raul E. Aguilar; Kitrinos, Kathryn M.; Subramanian, Mani; McHutchison, John G.; George, Jacob; Janssen, Harry L.; Buti, Maria; GÜREL, SELİM; Uludağ Üniversitesi/Tıp Fakültesi; HLH-8209-2023Item Long-term clinical outcomes in cirrhotic chronic hepatitis B patients treated with tenofovir disoproxil fumarate for up to 5 years(Springer, 2015-04) Buti, Maria; Fung, Scott; Gane, Edward; Afdhal, Nezam H.; Flisiak, Robert; Flaherty, John F.; Martins, Eduardo B.; Yee, Leland J.; Dinh, Phillip; Bornstein, Jeffrey D.; Subramanian, G. Mani; Janssen, Harry L. A.; George, Jacob; Marcellin, Patrick; Gürel, Selim; Uludağ Üniversitesi/Tıp Fakültesi/Gastroenteroloji Anabilim Dalı.; 7003706434Phase 3 clinical studies have shown that long-term treatment with tenofovir disoproxil fumarate (TDF) can suppress hepatitis B viral load and promote significant fibrosis regression and cirrhosis reversal in a majority of treated chronic hepatitis B (CHB) patients. This retrospective analysis investigated the impact of baseline cirrhosis status on virologic, serologic, and histologic outcomes in patients treated with TDF. Patients enrolled in studies GS-US-174-0102 and GS-US-174-0103 who had baseline liver biopsy-diagnosed cirrhosis and entered the open-label phase of the studies were included in the virologic and serologic analyses. Patients (both HBeAg positive and negative) with paired liver biopsies at baseline and 5 years (N = 348) were included in a histologic analysis. After 5 years on study, comparing patients with and without baseline cirrhosis, respectively: 99.2 and 98.0 % achieved virologic response (hepatitis B viral load < 69 IU/ml) (p = 0.686); 79.7 and 81.9 % had normal serum levels of alanine aminotransferase (p = 0.586); 4.0 and 1.2 % developed hepatocellular carcinoma (p = 0.044). In HBeAg-positive patients with and without baseline cirrhosis, HBsAg loss occurred in 14.4 and 8.3 % of patients, respectively (p = 0.188). One HBeAg-negative patient had HBsAg loss. This represents the largest analyses to date of CHB patients with sequential liver biopsies demonstrating that treatment with TDF for up to 5 years is associated with favorable virologic, serologic, and histologic outcomes, regardless of baseline cirrhosis status. Notably, histologic improvement was observed in the majority of cirrhotic and noncirrhotic patients.Item The majority of patients with HBeAg-negative chronic hepatitis B treated with peginterferon alpha-2a (40KD) [PEGASYS (R)] sustain responses 2 years post-treatment(Elsevier, 2006) Marcellin, Patrick; Bonino, Ferruccio; Lau, George; Farci, Patrizia; Yurdaydin, C.; Piratvisuth, Teerha; Jin, R.; Hadziyannis, Stephanos J.; Lu, Zhimeng; Popescu, Madalina; Gürel, Selim; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Gastroenteroloji Bilim Dalı.Item No association between IFNL3 (IL28B) genotype and response to peginterferon alfa-2a in HBeAg-positive or -negative chronic hepatitis B(Public Library Science, 2018-05-22) Wei, Lai; Wedemeyer, Heiner; Liaw, Yun-Fan; Chan, Henry Lik-Yuen; Piratvisuth, Teerha; Marcellin, Patrick; Jia, Jidong; Tan, Deming; Chow, Wan-Cheng; Brunetto, Maurizia R.; Diago, Moises; Morozov, Viacheslav; He, Hua; Zhu, Yonghong; Wat, Cynthia; Surujbally, Bernadette; Thompson, Alexander J.; Gürel, Selim; Uludağ Üniversitesi/Tıp Fakültesi/Gastroenteroloji Anabilim Dalı.; HLH-8209-2023; 7003706434Background & aims It has yet to be firmly established whether host IFNL3 (IL28B) genotype influences interferon responsiveness in patients with chronic hepatitis B. We investigated associations between single-nucleotide polymorphisms (SNPs) in the IFNL3 region and response to peginterferon alfa-2a in 701 patients enrolled in three large, randomized, international studies. Methods Responses were defined as hepatitis B surface antigen (HBsAg) loss and/or hepatitis B e antigen (HBeAg) seroconversion plus hepatitis B virus (HBV) DNA < 2000 IU/ml in HBeAg-positive patients, and HBsAg loss and/or HBV DNA < 2000 IU/ml in HBeAg-negative patients (24 weeks after end of treatment). Associations between treatment response and the number of copies of the poor-response allele at three SNPs (rs8099917, rs12980275, rs12979860) were explored with logistic regression models in Asian and white patients. Results The HBeAg-positive and -negative populations comprised 465 (92% Asian, 50% HBV genotype C) and 236 (79% Asian, 41% HBV genotype C) patients, respectively, and had respective response rates of 26% and 47%. The IFNL3 genotype was strongly associated with ethnicity. There was no association between IFNL3 genotype and treatment response in HBeAg-positive or -negative patients. Independent predictors of treatment response were: sex, HBV DNA level and alanine aminotransferase level in HBeAg-positive Asian patients; age in HBeAg-negative Asian patients; and HBV DNA in HBeAg-negative white patients. Conclusions This is the largest analysis to date of associations between IFNL3 genotype and peginterferon response in patients with chronic hepatitis B. The data suggest that IFNL3 polymorphism is not a major determinant of the response to peginterferon alfa-2a in either HBeAg-positive or HBeAg-negative patients.Publication No association between IL28B genotype and response to peginterferon alfa-2a (40KD) in HBe antigen-positive and HBe antigen-negative patients with chronic hepatitis B in three large randomized clinical studies(Wiley-blackwell, 2013-10-01) Wei, Lai; Wedemeyer, Heiner; Liaw, Yun-Fan; Chan, Henry Lik-Yuen; Piratvisuth, Teerha; Marcellin, Patrick; Jia, Jidong; Tan, Deming; Chow, Wan-Cheng; Brunetto, Maurizia R.; Diago, Moises; Morozov, Viacheslav; He, Hua; Zhu, Yonghong; Wat, Cynthia; Thompson, Alexander J.; Gurel, Selim; GÜREL, SELİM; Bursa Uludağ Üniversitesi/Tıp Fakültesi; HLH-8209-2023Item On-treatment predictors of sustained biochemical and virological response in patients with HBeAg-negative chronic hepatitis B (CHB) treated with peginterferon alpha-2a (40 kDa) (Pegasys (R))(Elsevier Science, 2005-04) Farci, Patrizia; Marcellin, Patrick; Lu, Zhi-Meng; Diago, Moises; Lai, Ming-Yang; Kittis, G; Yurdaydin, Cihan; Zahm, FE; Bonino, FD; Gürel, Selim; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.Item Peginterferon alfa-2a alone, lamivudine alone, and the two in combination in patients with HBeAg-negative chronic hepatitis B(Massachusetts Medical Soc, 2004-09-16) Marcellin, Patrick; Lau, George; Bonino, Ferruccio; Farci, Patrizia; Hadziyannis, Stephanos; Jin, R.; Lu, ZM; Piratvisuth, Teerha; Germanidis, Georgios; Yurtaydin, Cihan; Moises, Diago; Mingyang, Lai; Button, P.; Pluck, Nigel; Gurel, Selim; Bursa Uludağ Üniversitesi/Tıp Fakültesi.Background: Available treatments for hepatitis B e antigen (HBeAg)-negative chronic hepatitis B are associated with poor sustained responses. As a result, nucleoside and nucleotide analogues are typically continued indefinitely, a strategy associated with the risk of resistance and unknown long-term safety implications. Methods: We compared the efficacy and safety of peginterferon alfa-2a (180 microg once weekly) plus placebo, peginterferon alfa-2a plus lamivudine (100 mg daily), and lamivudine alone in 177, 179, and 181 patients with HBeAg-negative chronic hepatitis B, respectively. Patients were treated for 48 weeks and followed for an additional 24 weeks. Results: After 24 weeks of follow-up, the percentage of patients with normalization of alanine aminotransferase levels or hepatitis B virus (HBV) DNA levels below 20,000 copies per milliliter was significantly higher with peginterferon alfa-2a monotherapy (59 percent and 43 percent, respectively) and peginterferon alfa-2a plus lamivudine (60 percent and 44 percent) than with lamivudine monotherapy (44 percent, P=0.004 and P=0.003, respectively; and 29 percent, P=0.007 and P=0.003, respectively). Rates of sustained suppression of HBV DNA to below 400 copies per milliliter were 19 percent with peginterferon alfa-2a monotherapy, 20 percent with combination therapy, and 7 percent with lamivudine alone (P<0.001 for both comparisons with lamivudine alone). Loss of hepatitis B surface antigen occurred in 12 patients in the peginterferon groups, as compared with 0 patients in the group given lamivudine alone. Adverse events, including pyrexia, fatigue, myalgia, and headache, were less frequent with lamivudine monotherapy than with peginterferon alfa-2a monotherapy or combination therapy. Conclusions: Patients with HBeAg-negative chronic hepatitis B had significantly higher rates of response, sustained for 24 weeks after the cessation of therapy, with peginterferon alfa-2a than with lamivudine. The addition of lamivudine to peginterferon alfa-2a did not improve post-therapy response rates.Publication Seven years of treatment with tenofovir df for chronic hepatitis b virus infection is safe and well tolerated and associated with sustained virological, biochemical and serological responses with no detectable resistance(Wiley-blackwell, 2013-10-01) Marcellin, Patrick; Gane, Edward J.; Tsai, Naoky; Flisiak, Robert; Petersen, Joerg; Kotzev, Iskren A.; Flaherty, John F.; Dinh, Phillip; Gaggar, Anuj; Kitrinos, Kathryn M.; Subramanian, Mani; McHutchison, John G.; George, Jacob; Buti, Maria; Gurel, Selim; GÜREL, SELİM; Bursa Uludağ Üniversitesi/Tıp Fakültesi; HLH-8209-2023Item Seven-year efficacy and safety of treatment with tenofovir disoproxil fumarate for chronic hepatitis b virus ınfection(Springer, 2015-05) Tsai, Naoky; Petersen, Joerg; Flisiak, Robert; Krastev, Zahary; Schall, Raul Aguilar; Flaherty, John F.; Martins, Eduardo B.; Charuworn, Prista; Kitrinos, Kathryn M.; Subramanian, G. Mani; Gane, Edward; Marcellin, Patrick; Gürel, Selim; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Gastroenteroloji Bilim Dalı.; 7003706434Background Long-term tenofovir disoproxil fumarate (TDF) treatment for chronic hepatitis B (CHB) is associated with sustained viral suppression and regression of fibrosis and cirrhosis at year 5 (240 weeks) and no TDF resistance through 6 years (288 weeks). Aim We assessed the efficacy, safety, and resistance of TDF for up to 7 years (336 weeks) in HBeAg-positive and HBeAg-negative CHB patients. Methods Patients who completed 1 year (48 weeks) of randomized treatment with TDF or adefovir dipivoxil were eligible to receive open-label TDF for a total duration of 8 years (384 weeks). Results Of 641 patients initially randomized, 585 (91.3 %) entered the open-label phase; 437/585 (74.7 %) remained on study at year 7. For patients on treatment at year 7, 99.3 % maintained viral suppression (HBV DNA < 69 IU/mL), 80.0 % achieved serum alanine aminotransferase normalization, and in HBeAg-positive patients, 84/154 (54.5 %) and 25/154 (11.8 %) achieved HBeAg and HBsAg loss, respectively. One/375 (0.3 %) HBeAg-negative patients achieved HBsAg loss. No resistance to TDF was detected through 7 years. During the open-label phase, grade 3/4 drug-related adverse events were uncommon (1.0 %); ten (1.7 %) patients had elevation of serum creatinine >= 0.5 mg/dL above baseline. No significant change in bone mineral density was observed from year 4 to year 7 (week 192 to week 336). Conclusions Long-term TDF treatment was associated with sustained virologic, biochemical, and serologic responses, without resistance. TDF treatment was well tolerated, with a low incidence of renal and bone events. These data confirm the safety and efficacy of long-term TDF for CHB.Item Suppression of HBV DNA in patients with HBeAg-negative CHB treated with peginterferon alfa-2A (40KD) +/- lamivudine: 2-year follow-up results(Wiley, 2006-10) Marcellin, Patrick; Bonino, Ferruccio; Lau, George; Farci, Patrizia; Yurdaydin, Cihan; Piratvisuth, Teerha; Luo, Kangxian; Hadziyannis, Stephanos J.; Wang, Yuming; Popescu, Matei; Gürel, Selim; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı.Item Sustained response of Hepatitis B e Antigen-Negative patients 3 years after treatment with Peginterferon Alfa-2a(WB Saunders Co-Elsevier, 2009-06) Yurdaydın, Cihan; Marcellin, Patrick; Bonino, Ferruccio; Lau, George; Farci, Patrizia; Piratvisuth, Teerha; Jin, Rui; Lu, Zhi-Meng; Wu, Jian; Popescu, Matei; Hadziyannis, Stephanos; Gürel, Selim; Uludağ Üniversitesi/Tıp Fakültesi/Gastroenteroloji Anabilim Dalı.; 7003706434Background & Aims: Patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis B treated with peginterferon alfa-2a with or without lamivudine achieve significantly higher 6-month posttreatment rates of response compared with those treated with lamivudine alone. The durability of <= 3-year posttreatment response was investigated in this study. Methods: Patients received peginterferon alfa-2a only (180 p,g once weekly; n = 177), in combination with lamivudine (100 mg daily; n = 179) or lamivudine alone (n = 181) for 48 weeks. A total of 315 patients (116, 114, and 85, respectively) participated in this posttreatment observational study. Results: Three years after treatment, the percentage of patients with normal alanine aminotransferase (ATL) was higher for patients treated with peginterferon alfa-2a (31%) than with lamivudine (18%; P = 0.032). Similarly, 28% of patients treated with peginterferon had hepatitis B virus (HBV) DNA levels 10,000 copies/mL versus 15% of patients treated with lamivudine (P = .039). Peginterferon alfa-2a treatment and high baseline ALT level were independent baseline predictors of long-term virologic response (P = .040 and P = .01, respectively). Of the patients who had been treated with a peginterferon alfa-2a-containing regimen, 8.7% cleared hepatitis B surface antigen (HBsAg; 44% of those with undetectable HBV at 3-year posttreatment follow-up) compared with none treated with lamivudine alone. Conclusions: Biochemical and virologic responses were sustained for 53 years in approximately 25% of patients given a 48-week course of peginterferon alfa-2a, with or without lamivudine. The increased rate of HBsAg clearance in patients with HBeAg-negative chronic hepatitis B supports the use of peginterferon alfa-2a as a first-line treatment.Item Three years of tenofovir disoproxil fumarate (tdf) treatment in hbeag-negative patients with chronic hepatitis b (study 102); preliminary analysis(Wiley, 2009-10) Marcellin, Patrick; Buti, Maria; Krastev, Zahary; Germanidis, George; Kaita, Kelly D.; Kotzev, Iskren; Buggisch, Peter; Weilert, Frank; Trinh, Huy N.; Heathcote, E. Jenny; Sorbel, Jeff; Anderson, Jane; Mondou, Elsa; Rousseau, Franck; Gürel, Selim; Uludağ Üniversitesi/Tıp Fakültesi/İç Hastalıkları Anabilim Dalı/Gastroenteroloji Bilim Dalı.Amer Assoc Study Liver Dis