Efficacy & Safety of Tenofovir Disoproxil Fumarate (TDF) Plus Peginterferon α-2a (Peg-IFN) Versus TDF or Peg-IFN Monotherapy in Chronic Hepatitis B
- Registration Number
- NCT01277601
- Lead Sponsor
- Gilead Sciences
- Brief Summary
The primary objective of this study is to evaluate the efficacy of tenofovir disoproxil fumarate (TDF) plus peginterferon α-2a (Peg-IFN) combination therapy for 48 weeks versus standard of care TDF monotherapy or Peg-IFN monotherapy for 48 weeks in non-cirrhotic adults with chronic hepatitis B virus (HBV) as determined by loss of hepatitis B surface antigen (HBsAg).
The study will consist of 2 phases for participants in the TDF+Peg-IFN 48 Weeks, TDF 48 Weeks + Peg-IFN 16 Weeks, and Peg-IFN 48 Weeks groups. Following an initial 48 weeks of treatment, participants in these groups will be monitored for 24 weeks for signs of worsening HBV, and those meeting TDF retreatment and flare management criteria will be eligible to receive TDF monotherapy during a retreatment phase, up to Week 120.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 751
- Adults (age 18-75) with chronic HBV (positive for serum hepatitis B surface antigen (HBsAg) or HBV DNA for at least 6 months) prior to baseline
- Anti-HBV treatment-naive adults; adults who have taken oral anti-HBV nucleoside therapy with the last dose ≥ 24 weeks prior to screening are also eligible.
- Positive or negative for hepatitis B e antigen (HBeAg)
- HBV DNA ≥ 20,000 IU/ml (HBeAg-positive participants) and ≥ 2,000 IU/ml (HBeAg-negative participants)
- Alanine aminotransferase (ALT) > 54 U/L and ≤ 400 U/L for men and > 36 U/L and ≤ 300 U/L for women
- Creatinine clearance ≥ 70 mL/min
- Negative serum pregnancy test for females of childbearing potential
- Sexually active females of childbearing potential must agree to use a protocol-recommended method of contraception throughout the study and for 30 days following the last dose of study medication
- Lactating females must agree to discontinue nursing before initiation of study investigational medicinal product
- Known bridging fibrosis or cirrhosis and/or decompensated liver disease
- Evidence of hepatocellular carcinoma
- Significant kidney, heart, lung, neurological, autoimmune disease, or bone disease (eg, osteomalacia,chronic osteomyelitis, osteogenesis imperfecta, osteochondrosis, multiple bone fractures)
- Absolute neutrophil count < 1,500/mm^3, platelet < 100,000/mm^3, hemoglobin < 10 g/dL (female) or < 11 g/dL (male)
- History of severe depression or severe psychiatric disease
- Thyroid dysfunction
- Coinfection with HIV, hepatitis C virus (HCV) or hepatitis D virus (HDV)
- Pregnant
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description TDF 48 Weeks + Peg-IFN 16 Weeks TDF TDF plus Peg-IFN for 16 weeks, followed by TDF alone for an additional 32 weeks TDF 48 Weeks + Peg-IFN 16 Weeks Peg-IFN TDF plus Peg-IFN for 16 weeks, followed by TDF alone for an additional 32 weeks TDF 120 Weeks TDF TDF monotherapy for 120 weeks Peg-IFN 48 Weeks Peg-IFN Peg-IFN monotherapy for 48 weeks TDF+Peg-IFN 48 Weeks TDF TDF plus Peg-IFN for 48 weeks TDF+Peg-IFN 48 Weeks Peg-IFN TDF plus Peg-IFN for 48 weeks
- Primary Outcome Measures
Name Time Method Percentage of Participants With HBsAg Loss at Week 72 Following Treatment With 48 Weeks of TDF Plus Peg-IFN Combination Versus Peg-IFN Alone for 48 Weeks or TDF Alone Baseline; Week 72 Loss of HBsAg was defined as change of detectable HBsAg from positive to negative. Proportions are based on a Kaplan-Meier estimate.
The analysis visit window for Week 72 comprised Week 70 through Week 78, so results up to Week 78 are included in this analysis.
- Secondary Outcome Measures
Name Time Method Percentage of Participants With HBsAg Loss at Weeks 96 and 120 Baseline; Weeks 96 and 120 Loss of HBsAg was defined as change of detectable HBsAg from positive to negative. Proportions are based on a Kaplan-Meier estimate.
The analysis visit window for Week 96 comprised study Week 90 through Week 102, so results up to Week 102 are included in this analysis. The analysis visit window for Week 120 comprised study Week 114 through Week 126, so results up to Week 126 are included in this analysis.Percentage of Participants With HBsAg Seroconversion at Weeks 72, 96, and 120 Baseline; Weeks 72, 96, and 120 HBsAg seroconversion was defined as change of detectable antibody to HBsAg from negative to positive. Proportions are based on a Kaplan-Meier estimate.
The analysis visit window for Week 72 comprised Week 70 through Week 78, so results up to Week 78 are included in this analysis. The analysis visit window for Week 96 comprised Week 90 through Week 102, so results up to Week 102 are included in this analysis. The analysis visit window for Week 120 comprised Week 114 through Week 120.Percentage of Participants With HBeAg Loss and Seroconversion at Week 72 Baseline; Week 72 Loss of HBeAg was defined as change of detectable HBeAg from positive to negative. HBeAg seroconversion was defined as change of detectable antibody to HBeAg from negative to positive. Percentages were based on the number of subjects with non-missing HBeAg results or missing HBeAg results imputed as failures at each visit.
For the TDF+Peg-IFN 48 Weeks, TDF 48 Weeks + Peg-IFN 16 Weeks, and Peg-IFN 48 Weeks groups, data are presented in the "Not Retreated" column for participants who had not entered the retreatment phase by Week 72, and in the "Retreated" column for participants who did enter the retreatment phase by Week 72.Percentage of Participants With HBeAg Loss and Seroconversion at Week 96 Baseline; Week 96 Loss of HBeAg was defined as change of detectable HBeAg from positive to negative. HBeAg seroconversion was defined as change of detectable antibody to HBeAg from negative to positive. Percentages were based on the number of subjects with non-missing HBeAg results or missing HBeAg results imputed as failures at each visit.
For the TDF+Peg-IFN 48 Weeks, TDF 48 Weeks + Peg-IFN 16 Weeks, and Peg-IFN 48 Weeks groups, data are presented in the "Not Retreated" column for participants who had not entered the retreatment phase by Week 96, and in the "Retreated" column for participants who did enter the retreatment phase by Week 96.Percentage of Participants With HBeAg Loss and Seroconversion at Week 120 Baseline; Week 120 Loss of HBeAg was defined as change of detectable HBeAg from positive to negative. HBeAg seroconversion was defined as change of detectable antibody to HBeAg from negative to positive. Percentages were based on the number of subjects with non-missing HBeAg results or missing HBeAg results imputed as failures at each visit.
For the TDF+Peg-IFN 48 Weeks, TDF 48 Weeks + Peg-IFN 16 Weeks, and Peg-IFN 48 Weeks groups, data are presented in the "Not Retreated" column for participants who had not entered the retreatment phase by Week 120, and in the "Retreated" column for participants who did enter the retreatment phase by Week 120.Percentage of Participants With Virological Response (HBV DNA < 117 IU/mL) at Week 72 Week 72 For the TDF+Peg-IFN 48 Weeks, TDF 48 Weeks + Peg-IFN 16 Weeks, and Peg-IFN 48 Weeks groups, data are presented in the "Not Retreated" column for participants who had not entered the retreatment phase by Week 72, and in the "Retreated" column for participants who did enter the retreatment phase by Week 72.
Percentage of Participants With Virological Response (HBV DNA < 117 IU/mL) at Week 96 Week 96 For the TDF+Peg-IFN 48 Weeks, TDF 48 Weeks + Peg-IFN 16 Weeks, and Peg-IFN 48 Weeks groups, data are presented in the "Not Retreated" column for participants who had not entered the retreatment phase by Week 96, and in the "Retreated" column for participants who did enter the retreatment phase by Week 96.
Percentage of Participants With Virological Response (HBV DNA < 117 IU/mL) at Week 120 Week 120 For the TDF+Peg-IFN 48 Weeks, TDF 48 Weeks + Peg-IFN 16 Weeks, and Peg-IFN 48 Weeks groups, data are presented in the "Not Retreated" column for participants who had not entered the retreatment phase by Week 120, and in the "Retreated" column for participants who did enter the retreatment phase by Week 120.
Percentage of Participants With HBsAg Loss at Week 72 Following Treatment With TDF (48 Weeks) Plus Peg-IFN (16 Weeks) Combination Versus Peg-IFN Alone for 48 Weeks or TDF Alone Baseline; Week 72 Loss of HBsAg was defined as change of detectable HBsAg from positive to negative. Proportions are based on a Kaplan-Meier estimate.
The analysis visit window for Week 72 comprised Week 70 through Week 78, so results up to Week 78 are included in this analysis.Percentage of Participants With Normal ALT at Week 72 Week 72 Normal ALT was ≤ 30 U/L for males and ≤ 19 U/L for females (based on the American Association for the Study of Liver Diseases (AASLD) 2008 guidelines), and ≤ 41 U/L for males and ≤ 31 U/L for females (based on central laboratory upper limit of the normal range (ULN) for ALT).
For the TDF+Peg-IFN 48 Weeks, TDF 48 Weeks + Peg-IFN 16 Weeks, and Peg-IFN 48 Weeks groups, data are presented in the "Not Retreated" column for participants who had not entered the retreatment phase by Week 72, and in the "Retreated" column for participants who did enter the retreatment phase by Week 72.Percentage of Participants With Normal ALT at Week 96 Week 96 Normal ALT was ≤ 30 U/L for males and ≤ 19 U/L for females (based on the American Association for the Study of Liver Diseases (AASLD) 2008 guidelines), and ≤ 41 U/L for males and ≤ 31 U/L for females (based on central laboratory upper limit of the normal range (ULN) for ALT).
For the TDF+Peg-IFN 48 Weeks, TDF 48 Weeks + Peg-IFN 16 Weeks, and Peg-IFN 48 Weeks groups, data are presented in the "Not Retreated" column for participants who had not entered the retreatment phase by Week 96, and in the "Retreated" column for participants who did enter the retreatment phase by Week 96.Percentage of Participants With Normal ALT at Week 120 Week 120 Normal ALT was ≤ 30 U/L for males and ≤ 19 U/L for females (based on the American Association for the Study of Liver Diseases (AASLD) 2008 guidelines), and ≤ 41 U/L for males and ≤ 31 U/L for females (based on central laboratory upper limit of the normal range (ULN) for ALT).
For the TDF+Peg-IFN 48 Weeks, TDF 48 Weeks + Peg-IFN 16 Weeks, and Peg-IFN 48 Weeks groups, data are presented in the "Not Retreated" column for participants who had not entered the retreatment phase by Week 120, and in the "Retreated" column for participants who did enter the retreatment phase by Week 120.Percentage of Participants Who Required Retreatment Up to 120 weeks Participants in the TDF 120 week group were not eligible to enter the retreatment phase and are not presented.
Trial Locations
- Locations (170)
University of Chicago
🇺🇸Chicago, Illinois, United States
Tufts Medical Center
🇺🇸Boston, Massachusetts, United States
Private Practice
🇺🇸Philadelphia, Pennsylvania, United States
Royal Prince Alfred Hospital
🇦🇺Camperdown, New South Wales, Australia
Royal Brisbane & Women's Hospital
🇦🇺Herston, Queensland, Australia
Flinders Medical Center
🇦🇺Adelaide, South Australia, Australia
Saint Vincents Hospital
🇦🇺Fitzroy, Victoria, Australia
Toronto Liver Centre
🇨🇦Toronto, Ontario, Canada
VGM Hospital
🇮🇳Coimbatore, Tamil Nadu, India
Avail Clinical Research, LLC
🇺🇸Deland, Florida, United States
Westmead Hospital
🇦🇺Westmead, New South Wales, Australia
Medical Procare, PLLC
🇺🇸Flushing, New York, United States
Asian Pacific Liver Center
🇺🇸Los Angeles, California, United States
LSU Gastroenterology/Center for Digestive Diseases
🇺🇸New Orleans, Louisiana, United States
Stanford University Medical Center
🇺🇸Palo Alto, California, United States
Tulane University Hospital and Clinic
🇺🇸New Orleans, Louisiana, United States
Centre Hospitalier Universitaire Purpan
🇫🇷Toulouse, France
Johann-Wolfgang-Goethe Universitat,
🇩🇪Frankfurt, Germany
Charite Berlin
🇩🇪Berlin, Germany
Liver Institute of Virginia, Bon Secours Health System
🇺🇸Richmond, Virginia, United States
Hôpital Beaujon, Service Hepatologie- Centre Pierre Abrami
🇫🇷Clichy, Cedex, France
Asklepios Westklinikum
🇩🇪Hamburg, Germany
Toronto General Hospital
🇨🇦Toronto, Ontario, Canada
Liverpool Hospital,Gastroenterology Department
🇦🇺Liverpool, New South Wales, Australia
Department of Hepatology, Institute of Liver Diseases, HPB Surgery and Transplant, Global Hospital
🇮🇳Mumbai, Maharashtra, India
Hopital Tenon
🇫🇷Paris, France
Institute of digestive and liver disease, Dispur Hospital Ganeshguri
🇮🇳Guwahati, Assam, India
New York Univ. Medical Center
🇺🇸New York, New York, United States
Johannes Gutenberg-Universitat Mainz,
🇩🇪Mainz, Rheinland-pfalz, Germany
Digestive Disease Associates
🇺🇸Baltimore, Maryland, United States
Henry Ford Hospital
🇺🇸Detroit, Michigan, United States
Prince of Wales Hospital
🇭🇰Shatin, Hong Kong
Concord Repatriation General Hospital
🇦🇺Concord, New South Wales, Australia
Gordon & Leslie Diamond Health Care Centre
🇨🇦Vancouver, British Columbia, Canada
Universitatsklinik Koln
🇩🇪Köln, Germany
Mersin Üniversitesi Tip Fakültesi, Saglik Arastirma ve Uygulama Hastanesi
🇹🇷Mersin, Turkey
Royal Free Hospital
🇬🇧Hampstead,London, United Kingdom
Hôpital de la Croix Rousse
🇫🇷Lyon, Cedex, France
McGuire Research Institute
🇺🇸Richmond, Virginia, United States
Ankara Üniversitesi Tip Fakültesi
🇹🇷Ankara, Turkey
Chung Shan Medical University Hospital
🇨🇳Taichung, Taiwan
Istanbul Universitesi Istanbul Tip Fakultesi
🇹🇷Istanbul, Turkey
The Queen Elizabeth Hospital
🇬🇧Birmingham, WSTMID, United Kingdom
Fremantle Hospital
🇦🇺Fremantle, Australia
Universitätsklinikum Essen - klinikum für Gastroenterolgie und Hepatologie,
🇩🇪Essen, Germany
Liver and Intestinal Research Centre
🇨🇦Vancouver, British Columbia, Canada
Box Hill Hospital
🇦🇺Melbourne, Victoria, Australia
University of Milan,Azienda Ospedaliera San Giovanni, Battista di Torino,Dipartimento di Gastroenterologia
🇮🇹Torino, Italy
Chang Gung Memorial Hospital
🇨🇳Kaohsiung, Taiwan
Taichung Veterans Genl Hosp
🇨🇳Taichung, Taiwan
Hacettepe Üniversitesi Tip Fakültesi
🇹🇷Ankara, Turkey
Hospital Meixoeiro
🇪🇸Vigo, Pontevedra, Spain
Hospital de Egas Moniz
🇵🇹Lisboa, Portugal
Kaohsiung Medical University Hospital
🇨🇳Kaosiung, Taiwan
Chang Gung Medical Foundation-Keelung
🇨🇳Keelung Town/KEELUNG CITY, Taiwan
Cabinet Particular Policlinic Algomed SRL-Gastroenterologie
🇷🇴Timisoara, Romania
Wojewódzki Specjalistyczny Szpital im. Dr Wladyslawa Bieganskiego w Lodzi
🇵🇱Lodz, Poland
Samsung Medical Center
🇰🇷Seoul, Korea, Republic of
Chang Gung Medical Foundation.LinKou Branch
🇨🇳Tao-Yuan, Taoyuan, Taiwan
Wojewodzki Szpital Specjalistyczny Kazimierza Dluskeigo w Bialymstoku
🇵🇱Bialystok, Poland
SP ZOZ Wojewodzki Szpital Zakazny
🇵🇱Warszawa, Poland
Hospital General Universitari Vall d' Hebron
🇪🇸Barcelona, Spain
Gaziantep Üniversitesi Tip Fakültesi, Sahinbey Arastirma ve Uygulama Hastanesi
🇹🇷Gaziantep, Turkey
King's College Hospital
🇬🇧London, United Kingdom
Research and Education Inc
🇺🇸San Diego, California, United States
University of Miami / Jackson Memorial Medical Center
🇺🇸Miami, Florida, United States
Advanced Liver Therapies at St. Luke's Episcopal Hospital
🇺🇸Houston, Texas, United States
Kelsey Research Foundation
🇺🇸Houston, Texas, United States
Liver Associates of Texas,
🇺🇸Houston, Texas, United States
University of Utah
🇺🇸Salt Lake City, Utah, United States
Azienda Ospedaliero-Universitaria di Cagliari
🇮🇹Monserrato, Cagliari, Italy
The Ottawa Hospital,Division of Infectious Diseases
🇨🇦Ottawa, Ontario, Canada
Centre Hospitalier Universitaire de Rennes
🇫🇷Rennes Cedex 9, France
Centre Hospitalier Regional et Universitaire de Strasbourg, Hopital Civil
🇫🇷Strasbourg, France
Medizinische Hochschule Hannover,Hastroenterologie und Hepatologie
🇩🇪Hannover, Germany
Beth Israel Medical Center
🇺🇸New York, New York, United States
Weill Cornell Medical College of Cornell University
🇺🇸New York, New York, United States
San Jose Gastroenterology
🇺🇸San Jose, California, United States
Centre for Advanced Gastroenterology
🇺🇸Maitland, Florida, United States
ID Care, Inc.
🇺🇸Hillsborough, New Jersey, United States
Princess Alexandra Hospital
🇦🇺Woolloongabba, Queensland, Australia
Saint George's Hospital
🇦🇺Kogarah, New South Wales, Australia
Royal Adelaide Hospital
🇦🇺Adelaide SA, South Australia, Australia
Monash Medical Centre
🇦🇺Clayton, Victoria, Australia
University of Alberta, Zeidler Ledcore Centre
🇨🇦Zeidler Ledcore Centre, Alberta, Canada
Western Hospital
🇦🇺Footscray, Victoria, Australia
Alfred Hospital
🇦🇺Melbourne, Victoria, Australia
Austin Health
🇦🇺Heidelberg, Victoria, Australia
Gastrointestional Research Institute
🇨🇦Vancouver, British Columbia, Canada
Sir Charles Gairdner Hospital
🇦🇺Nedlands, Australia
Royal Perth Hospital
🇦🇺Perth, Australia
Royal Melbourne Hospital
🇦🇺Parkville, Victoria, Australia
Heritage Med Research Clinic, Univ of Calgary
🇨🇦Calgary, Alberta, Canada
Universitatsklinikum Leipzig
🇩🇪Leipzig, Germany
Hopital Charles Nicolle
🇫🇷Rouen, France
Hopital Paul Brousse
🇫🇷Villejuif Cedex, France
Ippokratio Hospital Salonica
🇬🇷Thessaloniki, Attica, Greece
General University Hospital of Patras
🇬🇷Patra, Greece
Ippokratio Hospital Athens
🇬🇷Attica, Greece
Hippokration General Hospital of Thessaloniki
🇬🇷Thessaloniki, Greece
Vedanta Institute of Medical Sciences
🇮🇳Ahmedabad, Gujarat, India
Liver Clinic
🇮🇳Surat, Gujarat, India
Manipal Hospitals
🇮🇳Bangalore, Karnataka, India
Institute of Post Graduate Medical Education And Research
🇮🇳Kolkata, West Bengal, India
Fondazione IRCCS Ca Granda - Ospedale Maggiore Policlinico
🇮🇹Milano, Italy
Fondazione PTV - Policlinico Tor Vergata
🇮🇹Roma, Italy
Ospedale San Raffaele
🇮🇹Milano, Italy
Azienda Ospedaliera di Parma,Department of Infectious Diseases and hepatology
🇮🇹Parma, Italy
Policlinico Umberto I
🇮🇹Rome, Italy
Seconda Universita degli Studi di Napoli
🇮🇹Napoli, Italy
Korea University Ansan Hospital
🇰🇷Ansan-si, Gyeonggi-d, Korea, Republic of
Yonsei Unversity Wonju College of Medicine Wonju Christian Hospital
🇰🇷Wonju, Gangwon-do, Korea, Republic of
SoonChunHyang University Hospital Cheonan
🇰🇷Cheonan, Chungcheon, Korea, Republic of
CHA Bundang Medical Center, CHA University
🇰🇷Sungnam, Gyeonggi-d, Korea, Republic of
Bucheon St. Mary's Hospital
🇰🇷Bucheon, Gyeonggi-d, Korea, Republic of
Korea University Guro Hospital
🇰🇷Seoul, Gyeonggi-d, Korea, Republic of
Pusan National University Hospital
🇰🇷Busan, Gyeongsang, Korea, Republic of
Kyungpook National University Hospital
🇰🇷Daegu, Gyeongsang, Korea, Republic of
Pusan National University Yangsan Hospital
🇰🇷Yangsan, Gyeongsang, Korea, Republic of
Inje University Busan Paik Hospital
🇰🇷Busan, Korea, Republic of
Inje University Ilsan Paik Hospital
🇰🇷Goyang, Gyeonggi-Do, Korea, Republic of
Asan Medical Center
🇰🇷Seoul, Korea, Republic of
Gangnam Severance Hospital
🇰🇷Seoul, Korea, Republic of
Digestive Disease Cntr, Konkuk Univ Hosp
🇰🇷Kwangjin-gu, Seoul, Korea, Republic of
Konkuk University Medical Center
🇰🇷Seoul, Korea, Republic of
Seoul Saint Mary's Hospital
🇰🇷Seoul, Korea, Republic of
Academisch Medisch Centrum
🇳🇱Amsterdam, Netherlands
Erasmus Medisch Centrum
🇳🇱Rotterdam, Netherlands
Vrije Universiteit Medisch Centrum
🇳🇱Amsterdam, Netherlands
Szpital Specjalistyczny w Chorzowie
🇵🇱Chorzów, Slaskie, Poland
Samodzielny Publiczny Szpital Kliniczny 1,Klinika Chorób Zakaznych,ulica Staszica 16
🇵🇱Lublin, Lubelskie, Poland
Wojewódzki Szpital Obserwacyjno Zakazny im. Tadeusza Browicza
🇵🇱Bydgoszcz, Poland
Szpital Uniwersytecki w Krakowie
🇵🇱Krakow, Poland
Hospital de Santa Maria
🇵🇹Lisboa, Portugal
Neomed Research
🇷🇴Brasov, Romania
Spitalul Clinic Judetean de Urgenta Sibiu
🇷🇴Sibiu, Romania
Spitalul Clinic Colentina
🇷🇴Bucuresti, Romania
Singapore General Hospital
🇸🇬Singapore, Singapore
Tan Tock Seng Hospital
🇸🇬Singapore, Singapore
Hospital Universitario Virgen del Rocio
🇪🇸Sevilla, Spain
Hospital Virgen de la Victoria
🇪🇸Malaga, Spain
Hospital Carlos III
🇪🇸Madrid, Spain
Hospital Universitario de La Princesa
🇪🇸Madrid, Spain
Far-Eastern Memorial Hosp
🇨🇳New Taipei City, Banciao Dist, Taiwan
Chiayi Christian Hosp
🇨🇳Chia-Yi, Taiwan
Buddhist Tzu Chi General Hospital
🇨🇳Hualien, Taiwan
Barts and The London NHS Trust
🇬🇧London, United Kingdom
Seoul National University Hospital
🇰🇷Seoul, Korea, Republic of
All India Institute of Medical Sciences, Ansari Nagar
🇮🇳Delhi, New Delhi, India
Centro Hospitalar do Porto
🇵🇹Porto, Portugal
Institutul National de Boli Infectioase "Prof. Dr. Matei Bals"
🇷🇴Bucharest, Romania
National Cheng Kung University Hospital
🇨🇳Tainan, Taiwan
National Taiwan University Hospital
🇨🇳Taipei, Taiwan
National University Hospital Singapore
🇸🇬Singapore, Singapore
Global Hospital, Lakdi Ka Pul
🇮🇳Hyderabad, Andhra Pradesh, India
Changhua Christain Hospital
🇨🇳Changhua, Taiwan
Institutul National de Boli Infectioase Prof.Dr. Matei Bals
🇷🇴Bucharest, Romania
Changi General Hospital
🇸🇬Singapore, Singapore
China Medical University Hospital
🇨🇳Taichung, Taiwan
North Shore University Hospital
🇺🇸Great Neck, New York, United States
Hospital São João
🇵🇹Porto, Portugal
Spitalul Clinic de Boli Infectioase si Tropicale "Dr. Victor Babes"
🇷🇴Bucharest, Romania
Seth GS Medical College and KEM Hospital, Acharya Donde Marg,Parel
🇮🇳Mumbai, Maharashtra, India
Midas Institute of Gastroenterology
🇮🇳Nagpur, Maharashtra, India
Dharamasi Hospital,Chandni Chowk, South Shivajinagar,
🇮🇳Sangli, Maharashtra, India
Cathay General Hospital
🇨🇳Taipei, Taiwan
Institute of Liver and Biliary Sciences
🇮🇳New Delhi, India
Queen Mary Hospital
🇭🇰Hong Kong, Hong Kong
Princess Margaret Hospital
🇭🇰Kowloon, Hong Kong
Alice Ho Miu Ling Nethersole Hospital
🇭🇰Tai Po, Hong Kong