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Article ; Online: Hepatitis B virus infection in Saudi Arabia and the UAE: Public health challenges and their remedial measures.

Sanai, Faisal / Alkhatry, Maryam / Alzanbagi, Adnan / Kumar, Shiva

2023 Volume 16, Issue 9, Page(s) 1410–1417

Abstract: Background: Hepatitis B virus (HBV) infection is a major public health concern globally with higher prevalence in Middle Eastern countries. Both Saudi Arabia and the UAE face critical challenges in HBV treatment and management despite the implementation ...

Abstract	Background: Hepatitis B virus (HBV) infection is a major public health concern globally with higher prevalence in Middle Eastern countries. Both Saudi Arabia and the UAE face critical challenges in HBV treatment and management despite the implementation of a mass vaccination program. This review aimed to understand the gaps and unmet needs related to HBV infection, public health challenges associated with its diagnosis, and treatment barriers in Saudi Arabia and the UAE. Additionally, the review aimed to provide the best practices in the HBV care pathway for effective remedial measures and disease reduction. Methods: The literature search was done from Pubmed. Results: The lack of disease awareness and knowledge about disease transmission among patients and their family members and healthcare professionals, lack of proper screening, underdiagnosis, social stigma, lack of established referral system, and treatment cost are the primary barriers to HBV diagnosis and management. Conclusion: Appropriate healthcare initiatives should be undertaken to lower the disease burden in Saudi Arabia and the UAE.
MeSH term(s)	Humans ; Hepatitis B virus ; Saudi Arabia/epidemiology ; Public Health ; Hepatitis B/diagnosis ; Hepatitis B/epidemiology ; Hepatitis B/prevention & control ; Hepatitis B Antibodies
Chemical Substances	Hepatitis B Antibodies
Language	English
Publishing date	2023-07-20
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	2467587-8
ISSN	1876-035X ; 1876-0341
ISSN (online)	1876-035X
ISSN	1876-0341
DOI	10.1016/j.jiph.2023.07.008
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Article ; Online: The Effect of Valproic Acid Drug on the Expression of SOCS1, SOCS3, JAK1, JAK2, STAT3, STAT5A and STAT5B Genes in HepG2 Cell Line Liver Cancer

M Sanai Jahormi / F Kaousi

Armaghane Danesh Bimonthly Journal, Vol 27, Iss 3, Pp 336-

2022 Volume 348

Abstract: Background & aim: Aberrant activation of various intracellular pathways is involved in differentiation, growth, apoptosis and cell survival. Different known intracellular pathways such as JAK/STAT cause tumor genesis and cancer development. This pathway ... ...

Abstract	Background & aim: Aberrant activation of various intracellular pathways is involved in differentiation, growth, apoptosis and cell survival. Different known intracellular pathways such as JAK/STAT cause tumor genesis and cancer development. This pathway plays an important role in various cellular functions and is activated by cytokines. Suppressors of cytokine signaling (SOCSs) genes play a pivotal role in regulating the immune system. Therefore, the aim of the research was to determine the effect of valproic acid drug on the expression of SOCS1, SOCS3, JAK1, JAK2, STAT3, STAT5A and STAT5B genes in HepG2 cell line liver cancer. Methods: In the present experimental study conducted in 2019, HepG2 liver cancer cells were purchased from Pasteur Institute and the overlapping of the cells reached about 80%. Using trypsin, the cells were collected and after washing, they were cultured in 96-well plates. After 24 hours of cell culture, the culture medium was drained and the medium containing valproic acid drug with different concentrations (0, 1, 5, 7.5, 10, 15, 20 and 25 μmol) was replaced (solvent only control group). They received the drug, DMSO). After 24 and 48 hours, the cells were washed with PBS solution. MTT technique was used to determine cell viability. To determine the amount of apoptotic cells and gene expression, the cells were treated with valproic acid with a concentration of 6.643 μmol for 24 hours and 5.401 μmol for 48 hours, and after 24 and 48 hours, flow cytometry and real-time techniques were used for Determination of apoptotic cells and expression of SOCS1, SOCS3, JAK1, JAK2, STAT3, STAT5A and STAT5B genes were used. The collected data were analyzed using one-way analysis of variance and Turkey’s test. Results: Valproic acid significantly increased the expression of SOCS1 and SOCS3 genes, decreased the expression of JAK1, JAK2, STAT3, STAT5A and STAT5B genes and inhibited cell growth. This combination significantly caused apoptosis (p<0.001). The percentage of apoptotic cells after 24 and ...
Keywords	valproic acid ; jak/stat pathway ; liver cancer ; apoptosis ; Medicine (General) ; R5-920
Subject code	610
Language	Persian
Publishing date	2022-04-01T00:00:00Z
Publisher	Yasuj University Of Medical Sciences
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: What the New Definition of MASLD Left Behind: Dual Etiology With Viral Hepatitis.

Fouad, Yasser / Sanai, Faisal / Alboraie, Mohamed / Zheng, Ming-Hua

Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association

2023

Language	English
Publishing date	2023-11-30
Publishing country	United States
Document type	Letter
ZDB-ID	2119789-1
ISSN	1542-7714 ; 1542-3565
ISSN (online)	1542-7714
ISSN	1542-3565
DOI	10.1016/j.cgh.2023.11.026
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Zs.A 5836: Show issues

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Article ; Online: Clinical and patient-reported outcomes in patients with chronic hepatitis B and C and non-alcoholic fatty liver disease from real-world practices in Saudi Arabia, Turkey and Egypt.

Alqahtani, Saleh A / Yilmaz, Yusuf / El-Kassas, Mohamed / Alswat, Khalid / Sanai, Faisal / AlZahrani, May / Abaalkhail, Faisal / AlShaikh, Manal / Al-Hamoudi, Waleed K / Nader, Fatema / Stepanova, Maria / Younossi, Zobair M

Journal of viral hepatitis

2024

Abstract: ... alcoholic steatohepatitis (NASH) were included. Clinical data and PRO questionnaires (FACIT-F, CLDQ and WPAI) were compared ...

Abstract	Patients with chronic liver disease (CLD) experience health-related quality of life (HRQoL) and patient-reported outcomes (PROs) impairments. We assessed and identified predictors of HRQoL and PROs in CLD patients from Saudi Arabia (SA), Turkey and Egypt. Patients enrolled in Global Liver Registry™ with chronic hepatitis B (CHB), chronic hepatitis C (CHC) and non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH) were included. Clinical data and PRO questionnaires (FACIT-F, CLDQ and WPAI) were compared across countries. Linear regression identified PRO predictors. Of the 4014 included patients, 26.9% had CHB, 26.9% CHC and 46.1% NAFLD/NASH; 19.2% advanced fibrosis. Compared across countries, CHB patients were younger in Egypt (mean age [years] 41.2 ± 11.4 vs. 45.0 ± 10.3 SA, 46.1 ± 12.0 Turkey), most often employed in SA (64.8% vs. 53.2% Turkey) and had the lowest prevalence of obesity in Turkey (26.7% vs. 37.8% SA, 38.5% Egypt). In SA, CHB patients had lowest prevalence of fibrosis and comorbidities (all p < .01). There was a higher frequency of males with NAFLD/NASH in SA (70.0% vs. 49.6% Turkey, and 35.5% Egypt). Among NAFLD/NASH patients, CLDQ-NAFLD/NASH scores were highest in SA (mean total score: 5.3 ± 1.2 vs. 4.8 ± 1.2 Turkey, 4.1 ± 0.9 Egypt, p < .01). Independent predictors of worse PROs included younger age, female sex, advanced fibrosis, non-hepatic comorbidities and lack of regular exercise (all p < .05). Clinical presentation and PRO scores of CLD patients vary across SA, Turkey and Egypt. Impairment of HRQoL is associated with demographic factors, lack of regular exercise, advanced fibrosis and non-hepatic comorbidities.
Language	English
Publishing date	2024-04-15
Publishing country	England
Document type	Journal Article
ZDB-ID	1212497-7
ISSN	1365-2893 ; 1352-0504
ISSN (online)	1365-2893
ISSN	1352-0504
DOI	10.1111/jvh.13935
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Zs.A 4119: Show issues

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Article ; Online: SASLT guidelines: Update in treatment of hepatitis C virus infection, 2024.

Alghamdi, Abdullah S / Alghamdi, Hamdan / Alserehi, Haleema A / Babatin, Mohammed A / Alswat, Khalid A / Alghamdi, Mohammed / AlQutub, Adel / Abaalkhail, Faisal / Altraif, Ibrahim / Alfaleh, Faleh Z / Sanai, Faisal M

Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association

2024 Volume 30, Issue Supp 1, Page(s) S1–S42

Abstract: Abstract: Hepatitis C virus (HCV) infection has been a major global health concern, with a significant impact on public health. In recent years, there have been remarkable advancements in our understanding of HCV and the development of novel therapeutic ...

Abstract	Abstract: Hepatitis C virus (HCV) infection has been a major global health concern, with a significant impact on public health. In recent years, there have been remarkable advancements in our understanding of HCV and the development of novel therapeutic agents. The Saudi Society for the Study of Liver Disease and Transplantation formed a working group to develop HCV practice guidelines in Saudi Arabia. The methodology used to create these guidelines involved a comprehensive review of available evidence, local data, and major international practice guidelines regarding HCV management. This updated guideline encompasses critical aspects of HCV care, including screening and diagnosis, assessing the severity of liver disease, and treatment strategies. The aim of this updated guideline is to assist healthcare providers in the management of HCV in Saudi Arabia. It summarizes the latest local studies on HCV epidemiology, significant changes in virus prevalence, and the importance of universal screening, particularly among high-risk populations. Moreover, it discusses the promising potential for HCV elimination as a public health threat by 2030, driven by effective treatment and comprehensive prevention strategies. This guideline also highlights evolving recommendations for advancing disease management, including the treatment of HCV patients with decompensated cirrhosis, treatment of those who have previously failed treatment with the newer medications, management in the context of liver transplantation and hepatocellular carcinoma, and treatment for special populations.
MeSH term(s)	Humans ; Hepacivirus ; Hepatitis C/diagnosis ; Hepatitis C/drug therapy ; Hepatitis C/epidemiology ; Liver Transplantation ; Risk Factors ; Liver Neoplasms ; Antiviral Agents/therapeutic use ; Hepatitis C, Chronic/diagnosis ; Hepatitis C, Chronic/drug therapy ; Hepatitis C, Chronic/epidemiology
Chemical Substances	Antiviral Agents
Language	English
Publishing date	2024-01-03
Publishing country	India
Document type	Review ; Journal Article
ZDB-ID	2299174-8
ISSN	1998-4049 ; 1319-3767
ISSN (online)	1998-4049
ISSN	1319-3767
DOI	10.4103/sjg.sjg_333_23
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Article ; Online: Incidence, Prevalence, and Clinical Epidemiology of Inflammatory Bowel Disease in the Arab World: A Systematic Review and Meta-Analysis.

Mosli, Mahmoud / Alawadhi, Sameer / Hasan, Fuad / Abou Rached, Antoine / Sanai, Faisal / Danese, Silvio

Inflammatory intestinal diseases

2021 Volume 6, Issue 3, Page(s) 123–131

Abstract: Objectives: Despite the recent findings of the rising incidence of inflammatory bowel disease (IBD) in Arab countries, there are limited data on the characteristics of IBD patients and the disease course in the Arab world. This systematic review aimed ... ...

Abstract	Objectives: Despite the recent findings of the rising incidence of inflammatory bowel disease (IBD) in Arab countries, there are limited data on the characteristics of IBD patients and the disease course in the Arab world. This systematic review aimed to investigate the incidence and epidemiology of IBD in the Arab world. Material and methods: We conducted a systematic literature review that utilized a comprehensive search of PubMed, Cochrane Central, SCOPUS, Google Scholar, and Web of Science from their inception till August 2020. We included cross-sectional, prospective, and retrospective studies that examined the prevalence and/or epidemiological characteristics of IBD in Arab countries. Results: A total of 16 studies that examined IBD in Saudi Arabia, Egypt, Kuwait, the United Arab Emirates, Bahrain, Lebanon, and Oman were included. Generally, the included studies covered the period from the early 1990s to the late 2010s. A total of 1,627 ulcerative colitis (UC) patients and 1,588 Crohn's disease (CD) patients were included in this systematic review. The mean age at diagnosis ranged from 24.13 to 43.6 years in adult cases and from 4.5 to 16 years in pediatric cases. In most of the included studies, the majority of patients were male. The quantitative analysis revealed a pooled incidence rate of 2.33 (95% confidence interval [CI] 1.2-3.4) per 100,000 persons per year for UC in the Arab world. Likewise, the pooled incidence rate for CD in the Arab world was 1.46 (95% CI 1.03-1.89) per 100,000 persons per year. Conclusion: There is a growing incidence of IBD in the Arab world, while IBD patients from Arab countries may present with some different characteristics, compared to their counterparts in Europe.
Language	English
Publishing date	2021-09-07
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2817967-5
ISSN	2296-9365 ; 2296-9403
ISSN (online)	2296-9365
ISSN	2296-9403
DOI	10.1159/000518003
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Article: Antibiotic Exposure Concurrently with Anti-PD1 Blockade Therapy Reduces Overall Survival in Patients with Child-Pugh Class A Advanced Hepatocellular Carcinoma.

Alshammari, Kanan / Alotaibi, Faizah M / Alsugheir, Futoon / Aldawoud, Mohammad / Alolayan, Ashwaq / Algarni, Mohammed Ahmad / Sabatin, Fouad / Mohammad, Mohammad F / Alosaimi, Abdulaziz / Sanai, Faisal M / Odah, Hassan / Alshehri, Ahmed Saleh / Aldibasi, Omar S / Alrehaily, Samah / Al Saleh, Abdullah S

Cancers

2023 Volume 16, Issue 1

Abstract: Hepatocellular carcinoma (HCC) is the third leading cause of cancer death worldwide with a poor prognosis. Treatment with immune checkpoint inhibitors (ICIs) has improved overall survival in patients with HCC. However, not all patients benefit from the ... ...

Abstract	Hepatocellular carcinoma (HCC) is the third leading cause of cancer death worldwide with a poor prognosis. Treatment with immune checkpoint inhibitors (ICIs) has improved overall survival in patients with HCC. However, not all patients benefit from the treatment. In this study, 59 patients with HCC were enrolled from two medical centers in Saudi Arabia, with 34% using antibiotics concurrently with their Nivolumab (anti-PD1 blockade). The impact of antibiotic use on the clinical outcomes of patients with HCC undergoing treatment with anti-PD1 blockade was examined. The patients' overall survival (OS) was 5 months (95% CI: 3.2, 6.7) compared to 10 months (95% CI: 0, 22.2) (
Language	English
Publishing date	2023-12-27
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2527080-1
ISSN	2072-6694
ISSN	2072-6694
DOI	10.3390/cancers16010133
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Article ; Online: Lower prevalence of hepatic fibrosis in low viremic hepatitis B patients with fluctuating HBV DNA levels.

Sanai, Faisal M / Alhouthali, Ahmad H / Alghamdi, Hamdan S / Badriq, Feras / Sanai, Eisa A / Mujalled, Mohammed K / Khayyat, Waleed / Attar, Motaz S / Bagadeem, Basil S / Meer, Alaa M / Alshumrani, Waleed / Albeladi, Khalid / AlTraif, Ibrahim / Alqahtani, Saleh

Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association

2022 Volume 28, Issue 5, Page(s) 341–347

Abstract: Background: In chronic hepatitis B virus (HBV) patients, fluctuations in HBV DNA serve as a "gray area" and impede the accurate identification of inactive carriers. We aimed to assess if such fluctuations impact the presence of significant hepatic ... ...

Abstract	Background: In chronic hepatitis B virus (HBV) patients, fluctuations in HBV DNA serve as a "gray area" and impede the accurate identification of inactive carriers. We aimed to assess if such fluctuations impact the presence of significant hepatic fibrosis (Metavir F2-4) in chronic HBV patients. Methods: Consecutive, untreated HBeAg-negative carriers (n = 234) with fluctuating HBV DNA (n = 73) above or below a level of 2000 IU/mL were included and compared to those without fluctuations (n = 161). Patients without fluctuating HBV DNA were further analyzed based on those with persistently low (<2,000 IU/mL, n = 137) and higher HBV DNA (2,000-20,000 IU/mL, n = 24). Hepatic fibrosis (assessed by transient elastography) was correlated with virologic and biochemical profiles. Results: The mean age of the overall cohort was 47.8 ± 11.1 years, of whom 107 (45.7%) were male. During a median of 60 months (interquartile range [IQR] 34-82) of follow-up, 73 (31.2%) patients had a mean of 1.6 ± 0.9 fluctuations in HBV DNA. The median time to the first fluctuation was at 14.5 (IQR 5.0-33.7) months. Patients with fluctuating viremia had higher log Conclusions: Fluctuating HBV DNA levels occur frequently but are not associated with significant fibrosis. Minor fluctuations in HBV DNA levels are unlikely to be of clinical relevance.
MeSH term(s)	Adult ; Alanine Transaminase ; DNA, Viral ; Female ; Hepatitis B/complications ; Hepatitis B e Antigens ; Hepatitis B virus/genetics ; Hepatitis B, Chronic ; Humans ; Liver Cirrhosis/complications ; Male ; Middle Aged ; Prevalence ; Viremia/complications ; Viremia/epidemiology
Chemical Substances	DNA, Viral ; Hepatitis B e Antigens ; Alanine Transaminase (EC 2.6.1.2)
Language	English
Publishing date	2022-04-22
Publishing country	India
Document type	Journal Article
ZDB-ID	2299174-8
ISSN	1998-4049 ; 1319-3767
ISSN (online)	1998-4049
ISSN	1319-3767
DOI	10.4103/sjg.sjg_48_22
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Article ; Online: Management of nonalcoholic fatty liver disease in the Middle East.

Sanai, Faisal M / Abaalkhail, Faisal / Hasan, Fuad / Farooqi, Muhammad Hamed / Nahdi, Nawal Al / Younossi, Zobair M

World journal of gastroenterology

2020 Volume 26, Issue 25, Page(s) 3528–3541

Abstract: The prevalence of nonalcoholic fatty liver disease (NAFLD) in the Middle East is increasing in parallel to an increase in the prevalence of associated risk factors such as obesity, metabolic syndrome, and type 2 diabetes mellitus. About 20% to 30% of the ...

Abstract	The prevalence of nonalcoholic fatty liver disease (NAFLD) in the Middle East is increasing in parallel to an increase in the prevalence of associated risk factors such as obesity, metabolic syndrome, and type 2 diabetes mellitus. About 20% to 30% of the patients progress to develop nonalcoholic steatohepatitis (NASH), a histological subtype of NAFLD, with features of hepatocyte injury such as hepatocyte ballooning. NASH can progress to fibrosis, cirrhosis, and even hepatocellular carcinoma. NAFLD thus causes a substantial burden on healthcare systems and it is imperative that appropriate strategies are discussed at a regional level to facilitate effective management tailored to the needs of the region. To fulfil this unmet need, expert gastroenterologists, hepatologists, and endocrinologists from the region came together in three advisory board meetings that were conducted in Saudi Arabia, United Arab Emirates, and Kuwait, to discuss current local challenges in NAFLD screening and diagnosis, and the different available management options. The experts discussed the disease burden of NAFLD/NASH in the Middle East; screening, diagnosis, and referral patterns in NAFLD; and available treatment options for NAFLD and NASH. This paper summarizes the discussions and opinion of the expert panel on the management of NAFLD/NASH and also presents an extensive literature review on the topic.
MeSH term(s)	Diabetes Mellitus, Type 2 ; Humans ; Liver Neoplasms ; Middle East/epidemiology ; Non-alcoholic Fatty Liver Disease/diagnosis ; Non-alcoholic Fatty Liver Disease/epidemiology ; Non-alcoholic Fatty Liver Disease/therapy ; Saudi Arabia/epidemiology
Language	English
Publishing date	2020-08-02
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2185929-2
ISSN	2219-2840 ; 1007-9327
ISSN (online)	2219-2840
ISSN	1007-9327
DOI	10.3748/wjg.v26.i25.3528
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Zs.A 6039: Show issues

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Article ; Online: Long-term health and economic benefits of switching to tenofovir alafenamide versus continuing on entecavir in chronic hepatitis B patients with low-level viremia in Saudi Arabia.

Sanai, Faisal M / Aljawad, Mohammed / Alghamdi, Abdullah Saeed / Yehoshua, Alon / Khathlan, Abdullah / Alghamdi, Mohammed / Kozma, Sam / Smith, Nathaniel / El-Moustaid, Fadoua / Jeyakumar, Sushanth / Kachru, Nandita

Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association

2023 Volume 30, Issue 1, Page(s) 23–29

Abstract: Background: Despite the success of current treatments, many chronic hepatitis B (CHB) patients still live with low-level viremia [LLV] resulting in liver disease progression. This study evaluated the long-term health and economic impact of switching to ... ...

Abstract	Background: Despite the success of current treatments, many chronic hepatitis B (CHB) patients still live with low-level viremia [LLV] resulting in liver disease progression. This study evaluated the long-term health and economic impact of switching to tenofovir alafenamide (TAF) from entecavir (ETV) in Saudi Arabia (SA) in chronic hepatitis B (CHB) LLV patients. Methods: A hybrid decision tree Markov state-transition model was developed to simulate a cohort of patients with CHB LLV treated with ETV and switched to TAF over a lifetime horizon in SA. While on treatment, patients either achieved complete virologic response (CVR) or maintained LLV. CVR patients experienced slower progression to advanced liver disease stages as compared to LLV patients. Demographic data, transition probabilities, treatment efficacy, health state costs, and utilities were sourced from published literature. Treatment costs were sourced from publicly available databases. Results: Base case analysis found that over a lifetime horizon, switching to TAF versus remaining on ETV increased the proportion of patients achieving CVR (76% versus 14%, respectively). Switching to TAF versus remaining on ETV resulted in a reduction in cases of compensated cirrhosis (-52%), decompensated cirrhosis (-5%), hepatocellular carcinoma (-22%), liver transplants (-12%), and a 37% reduction in liver-related deaths. Switching to TAF was cost-effective with an incremental cost-effectiveness ratio of $57,222, assuming a willingness-to-pay threshold of three times gross national income per capita [$65,790/QALY]. Conclusions: This model found that switching to TAF versus remaining on ETV in SA CHB LLV patients substantially reduced long-term CHB-related morbidity and mortality and was a cost-effective treatment strategy.
MeSH term(s)	Humans ; Tenofovir/therapeutic use ; Antiviral Agents/therapeutic use ; Hepatitis B, Chronic/drug therapy ; Saudi Arabia/epidemiology ; Viremia/drug therapy ; Quality-Adjusted Life Years ; Cost-Benefit Analysis ; Adenine/therapeutic use ; Treatment Outcome ; Liver Neoplasms/drug therapy ; Liver Cirrhosis/drug therapy
Chemical Substances	Tenofovir (99YXE507IL) ; Antiviral Agents ; entecavir (5968Y6H45M) ; Adenine (JAC85A2161)
Language	English
Publishing date	2023-06-30
Publishing country	India
Document type	Journal Article
ZDB-ID	2299174-8
ISSN	1998-4049 ; 1319-3767
ISSN (online)	1998-4049
ISSN	1319-3767
DOI	10.4103/sjg.sjg_170_23
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