Honors & Awards
Young Investigator Bursary, EASL 2018 International Liver Congress (2018)
Oxford-Kaifeng Graduate Full Scholarship, Oxford University (2016)
Rhodes Scholarship Finalist, Oxford University (2016)
Excellent Graduate, Tsinghua University (2015)
Scholarship for Academic Excellence, Tsinghua University (2014)
Scholarship for Leadership, Tsinghua University (2013)
American Association for the Study of Liver Disease, Trainee Membership
American College of Epidemiology, Associate
Education & Certifications
Bachelor of Economics, Tsinghua University (2015)
B.A in English Literature, Tsinghua University (2015)
Master of Public Policy, Oxford University (2016)
Current Research and Scholarly Interests
My research has been focusing on the disease and economic burden and risk factors of liver disease in the United States and Asia. Currently, I work on identifying causal risk factors for non-alcoholic fatty liver disease and the causal role of non-alcoholic fatty liver disease in various diseases including cardiovascular disease and cancer using a genetic epidemiology approach.
- Prevalence, incidence, and outcome of non-alcoholic fatty liver disease in Asia, 1999-2019: a systematic review and meta-analysis LANCET GASTROENTEROLOGY & HEPATOLOGY 2019; 4 (5): 389–98
- Factors Associated With Rates of HBsAg Seroclearance in Adults With Chronic HBV Infection: A Systematic Review and Meta-analysis GASTROENTEROLOGY 2019; 156 (3): 635-+
Prevalence of viremic HCV infection by age, race/ethnicity, birthplace and disease awareness among viremic persons in the U.S., 1999-2016.
The Journal of infectious diseases
Though curative therapy is now available for hepatitis C virus (HCV) infection in the United States, it is not clear if all affected persons have been diagnosed and/or linked to care.This cross-sectional study utilized data from the National Health and Nutrition Examination Survey (1999-2016) and included 46,465 non-incarcerated and non-institutionalized participants.Viremic HCV prevalence decreased from 1.32% in 1999-2004 to 0.80% in 2011-2016, though most of the decrease occurred in U.S.-born whites and blacks but not the foreign-born or those born after 1985. In 2011-2016, approximately 1.90 million U.S. adults remained viremic with HCV, and 0.33 million were at higher risk for advanced fibrosis, but only 49.8% were aware of their HCV infection, with higher disease awareness in those with health insurance coverage and US-born persons.The prevalence of viremic HCV has decreased in recent years among U.S. born whites and blacks but not in other race/ethnicities and foreign-born persons and birth cohort born after 1985. Less than half of the viremic population was aware of having HCV infection. Improved HCV screening and linkage to care are needed, especially for the uninsured, foreign-born, birth cohort after 1985 and certain ethnic minorities.
View details for DOI 10.1093/infdis/jiz479
View details for PubMedID 31560391
National Estimates of Overall and Liver-Related Inpatient Care Cost in Cirrhotic Patients with Diverse Etiologies and Ethnicities in the United States (US)
WILEY. 2018: 110A
View details for Web of Science ID 000446020500176
Increased Prevalence of Non-Alcoholic Fatty Liver Disease (NAFLD) in Asia: A Systematic Review and Meta-Analysis of 164 Studies and 1,704,963 Subjects from 13 Countries
WILEY. 2018: 983A
View details for Web of Science ID 000446020502522
Sex, Time-Period and Birthplace Specific Prevalence of Hepatitis B and Hepatitis C Virus Infection in Children and Adolescents in the United States during 1999-2016
WILEY. 2018: 1193A
View details for Web of Science ID 000446020503321
Prevalence of Hepatitis C Infection in Ethnically Diverse US Population Including Asian Americans and US-Born Vs Foreign-Born Persons: A Population-Base Study during 2011-2016
WILEY. 2018: 931A–932A
View details for Web of Science ID 000446020502431
- Higher mortality and hospital charges in patients with cirrhosis and acute respiratory illness: a population-based study SCIENTIFIC REPORTS 2018; 8
Factors Associated with Rates of HBsAg Seroclearance in Adults with Chronic HBV Infection: A systematic review and meta-analysis.
Seroclearance of hepatitis B surface antigen (HBsAg) is a marker for clearance of chronic hepatitis B virus (HBV) infection but reported annual incidence rates of HBsAg seroclearance vary. We performed a systematic review and meta-analysis to provide more precise estimates of HBsAg seroclearance rates among subgroups and populations.We searched PubMed, Embase, and Cochrane library for cohort studies that reported HBsAg seroclearance in adults with chronic HBV infection with more than 1 year of follow up and at least 1 repeat test for HBsAg. Annual and 5-, 10-, and 15-year cumulative incidence rates were pooled using a random effects model.We analyzed 34 published studies (with 42,588 patients; 303,754 person-years of follow-up; and 3194 HBsAg seroclearance events), including additional and updated aggregated data from 19 studies. The pooled annual rate of HBsAg seroclearance was 1.02% (95% CI, 0.79-1.27). Cumulative incidence rates were 4.03% at 5 years (95% CI, 2.49-5.93), 8.16% at 10 years (95% CI, 5.24-11.72), and 17.99% at 15 years (95% CI, 6.18-23.24). There were no significant differences between sexes. A higher proportion of patients negative for HBeAg at baseline had seroclearance (1.33%; 95% CI, 0.76-2.05) than patients positive for HBeAg (0.40%; 95% CI, 0.25-0.59) (P<.01). HBsAg seroclearance was also associated with a lower baseline HBV DNA (6.61 log10IU/mL; 95% CI, 5.94-7.27) than in patients without HBsAg seroclearance (7.71 log10IU/mL; 95% CI, 7.41-8.02) (P<.01) and lower level of HBsAg at baseline (2.74 log10IU/mL; 95% CI, 1.88-3.60) than in patients without HBsAg seroclearance (3.90 log10IU/mL, 95% CI, 3.73-4.06) (P<.01). HBsAg seroclearance was not associated with HBV genotype or treatment history. Heterogeneity was substantial across the studies (I2=97.49%).In a systematic review and meta-analysis, we found a low rate of HBsAg seroclearance in untreated and treated patients (pooled annual rate approximately 1%). Seroclearance occurred mainly in patients with less active disease. Patients with chronic HBV infection should therefore be counseled on the need for lifelong treatment, and curative therapies are needed.
View details for PubMedID 30342034
Systematic review with meta-analysis: effectiveness and tolerability of interferon-free direct-acting antiviral regimens for chronic hepatitis C genotype 1 in routine clinical practice in Asia.
Alimentary pharmacology & therapeutics
Direct-acting antiviral (DAA) regimens have shown high efficacy and tolerability for patients with HCV genotype 1/1b (GT1/1b) in clinical trials. However, robust real-world evidence of interferon (IFN)-free DAA treatment for HCV GT1-infected patients in Asia is still lacking.To systematically review and meta-analyse the effectiveness and tolerability of IFN-free DAA therapy for HCV GT1 infection in Asia.We included studies that enrolled adult patients with HCV GT1 infection in routine clinical practice in Asia, using IFN-free DAA regimens, and reported sustained virological response (SVR) after 12/24 weeks end-of-treatment by 31 May 2017. The pooled SVR rates were computed with a random-effects model. Subgroup analysis and meta-regression as previously registered in PROSPERO were performed to determine how pre-planned variables might have affected the pooled estimates.We included 41 studies from eight countries and regions, comprising of 8574 individuals. The pooled SVR rates for GT1 were 89.9% (95% CI 88.6-91.1, I2 = 55.1%) with daclatasvir/asunaprevir (DCV/ASV) and 98.1% (95% CI 97.0-99.0, I2 = 41.0%) with ledipasvir/sofosbuvir ± ribavirin (LDV/SOF ± RBV). Baseline cirrhosis but not prior treatment history and age, attenuated the effectiveness of both regimens. Baseline resistance associated substitutions (RASs) severely attenuated SVR of DCV/ASV (65.4% vs 94.3%, P < 0.001) and only minimally with LDV/SOF ± RBV (94.5% vs 99.2%, P = 0.003). Patients with renal dysfunction treated with DCV/ASV showed a higher SVR rate (93.9% vs 89.8%, P = 0.046). Patients with hepatocellular carcinoma (HCC) LDV/SOF ± RBV achieved a lower SVR than those without HCC (94.1% vs 98.7%, P = 0.001).All oral DAA treatment of HCV GT1 resulted in high cure rates in Asian patients in routine clinical practice setting including elderly patients and those with end-stage renal disease.
View details for PubMedID 29327780
Real-world effectiveness of sofosbuvir plus ribavirin for chronic hepatitis C genotype 2 in Asia: a systematic review and meta-analysis.
BMJ open gastroenterology
2018; 5 (1): e000207
Sofosbuvir plus ribavirin (SOF+RBV) for 12 weeks is the standard treatment for chronic hepatitis C (CHC) genotype 2 (GT2) in most of Asia despite availability of new CHC medications. SOF-RBV real-world effectiveness has only been reported in small and/or single-centre studies. Our goal was to determine the real-world effectiveness of 12-week SOF+RBV therapy for CHC GT2 in Asia.A systematic search on PubMed and Embase was conducted through 30 June 2017. We identified full articles and conference proceedings of at least 10 adult patients with CHC GT2 treated with SOF+RBV for 12 weeks under real-world setting in Asia.A total of 2208 patients from 13 studies were included. The pooled sustained virological response 12 weeks after the end of treatment (SVR12) was 95.8% (95% CI 94.6% to 96.9%) with non-significant heterogeneity (I2=34.4%). Anaemia (27.9%) was the most common adverse event (AE), with serious AEs in 2.0% and only 0.7% discontinued therapy prematurely. In subgroup analyses, patients with cirrhosis had 8.7% lower SVR12 than non-cirrhotic patients (P<0.0001), and treatment-experienced patients had 7.2% lower SVR12 than treatment-naïve patients (P=0.0002). Cirrhotic treatment-experienced patients had the lowest SVR12 at 84.5%. There were no significant differences in pooled SVR12 among patient subgroups: RBV dose reduction versus no dose reduction (P=0.30); hepatocellular carcinoma (HCC) versus no HCC (P=0.10); GT 2a versus 2b (P=0.86); and <65 vs ≥65 years of age (P=0.20).SOF+RBV for 12 weeks was safe and effective for patients with CHC GT2 in Asia, although those with cirrhosis and prior treatment failure had a lower pooled SVR12 rate.CRD42017067928.
View details for PubMedID 30002863
View details for PubMedCentralID PMC6038840
First-line Helicobacter pylori eradication therapies in countries with high and low clarithromycin resistance: a systematic review and network meta-analysis
2018; 67 (1): 20–27
To determine the optimal regimen of different first-line Helicobacter pylori eradication therapies according to the clarithromycin resistance rate.Electronic search for articles published between January 2005 and April 2016. Randomised, controlled trials that reported the effectiveness of first-line eradication therapies in treatment-naïve adults were included. Two independent reviewers performed articles screening and data extraction. Network and traditional meta-analyses were conducted using the random effect model. Subgroup analyses were performed to determine the ranking of regimens in countries with high (>15%) and low (<15%) clarithromycin resistance. Data including adverse events and therapeutic cure rate were also extracted and analysed.117 trials (totally 32 852 patients) for 17 H. pylori eradication regimens were eligible for inclusion. Compared with 7-day clarithromycin-based triple therapy, sequential therapy (ST) for 14 days had the highest effectiveness (OR=3.74, 95% CrI 2.37 to 5.96). ST-14 (OR=6.53, 95% CrI 3.23 to 13.63) and hybrid therapy (HY) for 10 days or more (OR=2.85, 95% CrI 1.58 to 5.37) represented the most effective regimen in areas with high and low clarithromycin resistance, respectively. The effectiveness of standard triple therapy was below therapeutic eradication rate in most of the countries. Longer duration was associated with higher eradication rate, but with a higher risk of events that lead to discontinuation.ST and HY appeared to be the most effective therapies in countries with high and low clarithromycin resistance, respectively. The clinical decision for optimal regimen can be supported by referring to the rank ordering of relative efficacies stratified by local eradication rates, antibiotic resistance and safety profile.CRD42015025445.
View details for DOI 10.1136/gutjnl-2016-311868
View details for Web of Science ID 000417778600005
View details for PubMedID 27670375
Real-world Effectiveness (RWE) of Sofosbuvir plus Ribavirin (SOF plus RBV) Chronic Hepatitis C Genotype 2 (CHC GT 2) in Asia: A Systemic Review and Meta-analysis of Pooled SVR12
WILEY. 2017: 811A
View details for Web of Science ID 000412089801660
Sustained Virological Response 12 Weeks after Therapy (SVR12) with Direct-Acting Antivirals (DAA) in Select Asian Populations with Chronic Hepatitis C Genotype 1 (HCV GT 1): A Meta-Analysis of Real-World Effectiveness from Asia
WILEY. 2017: 812A–813A
View details for Web of Science ID 000412089801662
Real Life Effectiveness of Direct-Acting Antivirals (DAAs) in Asian Patients with Chronic Hepatitis C Genotype 1: Systematic Review and Meta-analysis of 33 Published Articles and 7942 patients
WILEY. 2017: 596A–597A
View details for Web of Science ID 000412089801253