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Michael T Yin, Todd T Brown
The higher risk of osteoporosis and fracture associated with HIV infection and certain antiretrovirals has been well established and the need for risk stratification among older adults increasingly recognized. This review focuses upon emerging data on bone complications with HIV/HCV coinfection, in children and adolescents, and with pre-exposure prophylaxis (PrEP), as well as new management strategies to minimize the negative effects of ART on bone.
October 11, 2016: Current HIV/AIDS Reports
Christos Triantos, Christos Konstantakis, Paraskeui Tselekouni, Maria Kalafateli, Ioanna Aggeletopoulou, Spilios Manolakopoulos
Hepatitis C is a global health issue and constitutes a major cause of chronic liver disease worldwide. In this article, a comprehensive literature search was conducted for the prevalence of hepatitis C virus (HCV) infection in Greece, since data on the HCV prevalence, viremia and genotypes are important for developing strategies to manage or eliminate HCV infection. In addition, the pattern of HCV infection was analyzed according to the geographic region and the risk factors. These differences reflect not only distinct epidemiological characteristics among populations, but also differences on the strategy of data acquisition and quantification...
September 28, 2016: World Journal of Gastroenterology: WJG
Susanna Naggie, David Holland, Mark S Sulkowski, David L Thomas
Currently, 380,000-400,000 occupational exposures to blood borne pathogens occur annually in the United States. The management for occupational HIV or HBV exposures includes post-exposure prophylaxis (PEP) when necessary; however, PEP is not recommended for HCV exposures. Recent approval of HCV direct acting antivirals (DAAs) has renewed discussions as to whether these therapies could be used to prevent infection after exposure. There are no published studies addressing this question but the prescribing of DAA for PEP has been reported...
September 28, 2016: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Konstantinos Thomas, Dimitrios Vassilopoulos
PURPOSE OF REVIEW: To review recent evidence for infection rates in patients with systemic vasculitides, the role of specific infectious agents in the pathogenesis of vasculitis and recent breakthroughs in the treatment of virus-associated vasculitides. RECENT FINDINGS: In well designed recent studies, infections were found to be common during the first 6-12 months in patients with anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitides (AAV) and giant cell arteritis (GCA) and to contribute significantly to increased mortality during this period...
September 21, 2016: Current Opinion in Rheumatology
Claudio Bonifati, Viviana Lora, Dario Graceffa, Lorenzo Nosotti
The systemic therapies available for the management of Psoriasis (PsO) patients who cannot be treated with more conservative options, such as topical agents and/or phototherapy, with the exception of acitretin, can worsen or reactivate a chronic infection. Therefore, before administering immunosuppressive therapies with either conventional disease-modifying drugs (cDMARDs) or biological ones (bDMARDs) it is mandatory to screen patients for some infections, including hepatitis B virus (HBV) and hepatitis C virus (HCV)...
July 28, 2016: World Journal of Gastroenterology: WJG
David J Weber, William A Rutala
Health care personnel are commonly exposed to infectious agents via sharp injuries (eg, human immunodeficiency virus, hepatitis B virus, and hepatitis C virus), direct patient care (eg, pertussis and meningococcus), and the contaminated environment (eg, Clostridium difficile). An effective occupational program is a key aspect of preventing acquisition of an infection by offering the following: (1) education of health care personnel regarding proper handling of sharps, early identification and isolation of potentially infectious patients, and hand hygiene; (2) assuring immunity to vaccine-preventable diseases; and, (3) immediate availability of a medical evaluation after a nonprotected exposure to an infectious disease...
September 2016: Infectious Disease Clinics of North America
N Mikołajczyk-Korniak, O Tronina, K Ślubowska, A Perkowska-Ptasińska, M Pacholczyk, T Bączkowska, M Durlik
BACKGROUND: Assessment of the dynamics and degree of liver fibrosis in patients after liver transplantation is a basic element in the process of determining transplant survival prognosis. It allows planning and early initiation of prophylaxis or treatment, which translates into increased chances of preventing cirrhosis and of long-term optimal function of the graft. The aim of this study was to compare the results of biopsy and dynamic elastography in diagnostics of transplanted liver fibrosis, as well as determination of the stiffness cut-off point for assessment of significant fibrosis...
June 2016: Transplantation Proceedings
Martin-Walter Welker, Stefan Zeuzem
BACKGROUND: Hepatitis B virus (HBV)- and hepatitis C virus (HCV)-associated liver cirrhosis is a major indication for liver transplantation. This concise review gives an overview about current interferon (IFN)-free treatment options before and after liver transplantation in HBV- or HCV-associated liver disease. METHODS: A PubMed database search using the terms hepatitis B, hepatitis C, cirrhosis, and liver transplantation was performed to identify significant clinical studies as well as national and international guidelines...
April 2016: Visc Med
Heather Y Hughes, David K Henderson
PURPOSE OF REVIEW: Healthcare personnel are at risk for occupational exposures to bloodborne pathogens. Primary prevention remains the first line of defense, but secondary prevention measures known to be effective should be implemented when percutaneous exposures occur. Hepatitis C virus (HCV) is a major infectious cause of liver-related morbidity and mortality. Chronic HCV treatment has changed dramatically, with many all-oral directly acting anti-HCV antiviral (DAA) regimens now available...
August 2016: Current Opinion in Infectious Diseases
Ilaria Lenci, Leonardo Baiocchi, Laura Tariciotti, Daniele Di Paolo, Martina Milana, Francesco Santopaolo, Tommaso Maria Manzia, Luca Toti, Valentina Svicher, Giuseppe Tisone, Carlo Federico Perno, Mario Angelico
Tailored approaches have been attempted to prevent hepatitis B virus (HBV) reinfection in antibodies against hepatitis B surface antigen (HBsAg)-positive liver transplantation (LT) recipients in order to minimize the use of hepatitis B immune globulin (HBIG) and nucleoside analogues (NAs). We report the results of complete HBV prophylaxis withdrawal after a follow-up of at least 6 years in LT recipients with undetectable serum HBV DNA and intrahepatic total HBV DNA and covalently closed circular DNA at LT. We included 30 HBsAg positive, hepatitis B e antigen-negative recipients, 6 with hepatitis C virus and 7 with hepatitis D virus coinfection, who had received HBIG plus NA for at least 5 years after LT...
September 2016: Liver Transplantation
A B Zhebrun, O V Kalinina
Periodization of the evolution of epidemic process of hepatitis C is given based on the results of phylodynamic, phylogeographic, historic and demographic studies: invasion of the virus into European and North-American population in 1700-1850; primary activation of the epidemic process in the years of the World War 1; expansive giowth of prevalence in 40--60s of the 20th century due to mass parenteral interventions; new rise due to heroine drug abuse in 60--80s of the 20th century; manifold reduction of incidence of acute hepatitis C in industrial countries for the last 10-15 years as a result of general medical measures of prevention of hemocontact infec-tions...
January 2016: Zhurnal Mikrobiologii, Epidemiologii, i Immunobiologii
T A Semenenko, A P Suslov
The concept of occult infection caused by hepatitis B virus (HBV) is determined as the presence of HBV DNA in blood sera or liver with the absence of detectable HBsAg. The actuality of this problem is associated with the fact, that occult hepatitis B (OHB) can be transmitted during hemotransfusions, cause reactivation of chronic hepatitis B in immune compromised individuals, facilitate development of liver cirrhosis and hepatocellular carcinoma. Several different hypotheses of OHB immunopathogenesis have been proposed, including a low number of copies of HBV DNA, altered immune response of the macroorganism, genetic variability of the S gene, integration of viral DNA into host genome, infection of mononuclear cells of peripheral blood, presence of immune complexes that hide HBsAg, and interference by other viruses such as HCV and HIV...
November 2015: Zhurnal Mikrobiologii, Epidemiologii, i Immunobiologii
Alberto Ferrarese, Alberto Zanetto, Martina Gambato, Ilaria Bortoluzzi, Elena Nadal, Giacomo Germani, Marco Senzolo, Patrizia Burra, Francesco Paolo Russo
Liver transplantation (LT) is a life-saving treatment for patients with end-stage liver disease and for patients with liver cell cancer related to liver disease. Acute and chronic liver diseases related to hepatitis viruses are between the main indications for liver transplantation. The risk of viral reinfection after transplantation is the main limiting factor in these indications. Before the availability of antiviral prophylaxis, hepatitis B virus (HBV) recurrence was universal in patients who were HBV DNA-positive before transplantation...
January 28, 2016: World Journal of Gastroenterology: WJG
Jong Man Kim, Kwang-Woong Lee, Gi-Won Song, Bo-Hyun Jung, Hae Won Lee, Nam-Joon Yi, Choon Hyuck David Kwon, Shin Hwang, Kyung-Suk Suh, Jae-Won Joh, Suk-Koo Lee, Sung-Gyu Lee
PURPOSE: HCV-related liver disease is the most common indication for liver transplantation (LT) in Western countries, whereas HCV LT is rare in Korea. We conducted a survey of HCV RNA-positive patients who underwent LT and investigated the prognostic factors for patient survival and the effects of immunosuppression. METHODS: We retrospectively reviewed the multicenter records of 192 HCV RNA-positive patients who underwent LT. RESULTS: The 1-, 3-, and 5-year overall survival rates were 78...
January 2016: Annals of Surgical Treatment and Research
Nicolas de l'Escalopier, Laurent Mathieu, Guillaume Valade, Cécile Ficko, Sylvain Rigal
INTRODUCTION: In suicide bomber attacks (SBAs), the explosive forces may disperse fragments from the body of the bomber to which the device is attached. This biologic material can cause physical injury to bystanders and may represent a source of severe infectious diseases. PATIENTS AND METHODS: Two French soldiers, victims of an SBA in Africa, were managed in the Percy Military Teaching Hospital. They sustained multiple injuries, including some caused by bony fragments converted into projectiles by the explosion...
May 2016: International Orthopaedics
Federica Invernizzi, Mauro Viganò, Glenda Grossi, Pietro Lampertico
Patients with chronic hepatitis B virus (HBV) infection lacking the serum hepatitis B e antigen (HBeAg) and with antibodies against HBeAg (anti-HBe), are the prevalent subgroup of HBV carriers worldwide. The prognosis of these patients is different from inactive carriers (ICs), who are characterized by persistently normal serum alanine aminotransferase (ALT) and low (<2000 IU/ml) serum HBV DNA levels, a serological profile that may also be intermittently observed in patients with HBeAg-negative chronic hepatitis...
January 2016: Liver International: Official Journal of the International Association for the Study of the Liver
Andreas Brandl, Philipp Stolzlechner, Stephan Eschertzhuber, Felix Aigner, Sascha Weiss, Wolfgang Vogel, Alexander Krannich, Sabrina Neururer, Johann Pratschke, Ivo Graziadei, Robert Öllinger
Nonoptimal liver grafts, and among them organs from anti-HBc+ donors, are increasingly used for liver transplantation. In this retrospective study including 1065 adult liver transplantations performed between 1977 and 2012, we analyzed long-term patient and graft survival and occurrence of HBV infection. A total of 52 (5.1%) patients received an anti-HBc+ graft. The 10-year graft and patient survival of these recipients were 50.9% and 59.0% compared to 72.0% and 76.5% (P = 0.001; P = 0.004) of patients receiving anti-HBc- grafts, respectively...
April 2016: Transplant International: Official Journal of the European Society for Organ Transplantation
Doris Quon, Mark Reding, Chris Guelcher, Skye Peltier, Michelle Witkop, Susan Cutter, Cathy Buranahirun, Don Molter, Mary Jane Frey, Angela Forsyth, Duc Bobby Tran, Randall Curtis, Grant Hiura, Justin Levesque, Debbie de la Riva, Matthew Compton, Neeraj N Iyer, Natalia Holot, David L Cooper
Young adults with hemophilia face unique challenges during the transition to adulthood, including issues associated with switching from pediatric to adult hematology care, building mature interpersonal relationships, and establishing an independent career with an assurance of medical insurance coverage. A greater understanding of these challenges is essential for developing effective strategies to address the specific needs of this population. These challenges may be differentiated from those of older adults with hemophilia in large part because of more extensive childhood prophylaxis and safer factor products, resulting in fewer joint problems and lower rates of HIV and HCV infections...
December 2015: American Journal of Hematology
Laura Palareti, Silvia Potì, Frederica Cassis, Francesca Emiliani, Davide Matino, Alfonso Iorio
The study illuminates the subjective experience of haemophilia in people who took part in the Haemophilia Experience, Results and Opportunities (HERO) initiative, a quali-quantitative research program aimed at exploring psychosocial issues concerning this illness around the world. Applying a bottom-up analytic process with the help of software for textual data, we investigated 19 interviews in order to describe the core themes and the latent factors of speech, to explore the role of different variables in shaping the participants' illness experiences...
2015: International Journal of Qualitative Studies on Health and Well-being
Chrysoula Pipili, Evangelos Cholongitas
The combination of hepatitis B immune globulin with entecavir or tenofovir (at least for a certain period of time) seems to be the most reasonable prophylaxis against recurrent hepatitis B after liver transplantation. Entecavir represents an attractive option for treatment of naïve kidney transplant recipients, because of its high efficacy and the low rates of resistance. However antiviral treatment should be individualized in the view of kidney function and the previous resistance. To date, new captivating therapeutic strategies could make interferon-free regimens viable for treatment of hepatitis C virus positive liver transplant recipients...
November 6, 2015: World Journal of Gastrointestinal Pharmacology and Therapeutics
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