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https://www.readbyqxmd.com/read/28428719/safety-and-efficacy-of-tenofovir-in-chronic-hepatitis-b-related-decompensated-cirrhosis
#1
Soon Kyu Lee, Myeong Jun Song, Seok Hyun Kim, Byung Seok Lee, Tae Hee Lee, Young Woo Kang, Suk Bae Kim, Il Han Song, Hee Bok Chae, Soon Young Ko, Jae Dong Lee
AIM: To evaluate the safety and efficacy of tenofovir disoproxil fumarate (TDF) as a first-line therapy in decompensated liver disease. METHODS: We enrolled 174 chronic hepatitis B-related liver cirrhosis patients treated with 300 mg/d TDF at six Korean centers. Of the 174 cirrhosis patients, 57 were assigned to the decompensated cirrhosis group and 117 were assigned to the compensated cirrhosis group. We followed the patients for 12 mo and evaluated clinical outcomes, including biochemical, virological, and serological responses...
April 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28420441/autologous-bone-marrow-derived-cell-transplantation-in-decompensated-alcoholic-liver-disease-what-is-the-impact-on-liver-histology-and-gene-expression-patterns
#2
Nicolas Lanthier, Nathalie Lin-Marq, Laura Rubbia-Brandt, Sophie Clément, Nicolas Goossens, Laurent Spahr
BACKGROUND: Liver stem cell therapy (SCT) has been suggested as a promising means to improve liver regeneration in advanced liver disease. However, data from trials are heterogeneous, with no systematic histological evaluation. The aim of this study is to specifically analyze the effect of autologous SCT on liver regeneration and on gene expression changes. METHODS: Individuals in the randomized controlled trial of SCT in alcoholic hepatitis with paired liver biopsies were included (n = 58)...
April 18, 2017: Stem Cell Research & Therapy
https://www.readbyqxmd.com/read/28419938/direct-acting-antivirals-the-endgame-for-hepatitis-c
#3
REVIEW
Roberta D'Ambrosio, Elisabetta Degasperi, Massimo Colombo, Alessio Aghemo
Directly-acting antivirals (DAA) have finally allowed all patients to be potentially cured from chronic hepatitis C (HCV) infection. All-oral, Interferon (IFN)-free regimens are based upon the combination of molecules targeting different sites of the HCV replication process. Three classes of DAA exist: protease inhibitors (anti-NS3/4A), RNA-dependent polymerase inhibitors (anti-NS5B) and anti-NS5A inhibitors, which are characterized by different antiviral potency and barrier to resistance and therefore are usually combined in different treatment schedules...
April 15, 2017: Current Opinion in Virology
https://www.readbyqxmd.com/read/28418617/improved-survival-of-patients-with-hepatocellular-carcinoma-and-compensated-hcv-related-cirrhosis-who-attained-svr
#4
Savino Bruno, Vito Di Marco, Massimo Iavarone, Luigi Roffi, Vincenzo Boccaccio, Andrea Crosignani, Giuseppe Cabibbo, Sonia Rossi, Vincenza Calvaruso, Alessio Aghemo, Luca Giacomelli, Antonio Craxì, Massimo Colombo, Patrick Maisonneuve
BACKGROUND: Few studies examined the outcome of patients with HCV-related cirrhosis who developed hepatocellular carcinoma (HCC). The relative weight as determinant of death for cancer versus end-stage-liver-disease (ESLD) and the benefit of HCV eradication remain undefined. This multicenter, retrospective analysis evaluates overall survival (OS), rate of decompensation and tumor recurrence in compensated HCC patients treated with IFN according to HCV status since HCC diagnosis. METHODS: Two groups of patients with HCV-related cirrhosis and HCC were followed since HCC diagnosis: (i) compensated cirrhotics with prior sustained virologic response (SVR) on IFN-based regimens (N=19); (ii) compensated cirrhotics without SVR (viremic) (N=156)...
April 18, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28417463/pharmacological-interventions-for-primary-sclerosing-cholangitis-an-attempted-network-meta-analysis
#5
REVIEW
Francesca Saffioti, Kurinchi Selvan Gurusamy, Neil Hawkins, Clare D Toon, Emmanuel Tsochatzis, Brian R Davidson, Douglas Thorburn
BACKGROUND: Primary sclerosing cholangitis is a chronic cholestatic liver disease that is associated with both hepatobiliary and colorectal malignancies, which can result in liver cirrhosis and its complications. The optimal pharmacological treatment for patients with primary sclerosing cholangitis remains controversial. OBJECTIVES: To assess the comparative benefits and harms of different pharmacological interventions in people with primary sclerosing cholangitis by performing a network meta-analysis, and to generate rankings of available pharmacological interventions according to their safety and efficacy...
March 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28410915/early-hospital-readmission-in-decompensated-cirrhosis-incidence-impact-on-mortality-and-predictive-factors
#6
Betty P Morales, Ramon Planas, Ramon Bartoli, Rosa M Morillas, Margarita Sala, Eduard Cabré, Irma Casas, Helena Masnou
BACKGROUND & AIMS: The early hospital readmission of patients with decompensated cirrhosis is a current problem. A study is presented on the incidence, the impact on mortality, and the predictive factors of early hospital readmission. PATIENTS AND METHODS: On the study included 112 cirrhotic patients, discharged after some decompensation between January 2013 and May 2014. Multivariate analyses were performed to identify predictors of early readmission and mortality...
March 18, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28404098/screening-for-liver-fibrosis-in-the-general-population-a-call-for-action
#7
Pere Ginès, Isabel Graupera, Frank Lammert, Paolo Angeli, Llorenç Caballeria, Aleksander Krag, I Neil Guha, S Darwish Murad, Laurent Castera
Liver cirrhosis is one of the main causes of death and disability-adjusted life-years worldwide. Generally, cirrhosis develops after a long period of liver-cell injury that leads to the deposition of collagen, leading to progressive fibrosis and nodule formation in the liver tissue. Most patients are diagnosed in late stages when liver decompensation or liver cancer develops. The diagnosis is rarely made in early stages-when liver fibrosis is mild to moderate but cirrhosis is not yet established-because the disease is asymptomatic...
November 2016: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28404073/optimum-timing-of-treatment-for-hepatitis-c-infection-relative-to-liver-transplantation
#8
REVIEW
Audrey Coilly, Bruno Roche, Jean-Charles Duclos-Vallée, Didier Samuel
The approval of direct-acting antiviral agents that may be given orally in an interferon-free regimen has greatly changed the landscape of treatment for hepatitis C virus (HCV) infection, especially for patients with the most severe disease, who have decompensated cirrhosis, or who are waiting for or have undergone liver transplantation. Treatment with interferon proved to be ineffective and poorly tolerated because of high risks of infection and transplant rejection. The availability of new drugs poses new questions about the optimum time to give treatment to prevent HCV recurrence, taking into account efficacy, tolerance, and drug-drug interactions...
October 2016: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28404069/patient-reported-outcomes-with-sofosbuvir-and-velpatasvir-with-or-without-ribavirin-for-hepatitis-c-virus-related-decompensated-cirrhosis-an-exploratory-analysis-from-the-randomised-open-label-astral-4-phase-3-trial
#9
Zobair M Younossi, Maria Stepanova, Michael Charlton, Michael P Curry, Jacqueline G O'Leary, Robert S Brown, Sharon Hunt
BACKGROUND: Hepatitis C virus (HCV) treatment regimens with direct-acting antivirals have not been extensively studied in patients with decompensated cirrhosis. We assessed patient-reported outcomes (PROs) in patients with decompensated cirrhosis given a fixed-dose combination of sofosbuvir and velpatasvir with and without ribavirin. METHODS: This study was an exploratory analysis of data collected in a randomised, open-label phase 3 trial (ASTRAL-4) in which patients with HCV-related decompensated cirrhosis were randomly assigned to an all-oral fixed-dose combination of sofosbuvir (400 mg) and velpatasvir (100 mg) once daily for 12 weeks, sofosbuvir and velpatasvir plus oral ribavirin (weight-based 1000 mg or 1200 mg) for 12 weeks, or sofosbuvir and velpatasvir for 24 weeks...
October 2016: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28402928/management-of-advanced-fibrosis-in-the-context-of-hepatitis-c-virus-infection
#10
Elizabeth C Verna
Advanced fibrosis may be present in a substantial proportion of individuals with asymptomatic, chronic hepatitis C virus (HCV) infection, including those who have been newly diagnosed. HCV treatment improves all-cause and liver-related mortality in individuals with advanced fibrosis, and there is some evidence that reversal of decompensated liver disease may occur in those with a sustained virologic response. HCV treatment is also crucial for individuals undergoing liver transplantation, as recurrent HCV infection posttransplantation is associated with accelerated fibrosis progression and increased risk of poor outcomes...
February 2017: Topics in Antiviral Medicine
https://www.readbyqxmd.com/read/28396173/contribution-of-alcohol-use-disorders-on-the-burden-of-chronic-hepatitis-c-in-france-2008-2013-a-nationwide-retrospective-cohort-study
#11
Michaël Schwarzinger, Sylvain Baillot, Prof Yazdan Yazdanpanah, Prof Jürgen Rehm, Vincent Mallet
BACKGROUND AND AIMS: Hepatitis C virus (HCV) patients are at risk of alcohol use disorders (AUDs). We measured the contribution of AUDs on the burden of chronic HCV infection in French HCV patients. METHODS: We tracked the hospital trajectory of 97,347 French HCV patients aged 18-65 in January 2008 and followed until in-hospital death or December 2013. Primary outcome was the frequency of liver-related complications. Secondary outcomes were the frequency of liver transplantation and otherwise cause-specific mortality...
April 7, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28393104/safety-of-ercp-in-patients-with-liver-cirrhosis-a-national-database-study
#12
Udayakumar Navaneethan, Basile Njei, Xiang Zhu, Kiran Kommaraju, Mansour A Parsi, Shyam Varadarajulu
Background and aims Given the limited data on the safety of endoscopic retrograde cholangiopancreatography (ERCP) in patients with liver cirrhosis, we attempted to evaluate this question using a large national database. Methods We conducted a matched case - control study using the 2010 National Inpatient Sample database in which four non-cirrhotic controls were matched randomly for every cirrhotic patient from the same 10-year age group. We compared adverse events and safety of inpatient ERCP between patients with (n = 3228) and without liver cirrhosis (controls, n = 12 912)...
April 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28374965/closing-the-gap-the-challenges-of-treating-hepatitis-c-virus-genotype-3-infection
#13
Michelle T Martin, Paulina Deming
The efficacy of hepatitis C virus (HCV) treatment has increased over the last 5 years to nearly 100% for many patient groups. Patients with genotype (GT) 3 HCV infection, however, and specifically cirrhotic or treatment-experienced patients, have lower sustained virologic response (SVR) rates than patients with other GTs. As GT 3 presents more clinical challenges than other GTs, this review will focus on the evolution and efficacy of direct-acting antiviral (DAA) treatment options for HCV GT 3 infection after the historical standard of care with pegylated interferon and ribavirin...
April 4, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28374901/the-impact-of-carbapenem-resistance-on-clinical-deterioration-and-mortality-in-patients-with-liver-disease
#14
Philip G Ferstl, Natalie Filmann, Christian Brandt, Stefan Zeuzem, Michael Hogardt, Volkhard A J Kempf, Mona Müller, Oliver Waidmann, Claudia Reinheimer
BACKGROUND & AIMS: Infections with multidrug-resistant gram-negative bacteria are significantly impairing the prognosis of patients with liver disease. In particular, carbapenem resistance further narrows therapeutic options. This study investigates the impact of carbapenem-resistant gram-negative bacteria on the outcome of patients with liver disease and cirrhosis. METHODS: Between January 2011 and July 2015, 132 patients treated at the tertiary liver transplant center at University Hospital Frankfurt, Germany, were tested positive for carbapenem-resistant gram-negative bacteria and retrospectively analyzed in this study...
April 4, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28374327/scintigraphic-findings-in-end-stage-liver-disease-on-tc-99m-sestamibi-spect-ct-myocardial-perfusion-imaging
#15
Tarun Jain, N T K Thanseer, Ashwani Sood, Madan Parmar, Anish Bhattacharya, Bhagwant Mittal
Technetium-99m sestamibi myocardial perfusion imaging is commonly employed non-invasive study for evaluation of coronary artery disease; however, incidental extracardiac scintigraphic findings observed may provide additional diagnostic information. The authors present the unusual scintigraphic findings in a case of decompensated liver disease with right hepatic hydrothorax, being planned for orthotopic liver transplant.
April 3, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28368093/pharmacological-interventions-for-alcoholic-liver-disease-alcohol-related-liver-disease-an-attempted-network-meta-analysis
#16
REVIEW
Elena Buzzetti, Maria Kalafateli, Douglas Thorburn, Brian R Davidson, Maja Thiele, Lise Lotte Gluud, Cinzia Del Giovane, Gro Askgaard, Aleksander Krag, Emmanuel Tsochatzis, Kurinchi Selvan Gurusamy
BACKGROUND: Alcohol-related liver disease is due to excessive alcohol consumption. It includes a spectrum of liver diseases such as alcohol-related fatty liver, alcoholic hepatitis, and alcoholic cirrhosis. Mortality associated with alcoholic hepatitis is high. The optimal pharmacological treatment of alcoholic hepatitis and other alcohol-related liver disease remains controversial. OBJECTIVES: To assess the comparative benefits and harms of different pharmacological interventions in the management of alcohol-related liver disease through a network meta-analysis and to generate rankings of the available pharmacological interventions according to their safety and efficacy in order to identify potential treatments...
March 31, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28367169/sofosbuvir-based-therapy-in-hepatitis-c-patients-with-and-without-cirrhosis-is-there-difference
#17
Shahid Sarwar, Anwaar A Khan
OBJECTIVE: To compare sustained viral response to sofosbuvir/ribavirin ±interferon therapy in patients of hepatitis C with and without liver cirrhosis. METHODS: This observational study of chronic hepatitis C patients was carried out at Doctors Hospital and Medical Center (DH&MC). After diagnostic workup, Sofosbuvir/ribavirin for 24 weeks or sofosbuvir/ribavirin/pegylated interferon for 12 weeks were prescribed. Primary outcome was negative HCV RNA by PCR 12 weeks after treatment completion (SVR12)...
January 2017: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/28363639/increased-expression-of-ctla4-by-t-cells-induced-by-b7-in-sera-reduces-adaptive-immunity-in-patients-with-acute-liver-failure
#18
Wafa Khamri, Robin D Abeles, Tie Zheng Hou, Amy E Anderson, Ahmed El-Masry, Evangelos Triantafyllou, Christine Bernsmeier, Fin S Larsen, Arjuna Singanayagam, Nobuaki Kudo, Lucia A Possamai, Fanny Lebosse, Georg Auzinger, William Bernal, Christopher Willars, Christopher J Weston, Giovanna Lombardi, Julia Wendon, Mark Thursz, Charalambos G Antoniades
BACKGROUND & AIMS: Patients with acute liver failure (ALF) have defects in innate immune responses to microbes (immuneparesis) and are susceptible to sepsis. Cytotoxic T-lymphocyte associated protein 4 (CTLA4), which interacts with the membrane receptor B7 (also called CD80 and CD86), is a negative regulator of T-cell activation. We collected T cells from patients with ALF and investigated whether inhibitory signals downregulate adaptive immune responses in patients with ALF. METHODS: We collected peripheral blood mononuclear cells from patients with ALF and controls from September 2013 through September 2015 (45 patients with ALF, 20 patients with acute-on-chronic liver failure, 15 patients with cirrhosis with no evidence of acute decompensation, 20 patients with septic shock but no cirrhosis or liver disease, and 20 healthy individuals)...
March 28, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28360525/the-importance-of-a-multidisciplinary-approach-to-hepatocellular-carcinoma
#19
REVIEW
Osama Siddique, Eric R Yoo, Ryan B Perumpail, Brandon J Perumpail, Andy Liu, George Cholankeril, Aijaz Ahmed
Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related deaths worldwide. The rising incidence, genetic heterogeneity, multiple etiologies, and concurrent chronic liver diseases make diagnosis, staging, and selection of treatment options challenging in patients with HCC. The best approach to optimize the management of HCC is one that utilizes a core multidisciplinary liver tumor board, consisting of hepatologists, pathologists, interventional radiologists, oncologists, hepatobiliary and transplant surgeons, nurses, and general practitioners...
2017: Journal of Multidisciplinary Healthcare
https://www.readbyqxmd.com/read/28355381/bariatric-surgery-in-individuals-with-liver-cirrhosis-a-narrative-review
#20
Everton Cazzo, Martinho Antonio Gestic, Murillo Pimentel Utrini, Felipe David Mendonça Chaim, Francisco Callejas-Neto, José Carlos Pareja, Elinton Adami Chaim
Introduction: Bariatric surgery has become the gold standard treatment for morbid obesity, but there is no consensus regarding its safety and efficacy among individuals with chronic liver diseases. Objective: To critically evaluate the existing evidence on literature about bariatric surgery in individuals with liver cirrhosis. Method: Narrative review performed by means of an online search in the MEDLINE and LILACS databases. Results: Bariatric surgery is safe and effective in individuals with chronic liver disease without clinical decompensation or significant portal hypertension...
February 2017: Revista da Associação Médica Brasileira
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