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decompensated liver disease

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https://www.readbyqxmd.com/read/27906472/long-term-clinical-impact-and-cost-effectiveness-of-obeticholic-acid-for-the-treatment-of-primary-biliary-cholangitis
#1
Sumeyye Samur, Matthew Klebanoff, Reiner Banken, Daniel S Pratt, Rick Chapman, Daniel A Ollendorf, Anne M Loos, Kathleen Corey, Chin Hur, Jagpreet Chhatwal
: Primary biliary cholangitis (PBC) is a chronic, progressive autoimmune liver disease that mainly affects middle-aged women. Obeticholic acid (OCA), which was recently approved by the Food and Drug Administration for PBC treatment, has demonstrated positive effects on biochemical markers of liver function. Our objective was to evaluate the long-term clinical impact and cost-effectiveness of OCA as a second-line treatment for PBC in combination with ursodeoxycholic acid (UDCA) in adults with an inadequate response to UDCA...
November 7, 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/27895394/concise-review-interferon-free-treatment-of-hepatitis-c-virus-associated-cirrhosis-and-liver-graft-infection
#2
REVIEW
Nina Weiler, Stefan Zeuzem, Martin-Walter Welker
Chronic hepatitis C is a major reason for development of cirrhosis and hepatocellular carcinoma and a leading cause for liver transplantation. The development of direct-acting antiviral agents lead to (pegylated) interferon-alfa free antiviral therapy regimens with a remarkable increase in sustained virologic response (SVR) rates and opened therapeutic options for patients with advanced cirrhosis and liver graft recipients. This concise review gives an overview about most current prospective trials and cohort analyses for treatment of patients with liver cirrhosis and liver graft recipients...
November 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27894795/histological-parameters-and-alcohol-abstinence-determine-long-term-prognosis-in-patients-with-alcoholic-liver-disease
#3
Carolin Lackner, Walter Spindelboeck, Johannes Haybaeck, Philipp Douschan, Florian Rainer, Luigi Terracciano, Josef Haas, Andrea Berghold, Ramon Bataller, Rudolf E Stauber
BACKGROUND & AIMS: Few data exist on predictors of long-term prognosis in patients with alcoholic liver disease (ALD). Most studies have only assessed short-term prognosis in patients with advanced ALD. We aimed to assess the prognostic impact of clinical, biochemical and histological parameters on long-term prognosis in patients with early/compensated and decompensated ALD. METHODS: Consecutive patients (n=192) with biopsy-proven liver disease due to alcohol abuse were analyzed retrospectively...
November 25, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27885753/prognosis-of-1169-hepatitis-c-chronically-infected-patients-with-decompensated-cirrhosis-in-the-predirect-acting-antiviral%C3%A2-era
#4
S A McDonald, H A Innes, E Aspinall, P C Hayes, M Alavi, H Valerio, D J Goldberg, S J Hutchinson
At a population level, little is known regarding the risk of liver- and nonliver-related mortality and hospitalization and the development of hepatocellular carcinoma (HCC) in hepatitis C virus (HCV)-infected patients with decompensated cirrhosis (DC). This large-scale national record-linkage study estimates these outcomes following first hospital admission for DC. Record-linkages between national HCV diagnosis and clinical databases and the national inpatient hospital episode database and mortality register were conducted to follow-up the disease course of all identified HCV-diagnosed and chronically infected persons...
November 25, 2016: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/27882776/benefits-of-long-term-therapy-with-nucleos-t-ide-analogues-in-treatment-na%C3%A3-ve-patients-with-chronic-hepatitis-b
#5
Lai Wei, Jia-Horng Kao
OBJECTIVE: To assess the benefits of long-term nucleos(t)ide analogue (NA) therapy in reducing the severity and progression of liver disease in treatment-naïve patients with chronic hepatitis B (CHB). SCOPE: As complications of CHB, such as hepatic decompensation and hepatocellular carcinoma (HCC), take a long time to develop in patients with less advanced disease, the long-term benefits of NA therapy in such patients are more difficult to prove than short- or medium-term benefits...
November 24, 2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27878906/simeprevir-daclatasvir-and-sofosbuvir-for-hepatitis-c-virus-infected-patients-with-decompensated-liver-disease
#6
E Lawitz, F Poordad, J A Gutierrez, T N Kakuda, G Picchio, G Beets, A Vandevoorde, P Van Remoortere, B Jacquemyn, D Luo, S Ouwerkerk-Mahadevan, L Vijgen, V Van Eygen, M Beumont
Approximately three million individuals in the United States are chronically infected with hepatitis C virus (HCV). Chronic HCV infection may lead to the development of compensated as well as decompensated liver cirrhosis. The Phase II IMPACT study was conducted in HCV genotype 1- or 4-infected cirrhotic patients with portal hypertension or decompensated liver disease and assessed for the first time the combination of the three direct-acting antivirals simeprevir, daclatasvir and sofosbuvir. Treatment-naïve or treatment-experienced adults with Child-Pugh (CP) score <7 (CP A) and evidence of portal hypertension, or CP score 7-9 (CP B), received 12 weeks of simeprevir 150 mg, daclatasvir 60 mg and sofosbuvir 400 mg, once daily...
November 23, 2016: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/27872682/prophylactic-liver-transplantation-for-high-risk-recurrent-hepatocellular-carcinoma
#7
REVIEW
Po-Chih Yang, Cheng-Maw Ho, Rey-Heng Hu, Ming-Chih Ho, Yao-Ming Wu, Po-Huang Lee
Hepatocellular carcinoma (HCC) is the second most common cause of cancer-related death in the world. Radical treatment of HCC in early stages results in a long disease-free period and improved overall survival. The choice of optimal management strategy for HCC mainly depends on the severity of the underlying liver disease. For patients with decompensated liver cirrhosis and HCC within Milan criteria (MC), liver transplant (LT) is the choice of treatment. However, for patients with good residual liver reserve and HCC within MC, selection of other curative treatments such as liver resection (LR) or radiofrequency ablation may be a reasonable alternative...
November 8, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/27860118/association-between-serum-soluble-cd14-and-il-8-levels-and-clinical-outcome-in-primary-biliary-cholangitis
#8
Takeji Umemura, Tomohiro Sekiguchi, Satoru Joshita, Tomoo Yamazaki, Naoyuki Fujimori, Soichiro Shibata, Yuki Ichikawa, Michiharu Komatsu, Akihiro Matsumoto, Zakera Shums, Gary L Norman, Eiji Tanaka, Masao Ota
BACKGROUND & AIMS: Primary biliary cholangitis (PBC) is an autoimmune liver disease characterized by portal inflammation and immune-mediated destruction of intrahepatic bile ducts that often leads to liver decompensation, and liver failure. Although the biochemical response to ursodeoxycholic acid (UDCA) can predict disease outcome in PBC, few biomarkers have been identified as prognostic tools applicable prior to UDCA treatment. We therefore sought to identify such indicators of long-term outcome in PBC in the Japanese population...
November 17, 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27855947/-hepatitis-c-related-cirrhosis-current-status
#9
REVIEW
Isabel Conde, Carmen Vinaixa, Marina Berenguer
Chronic hepatitis C virus (HCV) infection affects around 150 million people. It is a leading cause of liver related morbidity and mortality through its predisposition to liver fibrosis, cirrhosis and end-stage liver complications. New treatments based on direct-acting antivirals have opened a new era in the management of HCV cirrhosis. They allow for HCV eradication without substantial side effects in almost all cirrhotic patients, reducing the risk of hepatocellular carcinoma, liver decompensation and mortality...
November 14, 2016: Medicina Clínica
https://www.readbyqxmd.com/read/27855457/-cholestatic-liver-disease
#10
Christine Pichler, Tobias Boettler, Robert Thimme
Common cholestatic liver diseases are primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC). Both diseases are considered autoimmune disorders; however, the precise pathogenesis remains elusive. Patients usually show no symptoms or present with pruritus and fatigue. High alkaline phosphatase and the presence of antimitochondrial antibodies are sufficient to diagnose PBC. Ursodeoxycholic acid is approved and recommended for the treatment of PBC. The diagnosis of PSC is established by elevated alkaline phosphatase-levels and typical cholangiographic findings...
November 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27847279/sofosbuvir-and-velpatasvir-combination-improves-outcomes-reported-by-patients-with-hcv-infection-without-or-with-compensated-or-decompensated-cirrhosis
#11
Zobair M Younossi, Maria Stepanova, Jordon Feld, Stefan Zeuzem, Mark Sulkowski, Graham R Foster, Alessandra Mangia, Michael Charlton, Jacqueline G O'Leary, Michael P Curry, Fatema Nader, Linda Henry, Sharon Hunt
BACKGROUND & AIMS: The combination of sofosbuvir and velpatasvir is used to treat patients with hepatitis C virus (HCV) infection of different genotypes. We compared the effects of this treatment regimen, with and without ribavirin, on outcomes reported by patients (patient-reported outcomes, or PROs) with HCV infection, with or without cirrhosis. METHODS: We performed a post-hoc analysis of data collected from phase 3 clinical trials (ASTRAL-1, -2, -3, and -4) of 1701 patients infected with HCV of different genotypes treated with sofosbuvir and velpatasvir with ribavirin for 12 weeks (n=87), sofosbuvir with ribavirin for 12 or 24 weeks (n=401), and ribavirin-free sofosbuvir and velpatasvir for 12 or 24 weeks (n=1213)...
November 12, 2016: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27843430/cirrhotic-cardiomyopathy-another-case-of-a-successful-approach-to-treatment-of-hepatorenal-syndrome
#12
Luis Otávio Mocarzel, Jessica Bicca, Luiza Jarske, Thamires Oliveira, Pedro Lanzieri, Ronaldo Gismondi, Mario Luiz Ribeiro
Hepatorenal syndrome (HRS) is defined as a failure of renal function, potentially reversible, in patients with liver cirrhosis and ascites. Recently, a component of cardiomyopathy associated with HRS was described, but the use of positive inotropic medicine as part of the treatment of the acute phase has not been extensively evaluated. We report a second case in our hospital of a patient with HRS type I without previous heart disease, with secondary hemodynamic decompensation due to liver disease, in which the abnormalities in systolic function by speckle-tracking echocardiography were observed and could be reversed by the use of inotropes...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/27822971/drug-induced-liver-injury-is-chronic-liver-disease-a-risk-factor-and-a-clinical-issue
#13
Rolf Teschke, Gaby Danan
Clinicians and practitioners caring for patients with chronic liver disease are often unsure whether drug therapy is a hazard that increases their patient's risk for drug-induced liver injury (DILI). Areas covered: We searched for reports of drug induced liver injury, both idiosyncratic and intrinsic, in patients with chronic liver disease including non-alcoholic and alcoholic liver disease, and cirrhosis. Reports we analyzed include statin treatment in patients with fatty liver, acetaminophen use in alcoholic fatty liver, antituberculous drugs in patients with tuberculosis and viral hepatitis, antiviral medications in hepatitis and antiretroviral medications in HIV/AIDS...
November 8, 2016: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/27809664/liver-surface-nodularity-score-allows-prediction-of-cirrhosis-decompensation-and-death
#14
Andrew D Smith, Kevin A Zand, Edward Florez, Reza Sirous, Darya Shlapak, Frederico Souza, Manohar Roda, Jason Bryan, Amit Vasanji, Michael Griswold, Seth T Lirette
Purpose To determine whether use of the liver surface nodularity (LSN) score, a quantitative biomarker derived from routine computed tomographic (CT) images, allows prediction of cirrhosis decompensation and death. Materials and Methods For this institutional review board-approved HIPAA-compliant retrospective study, adult patients with cirrhosis and Model for End-Stage Liver Disease (MELD) score within 3 months of initial liver CT imaging between January 3, 2006, and May 30, 2012, were identified from electronic medical records (n = 830)...
November 3, 2016: Radiology
https://www.readbyqxmd.com/read/27783223/value-of-treating-all-stages-of-chronic-hepatitis-c-a-comprehensive-review-of-clinical-and-economic-evidence
#15
REVIEW
Roberto Nuño Solinís, Patricia Arratibel Ugarte, Ander Rojo, Yuri Sanchez Gonzalez
INTRODUCTION: The goal of chronic hepatitis C (CHC) treatment is to achieve a sustained virologic response (SVR). The new generation of direct-acting antivirals (DAAs) offers 90-100% SVR rates. However, access to these treatments is generally limited to patients with advanced liver disease. The aim of this review is to provide an overview of the clinical and economic benefits of achieving SVR and to better understand the full value of CHC treatment in all stages of liver disease. METHODS: A comprehensive literature review was performed using the PubMed, Embase, and Cochrane library databases to identify articles examining the clinical, economic, and quality of life benefits associated with SVR...
October 25, 2016: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/27782157/albumin-homodimers-in-patients-with-cirrhosis-clinical-and-prognostic-relevance-of-a-novel-identified-structural-alteration-of-the-molecule
#16
Maurizio Baldassarre, Marco Domenicali, Marina Naldi, Maristella Laggetta, Ferdinando A Giannone, Maurizio Biselli, Daniela Patrono, Carlo Bertucci, Mauro Bernardi, Paolo Caraceni
Decompensated cirrhosis is associated to extensive post-transcriptional changes of human albumin (HA). This study aims to characterize the occurrence of HA homodimerization in a large cohort of patients with decompensated cirrhosis and to evaluate its association with clinical features and prognosis. HA monomeric and dimeric isoforms were identified in peripheral blood by using a HPLC-ESI-MS technique in 123 cirrhotic patients hospitalized for acute decompensation and 50 age- and sex-comparable healthy controls...
October 26, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27779196/thyroid-dysfunction-in-primary-biliary-cholangitis-a-comparative-study-at-two-european-centers
#17
Annarosa Floreani, Chiara Mangini, Anna Reig, Irene Franceschet, Nora Cazzagon, Lisa Perini, Llorenç Caballería, Silvia Cocchio, Vincenzo Baldo, Albert Parés
OBJECTIVES: Primary biliary cholangitis (PBC) is often associated with other autoimmune diseases, but little is known about the influence of thyroid disease (TD) on the natural history of PBC. Our aim is to analyze the association between PBC and TD, and the latter's impact on the natural history of PBC at two European centers. METHODS: The study involved 921 PBC patients enrolled between 1975 and 2015 in Padova (376 patients) and Barcelona (545 patients), with a mean follow-up of 126...
October 25, 2016: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/27770553/antiviral-treatment-and-liver-related-complications-in-hepatitis-delta
#18
Anika Wranke, Beatriz Calle Serrano, Benjamin Heidrich, Janina Kirschner, Birgit Bremer, Patrick Lehmann, Svenja Hardtke, Katja Deterding, Kerstin Port, Max Westphal, Michael P Manns, Markus Cornberg, Heiner Wedemeyer
: Hepatitis delta virus (HDV) is the most severe form of viral hepatitis. Pegylated interferon alfa (PEG-IFNα) is effective in only 25%-30% of patients and is associated with frequent side effects. The aim of this study was to analyze the clinical long-term outcome of hepatitis delta in relation to different antiviral treatment strategies. We studied 136 anti-HDV-positive patients who were followed for at least 6 months in a retrospective single-center cohort (mean time of follow-up, 5...
October 22, 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/27763575/optimal-treatment-of-hepatic-encephalopathy
#19
Sanath Allampati, Kevin D Mullen
Hepatic encephalopathy (HE) is a complex neuropsychiatric syndrome associated with decompensated liver disease. The spectrum of disease ranges from trivial abnormalities in complex decision-making and prolonged reaction time to coma in its most severe form. The very initial stages, recently termed covert hepatic encephalopathy, can only be diagnosed with the help of neuropsychiatric testing, while the later and more severe forms, termed overt hepatic encephalopathy, can be diagnosed clinically. Management of HE is very critical as it can dramatically increase morbidity and mortality...
December 2016: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/27747458/acute-on-chronic-liver-failure
#20
Shiv Kumar Sarin, Ashok Choudhury
Acute-on-chronic liver failure (ACLF) is a distinct entity that differs from acute liver failure and decompensated cirrhosis in timing, presence of treatable acute precipitant, and course of disease, with a potential for self-recovery. The core concept is acute deterioration of existing liver function in a patient of chronic liver disease with or without cirrhosis in response to an acute insult. The insult should be a hepatic one and presentation in the form of liver failure (jaundice, encephalopathy, coagulopathy, ascites) with or without extrahepatic organ failure in a defined time frame...
December 2016: Current Gastroenterology Reports
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