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Hepatic cirrhosis

Jelena Krstic, Markus Galhuber, Tim J Schulz, Michael Schupp, Andreas Prokesch
Lifestyle-related disorders, such as the metabolic syndrome, have become a primary risk factor for the development of liver pathologies that can progress from hepatic steatosis, hepatic insulin resistance, steatohepatitis, fibrosis and cirrhosis, to the most severe condition of hepatocellular carcinoma (HCC). While the prevalence of liver pathologies is steadily increasing in modern societies, there are currently no approved drugs other than chemotherapeutic intervention in late stage HCC. Hence, there is a pressing need to identify and investigate causative molecular pathways that can yield new therapeutic avenues...
March 20, 2018: International Journal of Molecular Sciences
Mariana Verdelho Machado, Anna Mae Diehl
Nonalcoholic fatty liver disease (NAFLD) encompasses a spectrum of obesity-associated liver diseases and it has become the major cause of cirrhosis in the Western world. The high prevalence of NAFLD-associated advanced liver disease reflects both the high prevalence of obesity-related fatty liver (hepatic steatosis) and the lack of specific treatments to prevent hepatic steatosis from progressing to more serious forms of liver damage, including nonalcoholic steatohepatitis (NASH), cirrhosis, and primary liver cancer...
March 20, 2018: Critical Reviews in Biochemistry and Molecular Biology
Alexandre de Araujo, Augusto Mantovani, Carlos Thadeu Schmidt Cerski, Antonio Barros Lopes, Luiza Cristina Bortoncello, Marcelo Basso Gazzana, Hugo Cheinquer
A 41-year-old woman diagnosed with idiopathic pulmonary hypertension presented symptoms despite the use of vasodilators, requiring treatment with bosentan. Previously, the patient had no signs of autoimmunity and had normal liver function. After three years of bosentan use, aminotransferase levels increased, without improvement after bosentan suspension, leading to complementary investigation. The diagnosis of autoimmune hepatitis was confirmed by biopsy, already in the stage of cirrhosis. In conclusion, in case of aminotransferase levels that remain persistently elevated, despite the reduction in doses and/or suspension of bosentan, autoimmune hepatitis must be investigated and treated urgently due to possibly rapid progression to cirrhosis...
March 2018: Journal of Gastrointestinal and Liver Diseases: JGLD
Alina M Suciu, Dana A Crisan, Bogdan D Procopet, Corina I Radu, Carmen Socaciu, Marcel V Tantau, Horia O Stefanescu, Mircea Grigorescu
BACKGROUND AND AIMS: Current management of alcoholic liver disease (ALD), especially for alcoholic hepatitis (AH) is still driven by liver biopsy. Therefore, the identification of novel and accurate noninvasive biomarkers for the diagnosis and assessment of severity is important. Metabolomics, because it unravels changes closest to the phenotype, may represent the key for novel biomarkers. The aim of this study was to identify and characterize potential metabolomic biomarkers for diagnosis, staging and severity assessment of ALD...
March 2018: Journal of Gastrointestinal and Liver Diseases: JGLD
A C Jemilohun, O G Adewoye
Autoimmune hepatitis (AIH) is a rare cause of chronic liver disease (CLD). It presents with varied clinical features from acute hepatitis to CLDs like chronic viral hepatitis and alcoholic liver disease, making it difficult to diagnose in the absence of a high index of suspicion and adequate laboratory support. Autoantibody-mediated hepatocyte injury is the major feature of AIH. We present a 44 year old woman with recurrent jaundice, ascites, splenomegaly, coagulopathy, negative chronic viral hepatitis screening, elevated IgG and positive anti-smooth muscle antibody...
December 2017: Annals of Ibadan Postgraduate Medicine
Henry H Nguyen, Abdel Aziz Shaheen, Natalia Baeza, Ellina Lytvyak, Stefan J Urbanski, Andrew L Mason, Gary L Norman, Marvin J Fritzler, Mark G Swain
BACKGROUND AND AIMS: Up to 20% of Primary Biliary Cholangitis (PBC) patients are estimated to have features that overlap with Autoimmune Hepatitis (AIH). Patients with PBC-AIH overlap syndrome (PBC-AIH OS) have been reported to exhibit suboptimal responses to ursodeoxycholic acid therapy, and are more likely to progress to cirrhosis. Anti-double stranded DNA (anti-dsDNA) and anti-p53 have been previously suggested to be potential autoantibodies for identifying patients with PBC-AIH OS...
2018: PloS One
Brian C Baumann, Jenny Wei, John P Plastaras, John N Lukens, Nevena Damjanov, Maarouf Hoteit, Christine Hsu, Matthew Levine, Jeffrey Mondschein, Gregory Nadolski, Kim Olthoff, Kim A Reiss, Mark Rosen, Evan Siegelman, James M Metz, Edgar Ben-Josef
OBJECTIVES: Stereotactic body radiotherapy (SBRT) is potentially curative treatment for small hepatocellular carcinomas (HCC), but data are limited on its efficacy and toxicity. We hypothesized that SBRT can achieve excellent local control (LC) with acceptable toxicity treating HCC lesions, even in advanced cirrhosis. MATERIALS AND METHODS: Thirty-seven nonmetastatic HCC patients received SBRT to 43 lesions between October 2012 and April 2016. Median dose was 50 Gy/5 fractions...
March 16, 2018: American Journal of Clinical Oncology
Matthew Klinge, Tami Coppler, Jane M Liebschutz, Mohannad Dugum, Ajay Wassan, Andrea DiMartini, Shari Rogal
Purpose of review: The treatment of pain in patients with cirrhosis is complicated by unpredictable hepatic drug metabolism and a higher risk of adverse drug reactions. We aimed to conduct a scoping review regarding pain management in cirrhosis. Recent findings: Despite the high prevalence of pain in patients with cirrhosis, there is little literature to guide the management of pain in this population. Complex pain syndromes and disease-specific pain etiologies exist are common in patients with cirrhosis...
March 2018: Current Hepatology Reports
Chaojie Liang, Yingchen Xu, Hua Ge, Guangming Li, Jixiang Wu
Background and aim: Constitutive activation of STAT3 through its phosphorylation (p-STAT3) plays a key role in the development and progression of various cancers. However, the relationship between p-STAT3 expression and the clinicopathological features and prognostic value in patients with hepatocellular carcinoma (HCC) remains controversial. We conducted a meta-analysis to evaluate the role of p-STAT3 in HCC. Methods: The PubMed, Cochrane Library, Web of Science, EMBASE, Chinese CNKI, and Chinese Wanfang databases were searched using the appropriate terms to find the relevant studies on p-STAT3 and HCC...
2018: OncoTargets and Therapy
Yao-Chun Hsu, Terry Cheuk-Fung Yip, Hsiu J Ho, Vincent Wai-Sun Wong, Yen-Tsung Huang, Hashem B El-Serag, Teng-Yu Lee, Ming-Shiang Wu, Jaw-Town Lin, Grace Lai-Hung Wong, Chun-Ying Wu
BACKGROUND & AIMS: The risk of hepatocellular carcinoma (HCC) during antiviral therapy in patients with chronic hepatitis B (CHB) is inadequately predicted by the scores built from untreated patients. We aimed to develop and validate a risk score to predict HCC in CHB patients on entecavir or tenofovir treatment. METHODS: This study analyzed population-wide data from the healthcare databases in Taiwan and Hong Kong to identify CHB patients continuously receiving entecavir or tenofovir...
March 15, 2018: Journal of Hepatology
Antonietta Romano, Paolo Angeli, Sara Piovesan, Franco Noventa, Georgios Anastassopoulos, Liliana Chemello, Luisa Cavalletto, Martina Gambato, Francesco Paolo Russo, Patrizia Burra, Valter Vincenzi, Pier Giorgio Scotton, Sandro Panese, Diego Tempesta, Tosca Bertin, Maurizio Carrara, Antonio Carlotto, Franco Capra, Giada Carolo, Giovanna Scroccaro, Alfredo Alberti
BACKGROUND & AIMS: Direct-acting antiviral agents (DAAs) are safe and effective in patients with hepatitis C. Conflicting data were reported on the risk of Hepatocellular carcinoma (HCC) during/after therapy with DAAs. Aim of this study was to evaluate incidence of newly diagnosed hepatocellular carcinoma and associated risk factors in patients with advanced hepatitis C treated with DAAs. METHODS: The study is based on the NAVIGATORE platform, a prospectively recording database of all patients with hepatitis C receiving DAAs in Veneto region (Italy)...
March 15, 2018: Journal of Hepatology
Massimo Puoti, Graham R Foster, Stanley Wang, David Mutimer, Edward Gane, Christophe Moreno, Ting Tsung Chang, Samuel S Lee, Rui Marinho, Jean-Francois DuFour, Stanislas Pol, Christophe Hezode, Stuart C Gordon, Simone I Strasser, Paul J Thuluvath, Zhenzhen Zhang, Sandra Lovell, Tami Pilot-Matias, Federico J Mensa
BACKGROUND AND AIMS: Glecaprevir plus pibrentasvir (G/P) is a pangenotypic, once-daily, ribavirin-free direct-acting antiviral (DAA) treatment for hepatitis C virus (HCV) infection. In nine phase 2 or 3 clinical trials, G/P achieved sustained virologic response 12 weeks post-treatment (SVR12) rates of 93-100% across all six major HCV genotypes (GTs). An integrated efficacy analysis of 8- and 12-week G/P in non-cirrhotic patients with HCV GT1-6 infection was performed. METHODS: Data were pooled from nine phase 2 and 3 trials and included patients with chronic HCV GT 1, 2, 3, 4, 5 or 6 infection without cirrhosis who received G/P (300mg/120mg) for either 8 or 12 weeks...
March 15, 2018: Journal of Hepatology
Li Liu, Di Xiao, Jin-Hong Yu, Rui Shen, Meng Wang, Qiang Li
OBJECTIVES: In China, the epidemic pattern of acute hepatitis E virus (HEV) infection has changed from waterborne outbreaks to foodborne sporadic cases. However, the clinical course of sporadic acute hepatitis E has not been well defined. METHODS: Consecutive AHE inpatients who were admitted to the Jinan Infectious Disease Hospital, Jinan, Shandong Province, between January 2003 and December 2014 were evaluated and followed. Demographic data, clinical manifestations, results of laboratory tests,and outcomes were recorded...
March 15, 2018: International Journal of Infectious Diseases: IJID
Tsung-Hsing Hung, Hsing-Feng Lee, Chih-Wei Tseng, Chih-Chun Tsai, Chen-Chi Tsai
BACKGROUND: Hepatic encephalopathy (HE) is a neuropsychiatric complication of decompensated cirrhosis. Proton pump inhibitors (PPIs), used as potent acid suppressants, are associated with HE occurrence in cirrhotic patients. However, it is still unknown if PPIs contribute to mortality in cirrhotic patients with HE and no active gastrointestinal bleeding. METHODS: We used the Taiwan National Health Insurance Database to identify 1004 cirrhotic patients with HE and no active gastric bleeding, who received oral PPIs between January 1, 2010 and December 31, 2013...
March 15, 2018: Clinics and Research in Hepatology and Gastroenterology
Maxime Mallet, Nicolas Weiss, Dominique Thabut, Marika Rudler
Hyperammonemia plays a key role in the pathophysiology of hepatic encephalopathy (HE) and most HE treatments are ammonia-lowering drugs. However, the usefulness of measuring ammonemia in routine practice remains controversial and not recommended systematically even when neurological symptoms are present. First, ammonemia measurement should be carefully performed in order to avoid a falsely elevated result. When performed, a normal ammonemia in a cirrhotic patient with neurological symptoms should lead to reconsider the diagnosis of HE...
March 15, 2018: Clinics and Research in Hepatology and Gastroenterology
Alessandra Maria Mont Alverne Pierre, Ana Cristina de Castro Amaral Feldner, Roberto José de Carvalho Filho, Edmundo Pessoa de Almeida Lopes, Michele Soares Gomes Gouvea, João Renato Rebello Pinho, Claudia Teresa Carvente, Christini Takemi Emori, Genimari Arruda da Silva, Maria Lúcia Cardoso Gomes Ferraz
INTRODUCTION: Hepatitis B virus infection is an important cause of liver disease in hemodialysis patients and renal transplant recipients. Hepatitis Delta virus is a defective virus transmitted by the same route of hepatitis B virus, which requires the helper function of hepatitis B virus. Data about hepatitis B virus/hepatitis delta virus coinfection are scarce and there are no studies regarding the coinfection among hemodialysis patients and renal transplant in our country. OBJECTIVE: This study aimed to investigate the prevalence of hepatitis delta virus infection among hemodialysis patients and renal transplant recipients...
March 2018: International Journal of Artificial Organs
Young-A Heo, Emma D Deeks
A fixed-dose combination of the hepatitis C virus (HCV) NS5B polymerase inhibitor sofosbuvir, the HCV NS5A inhibitor velpatasvir and the HCV NS3/4A protease inhibitor voxilaprevir (sofosbuvir/velpatasvir/voxilaprevir; Vosevi® ) is approved in the EU for the treatment of chronic HCV genotype 1, 2, 3, 4, 5 or 6 infection in adults. In the phase III POLARIS trials, in patients who had HCV genotype 1-6 infection with or without compensated cirrhosis, overall rates of sustained virological response at 12 weeks post-treatment (SVR12 ) with sofosbuvir/velpatasvir/voxilaprevir were high after 8 weeks of treatment in direct-acting antiviral (DAA)-naïve patients and 12 weeks of treatment in DAA-experienced patients...
March 15, 2018: Drugs
Sana Amhimmid Badr, Maryan Waheeb Fahmi, Manal Mahmoud Nomir, Mamdouh Mohammad El-Shishtawy
Objective: Hepatocellular carcinoma (HCC) is the fifth most common malignancy worldwide. The identification of new simple, inexpensive and highly accurate markers for HCC diagnosis and screening is needed. This case-control study evaluates the role of annexin A2 and voltage-gated calcium channels α2δ1 subunit as serum biomarkers for HCC diagnosis. Methods: The study comprised three groups: group 1, 50 patients with an initial diagnosis of HCC associated with chronic hepatitis C virus infection; group 2, 25 patients diagnosed with chronic hepatitis C virus infection and cirrhosis without any evidence of HCC; and group 3, 15 healthy controls...
February 2018: Cancer Biology & Medicine
Tatsuo Kanda, Shin Yasui, Masato Nakamura, Shingo Nakamoto, Koji Takahashi, Shuang Wu, Reina Sasaki, Yuki Haga, Sadahisa Ogasawara, Tomoko Saito, Kazufumi Kobayashi, Soichiro Kiyono, Yoshihiko Ooka, Eiichiro Suzuki, Tetsuhiro Chiba, Hitoshi Maruyama, Fumio Imazeki, Mitsuhiko Moriyama, Naoya Kato
Background: Interferon-free treatment can achieve higher sustained virological response (SVR) rates, even in patients in whom hepatitis C virus (HCV) could not be eradicated in the interferon treatment era. Immune restoration in the liver is occasionally associated with HCV infection. We examined the safety and effects of interferon-free regimens on HCV patients with autoimmune liver diseases. Results: All 7 HCV patients with autoimmune hepatitis (AIH) completed treatment and achieved SVR...
February 20, 2018: Oncotarget
Yujen Tseng, Lili Ma, Tiancheng Luo, Xiaoqing Zeng, Na Li, Yichao Wei, Ji Zhou, Feng Li, Shiyao Chen
Portal hypertension secondary to liver cirrhosis may cause a number of life-threatening complications. The rupture of gastroesophageal varices is associated with a high mortality rate of 15-30%. Hepatic venous pressure gradient (HVPG) is an accurate reflection of disease severity, however this can only be assessed via an invasive interventional procedure. The aim of the present study was to explore a non-invasive method based on 3D computed tomography (CT) volume rendering technology to accurately predict HVPG...
April 2018: Experimental and Therapeutic Medicine
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