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https://www.readbyqxmd.com/read/29352420/diagnosis-and-management-of-hepatitis-c-infection-in-primary-care-settings
#1
Debra Guss, Jagannath Sherigar, Paul Rosen, Smruti R Mohanty
Hepatitis C virus (HCV) infection is a significant health problem worldwide, and is the leading cause of cirrhosis, hepatocellular carcinoma, and liver transplantation in the United States. The management of HCV has changed significantly over the last 5 years, as treatments have become simpler and more efficacious. Medication efficacy is now greater than 90%, with a high barrier to resistance and few side effects. This review is a collaboration between primary care and hepatology providers to explore all aspects of HCV management: acute versus chronic HCV infection, transmission and testing, and diagnosis and treatment...
January 19, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29341979/wilson-s-disease-in-children-a-position-paper-by-the-european-society-for-paediatric-gastroenterology-hepatology-and-nutrition-committee
#2
Piotr Socha, Wojciech Janczyk, Anil Dhawan, Ulrich Baumann, Lorenzo D'Antiga, Stuart Tanner, Raffaele Iorio, Pietro Vajro, Roderick Houwen, Björn Fischler, Antal Dezsofi, Nedim Hadzic, Loreto Hierro, Jörg Jahnel, Valérie McLin, Valerio Nobili, Francoise Smets, Henkjan J Verkade, Dominique Debray
BACKGROUND: Clinical presentations of Wilson's disease (WD) in childhood ranges from asymptomatic liver disease to cirrhosis or acute liver failure, while neurological and psychiatric symptoms are rare. The basic diagnostic approach includes serum ceruloplasmin and 24h-urinary copper excretion. Final diagnosis of WD can be established using a diagnostic scoring system based on symptoms, biochemical tests assessing copper metabolism and molecular analysis of mutations in the ATP7B gene...
October 26, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29316001/directly-observed-therapy-of-chronic-hepatitis-c-with-ledipasvir-sofosbuvir-in-people-who-inject-drugs-at-risk-for-non-adherence-to-direct-acting-antivirals
#3
Angelika Schütz, Stephan Moser, Cornelia Schwanke, Raphael Schubert, Julian Luhn, Enisa Gutic, Tobias Lang, Michael Schleicher, Hans Haltmayer, Michael Gschwantler
An important subgroup of people who inject drugs (PWID) receiving opioid agonist therapy (OAT), cannot be treated in the setting of a hepatology center and would not regularly ingest their medication when handed to them for self-administration. Our hypothesis was that chronic hepatitis C in these patients could be ideally managed if modern, interferon-free regimens were administered together with OAT under direct observation of a physician or nurse at a low-threshold facility. In this open-label, non-interventional, proof-of-concept study (ClinicalTrials...
January 5, 2018: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/29315693/nacseld-acute-on-chronic-liver-failure-nacseld-aclf-score-predicts-30-day-survival-in-hospitalized-patients-with-cirrhosis
#4
Jacqueline G O'Leary, K Rajender Reddy, Guadalupe Garcia-Tsao, Scott W Biggins, Florence Wong, Michael B Fallon, Ram M Subramanian, Patrick S Kamath, Paul Thuluvath, Hugo E Vargas, Benedict Maliakkal, Puneeta Tandon, Jennifer Lai, Leroy R Thacker, Jasmohan S Bajaj
NACSELD (North American Consortium for the Study of End-Stage Liver Disease) definition of acute-on-chronic liver failure (NACSELD-ACLF) as ≥2 extra-hepatic organ failures has been proposed as a simple bedside tool to assess risk of mortality in hospitalized patients with cirrhosis. We validated NACSELD-ACLF's ability to predict 30-day survival (defined as in-hospital death or hospice discharge) in a separate multicenter prospectively enrolled cohort of both infected and uninfected hospitalized patients with cirrhosis...
January 8, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/29208877/significance-of-age-spleen-platelet-ratio-index-aspri-to-exclude-cirrhosis-in-patients-with-chronic-hepatitis-b
#5
F Ahmed, M A Mahtab, S Rahman, M F Karim, M Khan, T Akther, A H Manik, C R Debnath
Liver biopsy is an integral part of management of patients with Chronic Hepatitis B (CHB), which is helpful in confirming diagnosis, assessing grade of inflammation and stage of fibrosis and also in guiding treatment strategy. Although liver biopsy is relatively safe, morbidity occurs in 0.2-2% of patients. Hence various non-invasive markers, like AST-ALT Ratio (AAR), Age-Platelet Index (API), AST to Platelet Ratio Index (APRI), Fibroscan etc. have been developed worldwide to asses liver histology. Age-Spleen-Platelet Ratio Index (ASPRI) is new in this series...
October 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29189999/nafld-nash-in-patients-with-type-2-diabetes-and-related-treatment-options
#6
REVIEW
M G Radaelli, F Martucci, S Perra, S Accornero, G Castoldi, G Lattuada, G Manzoni, G Perseghin
Type 2 diabetes may reduce life expectancy and patients' quality of life due to its micro- and macro-vascular complications and to the higher risk of several types of cancer. An emerging important factor is represented by the hepatic involvement; it is recognized that excessive hepatic fat accumulation represents a typical feature of diabetic patients and that it also plays an important pathogenic role. It is now evident that non-alcoholic fatty liver disease (NAFLD), generally perceived as a benign condition, may have on the contrary an important deleterious impact for diabetic patients increasing the risk to develop cardiovascular complications but also serious hepatic diseases, in particular non-alcoholic steatohepatitis (NASH), cirrhosis and hepatocellular carcinoma...
November 30, 2017: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/29155355/molecular-ellipticity-of-circulating-albumin-bilirubin-complex-associates-with-mortality-in-patients-with-severe-alcoholic-hepatitis
#7
Sukanta Das, Jaswinder Singh Maras, Rakhi Maiwall, S M Shasthry, Md Shabir Hussain, Shvetank Sharma, S Sukriti, T P Singh, Shiv Kumar Sarin
BACKGROUND & AIMS: Hyperbilirubinemia and hypoalbuminemia are features of hepatic dysfunction that associate with disease severity. This is because hepatic insufficiency causes hypoalbuminemia, which indirectly increases the circulating levels of free bilirubin. Circular dichroism (CD) spectroscopy can be used to quantify the molecular ellipticity (ME) of the albumin-bilirubin complex, and might associate with the severity or outcome of severe alcoholic hepatitis (SAH). METHODS: We performed a cross-sectional study of 265 patients with SAH admitted in the Department of Hepatology, Institute of Liver and Biliary Sciences in New Delhi, India from January 2014 through January 2016...
November 16, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/29152039/hepatic-hydrothorax-an-update-and-review-of-the-literature
#8
REVIEW
Dmitry Victorovich Garbuzenko, Nikolay Olegovich Arefyev
This review considers the modern concepts of pathogenesis, diagnostic methods, and treatment principles of hepatic hydrothorax (HH). HH is the excessive (> 500 mL) accumulation of transudate in the pleural cavity in patients with decompensated liver cirrhosis but without cardiopulmonary and pleural diseases. It causes respiratory failure which aggravates the clinical course of liver cirrhosis, and the emergence of spontaneous bacterial pleural empyema may be the cause of death. The information was collected from the PubMed database, the Google Scholar retrieval system, the Cochrane reviews, and the reference lists from relevant publications for 1994-2016 using the keywords: "liver cirrhosis", "portal hypertension", "hepatic hydrothorax", "pathogenesis", "diagnostics", and "treatment"...
November 8, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/29142479/medication-beliefs-predict-medication-adherence-in-ambulatory-patients-with-decompensated-cirrhosis
#9
Kelly L Hayward, Patricia C Valery, Jennifer H Martin, Antara Karmakar, Preya J Patel, Leigh U Horsfall, Caroline J Tallis, Katherine A Stuart, Penny L Wright, David D Smith, Katharine M Irvine, Elizabeth E Powell, W Neil Cottrell
AIM: To investigate the impact of medication beliefs, illness perceptions and quality of life on medication adherence in people with decompensated cirrhosis. METHODS: One hundred adults with decompensated cirrhosis completed a structured questionnaire when they attended for routine outpatient hepatology review. Measures of self-reported medication adherence (Morisky Medication Adherence Scale), beliefs surrounding medications (Beliefs about Medicines Questionnaire), perceptions of illness and medicines (Brief Illness Perception Questionnaire), and quality of life (Chronic Liver Disease Questionnaire) were examined...
October 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29108189/-guidelines-on-the-management-of-ascites-and-complications-in-cirrhosis
#10
(no author information available yet)
No abstract text is available yet for this article.
September 20, 2017: Zhonghua Gan Zang Bing za Zhi, Zhonghua Ganzangbing Zazhi, Chinese Journal of Hepatology
https://www.readbyqxmd.com/read/29083080/underappreciation-of-non-alcoholic-fatty-liver-disease-by-primary-care-clinicians-limited-awareness-of-surrogate-markers-of-fibrosis
#11
Preya J Patel, Xuan Banh, Leigh U Horsfall, Kelly L Hayward, Fabrina Hossain, Tracey Johnson, Katherine A Stuart, Nigel N Brown, Nivene Saad, Andrew Clouston, Katharine M Irvine, Anthony W Russell, Patricia C Valery, Suzanne Williams, Elizabeth E Powell
BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is a common cause of incidental liver test abnormalities. General practitioners have a key role in identifying people with NAFLD at risk of significant liver disease. Recent specialist guidelines emphasize the use of fibrosis algorithms or serum biomarkers rather than routine liver tests, to assess advanced fibrosis. This study evaluated primary care clinicians' current approach to diagnosis, management and referral of NAFLD. METHODS: A cross-sectional survey of primary care clinicians was undertaken through a structured questionnaire about NAFLD...
October 30, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29069254/accuracy-of-transient-elastography-fibroscan%C3%A2-acoustic-radiation-force-impulse-arfi-imaging-the-enhanced-liver-fibrosis-elf-test-apri-and-the-fib-4-index-compared-with-liver-biopsy-in-patients-with-chronic-hepatitis-c
#12
Taisa Grotta Ragazzo, Denise Paranagua-Vezozzo, Fabiana Roberto Lima, Daniel Ferraz de Campos Mazo, Mário Guimarães Pessoa, Claudia Pinto Oliveira, Venancio Avancini Ferreira Alves, Flair José Carrilho
OBJECTIVES: Although liver biopsy is the gold standard for determining the degree of liver fibrosis, issues regarding its invasiveness and the small amount of liver tissue evaluated can limit its applicability and interpretation in clinical practice. Non-invasive evaluation methods for liver fibrosis can address some of these limitations. The aim of this study was to evaluate the accuracy of transient elastography-FibroScan®, acoustic radiation force impulse (ARFI), enhanced liver fibrosis (ELF), the aspartate aminotransferase-to-platelet ratio index (APRI), and the FIB-4 index compared with liver biopsy in hepatitis C...
October 2017: Clinics
https://www.readbyqxmd.com/read/29055934/cryptogenic-cirrhosis-and-sitosterolemia-a-treatable-disease-if-identified-but-fatal-if-missed
#13
Fateh Bazerbachi, Erin E Conboy, Taofic Mounajjed, Kymberly D Watt, Dusica Babovic-Vuksanovic, Shailendra B Patel, Patrick S Kamath
Sitosterolemia is an autosomal recessive metabolic disease caused by mutations in ABCG5 or ABCG8 genes which encode for the (ATP)-binding cassette (ABC) transporters that are responsible for the trafficking of xenosterols. Liver involvement is not a recognized manifestation of this disease, and cirrhosis has been reported only once in the medical literature. We describe a fatal case of a 21-year old South Asian male who presented with decompensated cirrhosis, and biochemical abnormalities consistent with sitosterolemia...
October 16, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28977116/variceal-bleeding-update-of-recommendations-from-the-brazilian-association-of-hepatology
#14
Paulo Lisboa Bittencourt, Edna Strauss, Alberto Queiroz Farias, Angelo Alves de Mattos, Edmundo Pessoa Lopes
Since the publication of the Brazilian Association of Hepatology recommendations for the prevention and treatment of variceal bleeding in 2010, new evidence-based data were reported in the literature. This has changed our current management for portal hypertension. This review updates the previous recommendations. It takes the new prognostic staging of cirrhosis into account allowing tailored treatment for advanced fibrosis, compensated or decompensated cirrhosis. An organizing panel of five experts reviewed all recommendations according to available data, which were subsequently scrutinized by all members of the Brazilian Association of Hepatology using a web-based approach...
December 2017: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/28977113/primary-sclerosing-cholangitis-in-children-and-adolescents
#15
Eleonora Druve Tavares Fagundes, Alexandre Rodrigues Ferreira, Caroline Caldeira Hosken, Thaís Costa Nascentes Queiroz
BACKGROUND: Primary sclerosing cholangitis is a rare disease, but its prevalence has been underestimated in children and adolescents due to broad variation in clinical presentation as well as diagnostic challenges in this life period. OBJECTIVE: To evaluate children and adolescents with primary sclerosing cholangitis and to describe their clinical, laboratorial, histopathological, and cholangiography conditions. METHODS: This is an observational descriptive research that took place from 2005 to 2016 and included all the patients seen in the Outpatient Unit for Pediatric Hepatology of Hospital das Clinicas of UFMG who had been diagnosed with primary sclerosing cholangitis before the age of 18...
October 2, 2017: Arquivos de Gastroenterologia
https://www.readbyqxmd.com/read/28870446/hepacontrol-a-program-that-reduces-early-readmissions-mortality-at-60-days-and-healthcare-costs-in-decompensated-cirrhosis
#16
Betty P Morales, Ramon Planas, Ramon Bartoli, Rosa M Morillas, Margarita Sala, Irma Casas, Carolina Armengol, Helena Masnou
BACKGROUND & AIMS: Decompensated cirrhosis patients have an elevated incidence of early readmission, mortality and economic burden. The aims of HEPACONTROL were to reduce early readmission and to evaluate its impact on mortality and emergency department visits. PATIENTS AND METHODS: Quasi-experimental study with control group which compared two cohorts of patients discharged after being admitted for cirrhosis-related complications. A prospective cohort (n=80), who followed the HEPACONTROL program, which began with a follow-up examination seven days after discharge at the Hepatology Unit Day Hospital and a retrospective cohort of patients (n=112), who had been given a standard follow-up...
August 13, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28857900/regression-of-liver-fibrosis-over-a-24-week-period-after-completing-direct-acting-antiviral-therapy-in-patients-with-chronic-hepatitis-c-receiving-care-within-the-national-hepatitis-c-elimination-program-in-georgia-results-of-hepatology-clinic-hepa-experience
#17
Ekaterine Dolmazashvili, Akaki Abutidze, Nikoloz Chkhartishvili, Marine Karchava, Lali Sharvadze, Tengiz Tsertsvadze
OBJECTIVE: We assessed the impact of direct-acting antiviral (DAA) therapy on liver fibrosis regression measured by transient elastography (TE) in patients with chronic hepatitis C virus (HCV) infection. PATIENTS AND METHODS: A prospective cohort study was carried out in HCV monoinfected patients with advanced liver fibrosis or cirrhosis receiving interferon (IFN)-containing or IFN-free DAA therapy. Liver stiffness (LS) score more than 14.5 kPa indicated LS-defined cirrhosis...
November 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28837442/diagnosis-follow-up-and-treatment-of-cystic-fibrosis-related-liver-disease
#18
Ivo P van de Peppel, Anna Bertolini, Johan W Jonker, Frank A J A Bodewes, Henkjan J Verkade
PURPOSE OF REVIEW: To provide an insight and overview of the challenges in the diagnosis, follow-up and treatment of cystic fibrosis-related liver disease (CFLD). RECENT FINDINGS: The variable pathophysiology of CFLD complicates its diagnosis and treatment. A 'gold standard' for CFLD diagnosis is lacking. Over the past years, new techniques to diagnose features of CFLD, such as transient elastography, have been investigated. Although most of these tests confirm cystic fibrosis-related liver involvement (CFLI), they are, however, not suitable to distinguish various phenotypical presentations or predict progression to clinically relevant cirrhosis or portal hypertension...
August 23, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28809742/treatment-of-chronic-hcv-infection-with-the-new-direct-acting-antivirals-daa-first-report-of-a-real-world-experience-in-southern-brazil
#19
Hugo Cheinquer, Hoel Sette-Jr, Fernando H Wolff, Alexandre de Araujo, Silvia Coelho-Borges, Silvia R P Soares, Mauricio F A Barros
INTRODUCTION AND AIM: There is almost no data regarding the efficacy of direct acting antivirals (DAAs) therapy in Brazil. The aim of this historical cohort study is to describe the sustained virologic response (SVR) rate among real-world compensated chronic hepatitis C patients in three hepatology centers from Southern Brazil. MATERIALS AND METHODS: Patients were included if they had at least 12 weeks follow-up after the end of therapy. Patients that were lost to follow-up or had treatment prematurely interrupted for any reason were considered treatment failure in this intention to treat analysis...
September 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28797326/severe-liver-disease-related-to-chronic-hepatitis-c-virus-infection-in-treatment-naive-patients-epidemiological-characteristics-and-associated-factors-at-first-expert-centre-visit-france-2000-to-2007-and-2010-to-2014
#20
Alice Sanna, Yann Le Strat, Françoise Roudot-Thoraval, Sylvie Deuffic Burban, Patrizia Carrieri, Elisabeth Delarocque-Astagneau, Christine Larsen
Given recent profound improvements in the effectiveness of antiviral treatment for chronic Hepatitis C virus (HCV) infection, we aimed to describe the characteristics of patients referred to hepatology expert centres in France from 2000 to 2007 and from 2010 to 2014, and to identify factors associated with severe liver disease at their first visit for evaluation. We analysed data from two sources covering all of France: the former hepatitis C surveillance network, which included patients between 2000 and 2007, and the ANRS CO22 HEPATHER multi-centre cohort, which included patients between 2012 and 2014...
July 27, 2017: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
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