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https://www.readbyqxmd.com/read/28480064/systemic-therapy-for-advanced-hepatocellular-carcinoma-an-update
#1
REVIEW
Jasmin Radhika Desai, Sebastian Ochoa, Petra Alexandra Prins, Aiwu Ruth He
Advanced hepatocellular carcinoma (HCC) is a deadly disease with few systemic therapeutic options. Sorafenib is the only agent to be FDA approved for the first-line treatment of patients with HCC. This drug increases overall survival (OS) by 3 months compared with placebo (10.7 months with sorafenib vs. 7.7 months with placebo). More recently, the RESORCE trial demonstrated efficacy of regorafenib in the second-line treatment of HCC: OS was increased from 7.8 months with placebo to 10.6 months with regorafenib after patients experienced disease progression on sorafenib...
April 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28476267/chronic-pain-among-patients-with-opioid-use-disorder-results-from-electronic-health-records-data
#2
Yih-Ing Hser, Larissa J Mooney, Andrew J Saxon, Karen Miotto, Douglas S Bell, David Huang
PURPOSE: To examine the prevalence of comorbid chronic pain among patients with opioid use disorder (OUD) and to compare other comorbidities (substance use disorder (SUD), mental health disorders, health/disease conditions) among patients in four categories: no chronic pain (No Pain), OUD prior to pain (OUD First), OUD and pain at the same time (Same Time), or pain condition prior to OUD (Pain First). METHODS: Using an electronic health record (EHR) database from 2006-2015, the study assessed 5307 adult patients with OUD in a large healthcare system; 35...
June 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28470665/pentamidine-blocks-hepatotoxic-injury-in-mice
#3
Enpeng Zhao, Ghulam Ilyas, Francesca Cingolani, Jae Ho Choi, François Ravenelle, Kathryn E Tanaka, Mark J Czaja
Toxin-induced liver diseases lack effective therapies despite increased understanding of the role factors such as an overactive innate immune response play in the pathogenesis of this form of hepatic injury. Pentamidine is an effective antimicrobial agent against several human pathogens, but studies have also suggested that this drug inhibits inflammation. This potential anti-inflammatory mechanism of action, together with the development of a new oral form of pentamidine isethionate VLX103, led to investigations of the effectiveness of this drug in the prevention and treatment of hepatotoxic liver injury...
May 3, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/28465155/effect-of-liver-disease-on-hepatic-transporter-expression-and-function
#4
REVIEW
Nilay Thakkar, Jason R Slizgi, Kim L R Brouwer
Liver disease can alter the disposition of xenobiotics and endogenous substances. Regulatory agencies such as the Food and Drug Administration (FDA) and the European Medicines Evaluation Agency (EMEA) recommend, if possible, studying the effect of liver disease on drugs under development to guide specific dose recommendations in these patients. While extensive research has been conducted to characterize the effect of liver disease on drug-metabolizing enzymes, emerging data have implicated that the expression and/or function of hepatobiliary transport proteins also are altered in liver disease...
April 29, 2017: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28464763/sporadic-porphyria-in-a-patient-with-stage-ii-melanoma-treated-with-interferon-%C3%AE
#5
Valerie Reymann, Celine Girard, Olivier Dereure, Bernard Guillot, Aurélie Du Thanh
Porphyria cutanea tarda (PCT) is the most common form of human porphyria, due to reduced activity of uroporphyrinogen decarboxylase (UROD). There are many factors which can trigger PCT such as viral infections, excessive alcohol intake, iron overload, hepatotoxic drugs and hepatic tumours. Drug induced PCT is well documented but PCT induced by interferon α has rarely been described and only in cases of Hepatitis C Virus (HCV) infection or haematological malignancies. Here, we report the first case of de novo PCT induced by adjuvant interferon α (IFNα) therapy in a patient with stage II melanoma...
May 2, 2017: Current Drug Safety
https://www.readbyqxmd.com/read/28442271/evaluation-of-the-xpert-hcv-viral-load-point-of-care-assay-from-venepuncture-collected-and-finger-stick-capillary-whole-blood-samples-a-cohort-study
#6
Jason Grebely, Francois M J Lamoury, Behzad Hajarizadeh, Yasmin Mowat, Alison D Marshall, Sahar Bajis, Philippa Marks, Janaki Amin, Julie Smith, Michael Edwards, Carla Gorton, Nadine Ezard, David Persing, Marika Kleman, Philip Cunningham, Beth Catlett, Gregory J Dore, Tanya L Applegate
BACKGROUND: Point-of-care hepatitis C virus (HCV) RNA testing offers an advantage over antibody testing (which only indicates previous exposure), enabling diagnosis of active infection in a single visit. In this study, we evaluated the performance of the Xpert HCV Viral Load assay with venepuncture and finger-stick capillary whole-blood samples. METHODS: Plasma and finger-stick capillary whole-blood samples were collected from participants in an observational cohort enrolled at five sites in Australia (three drug and alcohol clinics, one homelessness service, and one needle and syringe programme)...
April 21, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28426439/high-mortality-among-patients-with-opioid-use-disorder-in-a-large-healthcare-system
#7
Yih-Ing Hser, Larissa J Mooney, Andrew J Saxon, Karen Miotto, Douglas S Bell, Yuhui Zhu, Di Liang, David Huang
OBJECTIVES: Elevated mortality has been observed among individuals with opioid use disorder (OUD) treated in addiction specialty clinics or programs. Information about OUD patients in general healthcare settings is needed in light of the current effort to integrate addiction services into primary healthcare systems. This study examined mortality rates, causes of death, and associated risk factors among patients with OUD in a large general healthcare system. METHODS: Mortality data were linked with electronic health records of 2576 OUD patients cared for in a large university health system from 2006 to 2014...
April 20, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28426313/restrictions-of-hepatitis-c-treatment-for-substance-using-medicaid-patients-cost-versus-ethics
#8
Joshua M Liao, Michael A Fischer
Medicaid programs provide health insurance coverage for many patients with hepatitis C, a public health problem for which effective but very expensive treatments are now available. Facing constrained budgets, most states adopted prior authorization criteria for sofosbuvir, the first of these agents. Using fee-for-service utilization data from 42 Medicaid programs in 2014, we found that strict behavioral criteria-those that limited coverage on the basis of drug or alcohol use and included specific abstinence or treatment requirements-were associated with significantly less spending on sofosbuvir...
June 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28418984/anger-and-quality-of-life-in-patients-co-infected-with-hiv-and-hepatitis-c-virus-a-cross-sectional-study-anrs-co13-hepavih
#9
Fabienne Marcellin, Camelia Protopopescu, Laure Esterle, Linda Wittkop, Lionel Piroth, Hugues Aumaitre, Olivier Bouchaud, Cécile Goujard, Daniel Vittecoq, François Dabis, Dominique Salmon-Ceron, Bruno Spire, Perrine Roux, Maria P Carrieri
OBJECTIVE: The aim of this study is to document the relationship between anger dimensions (state, trait, expression, and control) and quality of life (QoL) in patients co-infected with HIV and hepatitis C virus (HCV). PATIENTS AND METHODS: This is a cross-sectional study nested in the ANRS CO13-HEPAVIH French national cohort. Anger and QoL were assessed using self-administered questionnaires in 536 HIV-HCV-co-infected patients. Correlations between anger scores (STAXI-2 scale) and QoL scores (WHOQOL-HIV BREF scale) were assessed using Spearman's coefficients...
April 17, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28404136/non-alcoholic-fatty-liver-disease-and-non-alcoholic-steatohepatitis-in-patients-with-hiv
#10
REVIEW
Elizabeth C Verna
Liver disease is a leading cause of morbidity and mortality among people with HIV, and in this era of safer and more effective hepatitis C therapy, non-alcoholic fatty liver disease (NAFLD) could soon emerge as the most common liver disease in this population. NAFLD is common among patients with HIV, and might be more likely to progress to non-alcoholic steatohepatitis (NASH) and NAFLD-related fibrosis or cirrhosis in these patients than in individuals without HIV. Several mechanisms of NAFLD pathogenesis are postulated to explain the disease severity in patients with HIV; these mechanisms include the influence of the gut microbiome, and also metabolic, genetic, and immunological factors...
March 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28404135/incidence-risk-factors-and-prevention-of-hepatitis-c-reinfection-a-population-based-cohort-study
#11
Nazrul Islam, Mel Krajden, Jean Shoveller, Paul Gustafson, Mark Gilbert, Jane A Buxton, Jason Wong, Mark W Tyndall, Naveed Zafar Janjua
BACKGROUND: People remain at risk of reinfection with hepatitis C virus (HCV), even after clearance of the primary infection. We identified factors associated with HCV reinfection risk in a large population-based cohort study in British Columbia, Canada, and examined the association of opioid substitution therapy and mental health counselling with reinfection. METHODS: We obtained data from the British Columbia Hepatitis Testers Cohort, which includes all individuals tested for HCV or HIV at the British Columbia Centre for Disease Control Public Health Laboratory during 1990-2013 (when data were available)...
March 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28378246/engagement-in-care-of-high-risk-hepatitis-c-patients-with-interferon-free-direct-acting-antiviral-therapies
#12
John B Dever, Julie H Ducom, Ariel Ma, Joseph Nguyen, Lin Liu, Ann Herrin, Erik J Groessl, Samuel B Ho
BACKGROUND AND AIMS: The extent to which hepatitis C (HCV) treatment uptake is improved following introduction of interferon-free direct-acting antiviral (DAA) treatments is unknown. The purpose of this study was to determine HCV patient engagement and barriers to care for accessing DAA treatments in a real-world setting. METHODS: Patients with HCV viremia at high risk for fibrosis were identified using the Veterans Affairs (VA) registry within San Diego's VA in October 2014...
April 4, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28372458/hepatocellular-carcinoma-presenting-with-budd-chiari-syndrome-right-atrial-thrombus-and-pulmonary-emboli
#13
Luís C Lourenço, David V Horta, Sara F Alberto, Jorge Reis
A 47-year-old patient presented with a two-week history of right upper quadrant pain, abdominal distention and new onset of shortness of breath. He had a history of intravenous drug abuse, no alcohol consumption and denied any known liver disease. On physical examination, he was tachypneic and had dullness in the flanks. His blood analysis at admission was as follows: hemoglobin, 12.9 g/dL; leukocyte count, 6,800/uL; platelet count, 63,000/uL; INR, 2.1; serum creatinine, 1.27 mg/dL; liver biochemistry tests were notable for marginal derangement, HBsAg was negative, anti-HCV was positive, HCV RNA was 367,498 IU/ml and alpha-fetoprotein was 992 mg/dL...
April 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28348464/liver-function-tests-abnormalities-and-hepatitis-b-virus-hepatitis-c-virus-co-infection-in-human-immunodeficiency-virus-hiv-infected-patients-in-india
#14
P Puri, P K Sharma, A Lolusare, V K Sashindran, S Shrivastava, A K Nagpal
BACKGROUND: While highly active anti-retroviral therapy (HAART) has improved survival of HIV-infected patients, there is increasing liver disease and progressive Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) related liver disease. AIMS: To study the liver function tests (LFT) and HBV and HCV co-infection in HIV-infected patients. MATERIAL AND METHODS: All HIV-positive patients presenting to a tertiary level hospital from April 2009 to April 2011 were evaluated...
March 2017: Journal of Clinical and Experimental Hepatology
https://www.readbyqxmd.com/read/28342409/perceived-health-and-alcohol-use-in-individuals-with-hiv-and-hepatitis-c-who-use-drugs
#15
Jennifer C Elliott, Deborah S Hasin, Don C Des Jarlais
BACKGROUND: Individuals who use illicit drugs are at heightened risk for HIV and/or Hepatitis C Virus (HCV). Despite the medical consequences of drinking for drug-using individuals with these infections, many do drink. In other studies, how individuals perceive their health relates to their engagement in risk behaviors such as drinking. However, among drug-using individuals with HIV and HCV, whether perceived health relates to drinking is unknown. OBJECTIVE: We examine the association between perceived health and drinking among drug-using individuals with HIV and/or HCV...
March 10, 2017: Addictive Behaviors
https://www.readbyqxmd.com/read/28340198/reasons-to-wait-or-to-treat-naive-patients-affected-by-chronic-hepatitis-c-with-low-fibrosis-stage-and-genotypes-2-or-3
#16
Lucio Boglione, Jessica Cusato, Giuseppe Cariti, Giovanni Di Perri, Antonio D'Avolio
New interferon (IFN)-free therapies are not currently available for all patients with chronic hepatitis C due to higher costs; in Italy, patients with genotype 2 (GT2) or GT3 without severe fibrosis can choose between wait or treatment with pegylated (PEG)-IFN and ribavirin. This study wants to examine the real rate of patients that accept or refused this therapy and the reasons related to decision. This prospective, observational analysis was performed at our centre between January 2014 and June 2015. Epidemiological, social and clinical data were collected in medical records; reasons for treatment acceptance/refusal were recorded through a questionnaire...
March 10, 2017: European Journal of Public Health
https://www.readbyqxmd.com/read/28327789/prevalence-of-hepatitis-c-virus-and-human-immunodeficiency-virus-in-a-group-of-patients-newly-diagnosed-with-active-tuberculosis-in-porto-alegre-southern-brazil
#17
Cintia Costi, Tarciana Grandi, Maria Laura Halon, Márcia Susana Nunes Silva, Cláudia Maria Dornelles da Silva, Tatiana Schäffer Gregianini, Lia Gonçalves Possuelo, Carla Adriane Jarczewski, Christian Niel, Maria Lucia Rosa Rossetti
BACKGROUND: Porto Alegre is the Brazilian state capital with second highest incidence of tuberculosis (TB) and the highest proportion of people infected with human immunodeficiency virus (HIV) among patients with TB. Hepatitis C virus (HCV) infection increases the risk of anti-TB drug-induced hepatotoxicity, which may result in discontinuation of the therapy. OBJECTIVES: The aim of this study was (i) to estimate prevalence of HCV and HIV in a group of patients newly diagnosed with active TB in a public reference hospital in Porto Alegre and (ii) to compare demographic, behavioural, and clinical characteristics of patients in relation to their HCV infection status...
April 2017: Memórias do Instituto Oswaldo Cruz
https://www.readbyqxmd.com/read/28296656/severity-and-outcome-of-acute-on-chronic-liver-failure-is-dependent-on-the-etiology-of-acute-hepatic-insults-analysis-of-368-patients
#18
Shalimar, Saurabh Kedia, Soumya J Mahapatra, Baibaswata Nayak, Deepak Gunjan, Bhaskar Thakur, Subrat K Acharya
BACKGROUND: Acute-on-chronic liver failure (ACLF) may be precipitated by various hepatic insults. The present study evaluated the outcomes of ACLF with different acute insults. PATIENTS AND METHODS: A total of 368 ACLF patients were included. Data collected included etiologies of acute hepatic insult and underlying chronic liver disease, and organ failure. Model for end-stage liver disease (MELD), chronic liver failure consortium (CLIF)-C ACLF, and acute physiology and chronic health evaluation (APACHE) II scores were calculated...
March 14, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28263455/liver-disease-and-fibrosis-assessment-in-substance-use-related-disorders
#19
Marija Zeremski, Anthony Martinez
Substance users have the highest prevalence of hepatitis C virus (HCV) infection but have rarely been treated, largely because of their mistrust of the health care system, misconceptions about the consequences of the infection, and concerns regarding interferon-related side effects. With the development of highly efficacious, interferon-free therapeutic regimens without significant side effects, the concept of colocating HCV and substance use treatment would appear to be highly feasible. This process has been further facilitated by widespread clinical adaptation of noninvasive assays for fibrosis assessment, which could be performed routinely in substance use treatment facilities...
March 2017: Clinical Pharmacology in Drug Development
https://www.readbyqxmd.com/read/28256512/transcriptome-based-repurposing-of-apigenin-as-a-potential-anti-fibrotic-agent-targeting-hepatic-stellate-cells
#20
Daniel F Hicks, Nicolas Goossens, Ana Blas-García, Takuma Tsuchida, Benjamin Wooden, Michael C Wallace, Natalia Nieto, Abigale Lade, Benjamin Redhead, Arthur I Cederbaum, Joel T Dudley, Bryan C Fuchs, Youngmin A Lee, Yujin Hoshida, Scott L Friedman
We have used a computational approach to identify anti-fibrotic therapies by querying a transcriptome. A transcriptome signature of activated hepatic stellate cells (HSCs), the primary collagen-secreting cell in liver, and queried against a transcriptomic database that quantifies changes in gene expression in response to 1,309 FDA-approved drugs and bioactives (CMap). The flavonoid apigenin was among 9 top-ranked compounds predicted to have anti-fibrotic activity; indeed, apigenin dose-dependently reduced collagen I in the human HSC line, TWNT-4...
March 3, 2017: Scientific Reports
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