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Hepatitis C combination therapy and the effects of alcohol

Tim Zimmermann, Dietrich Hueppe, Stefan Mauss, Peter Buggisch, Heike Pfeiffer-Vornkahl, Daniel Grimm, Peter R Galle, Ulrich Alshuth
BACKGROUND AND AIMS: Smoking has multiple effects on factors influencing hepatitis C and antiviral therapy, including lipid metabolism, fibrosis, platelet count and adherence aspects. The aim of this analysis was to determine the impact of smoking on hepatitis C virus antiviral therapy. METHODS: Data of two cohorts of an observational multicenter study including therapy-naïve patients infected with genotype 1 hepatitis C virus (HCV) treated with dual antiviral therapy (n=7,796) with pegylated interferon alpha 2a in combination with ribavirin, or triple antiviral therapy (n=1,122) containing telaprevir or boceprevir, were analysed...
March 2016: Journal of Gastrointestinal and Liver Diseases: JGLD
Audrey L French, Anna Hotton, Mary Young, Marek Nowicki, Michael Augenbraun, Kathryn Anastos, Eric Seaberg, William Rosenberg, Marion G Peters
BACKGROUND: Isolated hepatitis B core antibody (anti-HBc) is a common serologic finding in HIV-infected persons, but the clinical significance is uncertain. We studied HIV/hepatitis C virus (HCV)-infected women over time to determine whether the trajectory of liver disease progression is affected by isolated anti-HBc serologic status. METHODS: We performed serial enhanced liver fibrosis (ELF) markers on HIV/HCV-coinfected women to assess liver disease progression trajectory over time comparing women with isolated anti-HBc to women with either negative HB serologies, anti-HBs alone, or anti-HBc and anti-HBs...
July 1, 2016: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Ignacio Novo-Veleiro, Lucía Alvela-Suárez, Antonio-Javier Chamorro, Rogelio González-Sarmiento, Francisco-Javier Laso, Miguel Marcos
Alcohol consumption and hepatitis C virus (HCV) infection have a synergic hepatotoxic effect, and the coexistence of these factors increases the risk of advanced liver disease. The main mechanisms of this effect are increased viral replication and altered immune response, although genetic predisposition may also play an important role. Traditionally, HCV prevalence has been considered to be higher (up to 50%) in alcoholic patients than in the general population. However, the presence of advanced alcoholic liver disease (ALD) or intravenous drug use (IDU) may have confounded the results of previous studies, and the real prevalence of HCV infection in alcoholic patients without ALD or prior IDU has been shown to be lower...
January 28, 2016: World Journal of Gastroenterology: WJG
Tadashi Tsukamoto, Akishige Kanazawa, Sadatoshi Shimizu, Akihiro Murata, Masayuki Sakae, Shigeaki Kurihara, Tetsuzo Tashima, Sota Deguchi, Takashi Nakai, Yasuko Kawasaki, Kiyohide Kioka
Sorafenib has been a standard therapy for advanced hepatocellular carcinoma (HCC) with portal vein thrombosis. Hepatic arterial infusion chemotherapy (HAIC) is still preferably performed in Japan because of its relatively good tumor-shrinking effect. We report a case of advanced multiple HCC with portal thrombus that responded to combination chemotherapy with sorafenib and repeat hepatic arterial infusion with a fine-powder formulation of cisplatin (IA-call®). A 57-year-old man presented for the treatment of HCC with alcoholic cirrhosis...
November 2015: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Vicente Sperb Antonello, Ivan Carlos Ferreira Antonello, Sandra Herrmann, Cristiane Valle Tovo
OBJECTIVES: HIV-related renal diseases are the leading causes of chronic kidney diseases worldwide. The present study aimed to investigate the prevalence of pathological proteinuria and its risk factors among HIV patients. METHODS: A review of the medical records of 666 HIV-infected individuals aged 18 years or older in an urban HIV/AIDS clinic based in Porto Alegre in southern Brazil. Overt proteinuria was defined as a protein-to-creatinine ratio greater than 150 mg/g according to Kidney Disease: Improving Global Outcomes...
October 2015: Clinics
Marie Feillant, Caroline Jézéquel, Hortensia Lison, Aurélien Delluc, Florence Tanné, Antonia Le Gruyer, Zeineb Ben Ali, Isabelle Renard, Marianne Latournerie, Yves Deugnier, Armand Garioud, Jean-François Cadranel, Dominique Guyader, Michel Robaszkiewicz, Jean-Baptiste Nousbaum
BACKGROUND AND AIMS: In many countries, current treatment for patients with chronic hepatitis C involves a combination of peginterferon and ribavirin, associated with a protease inhibitor for hepatitis C virus genotype 1. More recent and efficient less toxic antiviral treatments are now available for some patients. Thus, the decision to treat or to wait is challenging. The aims of this study were to: (a) estimate the proportion of treated patients, (b) evaluate the reasons for this decision, and (c) examine the patients' points-of-view in treatment decision...
February 2016: European Journal of Gastroenterology & Hepatology
Phyllis C Tien
Visceral and hepatic adiposities have been associated with both cardiovascular and liver disease and are of concern in HIV-infected persons in the modern era of combination antiretroviral therapy (ART). The development of therapeutic targets to reduce visceral and hepatic adiposities in HIV-infected persons has been slow, because of early reports that attributed the excess adiposity to specific antiretroviral drugs. Visceral adiposity was initially thought to occur as part of a protease inhibitor-induced "HIV-associated lipodystrophy syndrome...
December 2015: Current Atherosclerosis Reports
I Ruiz, C Féray
Hepatocellular carcinoma is the major complication of chronic liver diseases and particularly of cirrhosis whatever its etiology. Once encountered mainly in the endemic countries of hepatitis B and C, the incidence of hepatocellular carcinoma (6/100,000) is parallel to the global development of diabetes, overweight and alcohol consumption. Little progress has been made for this cancer, whose mortality is 100 % at 10 years. Liver transplantation is the only truly curative treatment (survival more than 50 % at 10 years) since it allows the eradication of hepatocellular carcinoma and its essential cause, cirrhotic liver...
October 2015: Cancer Radiothérapie: Journal de la Société Française de Radiothérapie Oncologique
Juan Carlos Quer, Moisés Diago, Javier Crespo, Javier García-Samaniego, Rosa Morillas, Raúl Andrade, Miguel Ángel Simón
Chronic hepatitis C virus infection is usually asymptomatic. The severity of the hepatic lesion in these patients at diagnosis varies and, from the histopathologic point of view, most have mild disease. A series of factors have been described that correlate with the progression of fibrosis in patients with mild fibrosis: age at diagnosis, the duration of the infection, male sex, HIV coinfection, transaminase levels during follow-up, alcohol consumption, metabolic factors such as diabetes and overweight, necroinflammatory activity in the initial biopsy, and the degree of steatosis...
July 2014: Gastroenterología y Hepatología
N Deborah Friedman, Joanne H Green, Hanna M Weber, Shiny Stephen, Stephen E Lane, Alvin Y Ting, Jonathan P Watson
BACKGROUND: Published clinical trials of the treatment of HCV are largely multicentre prospective pharmaceutical trials. Patients in clinical trials tend to have more favorable outcomes than patients in the 'real-world', due to strict patient selection and differences in treatment conditions and available resources. OBJECTIVES: To assess the outcomes of Hepatitis C infected patients treated at the Barwon Health Liver Clinic with combination Pegylated interferon (PEG-IFN) and Ribavirin (RBV) therapy and to determine factors associated with a treatment response...
September 2014: Journal of Clinical and Experimental Hepatology
María-Carlota Londoño, Juan G Abraldes, José Altamirano, Thomas Decaens, Xavier Forns
The late and fast developments in the field of viral hepatitis were highly expected in the 2014 AASLD Liver Meeting®. Several combinations using direct acting antivirals (DAAs) showed high rates of sustained virological response (∼95%). Importantly, high cure rates were also demonstrated in patients with previous treatment failures, decompensated cirrhosis and hepatitis C recurrence after transplantation, making it clear that the interferon era is over (not so clear for ribavirin, which might still have a role in difficult-to-treat populations)...
May 2015: Journal of Hepatology
Michael W Jann
BACKGROUND: Patients with bipolar disorder are exceptionally challenging to manage because of the dynamic, chronic, and fluctuating nature of their disease. Typically, the symptoms of bipolar disorder first appear in adolescence or early adulthood, and are repeated over the patient's lifetime, expressed as unpredictable recurrences of hypomanic/manic or depressive episodes. The lifetime prevalence of bipolar disorder in adults is reported to be approximately 4%, and its management was estimated to cost the US healthcare system in 2009 $150 billion in combined direct and indirect costs...
December 2014: American Health & Drug Benefits
Laura Perez-Martinez, Isabel Sanjoaquin, Maria Rivero, Desiré Gil-Pérez, Santiago Letona, Carmen Irigoyen Olaiz, Piedad Arazo, Jose Ramón Blanco
INTRODUCTION: Several factors such as duration of infection, age, male gender, consumption of alcohol, HIV infection and low CD4 count have been associated with fibrosis progression rate. However, it is relatively scarce, the knowledge about the liver fibrosis progression rate in HIV-infected patients with undetectable HIV viral load (VL). For this reason, we performed the present study. MATERIALS AND METHODS: Observational and multicenter study (2008-2012) conducted in four hospitals of the northern Spain...
2014: Journal of the International AIDS Society
Indira Donepudi, Angelo Paredes, Sarah Hubbard, Chadi Awad, Richard K Sterling
OBJECTIVES: Although effective HCV treatment is available, it can be difficult to access for uninsured, urban patients. Our aim was to assess the utility of evaluation and outcomes in the uninsured with HCV when access to health care and treatment with triple therapy is provided. METHODS: We performed a retrospective review of consecutive patients referred for HCV from 2011 to June 2013 to an indigent HCV clinic. The primary outcomes were assessment of disease severity by noninvasive means and initiation of therapy...
April 2015: Digestive Diseases and Sciences
Naoki Hiramatsu, Tsugiko Oze, Tetsuo Takehara
The advance of antiviral treatment for chronic hepatitis C has brought a high sustained virological response (SVR) rate. In this review article, the suppressive effect of interferon (IFN)-based therapy on the development of hepatocellular carcinoma (HCC), risk factors for developing HCC and the characteristics of HCC development after SVR among chronic hepatitis C patients given IFN-based therapy were studied. The HCC incidence has been revealed to decrease with IFN-based antiviral therapy, especially in SVR, and the risk factors for developing HCC were older age, advanced liver fibrosis and male sex...
January 2015: Hepatology Research: the Official Journal of the Japan Society of Hepatology
Carola Berger, Inés Romero-Brey, Danijela Radujkovic, Raphael Terreux, Margarita Zayas, David Paul, Christian Harak, Simone Hoppe, Min Gao, Francois Penin, Volker Lohmann, Ralf Bartenschlager
BACKGROUND & AIMS: Direct-acting antivirals that target nonstructural protein 5A (NS5A), such as daclatasvir, have high potency against the hepatitis C virus (HCV). They are promising clinical candidates, yet little is known about their antiviral mechanisms. We investigated the mechanisms of daclatasvir derivatives. METHODS: We used a combination of biochemical assays, in silico docking models, and high-resolution imaging to investigate inhibitor-induced changes in properties of NS5A, including its interaction with phosphatidylinositol-4 kinase IIIα and induction of the membranous web, which is the site of HCV replication...
November 2014: Gastroenterology
C Cooper, K C Rollet-Kurhajec, J Young, C Vasquez, M Tyndall, J Gill, N Pick, S Walmsley, M B Klein
OBJECTIVES: Antiretroviral interruption is associated with liver fibrosis progression in HIV/hepatitis C virus (HCV) coinfection. It is not known what level of HIV viraemia affects fibrosis progression. METHODS: We evaluated 288 HIV/HCV-coinfected cohort participants with undetectable HIV RNA (<50 HIV-1 RNA copies/mL) on two consecutive visits while on combination antiretroviral therapy (cART) without fibrosis [aspartate aminotransferase to platelet ratio index (APRI) <1...
January 2015: HIV Medicine
Philipp Uhl, Gert Fricker, Uwe Haberkorn, Walter Mier
Hepatic diseases, like viral hepatitis, autoimmune hepatitis, hereditary hemochromatosis, non-alcoholic fatty liver disease (NAFLD) and Wilson's disease, play an important role in the development of liver cirrhosis and, hence, hepatocellular carcinoma. In this review, the current treatment options and the molecular mechanisms of action of the drugs are summarized. Unfortunately, the treatment options for most of these hepatic diseases are limited. Since hepatitis B (HBV) and C (HCV) infections are the most common causes of liver cirrhosis and hepatocellular carcinoma, they are the focus of the development of new drugs...
2014: International Journal of Molecular Sciences
Brian Kim, Anshu Trivedi, Swan N Thung, Priya Grewal
Fibrosing cholestatic hepatitis is an unusual complication of hepatitis C virus (HCV) recurrence after liver transplant. Fibrosing cholestatic hepatitis is marked by aggressive progression of cholestasis and fibrosis, leading to accelerated graft loss and/or death. Sofosbuvir (GS-7977) is an oral nucleotide analogue inhibitor of HCV polymerase activity. It is a second-generation, direct-acting, antiviral for the treatment of HCV infection. This case illustrates a patient with recurrent HCV with fibrosing cholestatic hepatitis, who was successfully treated with a combination of sofosbuvir and ribavirin with normalization of liver enzyme activities and resolution of HCV-related symptoms...
February 2014: Seminars in Liver Disease
Robert J Wong, Aijaz Ahmed
Higher rates of hepatitis C virus (HCV) recurrence and lower response to HCV antiviral therapy contribute to the lower post-liver transplantation (LT) survival among African Americans with HCV. The current study aims to evaluate race/ethnicity-specific and etiology-specific factors contributing to lower post-LT survival among African Americans in the USA. The 2002-2012 United Network for Organ Sharing registry was utilized to evaluate race/ethnicity-specific post-LT survival among patients with HCV, hepatocellular carcinoma (HCC), alcoholic liver disease (ALD), non-alcoholic steatohepatitis, and cryptogenic cirrhosis...
July 2014: Clinical Transplantation
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