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Decompensated cirrhosis

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https://www.readbyqxmd.com/read/28431001/invasive-aspergillosis-in-patients-with-underlying-liver-cirrhosis-a-prospective-cohort-study
#1
Juergen Prattes, Martin Hoenigl, Robert Krause, Walter Buzina, Thomas Valentin, Frederike Reischies, Christoph Koidl, Ines Zollner-Schwetz
The aim of this study was to determine the prevalence of invasive aspergillosis (IA) in patients with liver cirrhosis and the performance of serum galactomannan (GM) screening. Patients with decompensated liver cirrhosis and patients with compensated liver cirrhosis presenting with fever and/or respiratory symptoms were prospectively enrolled. All patients were screened by serum GM twice weekly irrespective of clinical signs and symptoms. Positive serum GM triggered work-up consisting of chest computed tomography and in case of pathological findings bronchoscopy...
April 20, 2017: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
https://www.readbyqxmd.com/read/28428719/safety-and-efficacy-of-tenofovir-in-chronic-hepatitis-b-related-decompensated-cirrhosis
#2
Soon Kyu Lee, Myeong Jun Song, Seok Hyun Kim, Byung Seok Lee, Tae Hee Lee, Young Woo Kang, Suk Bae Kim, Il Han Song, Hee Bok Chae, Soon Young Ko, Jae Dong Lee
AIM: To evaluate the safety and efficacy of tenofovir disoproxil fumarate (TDF) as a first-line therapy in decompensated liver disease. METHODS: We enrolled 174 chronic hepatitis B-related liver cirrhosis patients treated with 300 mg/d TDF at six Korean centers. Of the 174 cirrhosis patients, 57 were assigned to the decompensated cirrhosis group and 117 were assigned to the compensated cirrhosis group. We followed the patients for 12 mo and evaluated clinical outcomes, including biochemical, virological, and serological responses...
April 7, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28425407/persistence-of-virologic-response-after-liver-transplant-in-hepatitis-c-patients-treated-with-ledipasvir-sofosbuvir-plus-ribavirin-pretransplant
#3
Eric M Yoshida, Paul Kwo, Kosh Agarwal, Christophe Duvoux, François Durand, Markus Peck-Radosavljevic, Leslie Lilly, Bernard Willems, Hugo Vargas, Princy Kumar, Robert S Brown, Yves Horsmans, Shampa De-Oertel, Sarah Arterburn, Hadas Dvory-Sobol, Diana M Brainard, John G McHutchison, Norah Terrault, Mario Rizzetto, Beat Mu Llhaupt
INTRODUCTION: Recurrence of HCV infection in patients with chronic hepatitis C virus (HCV) at the time of liver transplantation is nearly universal and reduces the likelihood of graft and patient survival. MATERIALS AND METHODS: We evaluated outcomes of 17 patients (16 with HCV genotype 1 and 1 with genotype 4) who received up to 12 or 24 weeks of ledipasvir/sofosbuvir plus ribavirin prior to or up to the time of liver transplant in the SOLAR-1 and SOLAR-2 trials...
May 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28422043/real-world-efficacy-and-safety-of-ritonavir-boosted-paritaprevir-ombitasvir-dasabuvir-%C3%A2-ribavirin-for-hepatitis-c-genotype-1-final-results-of-the-rev1tal-study
#4
John Lubel, Simone Strasser, Katherine A Stuart, Gregory Dore, Alexander Thompson, Stephen Pianko, Steven Bollipo, Joanne L Mitchell, Vincenzo Fragomeli, Tracey Jones, Sarah Chivers, Paul Gow, David Iser, Miriam Levy, Edmund Tse, Alessia Gazzola, Wendy Cheng, Saroj Nazareth, Sam Galhenage, Amanda Wade, Martin Weltman, Alan Wigg, Gerry MacQuillan, Joe Sasadeusz, Jacob George, Amany Zekry, Stuart K Roberts
BACKGROUND: Limited data exist on the outcomes of ritonavir-boosted paritaprevir with ombitasvir and dasabuvir (PrOD) ± ribavirin in a real-world setting. The aim of this study was to compare the efficacy and safety of PrOD-based therapy in hepatitis C genotype 1 patients with and without cirrhosis, and to explore pre-treatment factors predictive of sustained viral response (SVR) and serious adverse events (SAEs) on treatment. METHODS: 451 patients with hepatitis C genotype 1 treated in 20 centres across Australia were included...
April 19, 2017: Antiviral Therapy
https://www.readbyqxmd.com/read/28420029/interlobar-artery-resistive-index-predicts-acute-on-chronic-liver-failure-syndrome-in-cirrhotic-patients-with%C3%A2-acute-decompensation
#5
Pablo A Solís-Muñoz, Christopher Willars, Julia Wendon, George Auzinger, Michael A Heneghan, Maria De la Flor-Robledo, José A Solís-Herruzo
Introduction Patients with acutely decompensated (AD) cirrhosis are at risk for developing acute-on-chronic liver failure (ACLF) syndrome. This syndrome is associated with a high short-term mortality rate. The aim of our study was to identify reliable early predictors of developing ACLF in cirrhotic patients with AD. Patients and Methods We assessed 84 cirrhotic patients admitted for AD without ACLF on admission. We performed routine blood testing and detailed ultrasound Doppler studies of systemic arteries and mayor abdominal veins and arteries...
April 18, 2017: Ultraschall in der Medizin
https://www.readbyqxmd.com/read/28419938/direct-acting-antivirals-the-endgame-for-hepatitis-c
#6
REVIEW
Roberta D'Ambrosio, Elisabetta Degasperi, Massimo Colombo, Alessio Aghemo
Directly-acting antivirals (DAA) have finally allowed all patients to be potentially cured from chronic hepatitis C (HCV) infection. All-oral, Interferon (IFN)-free regimens are based upon the combination of molecules targeting different sites of the HCV replication process. Three classes of DAA exist: protease inhibitors (anti-NS3/4A), RNA-dependent polymerase inhibitors (anti-NS5B) and anti-NS5A inhibitors, which are characterized by different antiviral potency and barrier to resistance and therefore are usually combined in different treatment schedules...
April 15, 2017: Current Opinion in Virology
https://www.readbyqxmd.com/read/28418617/improved-survival-of-patients-with-hepatocellular-carcinoma-and-compensated-hcv-related-cirrhosis-who-attained-svr
#7
Savino Bruno, Vito Di Marco, Massimo Iavarone, Luigi Roffi, Vincenzo Boccaccio, Andrea Crosignani, Giuseppe Cabibbo, Sonia Rossi, Vincenza Calvaruso, Alessio Aghemo, Luca Giacomelli, Antonio Craxì, Massimo Colombo, Patrick Maisonneuve
BACKGROUND: Few studies examined the outcome of patients with HCV-related cirrhosis who developed hepatocellular carcinoma (HCC). The relative weight as determinant of death for cancer versus end-stage-liver-disease (ESLD) and the benefit of HCV eradication remain undefined. This multicenter, retrospective analysis evaluates overall survival (OS), rate of decompensation and tumor recurrence in compensated HCC patients treated with IFN according to HCV status since HCC diagnosis. METHODS: Two groups of patients with HCV-related cirrhosis and HCC were followed since HCC diagnosis: (i) compensated cirrhotics with prior sustained virologic response (SVR) on IFN-based regimens (N=19); (ii) compensated cirrhotics without SVR (viremic) (N=156)...
April 18, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28417463/pharmacological-interventions-for-primary-sclerosing-cholangitis-an-attempted-network-meta-analysis
#8
REVIEW
Francesca Saffioti, Kurinchi Selvan Gurusamy, Neil Hawkins, Clare D Toon, Emmanuel Tsochatzis, Brian R Davidson, Douglas Thorburn
BACKGROUND: Primary sclerosing cholangitis is a chronic cholestatic liver disease that is associated with both hepatobiliary and colorectal malignancies, which can result in liver cirrhosis and its complications. The optimal pharmacological treatment for patients with primary sclerosing cholangitis remains controversial. OBJECTIVES: To assess the comparative benefits and harms of different pharmacological interventions in people with primary sclerosing cholangitis by performing a network meta-analysis, and to generate rankings of available pharmacological interventions according to their safety and efficacy...
March 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28412195/neutrophil-lymphocyte-ratio-predicts-hospital-acquired-bacterial-infections-in-decompensated-cirrhosis
#9
Yi-Jing Cai, Jia-Jia Dong, Jin-Zhong Dong, Nai-Bing Yang, Mei Song, Yu-Qun Wang, Yong-Ping Chen, Zhuo Lin, Ke-Qing Shi
BACKGROUND: Bacterial infection is a frequent complication and severe burden in cirrhotic patients. We determined the utility of neutrophil-to-lymphocyte ratio (NLR) to predict the hospital-acquired (HA) bacterial infections episode in patients with decompensated cirrhosis. METHODS: We retrospectively included 2066 consecutive decompensated cirrhotic patients from two separate tertiary hospitals, divided into training (n=1377) and validation (n=689) set. All data were collected on admission and all overt bacterial infections occurring after >48h of hospital stay were registered...
April 13, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28411380/metabolic-profile-of-obeticholic-acid-and-endogenous-bile-acids-in-rats-with-decompensated-liver-cirrhosis
#10
Aldo Roda, Rita Aldini, Cecilia Camborata, Silvia Spinozzi, Placido Franco, Massimiliano Cont, Antonia D'Errico, Francesco Vasuri, Alessio Degiovanni, Lorenzo Maroni, Luciano Adorini
Obeticholic acid (OCA) is a semisynthetic bile acid (BA) analogue and potent farnesoid X receptor agonist approved to treat cholestasis. We evaluated the biodistribution and metabolism of OCA administered to CCl4 -induced cirrhotic rats. This was to ascertain if plasma and hepatic concentrations of OCA are potentially more harmful than those of endogenous BA. After administration of OCA (30 mg/kg), we used liquid chromatography-mass spectrometry to measure OCA, its metabolites, and BA at different time-points in various organs and fluids...
April 14, 2017: Clinical and Translational Science
https://www.readbyqxmd.com/read/28410915/early-hospital-readmission-in-decompensated-cirrhosis-incidence-impact-on-mortality-and-predictive-factors
#11
Betty P Morales, Ramon Planas, Ramon Bartoli, Rosa M Morillas, Margarita Sala, Eduard Cabré, Irma Casas, Helena Masnou
BACKGROUND & AIMS: The early hospital readmission of patients with decompensated cirrhosis is a current problem. A study is presented on the incidence, the impact on mortality, and the predictive factors of early hospital readmission. PATIENTS AND METHODS: On the study included 112 cirrhotic patients, discharged after some decompensation between January 2013 and May 2014. Multivariate analyses were performed to identify predictors of early readmission and mortality...
March 18, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28404098/screening-for-liver-fibrosis-in-the-general-population-a-call-for-action
#12
Pere Ginès, Isabel Graupera, Frank Lammert, Paolo Angeli, Llorenç Caballeria, Aleksander Krag, I Neil Guha, S Darwish Murad, Laurent Castera
Liver cirrhosis is one of the main causes of death and disability-adjusted life-years worldwide. Generally, cirrhosis develops after a long period of liver-cell injury that leads to the deposition of collagen, leading to progressive fibrosis and nodule formation in the liver tissue. Most patients are diagnosed in late stages when liver decompensation or liver cancer develops. The diagnosis is rarely made in early stages-when liver fibrosis is mild to moderate but cirrhosis is not yet established-because the disease is asymptomatic...
November 2016: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28404073/optimum-timing-of-treatment-for-hepatitis-c-infection-relative-to-liver-transplantation
#13
REVIEW
Audrey Coilly, Bruno Roche, Jean-Charles Duclos-Vallée, Didier Samuel
The approval of direct-acting antiviral agents that may be given orally in an interferon-free regimen has greatly changed the landscape of treatment for hepatitis C virus (HCV) infection, especially for patients with the most severe disease, who have decompensated cirrhosis, or who are waiting for or have undergone liver transplantation. Treatment with interferon proved to be ineffective and poorly tolerated because of high risks of infection and transplant rejection. The availability of new drugs poses new questions about the optimum time to give treatment to prevent HCV recurrence, taking into account efficacy, tolerance, and drug-drug interactions...
October 2016: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28404069/patient-reported-outcomes-with-sofosbuvir-and-velpatasvir-with-or-without-ribavirin-for-hepatitis-c-virus-related-decompensated-cirrhosis-an-exploratory-analysis-from-the-randomised-open-label-astral-4-phase-3-trial
#14
Zobair M Younossi, Maria Stepanova, Michael Charlton, Michael P Curry, Jacqueline G O'Leary, Robert S Brown, Sharon Hunt
BACKGROUND: Hepatitis C virus (HCV) treatment regimens with direct-acting antivirals have not been extensively studied in patients with decompensated cirrhosis. We assessed patient-reported outcomes (PROs) in patients with decompensated cirrhosis given a fixed-dose combination of sofosbuvir and velpatasvir with and without ribavirin. METHODS: This study was an exploratory analysis of data collected in a randomised, open-label phase 3 trial (ASTRAL-4) in which patients with HCV-related decompensated cirrhosis were randomly assigned to an all-oral fixed-dose combination of sofosbuvir (400 mg) and velpatasvir (100 mg) once daily for 12 weeks, sofosbuvir and velpatasvir plus oral ribavirin (weight-based 1000 mg or 1200 mg) for 12 weeks, or sofosbuvir and velpatasvir for 24 weeks...
October 2016: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28403995/comparative-efficacy-of-pharmacological-strategies-for-management-of-type-1-hepatorenal-syndrome-a-systematic-review-and-network-meta-analysis
#15
Antonio Facciorusso, Apoorva K Chandar, M Hassan Murad, Larry J Prokop, Nicola Muscatiello, Patrick S Kamath, Siddharth Singh
BACKGROUND: Several drugs have been studied to improve outcomes for patients with hepatorenal syndrome, but trials have reported variable efficacy. We aimed to compare the efficacy of different management strategies for type 1 hepatorenal syndrome. METHODS: For this systematic review and network meta-analysis, we searched Ovid MEDLINE In-Process & Other Non-Indexed Citations, Ovid MEDLINE, Ovid Embase, Ovid Cochrane Central Register of Controlled Trials, Scopus, and Web of Science for papers published up to June 9, 2016...
February 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28403123/influence-of-genetic-variations-in-the-sod1-gene-on-the-development-of-ascites-and-spontaneous-bacterial-peritonitis-in-decompensated-liver-cirrhosis
#16
Sebastian Schwab, Jennifer Lehmann, Philipp Lutz, Christian Jansen, Beate Appenrodt, Frank Lammert, Christian P Strassburg, Ulrich Spengler, Hans-Dieter Nischalke, Jonel Trebicka
BACKGROUND: The balance between generation and elimination of reactive oxygen species by superoxide dismutase (SOD) is crucially involved in the pathophysiology of liver cirrhosis. Reactive oxygen species damage cells and induce inflammation/fibrosis, but also play a critical role in immune defense from pathogens. As both processes are involved in the development of liver cirrhosis and its complications, genetic variation of the SOD1 gene was investigated. PATIENTS AND METHODS: Two SOD1 single nucleotide polymorphisms (rs1041740 and rs3844942) were analyzed in 49 cirrhotic patients undergoing liver transplantation...
April 11, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28402124/percutaneous-radiofrequency-ablation-of-hepatocellular-carcinoma-in-cirrhosis-analysis-of-complications-in-a-single-center-over-20-years
#17
Antonio Giorgio, Maria Gabriella Merola, Luca Montesarchio, Francesca Merola, Pietro Gatti, Carmine Coppola, Valentina Giorgio, Giorgio Calisti
OBJECTIVES: To report on our 20 years' experience on complications after Radiofrequency Ablation (RFA) of Hepatocellular Carcinoma (HCC) in cirrhotic patients. METHODS: From 1994 to 2014, 1787 RFA procedures were performed percutaneously in 1162 cirrhotic patients (852 Child A and 310 Child B) with HCC nodules (1.2-7cm), PT>50%, platelet count of 50.000mm3 and total Bilirubin ranging from 0,80 to 4.5mg/dl. In 67 patients RFA was performed on both intraparenchymal HCC nodule and tumor thrombus extended in the main portal vein and/or its branches...
April 12, 2017: British Journal of Radiology
https://www.readbyqxmd.com/read/28400317/the-long-winding-road-to-transplant-how-sarcopenia-and-debility-impact-morbidity-and-mortality-on-the-waitlist
#18
Rahima A Bhanji, Elizabeth J Carey, Liu Yang, Kymberly D Watt
Frailty and sarcopenia are common complications of cirrhosis. Frailty has been described as an increased susceptibility to stressors secondary to a cumulative decline in physiologic reserve; this decline occurs with aging or is a result of disease process, across multiple organ systems. Sarcopenia, a key component of frailty, is defined as progressive and generalized loss of skeletal muscle mass and strength. The presence of either of these complications is associated with increased morbidity and mortality, as these are tightly linked to decompensation and increased complication rates...
April 8, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28396173/contribution-of-alcohol-use-disorders-on-the-burden-of-chronic-hepatitis-c-in-france-2008-2013-a-nationwide-retrospective-cohort-study
#19
Michaël Schwarzinger, Sylvain Baillot, Prof Yazdan Yazdanpanah, Prof Jürgen Rehm, Vincent Mallet
BACKGROUND AND AIMS: Hepatitis C virus (HCV) patients are at risk of alcohol use disorders (AUDs). We measured the contribution of AUDs on the burden of chronic HCV infection in French HCV patients. METHODS: We tracked the hospital trajectory of 97,347 French HCV patients aged 18-65 in January 2008 and followed until in-hospital death or December 2013. Primary outcome was the frequency of liver-related complications. Secondary outcomes were the frequency of liver transplantation and otherwise cause-specific mortality...
April 7, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28393104/safety-of-ercp-in-patients-with-liver-cirrhosis-a-national-database-study
#20
Udayakumar Navaneethan, Basile Njei, Xiang Zhu, Kiran Kommaraju, Mansour A Parsi, Shyam Varadarajulu
Background and aims Given the limited data on the safety of endoscopic retrograde cholangiopancreatography (ERCP) in patients with liver cirrhosis, we attempted to evaluate this question using a large national database. Methods We conducted a matched case - control study using the 2010 National Inpatient Sample database in which four non-cirrhotic controls were matched randomly for every cirrhotic patient from the same 10-year age group. We compared adverse events and safety of inpatient ERCP between patients with (n = 3228) and without liver cirrhosis (controls, n = 12 912)...
April 2017: Endoscopy International Open
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