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Hepatology

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95 papers 100 to 500 followers
https://www.readbyqxmd.com/read/28314735/non-alcoholic-fatty-liver-disease-and-its-relationship-with-cardiovascular-disease-and-other-extrahepatic-diseases
#1
REVIEW
Leon A Adams, Quentin M Anstee, Herbert Tilg, Giovanni Targher
Key physiological functions of the liver, including glucose and lipid metabolism, become disturbed in the setting of non-alcoholic fatty liver disease (NAFLD) and may be associated with a systemic inflammatory 'milieu' initiated in part by liver-secreted cytokines and molecules. Consequently, the pathophysiological effects of NAFLD extend beyond the liver with a large body of clinical evidence demonstrating NAFLD to be independently associated with both prevalent and incident cardiovascular disease (CVD), chronic kidney disease (CKD) and type 2 diabetes mellitus (T2DM)...
March 17, 2017: Gut
https://www.readbyqxmd.com/read/27575311/the-role-of-quantitative-hepatitis-b-surface-antigen-revisited
#2
REVIEW
Markus Cornberg, Vincent Wai-Sun Wong, Stephen Locarnini, Maurizia Brunetto, Harry L A Janssen, Henry Lik-Yuen Chan
In the past 10years, there has been a lot of enthusiasm surrounding the use of serum hepatitis B surface antigen (HBsAg) quantification to predict disease activity and monitor treatment response in chronic hepatitis B. The measurement of HBsAg levels have been standardized in IU/ml, and nowadays it is almost a mandatory measurement due to the development of new antiviral treatments aiming at HBsAg seroclearance, i.e., functional cure of hepatitis B. Recently, there has been an improved understanding of the molecular virology of HBsAg, and particularly the relative roles of covalently closed circular DNA and integrated hepatitis B virus (HBV) DNA...
February 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/27720915/validation-of-a-staging-system-for-acute-kidney-injury-in-patients-with-cirrhosis-and-association-with-acute-on-chronic-liver-failure
#3
Patricia Huelin, Salvatore Piano, Elsa Solà, Marialuisa Stanco, Cristina Solé, Rebeca Moreira, Elisa Pose, Silvano Fasolato, Nuria Fabrellas, Glòria de Prada, Chiara Pilutti, Isabel Graupera, Xavier Ariza, Antonietta Romano, Chiara Elia, Andrés Cárdenas, Javier Fernández, Paolo Angeli, Pere Ginès
BACKGROUND & AIMS: In patients with cirrhosis of the liver, acute kidney injury (AKI) is classified into 3 stages. Recent studies indicate that there are 2 subgroups of stage 1 disease, associated with different outcomes and serum levels of creatinine (SCr): stage 1A (SCr <1.5 mg/dL) and stage 1B (SCr ≥1.5 mg/dL). We performed a prospective study to validate, in a large series of patients with cirrhosis, the association between this new description and patient outcomes, and assess the relationship between AKI stage and the presence of acute-on-chronic liver failure...
March 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28417882/easl-clinical-practical-guidelines-on-the-management-of-acute-fulminant-liver-failure
#4
(no author information available yet)
The term acute liver failure (ALF) is frequently applied as a generic expression to describe patients presenting with or developing an acute episode of liver dysfunction. In the context of hepatological practice, however, ALF refers to a highly specific and rare syndrome, characterised by an acute abnormality of liver blood tests in an individual without underlying chronic liver disease. The disease process is associated with development of a coagulopathy of liver aetiology, and clinically apparent altered level of consciousness due to hepatic encephalopathy...
May 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/27699721/efficacy-of-long-term-tenofovir-based-rescue-therapy-in-patients-with-chronic-hepatitis-b-refractory-to-nucleoside-nucleotide-analogs
#5
Fumitaka Suzuki, Yoshiyuki Suzuki, Tetsuya Hosaka, Hitomi Sezaki, Norio Akuta, Shunichiro Fujiyama, Yusuke Kawamura, Masahiro Kobayashi, Satoshi Saitoh, Yasuji Arase, Kenji Ikeda, Mariko Kobayashi, Rie Mineta, Yukiko Suzuki, Hiromitsu Kumada
BACKGROUND: Few studies have investigated the efficacy of long-term tenofovir disoproxil fumarate (TDF)-based rescue therapy in patients with chronic hepatitis B refractory to nucleoside/nucleotide analogs. METHODS: We retrospectively analyzed 40 Japanese patients with chronic hepatitis B refractory to nucleoside/nucleotide analogs who received TDF-based rescue therapy [TDF monotherapy, TDF plus lamivudine (LAM) combination therapy, or TDF plus entecavir (ETV) combination therapy] followed up for a median of 45 months (range 14-99 months)...
May 2017: Journal of Gastroenterology
https://www.readbyqxmd.com/read/28215615/factors-associated-with-persistent-increase-in-level-of-alanine-aminotransferase-in-patients-with-chronic-hepatitis-b-receiving-oral-antiviral-therapy
#6
Ira M Jacobson, Mary K Washington, Maria Buti, Alexander Thompson, Nezam Afdhal, Robert Flisiak, Ulus Salih Akarca, Konstantin G Tchernev, John F Flaherty, Raul Aguilar Schall, Robert P Myers, G Mani Subramanian, John G McHutchison, Zobair Younossi, Patrick Marcellin, Keyur Patel
BACKGROUND & AIM: Despite complete suppression of viral DNA with antiviral agents, in some patients with chronic hepatitis B (CHB), serum levels of alanine aminotransferase (ALT) do not normalize. We investigated factors associated with persistent increases in level of ALT in patients with CHB given long-term tenofovir disoproxil fumarate. METHODS: We analyzed data from 471 hepatitis B e antigen (HBeAg)-positive and HBeAg-negative patients with CHB participating in 2 phase 3 trials...
February 12, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28176894/autoimmune-hepatitis-current-challenges-and-future-prospects
#7
REVIEW
Yoshio Aizawa, Atsushi Hokari
Autoimmune hepatitis (AIH) is a chronic progressive liver disease characterized by high levels of aminotransferases and autoantibodies, hypergammaglobulinemia, and interface hepatitis. AIH affects all races and all ages worldwide, regardless of sex, although a preponderance of females is a constant finding. The etiology of AIH has not been completely elucidated, but immunogenetic background and environmental parameters may contribute to its development. The most important genetic factor is human leukocyte antigens (HLAs), especially HLA-DR, whereas the role of environmental factors is not completely understood...
2017: Clinical and Experimental Gastroenterology
https://www.readbyqxmd.com/read/27693539/hepatocellular-carcinoma-in-the-absence-of-cirrhosis-in-patients-with-chronic-hepatitis-b-virus-infection
#8
Maneerat Chayanupatkul, Ronald Omino, Sahil Mittal, Jennifer R Kramer, Peter Richardson, Aaron P Thrift, Hashem B El-Serag, Fasiha Kanwal
BACKGROUND & AIMS: Cirrhosis related to chronic hepatitis B (CHB) is a major risk factor for hepatocellular carcinoma (HCC). The extent to which HCC occurs in U.S. in the absence of cirrhosis in CHB remains unclear. METHODS: We identified CHB patients who were diagnosed with HCC in the national Veterans Administration (VA) between 2001 and 2013. We defined presence and absence of cirrhosis at the time of HCC diagnosis using explicit histological, radiological, endoscopic, and laboratory criteria...
February 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28397875/treatment-of-nash-what-helps-beyond-weight-loss
#9
Bubu A Banini, Arun J Sanyal
No abstract text is available yet for this article.
April 11, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28130846/aasld-guidelines-for-the-treatment-of-hepatocellular-carcinoma
#10
Julie Heimbach, Laura M Kulik, Richard Finn, Claude B Sirlin, Michael Abecassis, Lewis R Roberts, Andrew Zhu, M Hassan Murad, Jorge Marrero
No abstract text is available yet for this article.
January 28, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/27547009/noninvasive-models-for-assessment-of-liver-fibrosis-in-patients-with-chronic-hepatitis-b-virus-infection
#11
REVIEW
Da-Wu Zeng, Jing Dong, Yu-Rui Liu, Jia-Ji Jiang, Yue-Yong Zhu
There are approximately 240 million patients with chronic hepatitis B virus (HBV) infection worldwide. Up to 40% of HBV-infected patients can progress to liver cirrhosis, hepatocellular carcinoma or chronic end-stage liver disease during their lifetime. This, in turn, is responsible for around 650000 deaths annually worldwide. Repeated hepatitis flares may increase the progression of liver fibrosis, making the accurate diagnosis of the stage of liver fibrosis critical in order to make antiviral therapeutic decisions for HBV-infected patients...
August 7, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28388736/liver-cancer-emergence-associated-with-antiviral-treatment-an-immune-surveillance-failure
#12
María Reig, Loreto Boix, Zoe Mariño, Ferran Torres, Xavier Forns, Jordi Bruix
The availability of new direct antiviral agents to safely and effectively treat the hepatitis C virus represents a major advancement in the field of liver disease. Most patients achieve complete viral eradication sustained over time. In addition, the administration of these new agents is safe and does not require limitations when liver function is impaired. Some now expect the hepatitis C virus to be completely eradicated in a few years. However, not all data are positive. In April 2016, we published a cohort study suggesting that viral eradication with the new agents could be associated in time with the emergence of recurrent cancer sites in patients previously treated for hepatocellular carcinoma...
April 7, 2017: Seminars in Liver Disease
https://www.readbyqxmd.com/read/28274107/pathophysiology-and-management-of-alcoholic-liver-disease-update-2016
#13
REVIEW
Felix Stickel, Christian Datz, Jochen Hampe, Ramon Bataller
Alcoholic liver disease (ALD) is a leading cause of cirrhosis, liver cancer, and acute and chronic liver failure and as such causes significant morbidity and mortality. While alcohol consumption is slightly decreasing in several European countries, it is rising in others and remains high in many countries around the world. The pathophysiology of ALD is still incompletely understood but relates largely to the direct toxic effects of alcohol and its main intermediate, acetaldehyde. Recently, novel putative mechanisms have been identified in systematic scans covering the entire human genome and raise new hypotheses on previously unknown pathways...
March 15, 2017: Gut and Liver
https://www.readbyqxmd.com/read/28067752/efficacy-and-safety-of-lamivudine-versus-entecavir-for-treating-chronic-hepatitis-b-virus-related-acute-exacerbation-and-acute-on-chronic-liver-failure-a-systematic-review-and-meta-analysis
#14
Kuang-Wei Huang, Ka-Wai Tam, Jiing-Chyuan Luo, Yi-Chun Kuan
BACKGROUND: Oral nucleos(t)ide analogs are recommended for patients with chronic hepatitis B virus (HBV)-related acute exacerbation (AE) and acute-on-chronic liver failure (ACLF). The efficacy and safety of administering entecavir (ETV) and lamivudine (LAM) to such patients remain unclear. METHODS: A comprehensive literature search was performed to select studies published before December 2015 on therapy involving ETV or LAM for chronic HBV-related AE with or without ACLF...
August 30, 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27859587/gamma-glutamyl-transpeptidase-to-platelet-ratio-is-an-independent-predictor-of-hepatitis-b-virus-related-liver-cancer
#15
Yong Eun Park, Beom Kyung Kim, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Kwang-Hyub Han, Sojung Han, Mi Young Jeon, Ja Yoon Heo, Kijun Song, Seung Up Kim
BACKGROUND AND AIMS: Gamma-glutamyl transpeptidase-to-platelet ratio (GPR) can evaluate the degree of liver fibrosis. We investigated whether GPR can predict the development of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients. METHODS: We retrospectively evaluated 1,109 CHB patients that were enrolled between 2006 and 2012, and all patients had available data for the assessment of GPR at enrollment. Three risk groups were defined according to tertile stratification: GPR < 0...
November 16, 2016: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28035553/rapid-alanine-aminotransferase-normalization-with-entecavir-and-hepatocellular-carcinoma-in-hepatitis-b-virus-associated-cirrhosis
#16
Eui Joo Kim, Jong Eun Yeon, Oh Sang Kwon, Heon Nam Lee, Seung Kak Shin, Seong Hee Kang, Kwan Soo Byun, Jeong Han Kim, So Young Kwon, Sang Jun Suh, Hyung Joon Yim, Yun Soo Kim, Ju Hyun Kim
BACKGROUND: Sustained abnormal serum alanine aminotransferase (ALT) levels can increase the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B. AIM: This study is aimed to confirm the impact of rapid ALT normalization (≤30 IU/L) on HCC risk in patients with hepatitis B virus (HBV)-associated cirrhosis after entecavir (ETV) commencement. METHODS: A total of 578 treatment-naïve patients with HBV-associated cirrhosis (mean age 51 ± 9 years, male sex 63...
March 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/26840752/chronic-hepatitis-b-virus-infection-disease-revisit-and-management-recommendations
#17
REVIEW
Man-Fung Yuen, Sang Hoon Ahn, Ding-Shinn Chen, Pei-Jer Chen, Geoffrey M Dusheiko, Jin-Lin Hou, Willis C Maddrey, Masashi Mizokami, Wai-Kay Seto, Fabien Zoulim, Ching-Lung Lai
Chronic hepatitis B virus (HBV) infection evolves from immune-tolerance phase, through immune clearance phase to a quiescent phase or reactivation as hepatitis B e antigen-negative hepatitis. Persistent infection may result in the development of cirrhosis and hepatocellular carcinoma (HCC). Host factors including gender, age, family history, HLA-DP, and viral factors including HBV DNA, genotypes, precore mutations, pre-S deletions, and hepatitis B surface antigen (HBsAg) level are associated with the development of these complications...
April 2016: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/27729952/cirrhosis-and-autoimmune-liver-disease-current-understanding
#18
REVIEW
Rodrigo Liberal, Charlotte R Grant
Primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC) and autoimmune hepatitis (AIH) constitute the classic autoimmune liver diseases (AILDs). While AIH target the hepatocytes, in PBC and PSC the targets of the autoimmune attack are the biliary epithelial cells. Persistent liver injury, associated with chronic AILD, leads to un-resolving inflammation, cell proliferation and the deposition of extracellular matrix proteins by hepatic stellate cells and portal myofibroblasts. Liver cirrhosis, and the resultant loss of normal liver function, inevitably ensues...
October 8, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/28053053/acute-on-chronic-liver-failure-an-update
#19
REVIEW
Ruben Hernaez, Elsa Solà, Richard Moreau, Pere Ginès
Acute-on-chronic liver failure (ACLF) is a syndrome characterised by acute decompensation of chronic liver disease associated with organ failures and high short-term mortality. Alcohol and chronic viral hepatitis are the most common underlying liver diseases. Up to 40%-50% of the cases of ACLF have no identifiable trigger; in the remaining patients, sepsis, active alcoholism and relapse of chronic viral hepatitis are the most common reported precipitating factors. An excessive systemic inflammatory response seems to play a crucial role in the development of ACLF...
March 2017: Gut
https://www.readbyqxmd.com/read/27995906/acg-clinical-guideline-evaluation-of-abnormal-liver-chemistries
#20
Paul Y Kwo, Stanley M Cohen, Joseph K Lim
Clinicians are required to assess abnormal liver chemistries on a daily basis. The most common liver chemistries ordered are serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase and bilirubin. These tests should be termed liver chemistries or liver tests. Hepatocellular injury is defined as disproportionate elevation of AST and ALT levels compared with alkaline phosphatase levels. Cholestatic injury is defined as disproportionate elevation of alkaline phosphatase level as compared with AST and ALT levels...
January 2017: American Journal of Gastroenterology
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