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Hepatology

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https://www.readbyqxmd.com/read/28035553/rapid-alanine-aminotransferase-normalization-with-entecavir-and-hepatocellular-carcinoma-in-hepatitis-b-virus-associated-cirrhosis
#1
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...
December 29, 2016: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/26840752/chronic-hepatitis-b-virus-infection-disease-revisit-and-management-recommendations
#2
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
#3
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
#4
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...
January 4, 2017: Gut
https://www.readbyqxmd.com/read/27995906/acg-clinical-guideline-evaluation-of-abnormal-liver-chemistries
#5
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
https://www.readbyqxmd.com/read/26989861/acute-on-chronic-liver-failure-in-india-the-indian-national-association-for-study-of-the-liver-consortium-experience
#6
Vivek Saraswat, Shivaram P Singh, Ajay Duseja, Akash Shukla, Chundamannil E Eapen, Dharmendra Kumar, Gaurav Pandey, Jayanti Venkataraman, Pankaj Puri, Krishnasamy Narayanswami, Radha K Dhiman, Sandeep Thareja, Sandeep Nijhawan, Shobna Bhatia, Uday Zachariah, Ujjwal Sonika, Thomas Varghese, Subrat K Acharya
BACKGROUND AND AIM: The aim of this study was to analyze etiologies and frequency of hepatic and extrahepatic organ failures (OFs) and outcome of acute-on-chronic liver failure (ACLF) at 10 tertiary centers in India. METHODS: In this retrospective study (2011-2014), patients satisfying Asian Pacific Association for the Study of the Liver definition of ACLF were included. Etiology of acute precipitating insult and chronic liver disease and outcomes were assessed...
October 2016: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27785449/hepatocellular-carcinoma-a-review
#7
REVIEW
Julius Balogh, David Victor, Emad H Asham, Sherilyn Gordon Burroughs, Maha Boktour, Ashish Saharia, Xian Li, R Mark Ghobrial, Howard P Monsour
Hepatocellular carcinoma (HCC) is the most common primary liver malignancy and is a leading cause of cancer-related death worldwide. In the United States, HCC is the ninth leading cause of cancer deaths. Despite advances in prevention techniques, screening, and new technologies in both diagnosis and treatment, incidence and mortality continue to rise. Cirrhosis remains the most important risk factor for the development of HCC regardless of etiology. Hepatitis B and C are independent risk factors for the development of cirrhosis...
2016: Journal of Hepatocellular Carcinoma
https://www.readbyqxmd.com/read/27818588/update-on-occult-hepatitis-b-virus-infection
#8
REVIEW
Manoochehr Makvandi
The event of mutations in the surface antigen gene of hepatitis B virus (HBV) results in undetectable hepatitis B surface antigen with positive/negative anti-hepatitis B core (anti-HBc) antibody status in serum and this phenomenon is named occult hepatitis B infection (OBI). The presence of anti-HBc antibody in serum is an important key for OBI tracking, although about 20% of OBI cases are negative for anti-HBc antibody. The diagnosis of OBI is mainly based on polymerase chain reaction (PCR) and real-time PCR assays...
October 21, 2016: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/27786365/portal-hypertensive-bleeding-in-cirrhosis-risk-stratification-diagnosis-and-management-2016-practice-guidance-by-the-american-association-for-the-study-of-liver-diseases
#9
Guadalupe Garcia-Tsao, Juan G Abraldes, Annalisa Berzigotti, Jaime Bosch
No abstract text is available yet for this article.
January 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
https://www.readbyqxmd.com/read/26943168/antiviral-effects-of-anti-hbs-immunoglobulin-and-vaccine-on-hbs-antigen-seroclearance-for-chronic-hepatitis-b-infection
#10
Masataka Tsuge, Nobuhiko Hiraga, Takuro Uchida, Hiromi Kan, Eisuke Miyaki, Keiichi Masaki, Atsushi Ono, Takashi Nakahara, Hiromi Abe-Chayama, Yizhou Zhang, Makokha Grace Naswa, Tomokazu Kawaoka, Daiki Miki, Michio Imamura, Yoshiiku Kawakami, Hiroshi Aikata, Hidenori Ochi, C Nelson Hayes, Kazuaki Chayama
BACKGROUND AND AIMS: Interferon and nucleotide/nucleoside analogues are the main treatments for chronic hepatitis B. These drugs effectively reduce serum hepatitis B virus (HBV) DNA titers but fail to sufficiently reduce hepatitis B surface antigen (HBsAg) levels. Following the recent identification of sodium taurocholate cotransporting polypeptide as a receptor for HBV entry, inhibition of HBV entry has become an attractive therapeutic target for chronic hepatitis B treatment. We therefore evaluated the antiviral effects of antibody to HBsAg (anti-HBs) immunoglobulin (HBIG), which can inhibit HBV entry, by in an vivo study and a clinical trial...
November 2016: Journal of Gastroenterology
https://www.readbyqxmd.com/read/26725904/hbv-do-i-treat-my-immunotolerant-patients
#11
REVIEW
Jiannis Vlachogiannakos, George V Papatheodoridis
Immunotolerant patients with chronic hepatitis B virus (HBV) infection are characterized by positive HBeAg, high viral replication, persistently normal ALT and no or minimal liver damage. Since the risk of the progression of liver disease and the chance of a sustained response with existing anti-HBV agents are low, current guidelines do not recommend treatment but close monitoring with serial alanine aminotransferase (ALT) and HBV DNA measurements instead. However, not treating all these patients is a concern because advanced histological lesions have been reported in certain cases who are usually older (>30-40 years old), and continued high HBV replication could increase the risk of hepatocellular carcinoma (HCC)...
January 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/26725905/the-prognosis-and-management-of-inactive-hbv-carriers
#12
REVIEW
Federica Invernizzi, Mauro Viganò, Glenda Grossi, Pietro Lampertico
Patients with chronic hepatitis B virus (HBV) infection lacking the serum hepatitis B e antigen (HBeAg) and with antibodies against HBeAg (anti-HBe), are the prevalent subgroup of HBV carriers worldwide. The prognosis of these patients is different from inactive carriers (ICs), who are characterized by persistently normal serum alanine aminotransferase (ALT) and low (<2000 IU/ml) serum HBV DNA levels, a serological profile that may also be intermittently observed in patients with HBeAg-negative chronic hepatitis...
January 2016: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/27717864/extensive-testing-or-focused-testing-of-patients-with-elevated-liver-enzymes
#13
Elliot B Tapper, Sameer D Saini, Neil Sengupta
BACKGROUND & AIMS: Many patients have elevated serum aminotransferases reflecting many underlying conditions, both common and rare. Clinicians generally apply one of two evaluative strategies: testing for all diseases at once (extensive) or just common diseases first (focused). METHODS: We simulated the evaluation of 10,000 adult outpatients with elevated with alanine aminotransferase to compare both testing strategies. Model inputs employed population-based data from the US (National Health and Nutrition Examination Survey) and Britain (Birmingham and Lambeth Liver Evaluation Testing Strategies)...
October 4, 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27625189/screening-and-diagnosis-of-hbv-in-low-income-and-middle-income-countries
#14
Jean-Pierre Allain, Ohene Opare-Sem
HBV testing and diagnosis of HBV-related liver disease in low-income and middle-income countries differs substantially from that in developed countries in terms of access to resources and expensive technologies requiring highly specialized staff. For identification and classification of HBV infection, genomic amplification methods to detect and quantify HBV DNA are often nonexistent or available only in central laboratories of major cities. When samples from peripheral locations do arrive, delays in receiving results generate loss to follow-up...
November 2016: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/27590353/targeting-the-muscle-for-the-treatment-and-prevention-of-hepatic-encephalopathy
#15
Krista Rombouts, Chantal Bémeur, Christopher F Rose
No abstract text is available yet for this article.
November 2016: Journal of Hepatology
https://www.readbyqxmd.com/read/27044761/a-concise-review-of-updated-guidelines-regarding-the-management-of-hepatocellular-carcinoma-around-the-world-2010-2016
#16
REVIEW
Su Jong Yu
Many guidelines for hepatocellular carcinoma (HCC) have been published and updated globally. In contrast to other cancers, there is a range of treatment options for HCC involving several multidisciplinary care of the patient. Consequently, enormous heterogeneity in management trends has been observed. To support standard care for HCC, we systematically appraised 8 current guidelines for HCC around the world, including 3 guidelines from Asia, 2 from Europe, and 3 from the United States according to the selection criteria of credibility influence and multi-faceted...
March 2016: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/27123974/%C3%AE-fetoprotein-levels-after-interferon-therapy-predict-regression-of-liver-fibrosis-in-patients-with-sustained-virological-response
#17
Yoshihiko Tachi, Takanori Hirai, Youji Ishizu, Takashi Honda, Teiji Kuzuya, Kazuhiko Hayashi, Masatoshi Ishigami, Hidemi Goto
BACKGROUND AND AIMS: Eradicating chronic hepatitis C virus (HCV) infection improves liver fibrosis and reduces hepatocellular carcinoma (HCC) incidence in chronic HCV patients. We evaluated the relationship between fibrosis regression, as assessed by sequential biopsies, and clinical factors of patients with sustained virological response (SVR). METHODS: We retrospectively enrolled 130 patients (74 men; 60.1 ± 8.1 years) with chronic HCV treated with interferon and ribavirin therapy who achieved SVR...
May 2016: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/27305847/association-between-level-of-fibrosis-rather-than-antiviral-regimen-and-outcomes-of-patients-with-chronic-hepatitis-b
#18
Hye Soo Kim, Beom Kyung Kim, Seung Up Kim, Jun Yong Park, Do Young Kim, Ki Jun Song, Jung Won Park, Yeong Jin Kim, Oidov Baatarkhuu, Kwang-Hyub Han, Sang Hoon Ahn
BACKGROUND & AIMS: We performed a propensity-score matched analysis to investigate whether entecavir, compared with lamivudine, can reduce risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B after adjusting for level of fibrosis. METHODS: We performed a retrospective study of 1079 patients with chronic hepatitis B who received first-line therapy with lamivudine (n = 435) or entecavir (n = 644) from 2006 through 2013. Only patients with available liver stiffness value measured by transient elastography were recruited...
November 2016: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/26962397/bacterial-infections-in-cirrhosis-a-critical-review-and-practical-guidance
#19
REVIEW
Chalermrat Bunchorntavakul, Naichaya Chamroonkul, Disaya Chavalitdhamrong
Bacterial infection is common and accounts for major morbidity and mortality in cirrhosis. Patients with cirrhosis are immunocompromised and increased susceptibility to develop spontaneous bacterial infections, hospital-acquired infections, and a variety of infections from uncommon pathogens. Once infection develops, the excessive response of pro-inflammatory cytokines on a pre-existing hemodynamic dysfunction in cirrhosis further predispose the development of serious complications such as shock, acute-on-chronic liver failure, renal failure, and death...
February 28, 2016: World Journal of Hepatology
https://www.readbyqxmd.com/read/27246107/evidence-based-clinical-practice-guidelines-for-liver-cirrhosis-2015
#20
REVIEW
Hiroshi Fukui, Hidetsugu Saito, Yoshiyuki Ueno, Hirofumi Uto, Katsutoshi Obara, Isao Sakaida, Akitaka Shibuya, Masataka Seike, Sumiko Nagoshi, Makoto Segawa, Hirohito Tsubouchi, Hisataka Moriwaki, Akinobu Kato, Etsuko Hashimoto, Kojiro Michitaka, Toshikazu Murawaki, Kentaro Sugano, Mamoru Watanabe, Tooru Shimosegawa
The Japanese Society of Gastroenterology revised the evidence-based clinical practice guidelines for liver cirrhosis in 2015. Eighty-three clinical questions were selected, and a literature search was performed for the clinical questions with use of the MEDLINE, Cochrane, and Igaku Chuo Zasshi databases for the period between 1983 and June 2012. Manual searching of the latest important literature was added until August 2015. The guidelines were developed with use of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system...
July 2016: Journal of Gastroenterology
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