Decentralized Care with Generic Direct-Acting Antivirals in the Management of Chronic Hepatitis C in a Public Health Care Setting

Of the 28 million population of Punjab (2011 Census), 3.6% are estimated to be positive for anti HCV antibody and 2.6% (728,000) are estimated to test positive for HCV RNA.[1,2] A majority of these people may progress to cirrhosis and its complications including variceal bleeding, liver failure and hepatocellular carcinoma (HCC), or death.[3,4] Successful treatment of chronic hepatitis C (CHC) is associated with 62-84% reduction in all-cause mortality, 68-79% reduction in risk of HCC and 90% reduction in need for liver transplantation.
Source: Journal of Hepatology - Category: Gastroenterology Authors: Source Type: research

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CONCLUSIONS: No clinical evidence was found to indicate that African Americans should be more often deemed ineligible for HCV treatment than other racial groups. Diabetes and renal disease do not fully explain the HCV treatment ineligibility racial disparity, because HCV patients with these conditions are priority patients for HCV treatment because of their greater risk for cirrhosis, steatosis, and hepatocellular carcinoma. The findings suggest that an underlying contributor to the HCV treatment eligibility disparity disfavoring African Americans could be racial discrimination. PMID: 31208545 [PubMed]
Source: Annals of Hepatology - Category: Gastroenterology Tags: Ann Hepatol Source Type: research
Conclusion Massive SI and immune cell paralysis associated with ACLF represent the extreme severity of CAID in response to an infectious or sterile challenge. The severe immune disturbance plays a pivotal role in the pathogenesis of the distinctive features of ACLF: organ failure and bacterial infection susceptibility. Excessive SI in ACLF results from the massive activation and dysfunction of an innate immune system challenged by increased PAMPs and DAMPs. SI leads to cell and tissue immunopathology contributing to hepatic and extrahepatic organ failure. Concomitantly, the course of ACLF is associated with a disproportio...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
ConclusionsUltrasound ‐guided liver biopsies of indeterminate lesions in patients at high risk of HCC yield important histopathological findings, important for management options including the provision of curative treatments and assisting future novel therapies such as immunotherapy and targeted therapies. The low com plication rates confirm its safety and the procedure should not be avoided for fear of complications.
Source: Journal of Medical Imaging and Radiation Oncology - Category: Radiology Authors: Tags: Medical Imaging —Original Article Source Type: research
This article is protected by copyright. All rights reserved. PMID: 30144216 [PubMed - as supplied by publisher]
Source: Accident and Emergency Nursing - Category: Emergency Medicine Authors: Tags: Acad Emerg Med Source Type: research
ConclusionsPatients with UD ascites do not have a negligible mortality rate as compared to overt ascites. Patients with cirrhosis after first decompensation have better transplant free survival with treatment of etiology and complications than previously mentioned in literature.
Source: Journal of Clinical and Experimental Hepatology - Category: Gastroenterology Source Type: research
CONCLUSIONS: after transplantation, hemophilia A cure and improved bleeding phenotype of type-3 vWD reduced morbidity and mortality. However, potential graft reinfection with HCV and relapsing HCC cast a shadow over these optimum results. PMID: 29931985 [PubMed - as supplied by publisher]
Source: Revista Espanola de Enfermedades Digestivas - Category: Gastroenterology Tags: Rev Esp Enferm Dig Source Type: research
We reported two cases of 62-year-old men, both with hepatitis C virus and alcoholic cirrhosis, but with compensated liver functions (MELD 9 –10 and Child–Pugh A5–A6). The patients were diagnosed with a single lesion in the left lobe. Robotic LLS was performed using intraoperative ultrasound to confirm findings of pre-operative image, and linear staplers were used to control left lobe inflow and outflow. The specimens were removed through Pfannenstiel incision in both patients. Both procedures followed the same standardization. The total operative time was 250 and 151 min with estimated blood loss of ...
Source: Journal of Robotic Surgery - Category: Surgery Source Type: research
CONCLUSIONS: No clinical evidence was found to indicate that African Americans should be more often deemed ineligible for HCV treatment than other racial groups. Diabetes and renal disease do not fully explain the HCV treatment ineligibility racial disparity, because HCV patients with these conditions are priority patients for HCV treatment because of their greater risk for cirrhosis, steatosis, and hepatocellular carcinoma. The findings suggest that an underlying contributor to the HCV treatment eligibility disparity disfavoring African Americans could be racial discrimination. PMID: 28611273 [PubMed - in process]
Source: Annals of Hepatology - Category: Gastroenterology Tags: Ann Hepatol Source Type: research
Conclusions Patients with UD ascites do not have a negligible mortality rate as compared to overt ascites. Patients with cirrhosis after first decompensation have better transplant free survival with treatment of etiology and complications than previously mentioned in literature.
Source: Journal of Clinical and Experimental Hepatology - Category: Gastroenterology Source Type: research
Chronic liver diseases (CLD) are very common: worldwide, an estimated 160 million people have chronic hepatitis C [1], 240 million have chronic hepatitis B [2], and 25% of the general population has non-alcoholic fatty liver disease (NAFLD) [3]. CLD can lead to a progressive accumulation of fibrosis in the liver which progressively evolves to cirrhosis and its life-threatening complications such as hepatocellular carcinoma (HCC), liver failure, variceal bleeding, or renal insufficiency. In 2012, driven by the growing worldwide burden of CLD, cirrhosis was responsible for more than 35 million years of lost life and thus bec...
Source: Journal of Hepatology - Category: Gastroenterology Authors: Tags: Research Article Source Type: research
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