Recurrent hepatitis C treatment with direct acting antivirals - a real life study at a Brazilian liver transplant center.

Recurrent hepatitis C treatment with direct acting antivirals - a real life study at a Brazilian liver transplant center. Braz J Med Biol Res. 2019;52(8):e8519 Authors: Zanaga LP, Santos AG, Ataíde EC, Boin IFSF, Stucchi RSB Abstract Recurrent hepatitis C (HCV) after liver transplantation (LT) is an important cause of morbidity and mortality. Antiviral treatment is recommended to avoid unfavorable outcomes. Direct-acting antivirals (DAA) have transformed HCV treatment, with higher efficacy and fewer side-effects than interferon-based therapies traditionally used. To evaluate DAA treatment outcomes at a Brazilian transplant unit, data of patients who finished HCV treatment at the Liver Transplant Unit of the University of Campinas were analyzed. Treatment consisted of sofosbuvir, daclatasvir, and ribavirin, for 12 or 24 weeks, according to the national guidelines. Fifty-five patients completed antiviral treatment and 54 had HCV-viral load results available. The majority of patients were male (78%), 58 years old on average, 65% had hepatocellular carcinoma (HCC) before LT, and 67% were interferon treatment-experienced. Most patients had HCV genotype 1 (65%), 35% had genotype 3, and started treatment on an average of 38 months after LT (range: 2-228). Fifty-eight percent were treated for 12 weeks and 42% for 24 weeks, using a mean dose of ribavirin of 10.1 mg/kg (4.2-16.1). There were no treatment interruptions due to serious side effects. The sustai...
Source: Braz J Med Biol Res - Category: Research Authors: Tags: Braz J Med Biol Res Source Type: research

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Conclusions: LT candidates without known alcohol or drug use may have a clinically significant consumption of alcohol and previous illicit drug use. Efforts should be put on identification of these patients during LT evaluation. The use of structured questionnaires such as the ASI and the LDH could facilitate detection of alcohol and drug problems. PMID: 31453745 [PubMed - as supplied by publisher]
Source: Scandinavian Journal of Gastroenterology - Category: Gastroenterology Tags: Scand J Gastroenterol Source Type: research
A 59-year-old man caucasian with hepatocellular carcinoma and liver cirrhosis due to hepatitis C underwent liver transplantation. Three months later he was admitted to the hospital due to voluminous diarrhea, nausea, and significant weakness. The patient was on immunosuppression with tacrolimus and mycophenolate mofetil, and never experienced transplanted organ rejection. Upon presentation, laboratory values showed a white blood cell count of 6.8 K/mcL, hemoglobin of 13.1 g/dL, platelet count of 207 K/mcL, creatinine of 1.99 mg/dL, aspartate aminotransferase of 22 units/L, alanine aminotransferase of 31 units/L, total bili...
Source: The American Journal of Medicine - Category: General Medicine Authors: Tags: Clinical Communication to the Editor Source Type: research
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
ConclusionPre-transplant performance status is one of the predictors of mortality after LDLT.
Source: Journal of Clinical and Experimental Hepatology - Category: Gastroenterology Source Type: research
CONCLUSIONS: Disease burden associated with chronic HCV infection is projected to peak in the Czech Republic in 30-40 years. Assuming that the current portion of DAAs used remains constant, a significant reduction in HCV disease burden is possible through increased diagnosis and treatment through 2030. This analysis provides evidence in order to facilitate the development of national strategies for HCV care and management in the Czech Republic. PMID: 31241282 [PubMed - in process]
Source: Central European Journal of Public Health - Category: International Medicine & Public Health Tags: Cent Eur J Public Health Source Type: research
Conclusion: Our data indicate that the risk of microvascular invasion is highest in tumors localized to segment 8. The size and number of HCC tumors were not associated with an increased risk of microvascular invasion. PMID: 31186641 [PubMed]
Source: Journal of Cancer Epidemiology - Category: Epidemiology Tags: J Cancer Epidemiol Source Type: research
Conclusions: While there is a certain overlap between the results of the current study and published transcriptomic profiles of non-transplanted livers with steatosis, we have identified discrete characteristics of the non-alcoholic fatty liver disease in liver grafts potentially utilizable for the establishment of predictive signature. Introduction Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in industrialized countries, its prevalence being estimated at 19–31.3% (1). It encompasses a range of conditions that are thought to arise from fatty liver (simple steatosis) throu...
Source: Frontiers in Endocrinology - Category: Endocrinology Source Type: research
Semin Liver Dis DOI: 10.1055/s-0039-1685538More than 70 million people are chronically infected with hepatitis C virus (HCV) worldwide. Chronic hepatitis C is associated with progressive liver fibrosis, which can result in cirrhosis, liver failure, and hepatocellular carcinoma (HCC). HCV-related liver disease has been the most common indication for liver transplantation in the past decade. The development of direct-acting antiviral agents (DAAs) that are simple, well-tolerated, and highly effective means that most people living with hepatitis C can now be cured, leading the World Health Organization to set targets for redu...
Source: Seminars in Liver Disease - Category: Gastroenterology Authors: Tags: Review Article Source Type: research
Joanna Mikulak1,2, Elena Bruni1,2, Ferdinando Oriolo1,2, Clara Di Vito1 and Domenico Mavilio1,2* 1Unit of Clinical and Experimental Immunology, Humanitas Clinical and Research Center, Milan, Italy 2Department of Medical Biotechnologies and Translational Medicine, University of Milan, Milan, Italy The liver is considered a preferential tissue for NK cells residency. In humans, almost 50% of all intrahepatic lymphocytes are NK cells that are strongly imprinted in a liver-specific manner and show a broad spectrum of cellular heterogeneity. Hepatic NK (he-NK) cells play key roles in tuning liver immune response in b...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Conclusion: IL-2 receptor expression demonstrated the highest diagnostic accuracy, while the peripheral eosinophil count was the only marker tested in more than one study. Presently, liver biopsy remains superior to noninvasive diagnostic biomarkers as most studies exhibited inferior designs, hindering possible translation into clinical application. Introduction Liver transplantation (LT) exhibits 20-year survival rates of up to 50% (1) and is of great clinical importance. LT is the treatment of choice for acute or acute-on-chronic liver failure, while organ replacement therapies are still waiting for the break (2)...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
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