HCV Eradication With DAAs Reduces Variceal Bleeding Risk HCV Eradication With DAAs Reduces Variceal Bleeding Risk

This study found that DAA-induced SVR in patients with hepatitis C is associated with a reduced risk of variceal bleeding, among both patients with and without established cirrhosis.Alimentary Pharmacology &Therapeutics
Source: Medscape Today Headlines - Category: Consumer Health News Tags: Gastroenterology Journal Article Source Type: news

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Conclusion: LC can be safely performed in cirrhotic patients. However, higher CTP and MELD scores, operative bleeding, more blood and plasma transfusion units, longer operative time, lower platelet count, and higher INR values are predictors of poor outcome that can be improved by proper patient selection and meticulous peri-operative care and by using Harmonic scalpel shears.
Source: Annals of Medicine and Surgery - Category: General Medicine Source Type: research
AbstractBackgroundThe ratio of von Willebrand Factor to platelets (VITRO) reflects the severity of fibrosis and portal hypertension and might thus hold prognostic value.MethodsPatients with compensated cirrhosis were recruited. VITRO, Child –Pugh score (CPS) and MELD were determined at study entry. Hepatic decompensation was defined as variceal bleeding, ascites or hepatic encephalopathy. Liver transplantation and death were recorded.ResultsOne hundred and ninety-four patients with compensated cirrhosis (CPS-A 89%, B 11%; 56% male; median age 56  years; 50% with varices) were included. During a median follow-up ...
Source: Journal of Gastroenterology - Category: Gastroenterology 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
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
dquo; Study Group Investigators Abstract BACKGROUND: Current guidelines do not address the post-sustained virological response management of patients with baseline hepatitis C virus (HCV) cirrhosis and oesophageal varices taking betablockers as primary or secondary prophylaxis of variceal bleeding. We hypothesized that in some of these patients portal hypertension drops below the bleeding threshold after sustained virological response, making definitive discontinuation of the betablockers a safe option. AIM: To assess the evolution of portal hypertension, associated factors, non-invasive assessment, and risk ...
Source: World Journal of Gastroenterology : WJG - Category: Gastroenterology Authors: Tags: World J Gastroenterol Source Type: research
AbstractIt has been estimated by the World Health Organization (WHO) that over 71  million people were infected with the hepatitis C virus (HCV) in 2015. Since then, a number of highly effective direct-acting antiviral (DAA) regimens have been licensed for the treatment of chronic HCV infection: sofosbuvir/daclatasvir, sofosbuvir/ledipasvir, elbasvir/grazoprevir, sofosbuvir/vel patasvir, glecaprevir/pibrentasvir, and sofosbuvir/velpatasvir/voxilaprevir. With these treatment regimens, almost all chronic HCV-infected patients, even including prior DAA failures, can be treated effectively and safely. It is therefore...
Source: Clinical Pharmacokinetics - Category: Drugs & Pharmacology 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
Management of patients with cirrhosis includes endoscopic screening and surveillance to detect esophageal varices (EV) and prevent bleeding. However, the Baveno VI guidelines recommend avoiding endoscopies for patients with liver stiffness measurements below 20 kPa and platelet counts above 150,000 (favorable Baveno VI status) and endoscopic assessment of patients with higher levels of liver stiffness and platelet counts (unfavorable Baveno VI status). We aimed to validate the Baveno VI guidelines, evaluating outcomes of patients in the ANRS-CO12 CirVir cohort with compensated cirrhosis associated with hepatitis B virus (H...
Source: Gastroenterology - Category: Gastroenterology Authors: 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
Background Noninvasive methods have been established to detect clinically significant portal hypertension in liver cirrhosis with variable limitations. The von Willebrand factor (vEF) has been found to increase in liver cirrhosis. Aim The aim of this study was to explore the vEF and VITRO (von Willebrand factor antigen/platelet ratio) score in the prediction of variceal bleeding in patients with portal hypertension. Materials and methods Fifty patients with hepatitis C-related liver cirrhosis (25 patients with variceal bleeding and 25 without variceal bleeding) as well as 80 healthy controls were included. Laborato...
Source: European Journal of Gastroenterology and Hepatology - Category: Gastroenterology Tags: Original Articles: Hepatology Source Type: research
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