Correction: The Role of Anticoagulation in Treating Portal Hypertension
The article The Role of Anticoagulation in Treating Portal Hypertension, written by Laura Turco, Filippo Schepis and Erica Villa, was originally published electronically on the publisher ’s internet portal (currently SpringerLink) on 18 June 2018 without open access. (Source: Current Hepatitis Reports)
Source: Current Hepatitis Reports - November 16, 2018 Category: Infectious Diseases Source Type: research
Update in the Management of Chronic Hepatitis B in Pregnancy
AbstractPurpose of ReviewVertical transmission accounts for almost half of the chronic hepatitis B infections worldwide. Therefore, management of HBV in pregnancy presents a unique opportunity for intervention, so that vertical transmission and overall HBV could be reduced. There is limited data on outcomes of acute HBV. There were several observational and prospective studies on effects of chronic HBV during pregnancy, modes of mother to child transmission (MTCT), role of obstetric interventions, indications for antiviral therapy during pregnancy which demonstrated variable findings. Our purpose is to summarize and update...
Source: Current Hepatitis Reports - November 8, 2018 Category: Infectious Diseases Source Type: research
Small Esophageal Varices in Patients with Cirrhosis —Should We Treat Them?
AbstractPurpose of ReviewThe natural history and classification systems of small varices ( ≤ 5 mm in diameter) in cirrhotic patients with portal hypertension are summarized. Studies that assessed the course of and therapeutic intervention for small varices are discussed.Recent FindingsCurrent non-invasive methods show suboptimal sensitivity to detect small varices in patients with cirrhosis. Next to etiological therapy, hepatic venous pressure gradient (HVPG)-guided non-selective betablocker or carvedilol treatment has shown to impact on natural history of small varices.SummaryThe main therapeutic focus in cirrhotic p...
Source: Current Hepatitis Reports - November 7, 2018 Category: Infectious Diseases Source Type: research
Long-term Outcomes in Patients with HBV Treated with Antiviral Agents
AbstractᅟChronic hepatitis B (CHB) infection is one of the main causes of chronic liver disease, cirrhosis, and hepatocellular carcinoma (HCC) worldwide. Long-term treatment with the most potent nucleos(t)ide analogues (NUCs), i.e., entecavir (ETV), tenofovir disoproxil fumarate (TDF), and the recently approved tenofovir alafenamide (TAF) are able to achieve and maintain virological suppression, and therefore are the first-line recommended therapies for all CHB patients.Purpose of ReviewTo assess the long-term outcome in CHB patients treated with NUCs.Recent FindingsThese NUCs are highly effective in suppressing viral re...
Source: Current Hepatitis Reports - November 5, 2018 Category: Infectious Diseases Source Type: research
Pathogenesis of NASH: the Impact of Multiple Pathways
AbstractPurpose of reviewAdvancing our understanding of the mechanisms that underlie NASH pathogenesis.Recent findingsRecent findings on NASH pathogenesis have expanded our understanding of its complexity including (1) there are multiple parallel hits that lead to NASH; (2) the microbiota play an important role in pathogenesis, with bacterial species recently shown to accurately differentiate between NAFL and NASH patients; (3) the main drivers of liver cell injury are lipotoxicity caused by free fatty acids (FFAs) and their derivatives combined with mitochondrial dysfunction; (4) decreased endoplasmic reticulum (ER) effic...
Source: Current Hepatitis Reports - October 31, 2018 Category: Infectious Diseases Source Type: research
Current State of Immunotherapy for HCC —Supporting Data and Toxicity Management
AbstractPurpose of ReviewAfter having tyrosine kinase inhibitor as only available one drug class to treat advanced hepatocellular carcinoma (HCC) for more than a decade, immunotherapy agents are now approved for second-line therapy and are currently being compared head-to-head with sorafenib for first-line treatment. It is becoming increasingly important for hepatologists to become aware of agents in development, potential adverse events, and suggested treatment monitoring.Recent FindingsNivolumab and pembrolizumab have both shown promising phase II data in the second-line setting for HCC and phase III data in both the fir...
Source: Current Hepatitis Reports - October 28, 2018 Category: Infectious Diseases Source Type: research
LI-RADS v2018: a Primer and Update for Clinicians
AbstractPurpose of ReviewTo familiarize readers with recent updates and additions to the Liver Imaging and Reporting Data System (LI-RADS) v2018 for hepatocellular carcinoma surveillance, diagnosis, and treatment response assessment.Recent FindingsUS surveillance, diagnosis, and treatment response assessment algorithms are now incorporated into LI-RADS v2018. Updates to the diagnostic algorithm for CT and MRI include clarification of the LI-RADS appropriate population, revision of LR-5 criteria to match with those advocated by the American Association for Study of Liver Disease, new specific criteria for the LR-M category,...
Source: Current Hepatitis Reports - October 24, 2018 Category: Infectious Diseases Source Type: research
Implications of Circulating Hepatitis B Virus RNA Levels in Assessment of Response to Antiviral Therapy
AbstractPurpose of ReviewTreatment of chronic hepatitis B infection with nucleos(t)ide analogues induces a significant inhibition of HBV DNA titer. However, reduction of viral DNA load is not an ideal marker to predict sustainable antiviral effect. Circulating HBV RNA has been, recently, explored as a novel biomarker for monitoring viral persistence and the progression of liver disease. This review aims to discuss the characteristics of circulating HBV RNA and to evaluate its applications in hepatitis B infection management.Recent FindingsHBV RNA is readily detectable in the blood of infected patients. Circulating viral RN...
Source: Current Hepatitis Reports - October 18, 2018 Category: Infectious Diseases Source Type: research
Hepatitis B Reactivation in the DAA Era: Minding the Gap Between the Black Box and Clinical Practice
AbstractPurpose of ReviewThe US Food and Drug Administration recently issued a black box warning regarding the risk of hepatitis B virus (HBV) reactivation with direct-acting antiviral (DAA) treatment in hepatitis C virus (HCV)-coinfected individuals. The warning included all HBV infection, active and resolved, which, along with the lack of consensus among the gastroenterology and hepatology guidelines, have left clinicians unsure on how to proceed. Recent data have filled some knowledge gaps regarding the true risk of HBV reactivation in HCV treatment. The clinical data pertaining to the risk of reactivation in active and...
Source: Current Hepatitis Reports - October 17, 2018 Category: Infectious Diseases Source Type: research
Update on Pediatric Fatty Liver Disease
AbstractPurpose of ReviewNon-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease in the USA, affecting over 7 million children. In this article, we provide an update on pediatric NAFLD by briefly reviewing the recent publications in diagnosis, screening, therapy, and follow-up.Recent FindingsNAFLD remains a diagnosis of exclusion and liver biopsy is the most accurate test to assess severity of the disease in children. There is a growing collection of studies testing noninvasive tests for hepatic steatosis and fibrosis, several of which have become available in more recent years, such as fibrosis ...
Source: Current Hepatitis Reports - October 17, 2018 Category: Infectious Diseases Source Type: research
Management of Combined Hepatocellular Carcinoma-Cholangiocarcinoma
AbstractPurpose of ReviewTo review the recent consensus on the nomenclature, clinical features, diagnosis, and treatment of combined hepatocellular carcinoma-cholangiocarcinoma (cHCC-CCA).Recent FindingscHCC-CCA is a primary liver carcinoma with varying degrees of hepatocytic and cholangiocytic cytology and architecture within the same tumor. The diagnosis of cHCC-CCA can only be established based on histologic examination. Surgical resection should be considered in patients with resectable tumors who do not have underlying liver disease or clinically significant portal hypertension. While treatment by liver transplantatio...
Source: Current Hepatitis Reports - October 17, 2018 Category: Infectious Diseases Source Type: research
Stereotactic Ablative Radiotherapy (SABR/SBRT) for Hepatocellular Carcinoma
AbstractPurpose of ReviewLiver-directed SABR (stereotactic ablative body radiotherapy) is emerging as an effective local therapy option for HCC (hepatocellular carcinoma). This review summarizes recent clinical progresses and proposes future directions.Recent FindingsSABR is an effective and safe, non-invasive local therapy option for HCC in the primary and salvage treatment settings, as well as a bridge to liver transplantation in selected patients. Randomized trials comparing SABR with other locoregional modalities are currently ongoing.SummaryResearch efforts are being made toward better predicting normal tissue toxicit...
Source: Current Hepatitis Reports - October 16, 2018 Category: Infectious Diseases Source Type: research
Non-invasive Fibrosis Testing in Patients with Chronic Hepatitis B
AbstractPurpose of ReviewSummarizing the available evidence and advantages and disadvantages of the use of non-invasive tests for the management of patients with chronic hepatitis B virus (HBV) infection, including before and during antiviral therapy.Recent FindingsStaging of liver fibrosis and early detection of compensated cirrhosis are critical in the treatment decisions and surveillance of HBV patients. Non-invasive assessment of liver fibrosis has been one of the major advances in hepatology over the past decade, relying either on the dosage of serum biomarkers or on the measurement of liver stiffness, using either ul...
Source: Current Hepatitis Reports - October 15, 2018 Category: Infectious Diseases Source Type: research
Impact of Chronic Hepatitis B Infection on Patient-Reported Outcomes
AbstractPurpose of ReviewHepatitis B virus (HBV) infects a large number of people worldwide causing tremendous clinical burden related to decompensated cirrhosis and hepatocellular carcinoma (HCC). Although clinical consequences of HBV are well described, the impact of chronic HBV infection on patient-reported outcomes (PROs) is not well described.Recent FindingsMostly asymptomatic, some HBV patients do have some impairment of their health-related quality of life. In general, the use of interferon-based regimens for HBV has been associated with negative impact on both physical function and psychological function of the tre...
Source: Current Hepatitis Reports - October 15, 2018 Category: Infectious Diseases Source Type: research
Prevention and Management of HBV Infection in Patients with Chronic Kidney Disease Requiring Renal Transplantation
AbstractPurpose of the ReviewThis review addresses clinical challenges of hepatitis B virus (HBV) infection in patients with chronic kidney disease and renal transplant recipients.Recent FindingsProphylactic antiviral therapy with nucleos(t)ide analogues is key to prevent HBV reactivation in renal transplant recipients. In addition, attaining adequate immunity following vaccination against HBV may permit transplantation of renal grafts from donors with evidence of prior HBV infection. The role of nucleos(t)ide analogues for treatment of recurrent or de novo HBV infection in renal transplant recipients is well established a...
Source: Current Hepatitis Reports - October 13, 2018 Category: Infectious Diseases Source Type: research
