Indications and Best Practices for Intra-arterial Therapies to Treat Hepatocellular Carcinoma
AbstractPurpose of ReviewThe purpose of this review is to re-evaluate the role of intra-arterial therapies for hepatocellular carcinoma (HCC) recommended by contemporary staging systems.Recent FindingsCurrently, intra-arterial therapies are recommended by the Barcelona Clinic Liver Cancer (BCLC) staging system only for patients with BCLC B HCC in the form of trans-arterial chemoembolization. Recently, randomized controlled trials in patients with BCLC C HCC without metastatic disease have suggested a potential role for trans-arterial radioembolization (TARE) with fewer adverse events and better quality of life compared to ...
Source: Current Hepatitis Reports - October 10, 2018 Category: Infectious Diseases Source Type: research
New Advances in Hepatitis B Vaccination for Adults
AbstractPurpose of ReviewThe mainstay of elimination of hepatitis B virus is through primary prevention by vaccination recommended by the World Health Organization. This review seeks to update readers on the performance of the current second-generation vaccine and the challenges including primary and secondary vaccine failure, as well as compliance and coverage.Recent FindingsPrimary vaccine failure in children may be overcome by HBIG and antiviral therapy in high-risk pregnancies, while in adults, a number of strategies to address this include intradermal delivery, double-dose vaccination, improved adjuvants, and a third-...
Source: Current Hepatitis Reports - October 8, 2018 Category: Infectious Diseases Source Type: research
Portal Cavernoma Cholangiopathy
AbstractPurpose of ReviewPortal cavernoma cholangiopathy is a rare condition, a proper recognition of which is critical. Solid data on this condition are scarce. This review aims at updating current knowledge on its definition, manifestations, diagnosis, and management.Recent FindingsA consensus has been reached to prefer the denomination portal cavernoma cholangiopathy for the bile duct irregularities associated with portal cavernoma. Such irregularities are characterized by stenosis with or without dilatation and are mostly related to the impinging on bile duct lumen by portoportal collaterals. While bile duct irregulari...
Source: Current Hepatitis Reports - October 5, 2018 Category: Infectious Diseases Source Type: research
Primary Liver Tumors Other than Hepatocellular Carcinoma: Clinical and Molecular Pearls
AbstractPurpose of ReviewLiver tumors, excluding hepatocellular carcinoma and metastatic disease, are rare. However, it is important to understand how to distinguish these lesions from hepatocellular carcinoma. They run the spectrum of benign to malignant, some aggressive with relatively few therapeutic options. The goal of this paper is to review the most recent literature to provide current insights into diagnosis, treatment, and pathogenesis of these tumor types.Recent FindingsRecent literature has focused on oncogenomics and putative targets for therapeutic intervention. Several ongoing studies are elucidating molecula...
Source: Current Hepatitis Reports - October 2, 2018 Category: Infectious Diseases Source Type: research
The Impact of Metabolic Syndrome on the Outcome of NASH: Cirrhosis, Hepatocellular Carcinoma, and Mortality
AbstractPurpose of ReviewIn this review, we examine the interaction between the metabolic syndrome (MS) and non-alcoholic fatty liver disease (NAFLD) and describe the impact of the features of MS on the most worrisome complications of non-alcoholic steatohepatitis (NASH), (cirrhosis, hepatocellular carcinoma) and, ultimately, on liver-related, cardiovascular, and overall mortality.Recent FindingsInsulin resistance, obesity, and dyslipidemia in a pro-inflammatory environment have a causal role in hepatic fibrogenesis and oncogenesis in NAFLD patients. Natural history, longitudinal studies confirm the conditions linked to MS...
Source: Current Hepatitis Reports - September 26, 2018 Category: Infectious Diseases Source Type: research
The Impact of Direct-acting Antiviral Therapy for Hepatitis C on Hepatocellular Carcinoma Risk
AbstractPurpose of ReviewDirect-acting antiviral agents (DAAs) eradicate hepatitis C virus (HCV) infection in the majority of patients. We critically evaluated the impact of DAAs on hepatocellular carcinoma (HCC) risk, a major complication of HCV infection.Recent FindingsLarge cohort studies show that patients who achieve sustained virologic response (SVR) with DAAs have a significantly lower risk of developing de novo HCC than patients who fail treatment or remain untreated. Furthermore, reduction in HCC risk is similar whether SVR is achieved with DAAs or interferon (IFN). However, DAA-induced SVR does not eliminate HCC ...
Source: Current Hepatitis Reports - September 20, 2018 Category: Infectious Diseases Source Type: research
The Role of Radiologic Modalities in Diagnosing Nonalcoholic Steatohepatitis (NASH) and Fibrosis
AbstractPurpose of ReviewThe dramatic increase in nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) fostered the development and evaluation of non-invasive, imaging based methods for diagnosing NAFLD, NASH, and its complications. We herein review different radiologic modalities in diagnosing steatosis, fibrosis, and liver cirrhosis.Recent FindingsWhile routine abdominal ultrasound with hyperechogenic liver structure only detects moderate to severe steatosis, controlled attenuation parameter (CAP), magnetic resonance spectroscopy (MRS), and, especially, MRI-proton density fat fraction (MRI-PDF...
Source: Current Hepatitis Reports - September 19, 2018 Category: Infectious Diseases Source Type: research
The Clinical and Economic Burden of Nonalcoholic Steatohepatitis
AbstractPurpose of reviewNonalcoholic fatty liver disease (NAFLD) will be the dominant and most impactful liver disease for the next generation. As the obesity and diabetes epidemic continues and the general populations in most industrialized countries become older, NAFLD and its progressive subtype nonalcoholic steatohepatitis (NASH) will have a significant clinical and economic impact on society, both in the USA and globally. This manuscript provides a review of recently published articles that detail the impact of NAFLD and NASH.Recent findingsOverall, the literature shows that NAFLD is the most common liver disease glo...
Source: Current Hepatitis Reports - September 19, 2018 Category: Infectious Diseases Source Type: research
The Role of Radiologic Modalities in Diagnosing Nonalcoholic Steatohepatitis (NASH) and Fibrosis
AbstractPurpose of ReviewThe dramatic increase in nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH) fostered the development and evaluation of non-invasive, imaging based methods for diagnosing NAFLD, NASH, and its complications. We herein review different radiologic modalities in diagnosing steatosis, fibrosis, and liver cirrhosis.Recent FindingsWhile routine abdominal ultrasound with hyperechogenic liver structure only detects moderate to severe steatosis, controlled attenuation parameter (CAP), magnetic resonance spectroscopy (MRS), and, especially, MRI-proton density fat fraction (MRI-PDF...
Source: Current Hepatitis Reports - September 19, 2018 Category: Infectious Diseases Source Type: research
The Clinical and Economic Burden of Nonalcoholic Steatohepatitis
AbstractPurpose of reviewNonalcoholic fatty liver disease (NAFLD) will be the dominant and most impactful liver disease for the next generation. As the obesity and diabetes epidemic continues and the general populations in most industrialized countries become older, NAFLD and its progressive subtype nonalcoholic steatohepatitis (NASH) will have a significant clinical and economic impact on society, both in the USA and globally. This manuscript provides a review of recently published articles that detail the impact of NAFLD and NASH.Recent findingsOverall, the literature shows that NAFLD is the most common liver disease glo...
Source: Current Hepatitis Reports - September 19, 2018 Category: Infectious Diseases Source Type: research
DILI Associated with Skin Reactions
AbstractPurpose of ReviewAdverse drug reactions (ADR) frequently involve the liver and skin in the form of drug-induced liver injury or cutaneous drug eruption.Recent FindingsSkin ADR can range from harmless rash to severe skin manifestations such as drug rash with eosinophilia and systemic symptom syndrome (DRESS syndrome), Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and acute generalized exanthematous pustulosis (AGEP), all of which can be associated with severe outcome, including a 30% mortality rate in case of TEN. The association with co-occurring liver injury varies and in DRESS and SJS/TEN can ...
Source: Current Hepatitis Reports - September 1, 2018 Category: Infectious Diseases Source Type: research
Treatment of Gastro-Fundal Varices (Including a Discussion of BRTO)
AbstractPurpose of ReviewThe goal of our review is to provide a better understanding of the anatomy of gastric varices (GV) and to provide guidance regarding the management of bleeding GV.Recent FindingsDespite a paucity of head-to-head controlled data in this field, there remain no further advances in therapy. Alterations to previous techniques, such as combining EUS-guided metallic coil injection with cyanoacrylate injection or approaching endovascular therapies such as balloon-occluded retrograde transvenous obliteration (BRTO) via different pathways, have been developed but not studied in a comparative manner.SummaryTh...
Source: Current Hepatitis Reports - September 1, 2018 Category: Infectious Diseases Source Type: research
