Hepatitis B Virus Elimination Strategies
AbstractPurpose of ReviewThe World Health Assembly called to eliminate viral hepatitis as a public health threat in 2016 and proposed elimination goals by 2030. This review examined current national and global progress with hepatitis B virus elimination, and the hurdles and solutions being undertaken to achieve elimination goals.Recent FindingsFew countries are on target to achieve the elimination targets of a 95% reduction in new infections and a 65% reduction in mortality by 2030. Gaps towards elimination remain, such as low infant vaccine coverage in low-income countries and continued under-diagnosis and low rates of tr...
Source: Current Hepatitis Reports - February 21, 2024 Category: Infectious Diseases Source Type: research
Portal Vein Thrombosis in Patients with Cirrhosis
AbstractPurpose of ReviewPortal vein thromboses occur in patients with cirrhosis, including those awaiting liver transplant, and uncertainty exists regarding its prognosis, workup, and optimal management.Recent FindingsThe prevalence of PVT is higher in those with more severe liver disease (24% vs 14% for Child-Pugh B/C vs A, respectively). PVT, especially those with complete occlusion, is associated with mortality and graft loss in liver transplant recipients. Increasing data on direct oral anticoagulant (DOAC) use in cirrhosis and specifically for use in patients with PVT provides physicians and patients with more appeal...
Source: Current Hepatitis Reports - February 15, 2024 Category: Infectious Diseases Source Type: research
Global Hepatitis C Virus Elimination — Where Are We?
AbstractPurpose of ReviewThe study aims to provide an overview of hepatitis C virus (HCV) elimination strategies and actions to show the progression of elimination efforts and path to elimination criteria globally. Additionally, we will highlight barriers and challenges facing global elimination actions and propose recommendations to achieve this goal.Recent FindingsSignificant advancements have been made in the field of HCV treatment with the introduction of oral direct-acting antivirals. In 2016, the World Health Organization launched a global health sector strategy to eliminate viral hepatitis by 2030. Over the recent y...
Source: Current Hepatitis Reports - February 14, 2024 Category: Infectious Diseases Source Type: research
A Practical Guide to Using Implementation Science and Getting To Implementation to Increase Access to Palliative Care for Patients with Decompensated Cirrhosis
AbstractPurpose of ReviewThe purpose of this review is to describe how implementation research methods can inform increased adoption of palliative care for patients with cirrhosis.Recent FindingsResearch demonstrates that specialty palliative care consultation and care improve health and health service outcomes for patients with cirrhosis, yet few patients receive such care.SummaryGetting To Implementation (GTI) and other implementation process models can offer steps to improve the implementation of evidence-based hepatology care. Future work should identify the combinations of implementation strategies that can promote eq...
Source: Current Hepatitis Reports - February 13, 2024 Category: Infectious Diseases Source Type: research
Should Indications for Antiviral Therapy for Hepatitis B Be Broadened to Include Immune-Tolerant Patients, Inactive Carriers, or Patients in the “Gray Zone”?
AbstractPurpose of ReviewCurrent antiviral therapy effectively suppresses hepatitis B virus (HBV) replication and improves the prognosis. It cannot cure HBV infection. Current clinical guidelines do not advocate universal treatment for all with chronic hepatitis B. However, recent studies are deliberating the expansion of treatment eligibility criteria to encompass those in immune-tolerant, inactive carrier, and gray zone statuses. This review examines the updated information regarding this issue.Recent FindingsFor immune-tolerant patients and patients in the gray zone, treatment eligibility might be considered for those w...
Source: Current Hepatitis Reports - February 12, 2024 Category: Infectious Diseases Source Type: research
Understanding the Role of Palliative Care Within Routine Care of Advanced Liver Disease
AbstractPurpose of ReviewThis paper aims to investigate the crucial role of palliative care in the management of chronic liver disease (CLD) and cirrhosis. Faced with a global surge in liver-related morbidity and mortality, our goal is to understand the impact of early engagement with palliative care specialists on symptom management, quality of life, and the overall trajectory of advanced liver disease.Recent FindingsWhile strides have been made in preventing and treating specific etiologies of CLD, such as viral infections, the escalating rates of alcohol use and obesity present new challenges for physicians. Despite adv...
Source: Current Hepatitis Reports - February 12, 2024 Category: Infectious Diseases Source Type: research
Secondary Sclerosing Cholangiopathies
AbstractPurpose of ReviewThis review synthesizes recent evidence of secondary sclerosing cholangiopathies, specifically IgG4-sclerosing cholangiopathy, post-transplant cholangiopathies, COVID-19-induced cholangiopathy, and sclerosing cholangiopathies due to critical illness.Recent FindingsThe clinical diagnostic criteria and practice guidelines have been updated for IgG4-sclerosing cholangiopathy. Cholangiopathy associated with livers donated after circulatory death has been further characterized, though incidence is expected to decline significantly as the use of normothermic perfusion technologies expands. COVID-19 scler...
Source: Current Hepatitis Reports - February 10, 2024 Category: Infectious Diseases Source Type: research
Perspective on Emerging Therapies to Achieve Functional Cure of Chronic Hepatitis B
AbstractPurpose of ReviewAdvancements in our understanding of the hepatitis B viral (HBV) life cycle have paved the way for novel approaches to treat HBV infection. This review summarizes the various strategies being pursued to achieve a functional cure, defined as loss of hepatitis B surface antigen (HBsAg) and absence of viral replication 6 months off-therapy.Recent FindingsDirect acting antiviral, host targeting antiviral, and immunological approaches are in various stages of development as treatment for chronic HBV infection.SummaryNovel treatments are being developed in pursuit of a cure for HBV. Current evidence su...
Source: Current Hepatitis Reports - February 10, 2024 Category: Infectious Diseases Source Type: research
Treatment of Gastric Varices
AbstractPurpose of ReviewGastric varices are an uncommon complication in patients with cirrhosis and portal hypertension. Significant advances have been made over the past 5 years with new classification and treatment paradigms in gastric variceal management. We will review the most up-to-date literature on classification, approach, and therapeutic options currently utilized for gastric variceal management.Recent FindingsThe American Gastroenterological Association recently proposed a simpler classification system that better aligns with existing treatment options for gastric varices. Moreover, there has been increasing ...
Source: Current Hepatitis Reports - February 8, 2024 Category: Infectious Diseases Source Type: research
Antimicrobial Resistance in Cirrhosis
AbstractPurpose of ReviewAntimicrobial resistance (AMR) is recognized as a critical global public health threat. This paper provides a comprehensive overview of AMR in the context of cirrhosis, a condition associated with increased susceptibility to bacterial infections. Patients with cirrhosis face elevated risks of both community-acquired and nosocomial infections, contributing to significant morbidity and mortality. The gut microbiome and leaky gut play a pivotal role in cirrhosis-associated immune dysregulation, creating an environment conducive to infections. Geographical variations in AMR prevalence underscore the im...
Source: Current Hepatitis Reports - February 8, 2024 Category: Infectious Diseases Source Type: research
Pulmonary Complications of the Liver
AbstractPurpose of ReviewHepatic hydrothorax (HH), hepatopulmonary syndrome (HPS), and portopulmonary hypertension (PoPH) are the most common complications of portal hypertension. In this review we will discuss the most relevant aspects regarding its diagnosis and treatment.Recent FindingsPulmonary complications of the liver are associated with a detrimental quality of life and decreased survival. HH can be reported in up to 15% of patients with cirrhosis and it is usually associated with ascites. HPS and PoPH are severe pulmonary vascular complications of portal hypertension and they are not associated with neither the se...
Source: Current Hepatitis Reports - February 8, 2024 Category: Infectious Diseases Source Type: research
Expanding the Donor Pool for Liver Transplantation: Assessing the Potential Use of HBV-Positive Allografts
AbstractPurpose of ReviewThis review summarizes the feasibility, benefits, and concerns of utilizing hepatitis B virus (HBV)-positive allografts for liver transplant.Recent FindingsAnalyses of registry-based and multi-center cohorts, in this current era of high-barrier nucleos(t)ide analogue therapies, have shown that recipients of HBV-positive allografts have long-term graft and recipient rates comparable to recipients of HBV-negative allografts. The utilization of HBV-positive allografts can also be cost-effective. However, early evidence indicates that for recipients with hepatocellular carcinoma (HCC), the utilization ...
Source: Current Hepatitis Reports - February 6, 2024 Category: Infectious Diseases Source Type: research
Optimising End of Life Care for Patients With End Stage Liver Disease: A Review
AbstractPurpose of ReviewThis review describes the challenges and possible solutions for improving access for patients with end stage liver disease to palliative care expertise. Although progress has been made, with consensus guidelines being published by learned societies, there remains significant variability.Recent FindingsThe developing evidence base describes improved medical and psychological outcomes for patients and caregivers when access to skilled palliative care exists. This may be provided by palliative care specialists or hepatologists/specialist nurses who have been upskilled. These skills include the ability...
Source: Current Hepatitis Reports - February 3, 2024 Category: Infectious Diseases Source Type: research
Liver and Tropical Infections
AbstractPurpose of ReviewTropical infections may present with primary hepatobiliary manifestations mimicking other liver diseases. Gastroenterologists and hepatologists practicing in endemic regions must be aware of appropriate diagnostic testing and treatment of these infections.Recent FindingsTropical infections like dengue, malaria, scrub typhus, and leptospirosis can mimic viral hepatitis, but certain subtle clues like ongoing fever after the onset of jaundice, hepatomegaly in the setting of acute liver failure-like presentation, preserved coagulation parameters, and multi-system involvement help in suspecting the diag...
Source: Current Hepatitis Reports - February 3, 2024 Category: Infectious Diseases Source Type: research
Advances and Challenges in Managing Hepatitis D Virus: Evolving Strategies
AbstractPurpose of ReviewHepatitis D Virus (HDV), although a small defective virus, poses a substantial public health challenge due to lack of awareness, underrecognized prevalence, and limited treatment options. Universal HDV screening within hepatitis B virus (HBV) cohorts is essential to address this issue. Despite its aggressive nature, effective HDV therapies have remained elusive for over four decades.Recent FindingsAdvances in understanding HDV ’s biology and clinical behavior offer potential therapeutic breakthroughs, fostering optimism. As insights grow, effective and targeted therapies are being developed to im...
Source: Current Hepatitis Reports - February 1, 2024 Category: Infectious Diseases Source Type: research
