Sarcopenia and Frailty in Advanced Liver Disease Patients: A Comprehensive Review
AbstractPurpose of ReviewThis comprehensive review explores the intricate nexus between liver and muscle disorders, with a primary focus on sarcopenia, elucidating their profound impact on clinical outcomes and patient well-being. The paper examines sarcopenia ’s clinical implications, diagnostic methods, pathogenesis, and management.Recent FindingsRecent research underscores sarcopenia as a robust predictor of adverse outcomes, affecting hospitalization rates, complications, and survival, both pre- and post-liver transplantation. Contributors to sarcopenia, including malnutrition, hyperammonemia, decreased Branched-Chai...
Source: Current Hepatitis Reports - February 1, 2024 Category: Infectious Diseases Source Type: research
Addiction and Liver Disease: Exploring the Complex Relationship and Implications for Clinical Management
AbstractPurpose of ReviewThe review focuses on addressing substance use disorders in individuals with chronic liver disease, specifically alcohol, tobacco, and cannabis.Recent FindingsPsychological interventions and medications like naltrexone and acamprosate are effective in treating alcohol use disorder in patients with liver disease. Tobacco smoking has a negative impact on fibrosis progression, it is recommended to regularly screen and provide structured brief interventions in combination with medications like varenicline and nicotine replacement therapy. Cannabis use disorder is associated with adverse health outcomes...
Source: Current Hepatitis Reports - January 23, 2024 Category: Infectious Diseases Source Type: research
Update on Hepatopulmonary Syndrome
AbstractPurpose of ReviewHepatopulmonary syndrome (HPS) is a common pulmonary vascular complication of liver disease associated with significant morbidity and mortality. Liver transplant (LT) is frequently curative in these patients, but effective medical therapies remain elusive. The purpose of this review is to highlight key clinical features and recent updates in the management of HPS in order to empower clinicians to take optimal care of these patients.Recent FindingsRecent HPS studies have focused on outcomes in patients with HPS who undergo LT, perioperative management of HPS, and variables associated with prognosis....
Source: Current Hepatitis Reports - January 23, 2024 Category: Infectious Diseases Source Type: research
Precision Management of Patients with HBV Infection
AbstractPurpose of ReviewThe strategies of precision management in chronic hepatitis B (CHB) are focused on prediction and action. Currently, several hepatitis B viral biomarkers are discovered to serve as predictors for disease progression, risk of hepatocellular carcinoma (HCC) occurrence, and responses to nucleos(t)ide analogue (NA) therapy. In this narrative review, three serum biomarkers, quantitative HBsAg, HBcrAg, and HBV RNA, for the precision management of patients with CHB will be summarized and discussed.Recent FindingsQuantitative HBsAg provides prediction in staging clinical phases, HBsAg seroclearance, rela...
Source: Current Hepatitis Reports - January 23, 2024 Category: Infectious Diseases Source Type: research
Non-Cirrhotic Portal Hypertension: an Overview
AbstractPurpose of ReviewNon-cirrhotic portal hypertension (NCPH) is a broad term, which includes a heterogeneous group of disorders characterized by elevated portal pressure in the absence of cirrhosis. Despite a better understanding, the diagnosis and treatment remains challenging. This review gives new insights into some of the recent advances.Recent FindingsAlthough current guidelines for varices screening/surveillance are inadequate for NCPH, discovery of new genetic mutations helps us better understand its pathogenesis. Endohepatology is a promising emerging technique for an accurate diagnosis of NCPH. Pregnancy is n...
Source: Current Hepatitis Reports - January 23, 2024 Category: Infectious Diseases Source Type: research
Hepatic Sarcoidosis: A Review of the Diagnosis and Management
AbstractPurpose of ReviewHepatic sarcoidosis is a type of granulomatous liver disease frequently presenting as an extrapulmonary manifestation of systemic sarcoidosis. Management of this disease is complicated by the absence of specific diagnostic criteria or concise treatment guidelines. This review provides a comprehensive overview of the existing literature on the diagnosis, clinical features, and management of hepatic sarcoidosis.Recent FindingsHepatic sarcoidosis presents with distinct clinicopathologic characteristics that differentiate it from other types of granulomatous liver disease. Although hepatic sarcoidosis ...
Source: Current Hepatitis Reports - January 20, 2024 Category: Infectious Diseases Source Type: research
Endocrinology for the Hepatologist
AbstractPurpose of reviewThe purpose of this review is to discuss endocrine diseases that affect the liver and how chronic liver disease affects endocrine function.Recent findingsOver the past 2 decades, we have gained an expanding knowledge of the liver as an endocrine organ. There have been numerous discoveries in hepatic hormone and hepatokine synthesis, metabolism, and production of hormone binding proteins. Global awareness of metabolic dysfunction-associated steatotic liver disease (MASLD) is increasing as the most common cause of chronic liver disease, and its mutually detrimental relationship with type 2 diabetes (...
Source: Current Hepatitis Reports - January 18, 2024 Category: Infectious Diseases Source Type: research
Prophylaxis and Treatment of Bacterial Infections in Cirrhosis
AbstractPurpose of ReviewWe aim to succinctly summarize key clinical management principles in commonly encountered clinical scenarios with regard to prevention, diagnosis, and management of bacterial infections in patients with cirrhosis.Recent FindingsWe review studies detailing the role for antibiotic prophylaxis in acute liver failure and in alcohol-related hepatitis. We also review growing concerns related to antibiotic resistance and emerging biomarkers for infection prediction in cirrhosis.SummaryWe found that there is evidence of improved outcomes with administration of antibiotic prophylaxis to cirrhotic patients i...
Source: Current Hepatitis Reports - January 18, 2024 Category: Infectious Diseases Source Type: research
Update on HCC Surveillance in Patient With Hepatitis B Virus Infection With Focus on Biomarkers
AbstractPurpose of ReviewChronic hepatitis B (CHB) infection is a major risk factor for hepatocellular carcinoma (HCC) worldwide. Current guidelines recommend HCC surveillance in individuals with cirrhosis and certain CHB subgroups using ultrasound with alpha-fetoprotein (AFP). However, ultrasound-based screening is limited by suboptimal sensitivity, operator and patient variability, and poor adherence. Risk scores and biomarker-based screening modalities have emerged as an alternative surveillance strategy. The purpose of this review is to summarize HCC surveillance in CHB patients, including the literature regarding risk...
Source: Current Hepatitis Reports - January 17, 2024 Category: Infectious Diseases Source Type: research
Worldwide Increasing Prevalence of Non-alcoholic Steatohepatitis as an Indication of Liver Transplantation: Epidemiological View and Implications
AbstractPropose of ReviewNon-alcoholic fatty liver disease (NAFLD) has progressively become one of the main causes of chronic liver disease (CLD) in transplant centers on all continents. Most epidemiological studies that demonstrate these trends are country-centered reports. For this reason, this review aimed to collect individual studies carried out in the last decades to appreciate the overwhelming dimension of the problem. Additionally, a summary of the prognostic impact of NAFLD and its comorbidities in the context of liver transplant setting was performed.Recent FindingsRegardless of ethnicity, cultural background, so...
Source: Current Hepatitis Reports - January 12, 2024 Category: Infectious Diseases Source Type: research
TIPS for Refractory Ascites and Hepatic Hydrothorax
AbstractPurpose of ReviewThis review summarizes the pathophysiology of portal hypertension, outcome data through the years supporting the use of TIPS in refractory ascites (RA) and hepatic hydrothorax (HH), and considerations for ideal TIPS candidates.Recent FindingsAdvances in stent technology over the last three decades have dramatically improved both quality of life and survival for patients with RA and HH. Importantly, the advent of controlled-expansion, covered stents has reduced the incidence of post-TIPS hepatic encephalopathy (HE) and mortality rates.SummaryControlled-expansion covered stents are now the guideline-...
Source: Current Hepatitis Reports - January 11, 2024 Category: Infectious Diseases Source Type: research
Current Management of Hepatic Encephalopathy
AbstractPurpose of ReviewHepatic encephalopathy (HE) is a complication of liver dysfunction and portosystemic shunting. The purpose of this review is to discuss the management of HE.Recent FindingsTraditional therapies include lactulose and rifaximin, but other treatment options have recently emerged. Branched chain amino acids are involved in the Krebs cycle and have an inverse relationship with ammonia. Flumazenil, a benzodiazepine antagonist, has a negative effect on the gamma-aminobutyric acid receptor, which plays a role in cognitive deficits. Because of microbiome changes, fecal microbiota transplantation and probiot...
Source: Current Hepatitis Reports - January 8, 2024 Category: Infectious Diseases Source Type: research
Emerging Drug Therapies for Metabolic Dysfunction-Associated Steatotic Liver Disease: A Glimpse into the Horizon
AbstractPurpose of ReviewMetabolic dysfunction –associated steatotic liver disease (MASLD) and its aggressive form, metabolic dysfunction-associated steatohepatitis (MASH), are highly prevalent and can lead to fibrosis, cirrhosis, hepatocellular carcinoma, and liver failure. Currently, there is no approved pharmacological treatment for MASLD. In this review, we aim to summarize recent data on therapeutic agents under study in phase 2 and 3 trials.Recent FindingsBuilding on a better understanding of MASLD/MASH pathophysiology, a myriad of drugs has been developed. Recent results from clinical trials show promise, with som...
Source: Current Hepatitis Reports - January 6, 2024 Category: Infectious Diseases Source Type: research
Novel Blood-Based Biomarkers for HCC
AbstractPurpose of ReviewHepatocellular carcinoma (HCC) is a leading cause of cancer mortality. Early detection is crucial for improving patient survival. This review summarizes research on novel biomarkers for HCC, outlining the steps necessary prior to their use in clinical practice.Recent FindingsThe most commonly used biomarker used for HCC, alpha-fetoprotein (AFP), has limited sensitivity and specificity for early detection. Recent advances have identified several novel candidates such as AFP-L3, des-gamma carboxyprothrombin (DCP), and cell-free DNA (cfDNA), which can be used independently or incorporated into algorit...
Source: Current Hepatitis Reports - January 3, 2024 Category: Infectious Diseases Source Type: research
Hepatotoxicity in Adeno-Associated Viral Vector Gene Therapy
AbstractPurpose of ReviewRecombinant adeno-associated virus (rAAV) is the commonest viral vector used in gene therapies. With the increase in the number of such therapies being employed in human clinical trials and approved clinical use, the associated adverse events are increasingly observed. Hepatotoxicity is the most common adverse event.Recent FindingsAlthough mild in most, hepatotoxicity may affect gene therapy efficacy, lead to acute liver failure, death and persisting hepatitis necessitating prolonged use of immunosuppressants. There has been an increase in the referrals of such cases to hepatologists.SummaryThere i...
Source: Current Hepatitis Reports - December 20, 2023 Category: Infectious Diseases Source Type: research
