An Overview of the Therapeutic Development of Cholangiocarcinoma with Special Emphasis on Targeted and Biologic Therapies
Abstract Purpose of ReviewCholangiocarcinoma remains difficult to treat with a poor prognosis. Nevertheless, the treatment landscape is rapidly evolving to include chemotherapy, immunotherapy, and targeted therapies. This paper will summarize recent developments in targeted therapies.Recent FindingsGemcitabine/cisplatin plus durvalumab or pembrolizumab is the standard first-line treatment for patients with advanced cholangiocarcinoma. Multiple alterations have been identified with corresponding approved targeted agents, including fibroblast growth factor receptor inhibitors pemigatinib, infigratinib, and futibatini...
Source: Current Hepatitis Reports - June 28, 2023 Category: Infectious Diseases Source Type: research
Non-Cirrhotic Portal Hypertension in Children: Current Management Strategies
AbstractPurpose of ReviewNon-cirrhotic portal hypertension (NCPH) is primarily comprised of extrahepatic portal venous obstruction (EHPVO), followed by congenital hepatic fibrosis (CHF) and non-cirrhotic portal fibrosis (NCPF). Various complications besides variceal bleeding pose a management challenge. This review summarizes the best evidence-based management practices for children with NCPH.Recent FindingsEndotherapy in EHPVO eradicates esophageal varices but does not tackle problems like ectopic varices, portal biliopathy, massive splenomegaly, growth failure, etc. Meso-Rex shunt is a physiological shunt that ameliorate...
Source: Current Hepatitis Reports - June 22, 2023 Category: Infectious Diseases Source Type: research
The Role of Micronutrients in Chronic Liver Disease
AbstractPurpose of ReviewThe importance of general nutrition in chronic liver disease is well established. The role of this review is to identify and summarise recent developments in the associations between specific micronutrients and chronic liver disease; and whether there is data to support therapeutic interventions.Recent FindingsThere is a significant association between micronutrient deficiencies and chronic liver disease. Rates of deficiency in vitamin D, zinc, selenium, and vitamin A have been noted to be as high as 85 –95% in patients with decompensated liver disease. A correlation exists between severity of th...
Source: Current Hepatitis Reports - June 22, 2023 Category: Infectious Diseases Source Type: research
Management of Immune-Tolerant Patients with Chronic HBV Infection
AbstractPurpose of ReviewHepatitis B virus (HBV) is a leading cause of hepatocellular carcinoma (HCC). Patients in the early phase of chronic HBV infection are designated “immune-tolerant” due to highly active viral replication without significant liver damage. Although these individuals are believed to have a low HCC risk, recent data showed conflicting results, which are summarized in this review.Recent FindingsClonally expanded hepatocytes with HBV integration have been detected in immune-tolerant patients, implying a theoretical HCC risk. Different cohort studies have shown conflicting HCC risk due to the heterogen...
Source: Current Hepatitis Reports - June 9, 2023 Category: Infectious Diseases Source Type: research
Extrahepatic Manifestations of Hepatitis B
AbstractPurpose of ReviewHepatitis B virus (HBV) infection is a global public health issue. While cirrhosis and hepatocellular carcinoma commonly affect patients with chronic HBV, extrahepatic manifestations are often unappreciated.Recent FindingsExtrahepatic manifestations can be variable in presentation but include several commonly described syndromes including HBV-related nephropathy, vasculitides, dermatitis, and arthritis. However, recently described entities include hematologic and neurologic manifestations.SummaryThe primary immune-mediated mechanism common to many extrahepatic manifestations involves viral antigen-...
Source: Current Hepatitis Reports - May 24, 2023 Category: Infectious Diseases Source Type: research
Role of Nutrition in Preventing Liver Disease
AbstractPurposeof ReviewNonalcoholic fatty liver disease (NAFLD) is a leading cause of chronic liver disease, and data supporting different nutritional recommendations are varied in their methods and outcomes measures. We conducted a MEDLINE literature review to assess recent studies on the effects of diets and supplements on NAFLD.Recent FindingsCurrent data support weight loss as a mechanism to halt or reverse progression of NAFLD, without a definitive answer yet on which type of diet is most effective. Research on supplements, macronutrients, and alterations of the microbiome is ongoing, and future findings may add tool...
Source: Current Hepatitis Reports - May 9, 2023 Category: Infectious Diseases Source Type: research
Portal Hypertension in Alcohol-Associated Hepatitis
AbstractPurpose of ReviewThis review article will examine portal hypertension in alcoholic hepatitis (AH) from both a basic mechanistic and a clinical perspective.Recent FindingsAlcoholic hepatitis is a major public health problem in the USA, accounting for over 300,000 hospital admissions in a recent year of data (Jinjuvadia et al. J Clin Gastroenterol. 60;49:506 –511). Portal hypertension is a key consequence of AH and a driver of liver-related morbidity and mortality. Alcohol may directly mediate portal hypertension via multiple possible mechanisms, including increased portal inflow, increased intrahepatic vasoconst...
Source: Current Hepatitis Reports - April 5, 2023 Category: Infectious Diseases Source Type: research
Risk Stratification for Hepatocellular Carcinoma in Patients with Non-alcoholic Fatty Liver Disease
AbstractPurposeof ReviewThis review aims to supply up-to-date recommendations on risk stratification for hepatocellular carcinoma (HCC) in patients with non-alcoholic fatty liver disease (NAFLD).Recent FindingsNAFLD is the most rapidly growing cause of HCC in the USA. HCC surveillance in patients with NAFLD remains a clinical challenge due to the large global burden of NAFLD, limitations in surveillance modalities, and the widely recognized possibility of HCC development in NAFLD in the absence of cirrhosis.SummaryBased on fibrosis staging, HCC screening in NAFLD is recommended in cirrhosis, considered in advanced fibrosis...
Source: Current Hepatitis Reports - March 1, 2023 Category: Infectious Diseases Source Type: research
Pharmacotherapies for Portal Hypertension: Current Status and Expanding Indications
AbstractPurposeNon-selective beta blockers remain the pharmacotherapy of choice for prevention of the first episode of variceal bleeding (primary prevention) and for prevention of its recurrence after initial hemostasis (secondary prophylaxis). This review will update the current and emerging pharmacological therapies for portal hypertension.Recent FindingsData have emerged on carvedilol in preventing hepatic decompensation and improving patient survival among patients with clinically significant portal hypertension. Because measurement of WHVP is invasive and not feasible in routine practice, non-invasive tests with liver...
Source: Current Hepatitis Reports - February 20, 2023 Category: Infectious Diseases Source Type: research
Emerging Therapeutic Targets for Portal Hypertension
Abstract
Purpose of ReviewPortal hypertension is responsible of the main complications of cirrhosis, which carries a high mortality. Recent treatments have improved prognosis, but this is still far from ideal. This paper reviews new potential therapeutic targets unveiled by advances of key pathophysiologic processes.Recent FindingsRecent research highlighted the importance of suppressing etiologic factors and a safe lifestyle and outlined new mechanisms modulating portal pressure. These include intrahepatic abnormalities linked to inflammation, fibrogenesis, vascular occlusion, parenchymal extinction, and angiogenesis; ...
Source: Current Hepatitis Reports - February 11, 2023 Category: Infectious Diseases Source Type: research
Management of Gastric and Ectopic Varices
AbstractPurpose of ReviewGastric varices (GV) are seen commonly in patients with portal hypertension and esophageal varices, more so in variceal bleeders. Compared to esophageal varices, there is limited data on the management of GV and ectopic varices. The current review provides a practical and updated approach for the management of patients with GV and ectopic varices.Recent FindingsThe management of isolated gastric varices (IGV) and esophageal varices continuing on the greater curvature of the stomach, the gastro-esophageal varices type 2 (GOV2) has improved significantly. Control of active bleed or prevention of rebl...
Source: Current Hepatitis Reports - February 6, 2023 Category: Infectious Diseases Source Type: research
Dietary Management of Metabolic Liver Disease
AbstractPurpose of ReviewMetabolic liver diseases encompass several different inherited conditions that affect metabolism and can lead to hepatic dysfunction. Understanding the role of dietary interventions is critical, as nutrition continues to play a large role in management of these diseases and at times can even be lifesaving.Recent FindingsDespite novel genetic and enzymatic therapies, dietary management remains fundamental in inherited metabolic diseases of the liver. Appropriate restriction, supplementation, and overall nutrition must be taken into consideration for optimal growth and hepatoprotection.SummaryUnderst...
Source: Current Hepatitis Reports - February 2, 2023 Category: Infectious Diseases Source Type: research
Nutrition in Viral Hepatitis
AbstractPurpose of ReviewViral hepatitis caused by various hepatotropic viruses (Hepatitis A, B, C, and E) is common in developing countries and continues to cause significant morbidity and mortality. The liver is the largest organ of the body with various metabolic functions. Patients with acute and chronic viral hepatitis often have altered metabolism leading to decreased food intake and malnutrition. The presence of protein and calorie malnutrition in these patients may increase morbidity and mortality. Early identification and prompt treatment of malnutrition improve prognosis and overall survival. The aim of this revi...
Source: Current Hepatitis Reports - January 20, 2023 Category: Infectious Diseases Source Type: research
Nutrition in Alcohol-Related Liver Disease
AbstractPurpose of ReviewAlcohol use represents one of the five major causes of morbimortality globally, and alcohol-related liver disease (ALD) is the most common cause of cirrhosis worldwide. Malnutrition is one of the most frequent complications in ALD and is associated with decreased survival. Additionally, protein-energy malnutrition causes sarcopenia, frailty, and immunosuppression. This review summarizes the diverse mechanisms involved in the pathophysiology of malnutrition in ALD and its management.Recent FindingsMechanisms regarding malnutrition in ALD have been recently described. There is also an important area ...
Source: Current Hepatitis Reports - November 16, 2022 Category: Infectious Diseases Source Type: research
Asian Perspective of Nutrition in Liver Disease
Abstract
Purpose of ReviewNutrition is one of the essential foundations of the management of chronic liver disease. In cirrhosis, malnutrition is common and is associated with poor prognosis. There will be differences in cultural, social, and ethnic specific body composition among various nations and these are to be considered during the nutritional advice. This review will discuss the assessment and management of nutrition in ambulatory adult patients with cirrhosis from an Asian perspective.Recent FindingsAll patients with chronic liver disease are to be screened for risk of malnutrition and those at risk of malnutrit...
Source: Current Hepatitis Reports - November 2, 2022 Category: Infectious Diseases Source Type: research
