Artificial Intelligence in the Assessment and Management of Nutrition and Metabolism in Liver Disease
AbstractPurpose of ReviewArtificial Intelligence (AI) has the potential to transform detection and management of nutrition-related complications through advances in wearable technology, mobile applications, and machine learning. The literature, however, lacks studies specific to the interplay between AI and nutrition in patients with liver disease. The aim of this article is to address the current state of AI in nutrition and metabolic liver disease. We seek to understand how AI can be utilized to address gaps in the care of patients with liver disease, particularly as it relates to their nutrition.Recent FindingsAdvances ...
Source: Current Hepatitis Reports - October 28, 2022 Category: Infectious Diseases Source Type: research
Noninvasive Tests for Liver Fibrosis in Chronic Hepatitis B Virus
AbstractPurpose of ReviewHepatitis B virus (HBV) can be a potentially life-threatening liver infection. Prior to starting therapy, the first step is to establish the diagnosis, then to assess disease severity and determine if treatment is indicated. Assessing the degree of liver fibrosis is imperative to guiding treatment options. While liver biopsy has been the primary method to establish the degree of fibrosis, noninvasive tests (NIT) have now replaced liver biopsy as the initial step.Recent FindingsHere, we present a recent review of literature on NIT to assess liver fibrosis in chronic HBV from 2019 to 2022.SummaryBein...
Source: Current Hepatitis Reports - October 24, 2022 Category: Infectious Diseases Source Type: research
Topic: Nutrition and the Gut-Liver-Brain Axis
AbstractThe gut-liver brain-axis describes the bidirectional interaction between the gastrointestinal system, the liver, and the central nervous system with involvement of the gut microbiota. Regulated by the intestinal, blood –brain and gut-vascular barrier, the immune system, and the microbially derived molecules that are derived from diet, the nutrition-gut-liver-brain axis has an essential role in a number of diseases. This review will canvass some of the concepts regarding the nutrition-gut-liver-brain axis and foc us on common diseases with recent evidence. (Source: Current Hepatitis Reports)
Source: Current Hepatitis Reports - October 17, 2022 Category: Infectious Diseases Source Type: research
Novel Combination Strategies With Investigational Agents for Functional Cure of Chronic Hepatitis B Infection
Abstract Purpose of ReviewFunctional cure, defined as sustained seroclearance of hepatitis B surface antigen (HBsAg), is a favorable treatment endpoint in chronic hepatitis B (CHB). As current drugs rarely induce functional cure, investigational agents with different modes of action are being developed. Combination of investigational agents may synergistically induce functional cure, and we reviewed the evidence on novel combination strategies for CHB.Recent FindingsCombination strategies involving novel virus-targeting agents with immunomodulators can target both the virus and the host. In particular, potent HBsAg suppr...
Source: Current Hepatitis Reports - October 6, 2022 Category: Infectious Diseases Source Type: research
Nutrition in Critical Care Hepatology
AbstractPurpose of ReviewPatients with cirrhosis necessitating admission to the intensive care unit are often malnourished and have a high short-term mortality. This review describes the role of nutritional therapy in improving outcomes in critically ill patients with liver disease. We also describe nutritional needs in special situations like hepatic encephalopathy, gastrointestinal bleed, acute liver failure, alcohol-associated hepatitis, and acute-on-chronic liver failure.Recent FindingsMalnutrition and sarcopenia are identified as predictors of high wait-list mortality and poor post-transplant outcomes in cirrhosis. Re...
Source: Current Hepatitis Reports - October 5, 2022 Category: Infectious Diseases Source Type: research
Risk of HCC in Patients with HBV, Role of Antiviral Treatment
AbstractPurpose of ReviewRisk prediction and reduction of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B virus (HBV) infection has been a hot topic over the last decade. This review summarizes the latest evidence of HCC risk prediction and reduction.Recent FindingsRisk prediction models have been moving from traditional regression analysis on clinical parameters as well as HBV and liver fibrosis biomarkers to novel machine-learning models which maximize data use while minimizing bias. Different studies and meta-analyses have been performed to compare the risk of HCC in chronic HBV patients treated by e...
Source: Current Hepatitis Reports - September 5, 2022 Category: Infectious Diseases Source Type: research
Use of Newer Anticoagulants in Patients with Cirrhosis
AbstractPurpose of ReviewThis review addresses common clinical scenarios which may require anticoagulation in liver disease patients, the safety and efficacy of direct acting oral anticoagulation (DOAC) agents in liver disease, DOAC dosing considerations based on hepatic or renal impairment, and when anticoagulation should possibly be held or reversed.Recent FindingsThe use of DOACs is considered safe and effective compared to traditional therapies like vitamin K antagonists (VKAs) and heparin in patients with liver disease although there is likely an increased risk of bleeding in patients with Child –Pugh B and C.Summar...
Source: Current Hepatitis Reports - September 5, 2022 Category: Infectious Diseases Source Type: research
Evidence-Based Management of Oral Nucleos(t)ide Analogue Withdrawal in Virally Suppressed Patients with Chronic HBV Infection
AbstractPurpose of ReviewThe strategy of finite Nuc therapy has been increasingly accepted globally. How to manage Nuc withdrawal in HBV-suppressed patients has become an important issue. This review aimed to provide an evidence-based approach.Recent FindingsHBV suppression may sustain after Nuc cessation at an incidence the higher the lower the end of therapy HBsAg level. Clinical relapse and hepatitis flare may occur after Nuc cessation at a 2-year incidence of 60% and 42%, respectively. Timely retreatment may prevent/rescue deterioration to hepatic decompensation albeit at an incidence of almost 0 in non-cirrhotic patie...
Source: Current Hepatitis Reports - August 30, 2022 Category: Infectious Diseases Source Type: research
Evolving Screening and Vaccination Recommendations for Hepatitis B in the USA
AbstractPurpose of ReviewScreening for hepatitis B viral infection in the USA is currently recommended for high-risk individuals and pregnant persons. Effective vaccines for hepatitis B have been available since the early 1980s, and have been recommended as part of the universal childhood immunization series since the 1990s.Recent FindingsVaccination rates remain low among the general population of persons who were not vaccinated in childhood or adolescence; despite efforts to increase adult vaccination rates, persons at highest risk of exposure —for example, injection drug users—may also be among those with low access...
Source: Current Hepatitis Reports - June 10, 2022 Category: Infectious Diseases Source Type: research
Use of Non-selective Beta blockers in Decompensated Cirrhosis and ACLF
AbstractPurpose of ReviewOur understanding of beta blockers in liver cirrhosis has transformed over the last 40 years. However, questions remain over their safety in acute decompensation and acute on chronic liver failure. Since these conditions are associated with significant morbidity and mortality, a critical appraisal of recent literature is imperative to help guide clinicians.Recent FindingsThe latest BAVENO guidelines now recommend carvedilol in all patients with clinically significant portal hypertension to prevent decompensation. There is significant data which shows safety of beta blocker use in decompensated ci...
Source: Current Hepatitis Reports - June 9, 2022 Category: Infectious Diseases Source Type: research
HCV Treatment in Decompensated Disease
This article will review the treatment of hepatitis C virus (HCV) with direct-acting antiviral agents in special populations. Patients with decompensated cirrhosis are physiologically distinct from those without cirrhosis or with compensated cirrhosis and require additional treatment considerations. Additional discussion will center on other unique populations for HCV treatment, including those with end-stage renal disease, HIV, or hepatitis B virus coinfection, and hepatocellular carcinoma.Recent FindingsPatients with decompensated cirrhosis are ineligible for certain direct-acting antiviral agents due to the risk of furt...
Source: Current Hepatitis Reports - June 2, 2022 Category: Infectious Diseases Source Type: research
Care of the Hepatology Patient in the COVID-19 Era
ConclusionsThe impacts of COVID-19 on the liver range from a potential increased risk of severe infection in chronic liver disease patients, to hepatotoxic effects of proposed treatments, to second and third order impacts on the care of patients with chronic liver disease. (Source: Current Hepatitis Reports)
Source: Current Hepatitis Reports - April 1, 2022 Category: Infectious Diseases Source Type: research
Addressing Chronic HCV in People Who Inject Drugs and Inmates Is Necessary to Achieve HCV Elimination
AbstractPurpose of ReviewDirect-acting antivirals (DAA) have revolutionized the field of hepatitis C in the last decade; however, significant challenges remain in eliminating the disease specifically among difficult-to-reach populations. This paper reviews the barriers to viral elimination with a specific emphasis on people who inject drugs and incarcerated patients.Recent FindingsPeople who inject drugs face challenges at every stage of the “cascade of care”—screening, diagnosis, accessing medications, and completing treatment. Despite this, evidence suggests that treatment of these high-risk groups is essential to ...
Source: Current Hepatitis Reports - February 3, 2022 Category: Infectious Diseases Source Type: research
Burden, Quality of Life, and Palliative Care for Family Caregivers of Individuals with Advanced Liver Disease: a Systematic Literature Review
AbstractPurpose of ReviewIdentify and describe prior studies of family caregiver quality of life, health, and burden experienced while caring for patients with advanced liver disease and the possible role of palliative care.Recent FindingsThirty-six articles were identified that met inclusion criteria. Studies identified included cross-sectional, longitudinal, and prospective intervention studies, with a high proportion of qualitative and descriptive research. Resulting studies addressed type of family caregiver burden, including physical, psychological, and financial causes of burden, including HE, lack of information and...
Source: Current Hepatitis Reports - November 12, 2021 Category: Infectious Diseases Source Type: research
Screening for Non-alcoholic Fatty Liver Disease in Current Practice
AbstractPurpose of ReviewNAFLD is highly prevalent in the global population and is underdiagnosed in current practice. The lack of standardized screening protocols, increasing risk factors for NAFLD, and limited treatment options contribute to the late identification of disease often in advanced forms. The purpose of this review is to discuss the trajectory of current screening strategies.Recent FindingsPredictive scoring tools and imaging can aid in leading to a diagnosis of NAFLD. These complementary modalities can be used to avoid liver biopsy. These may have a greater role in the future for NAFLD screening.SummaryThe r...
Source: Current Hepatitis Reports - November 6, 2021 Category: Infectious Diseases Source Type: research
