Diagnostic Testing for SARS-CoV-2 Infection
AbstractPurpose of ReviewGiven the rapid development of diagnostic approaches to test for and diagnose infection with SARS-CoV-2, many options are available to assess infection. Multiple established diagnostic companies are now providing testing platforms whereas initially, testing was being performed with simple PCR-based tests using standard laboratory reagents.Recent Findings.Additional testing platforms continue to be developed but challenges with testing, including obtaining testing reagents and other related supplies, are frequently encountered. With time, the testing supply chain will improve and more companies will...
Source: Current Hepatitis Reports - October 28, 2021 Category: Infectious Diseases Source Type: research
HCV and Liver Transplantation
AbstractPurpose of the ReviewThis review presents the epidemiology, diagnosis, and treatment of HCV in those with cirrhosis, with a particular focus on unique challenges surrounding liver transplantation in the post-DAA era.Recent FindingsRates of hepatitis C virus (HCV) infection have been rising over the past several years, largely attributable to the opioid epidemic in the USA. Fortunately, despite this increase, the advent of direct-acting antiviral therapy (DAA) for the treatment of HCV has led to dramatic improvements in the quality of life and lifespan in persons living with the disease.SummaryIn the post-DAA era, t...
Source: Current Hepatitis Reports - October 23, 2021 Category: Infectious Diseases Source Type: research
Addressing Hepatitis B in the Context of Hepatitis C
AbstractPurpose of ReviewThere are worldwide efforts focused on targeting the screening and treatment of viral hepatitis B and C. This review highlights liver and treatment-related impacts of hepatitis B and C dual infection.Recent FindingsIt is important to identify the subset of individuals who may have been coinfected with both hepatitis B and C who are at increased risk for liver fibrosis, hepatocellular carcinoma as well as clinically significant hepatitis B reactivation when hepatitis C is treated. Those with hepatitis B surface antigen positivity are at greatest risk for hepatitis B reactivation. Treatment with newe...
Source: Current Hepatitis Reports - October 20, 2021 Category: Infectious Diseases Source Type: research
Management of Hepatitis B in Persons Who Inject Drugs (PWID)
AbstractPurpose of ReviewHepatitis B remains an infectious disease causing a significant number of morbidity and mortality worldwide. Notably, the management of hepatitis B in persons who inject drugs (PWID) is a crucial part for hepatitis B virus (HBV) elimination. This narrative review summarizes the updated strategies of screening, prevention, and treatment for this special clinical setting.Recent FindingsA PWID are associated with impaired immune responses and substantial vulnerability to parenteral HBV transmission with multiple co-infections, poor adherence, and social stigma. Multi-disciplinary support with integrat...
Source: Current Hepatitis Reports - October 19, 2021 Category: Infectious Diseases Source Type: research
Recurrent NASH Post-liver Transplant: Implications and Treatment
AbstractPurpose of ReviewWith obesity prevalence increasing, nonalcoholic steatohepatitis (NASH) is the fastest growing indication for liver transplantation (LT). It is a common phenomenon to observe recurrence of NASH in post-LT patients. This review discusses about the prevalence of NASH and summarizes the diagnosis and management of recurrent and de novo NASH in post-LT patients.Recent Findings.Due to the increased incidence of recurrent and de novo NASH in post-LT patients, it is important to prevent and control metabolic risk factors such as diabetes mellitus, hypertension, and obesity.SummaryTailored immunosuppressio...
Source: Current Hepatitis Reports - October 19, 2021 Category: Infectious Diseases Source Type: research
Viral Hepatitis B —Management in Children
AbstractPurpose of ReviewChronic hepatitis B (CHB) infection is a worldwide health problem with significant morbidity. Children with CHB require a lifetime of monitoring for infection activation, hepatic disease and its complications, and hepatocellular carcinoma (HCC). Children with CHB which is in the immune active stage are candidates for antiviral treatment. As new medications have been approved for children, the treatment recommendations have changed. This review summarizes the recent data.Recent FindingsWith the demonstration of safety and efficacy of entecavir and tenofovir in children, previously used medications l...
Source: Current Hepatitis Reports - October 19, 2021 Category: Infectious Diseases Source Type: research
Emerging Biomarkers for HBV Cure: HBsAg and Beyond
AbstractPurpose of ReviewOur purpose was to examine current and emerging biomarkers that are being utilized or under study with current therapies and examine the preliminary data with emerging therapies that will likely be combined moving forward to achieve higher rates of functional cure.Recent FindingsQuantitative HBsAg is the most important biomarker to assess response to current and novel therapies that inhibit viral replication and restore the immune response to those with HBV infection with loss of HBsAg reflecting functional cure. Hepatitis B core-related antigen and serum HBV RNA reflect transcription from cccDNA a...
Source: Current Hepatitis Reports - October 18, 2021 Category: Infectious Diseases Source Type: research
Care After Cure: Long-term Follow-up in Hepatitis C
AbstractPurpose of ReviewTo summarize recommendations and common practices for long-term surveillance after hepatitis C cure.Recent FindingsPatients with advanced fibrosis and cirrhosis have continued risk of the complications of portal hypertension and hepatocellular carcinoma after hepatitis C cure. While improvement in fibrosis has been noted, the clinical implications are not fully understood. Guidelines recommend no alteration in surveillance strategies based upon fibrosis measurements after hepatitis C cure.SummaryLiver wellness approaches and strategies to avoid reinfection are recommended for all patients after hep...
Source: Current Hepatitis Reports - October 16, 2021 Category: Infectious Diseases Source Type: research
Reframing: Sociopolitical Conditions and Geographical Risk Factors for Hepatitis B Screening and Elimination
(Source: Current Hepatitis Reports)
Source: Current Hepatitis Reports - October 16, 2021 Category: Infectious Diseases Source Type: research
Real-World Safety and Effectiveness of Oral Nucleos(t)ide Analogs in the Treatment of Chronic Hepatitis B Virus Infection
AbstractPurpose of ReviewChronic hepatitis B (CHB) remains a major global contributor to liver related morbidity and mortality. Currently available first line therapies offer all oral, highly effective, and safe treatment options for suppression of hepatitis B virus (HBV) and reduce long-term CHB-related complications. This review summarizes some of the more recent real-world data on the safety and effectiveness of oral nucleos(t)ide analogs in the treatment of CHB.Recent FindingsCurrent first line CHB oral treatment options include entecavir (ETV), tenofovir disoproxil fumarate (TDF), and tenofovir alafenamide (TAF). Rece...
Source: Current Hepatitis Reports - October 12, 2021 Category: Infectious Diseases Source Type: research
Sexual Dimorphisms in Nonalcoholic Fatty Liver Disease
AbstractPurpose of Review
This review focuses on how sex differences play a role in the development and progression of NAFLD, describe inconsistencies in current findings, and propose goals for future studies.Recent FindingsNAFLD prevalence and severity is higher in men than in premenopausal women. After menopause, prevalence of NAFLD increases, suggesting a protective effect of estrogen. Androgen excess may also increase the risk of steatosis in women. Furthermore, there is a strong interplay between hormonal changes and development of visceral adiposity and metabolic syndrome, both closely related to NAFLD progression...
Source: Current Hepatitis Reports - October 12, 2021 Category: Infectious Diseases Source Type: research
Sarcopenia in Non-alcoholic Steatohepatitis (NASH)
AbstractPurpose of Review Sarcopenia is the progressive loss of skeletal muscle mass and functionality that is typically associated with older age. Recent literature has noted a high prevalence of sarcopenia in patients with non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). This review seeks to compile the current understanding of the pathophysiology, diagnosis, outcomes, and management of sarcopenia in the setting of NAFLD and NASH.Recent FindingsPatients with advanced fibrosis from NASH and NASH-related cirrhosis have been found to have significantly higher risks of developing sarcopenia...
Source: Current Hepatitis Reports - October 12, 2021 Category: Infectious Diseases Source Type: research
Advance Care Planning and Goals of Care Discussions in Advanced Liver Disease
AbstractPurpose of ReviewAdvance care planning (ACP) has been shown to improve multiple outcomes in patients with serious illnesses; however, patients with advanced liver disease, or cirrhosis, rarely receive timely ACP. The purpose of this review is to evaluate the current state of ACP for patients with advanced liver disease and to provide practical guidance for integrating early ACP into routine outpatient hepatology care.Recent FindingsDue to multiple patient-, physician-, and systems-level barriers, patients with advanced liver disease have low rates of timely ACP engagement. Early identification and preparation of a ...
Source: Current Hepatitis Reports - July 21, 2021 Category: Infectious Diseases Source Type: research
Determining Energy Requirements in Cirrhosis: an Update on the Role of Indirect Calorimetry
AbstractPurpose of ReviewMalnutrition in cirrhosis is associated with significant morbidity and mortality, and an accurate energy prescription is central to effective nutrition therapy. Indirect calorimetry is recommended to determine energy requirements, with novel handheld devices offering a simpler and lower cost assessment. This review summarises the published literature from 2010 to 2020 regarding the measurement of energy expenditure in patients with liver cirrhosis.Recent FindingsTwelve studies involving 1039 patients were identified. Results indicate discordance between predicted and measured requirements in cirrho...
Source: Current Hepatitis Reports - July 19, 2021 Category: Infectious Diseases Source Type: research
Dietary Interventions in Liver Diseases: Focus on MAFLD and Cirrhosis
AbstractPurpose of ReviewDietary interventions (DI) aimed at improving overweight and metabolic abnormalities in metabolic dysfunction-associated fatty liver disease (MAFLD) and at reducing malnutrition and sarcopenia in cirrhosis should become part of routine care in hepatology. This review focuses on recent advances in this field.Recent FindingsIn patients with MAFLD, a gradual reduction, respectively, of 7 –10% of body weight if overweight or of 3–5% if lean, obtained by moderately reducing caloric intake, is effective to improve liver disease. Intermittent energy restriction might be an alternative to continuous en...
Source: Current Hepatitis Reports - April 19, 2021 Category: Infectious Diseases Source Type: research
