Nutritional Supplementation for Patients with Decompensated Cirrhosis
AbstractPurpose of ReviewMalnutrition is common in patients with decompensated cirrhosis and portal hypertension and is associated with impaired health-related quality of life and reduced survival. This review aims to explore the outcomes of specific nutritional interventions in the management of malnourished patients with decompensated cirrhosis.Recent FindingsNutritional assessment and intervention is an important adjunct in the management of decompensated cirrhosis. Nutrition support in patients with decompensated cirrhosis can preserve muscle mass and alleviate the manifestations of decompensation including ascites, he...
Source: Current Hepatitis Reports - April 15, 2021 Category: Infectious Diseases Source Type: research
Creating Effective Models for Delivering Palliative Care in Advanced Liver Disease
AbstractPurpose of ReviewThe current healthcare system is not fully equipped to provide comprehensive support for patients with advanced liver disease (ALD) and their caregivers resulting in concomitant suffering and reduced quality of life (QoL). Integration of palliative care (PC) within routine care has demonstrated benefits in improving symptoms and QoL and reducing healthcare utilization for other serious illnesses but has been underutilized or delayed for ALD care. The purpose of this article is to outline the domains and benefits of PC and discuss the misconceptions and barriers for PC integration, and healthcare de...
Source: Current Hepatitis Reports - April 10, 2021 Category: Infectious Diseases Source Type: research
Recent Advances in Systemic Therapies for Advanced Hepatocellular Carcinoma
AbstractPurpose of ReviewThis paper aims to summarize the data of recently completed and key ongoing clinical trials of systemic agents for advanced hepatocellular carcinoma (aHCC). In particular, the review focuses on ongoing checkpoint inhibitor combination trials and promising studies combining tyrosine kinase inhibitors with checkpoint inhibitors.Recent FindingsThe recently approved combination of atezolizumab and bevacizumab based on the IMbrave150 trial has shown the most potential with the highest overall survival of any systemic agent in HCC to date, surpassing sorafenib. Despite COVID-19 delays, other promising tr...
Source: Current Hepatitis Reports - February 1, 2021 Category: Infectious Diseases Source Type: research
Stereotactic Body Radiation Therapy (SBRT) in Hepatocellular Carcinoma
AbstractPurpose of ReviewHepatocellular carcinoma (HCC) is a rising cause of mortality and morbidity, and although surgical resection is the preferred curative local therapy,< 30% of patients are candidates at diagnosis. This review discusses SBRT as an option in a variety of clinical scenarios.Recent FindingsMultiple retrospective and prospective studies demonstrate that stereotactic body radiation therapy (SBRT) is an effective bridge for transplant candidates and local therapy for patients with inoperable early-, intermediate-, or advanced-stage disease. SBRT is associated with excellent local control, and it is w...
Source: Current Hepatitis Reports - January 14, 2021 Category: Infectious Diseases Source Type: research
Hepatitis B Virus Elimination in the U.S.: Time to Dismantle Barriers and Implement Solutions
AbstractPurpose of ReviewThe World Health Organization has set a target for the elimination of hepatitis B virus (HBV) infection as a public health threat by 2030, but the U.S. is not currently on track. In this review, we describe specific barriers to HBV elimination, provide examples of potential solutions, and offer recommendations for how the U.S. can reach HBV elimination goals.Recent FindingsIn the U.S., there are many barriers to eliminating hepatitis B, worsened by the siloing of healthcare and public health services. In recent years, we have not seen progress toward improving HBV screening or adult vaccination, an...
Source: Current Hepatitis Reports - January 7, 2021 Category: Infectious Diseases Source Type: research
Herbal Medicines for the Treatment of Nonalcoholic Steatohepatitis
AbstractPurpose of ReviewNonalcoholic fatty liver disease encompasses both, nonalcoholic fatty liver and nonalcoholic steatohepatitis (NASH). The prevalence of NASH is rising globally and has become one of the leading causes of chronic liver disease and indications for liver transplantation. Its complex and multifaceted pathophysiology makes the management of NASH challenging. In the absence of effective pharmacotherapies, there has been an increasing interest for the use of herbal medicines/supplements in the treatment of NASH. Here we review some of the more popular herbal medicines/supplements used to treat NASH.Recent ...
Source: Current Hepatitis Reports - January 6, 2021 Category: Infectious Diseases Source Type: research
Diagnosis and Management of Occult Hepatitis B Infection
AbstractPurpose of ReviewOccult hepatitis B infection refers to the presence of replication-competent hepatitis B virus despite the lack of hepatitis B surface antigen due to epigenetic or immune control. Risk factors for occult hepatitis B infection include sex work, blood transfusion, hemodialysis, and liver transplantation. Historically, the recognition of occult hepatitis B infection has been important in preventing reactivation of hepatitis B infection and mortality in those receiving treatment for HIV and hepatitis C virus along with those receiving immunosuppressive therapy.Recent FindingsRecognition of occult hepat...
Source: Current Hepatitis Reports - November 23, 2020 Category: Infectious Diseases Source Type: research
Racial and Sex Disparities in Hepatocellular Carcinoma in the USA
AbstractPurpose of ReviewIn this review, we aim to provide a summary of the current literature on race and gender disparities in hepatocellular carcinoma (HCC) incidence, stage at diagnosis, treatment, and prognosis in the USA.Recent FindingsHCC incidence rates are rising in the USA in all racial/ethnic groups except for Asian/Pacific Islanders, with disproportionate rises and the highest rates among Hispanics compared to Blacks and non-Hispanic Whites. There are striking sex disparities in HCC incidence and mortality; however, with the shifting epidemiology of HCC risk factors in the USA, there is recent evidence that HCC...
Source: Current Hepatitis Reports - November 12, 2020 Category: Infectious Diseases Source Type: research
Genomic Landscape of HCC
AbstractIntroductionHepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality in the world, and it has limited treatment options. Understanding the molecular drivers of HCC is important to develop novel biomarkers and therapeutics.Purpose of ReviewHCC arises in a complex background of chronic hepatitis, fibrosis, and liver regeneration which lead to genomic changes. Here, we summarize studies that have expanded our understanding of the molecular landscape of HCC.Recent FindingsRecent technological advances in next-generation sequencing (NGS) have elucidated specific genetic and molecular programs involv...
Source: Current Hepatitis Reports - November 10, 2020 Category: Infectious Diseases Source Type: research
Spontaneous Bacterial Peritonitis and Secondary Bacterial Peritonitis —a Comprehensive Review
AbstractPurpose of ReviewSpontaneous bacterial peritonitis (SBP) and secondary bacterial peritonitis are life-threatening complications of cirrhosis if not recognized immediately and managed appropriately. SBP occurs in ~ 3.5 to 10% of patients with cirrhosis and ascites, whereas secondary bacterial peritonitis occurs in 5%. Prompt recognition of SBP variants is vital for tailoring therapy to decrease mortality rate from 90 to 20%. Our objective is to provide an update on the recent publications to elucidate the v ariants of SBP and provide a management algorithm for the potentially life-threatening complications of cir...
Source: Current Hepatitis Reports - November 6, 2020 Category: Infectious Diseases Source Type: research
Current Transplant Criteria for Hepatocellular Carcinoma —Overuse or Underuse
AbstractIn the USA, hepatocellular carcinoma (HCC) has the most rapidly increasing cancer incidence since 1980, has a rate of death that has increased by 43% between 2000 and 2016 and is currently the second most lethal tumor with a 5-year survival of 18%. While the expected 5-year survival after liver transplant (LT) in patients with HCC is attractive at over 70%, LT is limited by extreme shortage of organs and post-LT immunosuppression. Numerous changes to the liver allocation system for HCC in the USA have been applied since 2002. However, for the most part, USA HCC patients continue to receive similar priority for LT d...
Source: Current Hepatitis Reports - November 4, 2020 Category: Infectious Diseases Source Type: research
National and Global Ethnicity Differences in Non-alcoholic Fatty Liver Disease
AbstractPurpose of ReviewNon-alcoholic fatty liver disease (NAFLD) remains a leading cause of chronic liver disease and a growing public health concern. This review aims to examine the reported national and international ethnicity differences in NAFLD.Recent FindingsPrior studies have shown that Latino populations were disproportionately affected by both NAFLD and non-alcoholic steatohepatitis (NASH) in the USA compared to non-Latino White populations. Black and Asian Americans are reported to have a lower prevalence of NAFLD. Contributing factors for ethnic disparities may include socioeconomic factors, body fat distribut...
Source: Current Hepatitis Reports - November 3, 2020 Category: Infectious Diseases Source Type: research
The Role of Gut Microbiome-Targeted Therapy in Nonalcoholic Fatty Liver Disease
AbstractPurpose of ReviewTo review the role and progress of microbiome-targeting therapies in nonalcoholic fatty liver disease (NAFLD). This review summarizes recent clinical trials of probiotics, prebiotics, synbiotics, and fecal microbiota transplantation (FMT) and analyzes the potential clinical impact of reverse dysbiosis in NAFLD.Recent FindingsThough results might be mixed, the recent randomized clinical trials and systemic reviews indicate probiotics, prebiotics, and synbiotics are promising therapies that improve transaminitis and hepatic steatosis. The scarcity of FMT clinical trials limits the power to conclude t...
Source: Current Hepatitis Reports - November 2, 2020 Category: Infectious Diseases Source Type: research
A Contemporary Approach to Diagnosis and Treatment of Combined Hepatocellular-Cholangiocarcinoma
AbstractPurpose of ReviewTo provide updates on terminology, epidemiology, diagnosis, and treatment of combined hepatocellular-cholangiocarcinoma (cHCC-CCA).Recent FindingscHCC-CCAs are tumors that in the same nodule contain a variable degree of HCC and CCA components with a transition zone. cHCC-CCAs develop in cirrhotic and non-cirrhotic livers like and is associated with poor outcomes. Mutations inTP53,TERT promoter, andARID1A are the most common genetic aberrations in cHCC-CCA. Fusion genePTMS-AP1G1 is unique for cHCC-CCA. A biopsy is required for diagnosis. Surgical resection remains treatment of choice, while liver tr...
Source: Current Hepatitis Reports - October 31, 2020 Category: Infectious Diseases Source Type: research
The Role of RNA Interference in Functional Cure Strategies for Chronic Hepatitis B
AbstractPurpose of ReviewCurrent treatments for chronic hepatitis B (CHB) are associated with low rates of cure. Functional cure has been accepted as a viable treatment end point in CHB. There have been substantial advances in the field of RNA interference (RNAi) therapeutics across a wide range of specialties, and the clinical pipeline now encompasses CHB. This review will highlight some of the challenges in therapeutic development, the data for RNAi in CHB, and future directions for the field.Recent FindingsEarly phase clinical trials have reported good safety data for RNAi therapies in CHB and demonstrated significant r...
Source: Current Hepatitis Reports - October 28, 2020 Category: Infectious Diseases Source Type: research
