LI-RADS Imaging Criteria for HCC Diagnosis and Treatment: Emerging Evidence
AbstractPurpose of ReviewThe purpose of this study is to review the recent literature analyzing the performance of Liver Imaging Reporting and Data System (LI-RADS) v2018 diagnostic and treatment response algorithm (TRA) for initial diagnosis and assessment of hepatocellular carcinoma (HCC) following locoregional therapy (LRT).Recent FindingsLI-RADS is a comprehensive tool for assessment and reporting of observations in patients at risk of developing HCC. Since HCC is predominantly an imaging diagnosis, it is important to achieve a high sensitivity and specificity for each LR category. Therefore, a multitude of studies hav...
Source: Current Hepatitis Reports - October 28, 2020 Category: Infectious Diseases Source Type: research
Role of Nucleic Acid Polymers and Entry Inhibitors in Functional Cure Strategies for HBV
AbstractPurpose of ReviewHepatitis B virus (HBV) infection is one of the most common viral infections worldwide with an estimated 2 billion people exposed to HBV and 240 million with active chronic infection. Despite this, less than 1% of patients with chronic HBV infection receive treatment, and less than 3% of those achieve functional cure with traditional therapies. This review summarizes recent advances in the treatment of chronic HBV utilizing nucleic acid polymers (NAP) and entry inhibitors (EI).Recent FindingsA recent phase 2 study evaluating the use of NAP following tenofovir and pegylated interferon (PEG-IFN) demo...
Source: Current Hepatitis Reports - October 26, 2020 Category: Infectious Diseases Source Type: research
Medication Non-adherence among Liver Transplant Recipients
AbstractPurpose of ReviewWe provide an overview of the recent evidence on the prevalence, risk factors, and consequences of medication non-adherence (NA) in liver transplant (LT) recipients.Recent FindingsNA in LT is associated with socio-demographic and medication-related factors, low social support, and poor health literacy. Patient-reported adherence is one of the most common methods to measure NA using validated assessments; immunosuppression (IS) drug levels and electronic monitoring may also be used. Simplification of IS regimens such as the conversion from twice daily to once daily has been shown to be safe, effecti...
Source: Current Hepatitis Reports - October 24, 2020 Category: Infectious Diseases Source Type: research
Correction to: Hepatitis B Core Antibody: Role in Clinical Practice in 2020
The article “Hepatitis B Core Antibody: Role in Clinical Practice in 2020,” written by Robert G. Gish, Syed Abdul Basit, John Ryan, Altaf Dawood, and Ulrike Protzer, was originally published Online First without Open Access. After publication in volume 19, issue 3, pages 254–265, the author decided to opt for Open Choice and to make the article an Open Access publication. Therefore, the copyright of the article has been changed to © The Author(s) 2020, and the article is forthwith distributed under the terms of the Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distri...
Source: Current Hepatitis Reports - October 6, 2020 Category: Infectious Diseases Source Type: research
Chronic Hepatitis B and HIV Coinfection: a Continuing Challenge in the Era of Antiretroviral Therapy
AbstractPurpose of ReviewThe burden of chronic hepatitis B (HBV) remains disproportionately high among people living with HIV (PLWH) despite the advent of HBV vaccination and HBV-active antiretroviral therapy (ART). This review summarizes new insights and evolving issues in HIV-HBV coinfection.Recent FindingsHBV-HIV coinfection is still a leading cause of cirrhosis, hepatocellular carcinoma (HCC), and liver-related mortality more than a decade after the approval of tenofovir. While tenofovir-based ART has been shown to improve rates of HBV virologic suppression and halt fibrosis progression, the long-term benefits on the p...
Source: Current Hepatitis Reports - September 15, 2020 Category: Infectious Diseases Source Type: research
Exercise as Medicine: The Impact of Exercise Training on Nonalcoholic Fatty Liver Disease
AbstractPurpose of ReviewNonalcoholic fatty liver disease (NAFLD) is a leading cause of global liver disease. Because current pharmacologic treatments are ineffective, lifestyle change centered on exercise remains the most effective NAFLD treatment. The aim of this systematic review is to summarize and evaluate the current evidence supporting the use of exercise training as a medical treatment for adult patients with NAFLD.Recent FindingsAt least 150 min each week of moderate intensity exercise of any type can improve NAFLD, both with and without modest weight loss. Exercise training reduces hepatic steatosis and liver i...
Source: Current Hepatitis Reports - September 8, 2020 Category: Infectious Diseases Source Type: research
Alcohol Consumption in Non-Alcoholic Fatty Liver Disease: Safety and Disease Overlap
AbstractPurpose of ReviewAs the non-alcoholic fatty liver disease (NAFLD) epidemic continues to grow, more patients will be seeking advice on the safety of low to moderate alcohol use in the setting of underlying liver disease. Data suggests a beneficial effect in the general population, but whether this can be extended to the NAFLD population remains unclear. The purpose of this review is to summarize pertinent data in order to help guide medical decision-making and patient counseling.Recent FindingsNewer data suggests light to moderate alcohol use in patients with NAFLD can improve all-cause mortality, as well as cardiov...
Source: Current Hepatitis Reports - September 6, 2020 Category: Infectious Diseases Source Type: research
High-Risk Groups for Non-alcoholic Fatty Liver and Non-alcoholic Steatohepatitis Development and Progression
AbstractPurpose of ReviewThis paper reviews the pathophysiology of non-alcoholic fatty liver disease/non-alcoholic steatohepatitis (NAFLD/NASH) development and the clinical and genetic risk factors associated with its progression.Recent FindingsLipotoxicity underlies the development and progression of NAFLD/NASH. Obesity, insulin resistance, metabolic syndrome, ethnicity, and genetics are associated with the severity and progression of NAFLD/NASH.SummaryPersonalized approaches to NAFLD/NASH management should take these “high-risk” categories of NAFLD/NASH progression into account in order to reduce NAFLD/NASH-associate...
Source: Current Hepatitis Reports - August 31, 2020 Category: Infectious Diseases Source Type: research
Role of Immunomodulators in Functional Cure Strategies for HBV
AbstractPurpose of ReviewChronic Hepatitis B Virus (HBV) Infection is a major global health burden. Currently, a curative therapy does not exist; thus, there is an urgent need for new therapeutical options. Viral elimination in the natural course of infection results from a robust and multispecific T and B cell response that, however, is dysfunctional in chronically infected patients. Therefore, immunomodulatory therapies that strengthen the immune responses are an obvious approach trying to control HBV infection. In this review, we summarize the rationale and current options of immunological cure of chronic HBV infection....
Source: Current Hepatitis Reports - August 26, 2020 Category: Infectious Diseases Source Type: research
Current and Emerging Treatments for Non-alcoholic Steatohepatitis
AbstractIntroductionNon-alcoholic fatty liver disease (NAFLD) is highly prevalent globally, and its progressive form, non-alcoholic steatohepatitis (NASH), has become a leading cause of cirrhosis, hepatocellular carcinoma, and liver transplantation. Unfortunately, there remains an urgent unmet need for regulatory approved NASH treatments.Purpose of ReviewThis review focuses on the current NASH treatment recommendations and critically discusses investigational agents in clinical development.Recent FindingsMost NASH clinical trials are currently in early phase. Many later phase drugs have already failed to meet key endpoints...
Source: Current Hepatitis Reports - August 24, 2020 Category: Infectious Diseases Source Type: research
Metabolic Targets in Nonalcoholic Steatohepatitis: Treating the Disease at the Metabolic Root
AbstractPurpose of ReviewNonalcoholic fatty liver disease (NAFLD) and its more aggressive form nonalcoholic steatohepatitis (NASH) are a leading cause of chronic liver disease worldwide. Thus far, there are no FDA-approved therapeutic options for NASH. This review discusses relevant and recent findings in the development of pharmacotherapy that targets the metabolic processes implicated in NASH.Recent FindingsSeveral key drugs have been identified across various drug classes. Among inhibitors of de novo lipogenesis, the SCD-1 inhibitor aramchol and the ACC inhibitor firsocostat are the most advanced. Within nuclear hormone...
Source: Current Hepatitis Reports - August 4, 2020 Category: Infectious Diseases Source Type: research
Management of Acute Hepatitis B Virus Infection
AbstractPurpose of the ReviewThis review will summarize the sequence of events which occur when patients develop acute HBV, how flares in chronic HBV can be identified and prevented, and when treatment of acute HBV with antiviral therapy is appropriate.Recent FindingsSevere forms of acute HBV may be due to coinfection and superinfection with hepatitis D, and this may be more prevalent than previously thought. Patients with chronic HBV, who develop diseases and require medications that alter the immune response, are at risk to develop flares in HBV. If the patient is not known to have chronic HBV, these flares may be mistak...
Source: Current Hepatitis Reports - July 20, 2020 Category: Infectious Diseases Source Type: research
IgG4-Related Sclerosing Cholangitis
AbstractPurpose of ReviewIgG4-related sclerosing cholangitis (ISC) is a frequent occurrence. However, its diagnosis is difficult. This review summarizes the clinical features, pathogenesis, differential diagnosis, and management of ISC.Recent FindingsA precise diagnosis of ISC is important. Diagnosis is based on the Japanese criteria which has recently been provided. The characteristic features of plasma cell infiltration and raised IgG4 levels along with classical histopathological and imaging findings help in diagnosis. Steroid therapy is very effective in ISC. Immunomodulatory drugs have also shown promising results.Sum...
Source: Current Hepatitis Reports - July 19, 2020 Category: Infectious Diseases Source Type: research
Prevention and Management of HBV in Organ Transplantation
AbstractPurpose of ReviewHepatitis B (HBV) infection and reactivation have a significant impact on solid organ transplantation. This review summarizes past significant studies and new findings in the field, and presents the latest recommendations for HBV management in solid organ transplant population.Recent FindingsSignificant advances in antiviral therapy have resulted in improved graft outcomes and have notably reduced the need for prophylaxis with hepatitis B immunoglobin. Emerging treatment avenues such as immunotherapies and small molecules inhibitors are being developed with the intent of eradicating HBV infection.S...
Source: Current Hepatitis Reports - July 17, 2020 Category: Infectious Diseases Source Type: research
Hepatitis B Core Antibody: Role in Clinical Practice in 2020
AbstractPurpose of ReviewIt is crucial for clinicians to understand the need to screen for hepatitis B core antigen (anti-HBc status), proper interpretation of HBV biomarkers, and that “anti-HBc only” indicates HBV exposure, lifelong persistence of cccDNA with incomplete infection control, and potential risk for reactivation.FindingsMany common misconceptions exist, including that tests for anti-HBc have high false-positive rates, that patients with anti-HBc alone or occult hepatitis B may profit from “vaccine boosting” to achieve immune control of HBV, and that anti-HBc(+)/anti-HBs(+) patients have cleared HBV whe...
Source: Current Hepatitis Reports - July 10, 2020 Category: Infectious Diseases Source Type: research
