MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Current Hepatitis Reports' source. Wed, 08 Feb 2012 18:15:38 +0100 http://www.medworm.com/index.php?rid=5598893&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fy83636l3p135g645%2F Abstract  Iron overload of varying degrees is common among patients with chronic hepatitis C. The clinical significance of this iron overload is uncertain. Studies that have evaluated the effect of hepatic iron stores on the response to anti-viral treatment or on the natural history of chronic hepatitis C have found variable results depending on the technique used to measure hepatic iron stores and the degree of iron overload present among the study population. We have tried to comprehensively analyze the literature regarding the clinical interaction between iron overload and the natural history of chronic hepatitis C. The one clear relationship that emerges is that pre treatment serum ferritin inversely correlates with the odds of achieving sustained virological(SVR) respo... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=5598893 Thu, 12 Jan 2012 16:47:24 +0100 5598893 http://www.medworm.com/index.php?rid=5598894&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ff830u5583m37lk22%2F Abstract  Boceprevir (BOC or B) and telaprevir (TVR or T), two newly approved NS3/4A protease inhibitors, have revolutionized hepatitis C therapy for genotype 1 since their availability in 2011. The new regimens are highly effective in treatment naive and treatment experienced patients. They are administered three times daily, and have an extensive list of drug-drug interactions that require vigilance with drug co-administration. The phase 3 clinical trials that led to the drugs’ approval are reviewed in detail with regard to the clinical trial design, efficacy and safety data. Both drugs utilize response guided therapy (RGT) based upon rapid virological response (RVR) and extended rapid virological response, (eRVR) and depend upon defined stopping rules to minimize the r... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=5598894 Thu, 12 Jan 2012 16:47:23 +0100 5598894 http://www.medworm.com/index.php?rid=5583590&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F7r3543g235470200%2F Abstract  The approval of the first direct-acting antiviral (DAA) drugs for treatment of HCV in 2011 has lead to improved sustained viral response (SVR) rates up to 79% in treatment-naïve or relapse genotype 1 (G1) patients, and up to 59% for non-responder G1 patients. This review discusses the clinical skills required for the use of direct-acting anti-viral drugs (DAA), the use of genetic tests and HCV RNA assays, resistance-associated variants (RAV), treatment of special populations, and future directions. The results of the pivotal phase 3 trials with both telaprevir and boceprevir are summarized, including the efficacy, safety and tolerability, drug-drug interactions and management of the most common side-effects. Treatment strategies implemented in order to minimize t... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=5583590 Wed, 11 Jan 2012 06:57:50 +0100 5583590 http://www.medworm.com/index.php?rid=5583591&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc283g7813l003718%2F Abstract  HCV infection will spontaneously resolve in 30% to 50% of patients. Patients with beneficial IL28B genotypes are more likely to clear spontaneously, while other are unlikely to, with less than 15% clearance rate. These patients would therefore be very likely to benefit from immediate treatment with pegylated interferon. In delayed treatment, ribavirin might be required to achieve similar results, making the delayed treatment also from the cost perspective only attractive in those likely to clear spontaneously: Patients with beneficial IL28B genotype and jaundiced patients with the intermediate IL28B genotype. Content Type Journal ArticleCategory Hepatitis C: Complex Clinical Issues (S Harrison and N Reau, Section Editors)Pages 1-5DOI 10.1007/s11901-011-0121-3Au... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=5583591 Sat, 07 Jan 2012 16:51:48 +0100 5583591 http://www.medworm.com/index.php?rid=5572853&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fhxh3n54041961837%2F Abstract  The discovery of genetic variants near the gene for IL28B has provided new insight into the biology of hepatitis C infection and response to treatment with pegylated interferon alpha and ribavirin. Patients that carry the favorable CC genotype for SNP rs12979860 or TT genotype for SNP rs8099917 are more likely to spontaneously clear the virus after acute infection and to respond to therapy with pegylated interferon alpha and ribavirin. IL28B genotype may also have a relationship with the natural history of chronic hepatitis and has implications for organ allocation in liver transplantation. Now that the protease inhibitors telaprevir and boceprevir have improved the response rates to hepatitis c treatment, the applicability of IL28B genotyping in clinical practice ... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=5572853 Thu, 05 Jan 2012 06:52:48 +0100 5572853 http://www.medworm.com/index.php?rid=5572854&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F55654762315081h5%2F Abstract  Hepatitis C virus (HCV), a major cause of chronic liver disease, affects an estimated 5 million people in the Unites States [1] and close to 170 million people worldwide. Certain subpopulations including injection drug users, prison inmates, the homeless, ethnic minorities, American veterans, and HIV co-infected patients are considered high risk for viral acquisition and are disproportionately affected by HCV. This review describes the prevalence of HCV in these at-risk populations including those with cirrhosis, chronic kidney disease (CKD), solid organ transplantation and presents current treatment options. Content Type Journal ArticleCategory Hepatitis C: Complex Clinical Issues (S Harrison and N Reau, Section Editors)Pages 1-9DOI 10.1007/s11901-011-0119-xAu... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=5572854 Wed, 04 Jan 2012 06:58:50 +0100 5572854 http://www.medworm.com/index.php?rid=5538852&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F2k518770617q6156%2F Abstract  Hepatitis C infects 1.6% of the United States adult population, and the peak prevalence of infection is present in the Baby Boomer generation. HCV infection predisposed patients to both hepatic and non-hepatic malignancies, leading to an increasing number of HCV infected patients needing chemotherapy. Since the liver is the most important site of drug metabolism, it is critical to understand how HCV impacts chemotherapy. Clinical decisions regarding chemotherapy dosing are traditionally based on serum biochemical tests; however these do not measure liver function, and liver biopsy combined with the Child classification are better measures of true liver function. Fortunately, patients without cirrhosis have intact synthetic function. However, patients with cirrhosi... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=5538852 Tue, 20 Dec 2011 16:48:24 +0100 5538852 http://www.medworm.com/index.php?rid=5389047&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fb05257p7414617h3%2F This article discusses and reviews the natural history, epidemiology, and management of HBV patients coinfected with HIV, HCV, or HDV. It includes an updated summary of the outcomes with liver transplantation and post transplant recurrence in the coinfected population with HBV. It also discusses the role of occult HBV in HIV and HCV coinfection respectively. Content Type Journal ArticleCategory Hepatitis B: Epidemiology, Natural History, Treatment, and Transplantation (Thomas Berg and Steven-Huy Han, Section Editors)Pages 262-268DOI 10.1007/s11901-011-0115-1Authors Kalyan Ram Bhamidimarri, Division of Liver Diseases, Department of Medicine, The Mount Sinai Medical Center, One Gustave Levy Place, New York, NY 10029, USAJames Park, Division of Liver Diseases, Department of Medicine,... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=5389047 Thu, 03 Nov 2011 05:55:20 +0100 5389047 http://www.medworm.com/index.php?rid=5324750&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq268126068365t21%2F Abstract  Antiviral drug-resistance is a major issue during nucleoside/nucleotide analogue long-term therapy that leads to treatment failure and progression to liver disease. The spread of drug-resistant hepatitis B virus (HBV) mutants can be reduced by avoiding unnecessary treatment, choosing potent antiviral drugs with a high barrier to resistance as a first-line therapy, and virological monitoring. In case of virologic breakthrough or partial response to therapy, treatment adherence should be checked and HBV resistance mutations should be identified in order to adapt therapy, as early as possible, with a more potent drug that does not share cross-resistance. However, HBV infection cannot be completely eradicated due to the persistence of cccDNA in infected hepatocytes. N... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=5324750 Fri, 14 Oct 2011 15:44:41 +0100 5324750 http://www.medworm.com/index.php?rid=5286847&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq1jn86p1529jv875%2F Abstract  Hepatitis B virus (HBV) infection remains an important cause of liver disease in the population with chronic kidney disease, including patients on long-term dialysis and renal transplant (RT) recipients. Diminished survival due to hepatitis B has been observed after RT. A thorough evaluation, including liver biopsy as well as assessment of serum markers of HBV replication (ie, hepatitis B e antigen and/or HBV DNA) is required before transplantation. Tolerance to interferon is poor both in dialysis patients and after renal transplant. Oral antiviral therapy now permits safe and potent antiviral treatment of HBV-related liver disease in chronic kidney disease patients with prevention of progressive liver disease. Preliminary evidence shows an improved survival of HB... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=5286847 Thu, 29 Sep 2011 06:17:32 +0100 5286847 http://www.medworm.com/index.php?rid=5210288&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa24508613nt1jl81%2F Abstract  Epigenetics is the study of changes in phenotype or gene expression that take place outside of the DNA sequence. Examples of epigenetic phenomena include the methylation of DNA, acetylation of histones involved in DNA packaging, and the production of microRNAs. Collectively, these processes can alter gene transcription and translation, post-translational modifications, and insertional mutagenesis in order to modify health and disease. In recent years, tremendous in vivo and in vitro evidence has accumulated that replication of hepatitis B virus (HBV), the production of RNA intermediates, as well as antigen expression can be regulated by epigenetic mechanisms. Furthermore, an understanding of the epigenetic regulation of HBV has already been applied toward new appr... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=5210288 Fri, 09 Sep 2011 16:46:33 +0100 5210288 http://www.medworm.com/index.php?rid=5210289&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fjxx31623568u22r5%2F Abstract  A major goal of antiviral therapy in patients with chronic hepatitis B (CHB) is to achieve durable suppression of viral replication. By maintaining undetectable serum HBV DNA levels, one hopes to improve the clinical outcome of these CHB patients. Recent studies have demonstrated that prolonged viral suppression using first-line antiviral medications such as entecavir or tenofovir is associated with a significant reduction in necroinflammation, fibrosis, and even reversal of cirrhosis. Thus, durable suppression of viral replication might decrease the rates of developing cirrhosis, hepatocellular carcinoma, and most importantly, the mortality from complications associated with HBV-related liver diseases. The first-line medications, entecavir, tenofovir and pegylate... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=5210289 Wed, 07 Sep 2011 15:48:13 +0100 5210289 http://www.medworm.com/index.php?rid=5163705&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fn16v2n2774441707%2F Abstract  There are a number of antiviral treatments for chronic hepatitis B currently available, and these include both interferon and a variety of nucleoside and nucleotide analogues. Interferon has been shown in numerous trials to be superior to the nucleoside analogues in inducing virologic, biochemical, histologic, and serologic responses. However, this response is not universal among patients and the side effects of interferon can be dose limiting. It is thus important to consider interferon in select populations, who are most likely to respond. In this review, we aim to identify the patient population in which interferon therapy will yield the most benefit while minimizing its use in those who may be better served using the nucleoside or nucleotide analogues. Co... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=5163705 Fri, 19 Aug 2011 05:51:48 +0100 5163705 http://www.medworm.com/index.php?rid=5163706&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fm31tgrp3k000m513%2F Abstract  Four phases of chronic hepatitis B virus [1] infection have been identified: immune tolerant, immune active, inactive, and hepatitis B surface antigen (HBsAg) clearance. These phases are defined by using a combination of hepatitis B “e” antigen (HBeAg) status, alanine aminotransferase (ALT) level, and HBV DNA level. To determine the extent of liver inflammation and fibrosis needed to decide whether antiviral therapy is necessary often requires a liver biopsy. Recent studies have found that levels of HBsAg can also be used to determine the phase of HBV and can even predict persons who may remain in the inactive phase over time. Non invasive markers including transient elastography can detect a proportion of those with a high probability of severe fibrosis and mi... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=5163706 Fri, 19 Aug 2011 05:51:46 +0100 5163706 http://www.medworm.com/index.php?rid=5120646&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fn0k4m876185105q1%2F Abstract  The treatment of chronic hepatitis B is in constant evolution. Interferon, the first agent licensed for chronic hepatitis B treatment, has been superseded by the growing popularity of nucleoside/nucleotide analogues (NA). However, resistance to these agents is a major challenge. Newer NAs, such as entecavir and tenofovir dipivoxil fumarate, have very low resistance rates and favorable safety profiles. Long-term use of these agents can effectively suppress hepatitis B virus DNA, leading to decrease in incidence of hepatitic flares, as well as in the development of cirrhosis and hepatocellular carcinoma. The efficacy and safety of various antiviral agents is discussed in this review. Content Type Journal ArticlePages 1-9DOI 10.1007/s11901-011-0109-zAuthors Yuk... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=5120646 Mon, 08 Aug 2011 19:51:41 +0100 5120646 http://www.medworm.com/index.php?rid=5120647&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ff271412165204q2m%2F Abstract  Patients who undergo liver transplantation (LT) for chronic hepatitis B virus (HBV) infection are at high risk of developing recurrent HBV in the absence of effective prophylaxis. Pre-LT management should focus on suppression of HBV DNA levels, which have been associated with HBV recurrence. Evidence linking hepatocellular carcinoma (HCC) recurrence to HBV recurrence has been less clear. Prophylaxis against recurrent HBV after LT with combination HBIG and antiviral therapy is the current standard of care and is effective in >90% of patients, but investigation is ongoing to determine the most cost-effective treatment regimens. While antiviral therapy with newer nucleos(t)ide analogues without HBIG is assumed to be effective, no recent studies have examined the l... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=5120647 Mon, 08 Aug 2011 05:42:02 +0100 5120647 http://www.medworm.com/index.php?rid=5064425&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F1729724v32u65482%2F Abstract  The past standard-of-care (SOC) for treatment of the chronic hepatitis C virus (HCV) was the combination of peginterferon with ribavirin (P + R). Sustained virologic response (SVR) for patients with HCV, genotype 1, was less than 50%. The new emerging SOC, Triple Therapy, using direct-acting antivirals (DAAs) with P + R will improve SVR for HCV genotype 1 infection to approximately 75%. Telaprevir and boceprevir are inhibitors of HCV NS3/4A serine protease and will be the first DAAs for treatment of patients with chronic hepatitis C. The treatment provider must effectively manage dosage and adherence to the regimen to avoid emergence of resistant variants of HCV. Close monitoring of patients, awareness of drug interactions, management of known telaprevir a... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=5064425 Tue, 19 Jul 2011 23:43:53 +0100 5064425 http://www.medworm.com/index.php?rid=5000121&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fw6425wt633441546%2F Abstract  In the last decade, hepatitis C virus (HCV) kinetics has become an important clinical tool for the optimization of therapy with pegylated-interferon-α (PEG-IFN) and ribavirin (RBV). Mathematical models have generated important insights into HCV pathogenesis, HCV-host dynamics, as well as IFN and RBV modes of action. Clinical trials with direct-acting antiviral agents (DAAs) against various steps of the HCV-life cycle have revealed new viral-kinetic patterns that have not been observed with (PEG)-IFN+RBV. Very recently, studies have shown that single nucleotide polymorphisms (SNPs) in the interleukin-28B (IL28B) gene region were associated with race/ethnicity, and with response to PEG-IFN+RBV. Here, we review our current knowledge of HCV kinetics and related mathe... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=5000121 Fri, 01 Jul 2011 05:45:07 +0100 5000121 http://www.medworm.com/index.php?rid=4987066&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fb230219071p21126%2F The objective of this report is to review advances in our understanding of HCV and host innate immune defenses, and to highlight their clinical translation. Content Type Journal ArticlePages 1-10DOI 10.1007/s11901-011-0106-2Authors Anil Seetharam, Department of Internal Medicine/Division of Gastroenterology, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8124, St. Louis, MO 63110, USAJeffrey S. Crippin, Department of Internal Medicine/Division of Gastroenterology, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8124, St. Louis, MO 63110, USA Journal Current Hepatitis ReportsOnline ISSN 1541-0706Print ISSN 1540-3416 (Source: Current Hepatitis Reports) Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4987066 Wed, 29 Jun 2011 06:00:11 +0100 4987066 http://www.medworm.com/index.php?rid=4987068&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fv585l64qx8m1t818%2F Abstract  Hepatitis C virus (HCV) is one of the leading causes of chronic liver disease in the world. It is particularly common in patients with end-stage renal disease (ESRD), both due to risk for chronic kidney disease related to HCV infection and risk for HCV infection acquisition in the hemodialysis population. In the United States, nosocomial risk of HCV has diminished, but this continues to be a major challenge in the developing world. Current available HCV therapies are more complex and less efficacious in the setting of ESRD. In the setting of donor organ shortage, transplant specialists must weigh the risks and benefits of using donor kidneys from patients positive for HCV antibody. The goal of this review is to update the reader on significant findings in HCV and ... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4987068 Tue, 28 Jun 2011 15:46:53 +0100 4987068 http://www.medworm.com/index.php?rid=4971226&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ft1687846rg652717%2F Abstract  Hepatitis-C induced liver failure is the leading indication for liver transplantation in the United States, and the burden of hepatitis C virus (HCV)-induced liver disease is not expected to peak for at least another decade. 2011 will usher in a new era of directly acting antiviral therapies and personalized medicine that will assist patients and clinicians in choosing the best drug regimen. Specific markers to predict sustained virologic response (SVR) in the posttransplant setting are under development, and the role of graft genetic markers like interleukin-28B and interferon-γ inducible protein-10 have yet to be fully defined. Lessons and experiences from treating the pretransplant population will be applied to patients with recurrent posttransplant HCV while ... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4971226 Fri, 24 Jun 2011 16:00:33 +0100 4971226 http://www.medworm.com/index.php?rid=4971227&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fy564n2702481p652%2F Abstract  Ribavirin is a synthetic guanosine analogue, which acts against hepatitis C virus (HCV) through several mechanisms that include 1) immune modulation; 2) inhibition of inosine monophosphate dehydrogenase 3) inhibition of RNA-dependent RNA polymerase; 4) induction of HCV mutagenesis; and 5) modulation of interferon-stimulated gene expression. Addition of ribavirin to peginterferon-α substantially improves sustained virologic response (SVR) and decreases relapse rates. Ribavirin can be associated with hemolytic anemia. However, recent data suggest that SVR is not negatively impacted by treatment-induce anemia. Notably, optimal dosing strategy and the proper management of anemia are crucial to achieve the best treatment outcome. Several advances have been made in the... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4971227 Tue, 21 Jun 2011 20:37:19 +0100 4971227 http://www.medworm.com/index.php?rid=4962168&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx4813v00l0r35773%2F Abstract  Hepatitis C treatment-response rates range from 50%–80% depending on genotype, viral load, fibrosis stage, interleukin 28B (IL28B) polymorphism, and metabolic abnormalities. Lipid metabolism could influence sustained-virological response (SVR), and raised levels of low-density lipoprotein cholesterol were found in sustained responders. The capacity of 3-hydroxy-3-methylglutaryl coenzyme A(HMG-CoA) reductase inhibitors to impede hepatitis C virus (HCV) replicon replication in vitro in a dose-dependent fashion raised hope that this class of medications could serve as an adjunct to standard interferon-based therapy. In cell culture models of HCV infection, antiviral activity of statins was greater for fluvastatin. The mechanisms by which statins interfere with HCV ... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4962168 Mon, 20 Jun 2011 14:21:57 +0100 4962168 http://www.medworm.com/index.php?rid=4947093&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp20r738092326364%2F Abstract  Within the last 2 years, a number of Genome-Wide Association Studies (GWAS) have shown that single nucleotide polymorphisms (SNPs) in the interleukin 28B (IL28B) gene region, encoding interferon-λ3, are predictive of hepatitis C clearance in patients receiving interferon-α and ribavirin-based treatment regimens. In addition, the same SNPs are strongly linked with spontaneous clearance of hepatitis C virus in treatment-naïve patients. The causal variant responsible for these findings has not been identified. Nevertheless, the discovery of a correlation between the IL28B genotype status and treatment outcome has impacted all aspects of clinical decision making in patients with hepatitis C, and has opened up the very real possibility of individualized treatment re... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4947093 Wed, 15 Jun 2011 05:47:34 +0100 4947093 http://www.medworm.com/index.php?rid=4687379&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F2h2p0x8247213871%2F Abstract  Hepatocellular carcinoma (HCC) is a malignant tumor arising primarily in cirrhotic livers as a consequence of chronic hepatitis B or C virus infection or alcohol-induced cirrhosis. Unlike the majority of other common cancer types, the incidence of HCC in the United States is still rising, with peak incidence expected for 2020. Although hepatitis B is a less common etiology for the development of HCC in the West, it is the most common risk factor among certain ethnic groups in the United States. Given the high case fatality of HCC, surveillance efforts have been recommended. Specifically, HCC surveillance has demonstrated a survival benefit in patients with chronic hepatitis B. In this review, we discuss the demographics of patients with HCC in the United States, t... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4687379 Sat, 02 Apr 2011 05:53:44 +0100 4687379 http://www.medworm.com/index.php?rid=4578698&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fj2xu149805j3515x%2F Abstract  Hepatitis B viral genotypes influence natural history, with genotype C more likely to develop hepatocellular carcinoma than genotype B, thus influencing the need for intervention. In hepatitis B early antigen (HBeAg)-positive disease, the data with conventional interferon and pegylated interferon (peginterferon) provide compelling evidence that genotype A responds best. The argument for differentiating between genotypes B and C is less clear, but the response in genotype B appears better than in C. Loss of hepatitis B surface antigen (HBsAg) is also most common in genotype A. Patients with genotype A and B should be offered peginterferon as first-line therapy, because it offers potential for HBeAg seroconversion with a finite course of therapy. In HBeAg-negative d... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4578698 Thu, 10 Mar 2011 17:11:54 +0100 4578698 http://www.medworm.com/index.php?rid=4541785&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F0wx6v02776120g57%2F In conclusion, FibroTest and LSM were the most validated biomarkers of fibrosis in CHB. However, the reliability of Fibroscan must be better assessed. Content Type Journal ArticlePages 1-11DOI 10.1007/s11901-011-0096-0Authors Thierry Poynard, Assistance Publique Hôpitaux de Paris-University Pierre et Marie Curie, Liver Center, Groupe Hospitalier Pitié Salpêtrière, 75013 Paris, FranceYen Ngo, Biopredictive, 40 Rue du Bac, 75007 Paris, FranceMona Munteanu, Biopredictive, 40 Rue du Bac, 75007 Paris, FranceDominique Thabut, Assistance Publique Hôpitaux de Paris-University Pierre et Marie Curie, Liver Center, Groupe Hospitalier Pitié Salpêtrière, 75013 Paris, FranceVlad Ratziu, Assistance Publique Hôpitaux de Paris-University Pierre et Marie Curie, Liver Center, Groupe Hospital... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4541785 Mon, 28 Feb 2011 06:43:52 +0100 4541785 http://www.medworm.com/index.php?rid=4503281&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F53x158m84741k153%2F Abstract  Chronic hepatitis B virus infection is an important cause of liver-related morbidity and mortality, with hepatocellular carcinoma being the most life-threatening complication. Because of the highly variable clinical course of the disease, enormous research efforts have been made with the aim of revealing the factors in the natural history that are relevant to hepatocarcinogenesis. These include epidemiological studies of predisposing risk groups, viral studies of mutations within the hepatitis B viral genome, and clinical correlation of these risk factors in predicting the likelihood of development of hepatocellular cancer in susceptible hosts. This update addresses these risks, with emphasis on the latest research relevant to hepatocarcinogenesis. Content Typ... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4503281 Fri, 18 Feb 2011 17:15:16 +0100 4503281 http://www.medworm.com/index.php?rid=4503282&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F405l2n55605qq073%2F Abstract  Hepatitis B infection remains a major public health problem globally and in the United States, with significant use of healthcare resources. Several therapeutic agents active against viral and host targets are currently available for its treatment. The success of combination therapy in HIV infection, which has similarities to hepatitis B in both therapeutic targets and treatment options, stimulated studies on the efficacy and safety of various combinations of available drugs in the treatment of hepatitis B infection. In this review, we analyze the current role of combination therapy in chronic hepatitis B infection. Content Type Journal ArticlePages 1-8DOI 10.1007/s11901-011-0095-1Authors Navin Paul, Department of Medicine/Division of Digestive Diseases, Davi... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4503282 Fri, 18 Feb 2011 17:14:38 +0100 4503282 http://www.medworm.com/index.php?rid=4503283&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr700v25275405112%2F Abstract  A primary challenge in the management of pediatric chronic hepatitis B (CHB) is the lack of established child-specific guidelines. Treatment decisions for children with CHB are extrapolated from the robust adult-focused treatment and management guidelines. However, the rationale for treating children differs from adults, and appropriate patient selection for treatment is imperative to avoid mutant virus development and an indefinite treatment course. Few approved therapies exist for children less than 10 years of age, a group who may benefit greatly from novel and effective therapeutics. It is hoped this gap will be met in the near future, as the field of CHB is rapidly evolving and new therapeutics come to market. This review focuses on the currently availab... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4503283 Thu, 17 Feb 2011 17:03:14 +0100 4503283 http://www.medworm.com/index.php?rid=4461272&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx1057q88465m5694%2F Interferon (IFN) not only may have antiviral properties against hepatitis C, but also may reduce the risk of hepatocellular carcinoma (HCC) through anticarcinogenic properties or indirectly by antifibrotic effects. Because patients with chronic hepatitis C and cirrhosis are at risk for HCC, IFN was used to prevent or treat HCC in patients with hepatitis C. Studies demonstrate that the risk of HCC in hepatitis C patients who are sustained viral responders is substantially reduced but not eliminated. The Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis trial demonstrated that maintenance therapy with IFN does not reduce the risk of HCC in patients with bridging fibrosis or cirrhosis. Other studies suggest the risk of HCC is reduced with IFN maintenance therapy in older patie... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4461272 Tue, 08 Feb 2011 13:17:31 +0100 4461272 http://www.medworm.com/index.php?rid=4461273&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fe6788t68q1833p71%2F The hepatitis C virus (HCV) is a major public health concern and a leading cause of chronic liver disease and liver transplantation. If the virus is not eradicated before liver transplantation, HCV infection can recur in almost all patients. Recurrent HCV after liver transplantation has a variable clinical course. Rarely, a severe cholestatic form of recurrent HCV can occur, better known as fibrosing cholestatic hepatitis (FCH). This type of cholestasis can lead to fibrosis and graft dysfunction in an accelerated fashion and is associated with a high morbidity and mortality. It was described in other organ transplant recipients and patients with HIV/ HCV coinfection, suggesting that an immunocompromised state is necessary to develop FCH. Content Type Journal ArticlePages 1-5DOI 1... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4461273 Tue, 08 Feb 2011 13:17:30 +0100 4461273 http://www.medworm.com/index.php?rid=4461274&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fw43wx30357g11464%2F This article summarizes existing evidence on the prevalence and risk factors for hepatic steatosis in CHB, proposed pathogenetic links between HBV and hepatic steatosis, impact on the risk for liver fibrosis and HCC, and implications for antiviral therapy. Content Type Journal ArticlePages 1-8DOI 10.1007/s11901-011-0090-6Authors Joseph K. Lim, Section of Digestive Diseases and Yale Liver Center, Yale University School of Medicine, New Haven, CT USAMindie H. Nguyen, Division of Gastroenterology and Hepatology, Stanford University Medical Center, 750 Welch Road, Suite 210, Palo Alto, CA 94304-1509, USA Journal Current Hepatitis ReportsOnline ISSN 1541-0706Print ISSN 1540-3416 (Source: Current Hepatitis Reports) Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4461274 Mon, 07 Feb 2011 22:04:33 +0100 4461274 http://www.medworm.com/index.php?rid=4461275&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fk4p238u0064204j6%2F Abstract  Prior to the availability of effective post-transplant immunoprophylaxis, outcomes following liver transplant for hepatitis B-related liver disease were very poor as a result of high rates of graft reinfection and accelerated graft failure. With the advent of hepatitis B immune globulin and nucleos(t)ide analogue therapies, reinfection rates and transplant outcomes have dramatically improved. Although current immunoprophylaxis treatments are highly effective in preventing reinfection, they are very costly and cumbersome to administer. The goal of evolving strategies is to minimize the dose and duration of hepatitis B immune globulin treatment without a loss in efficacy. As the number of effective, direct acting antiviral therapies has increased over the past sever... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4461275 Mon, 07 Feb 2011 06:40:24 +0100 4461275 http://www.medworm.com/index.php?rid=4433888&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F11104373qn3u021p%2F Abstract  Hepatitis B virus (HBV) is the leading cause of chronic liver disease worldwide. Antiviral therapy for HBV is a safe and effective strategy for preventing the development of complications of chronic infection, including cirrhosis and hepatocellular carcinoma; however, treatment is expensive and may be required long-term. Thus, prevention of HBV infection with universal vaccination at birth, and after birth in specific unvaccinated risk groups, is a preferred strategy that confers durable life-long protection against HBV and will eliminate a future reservoir of infected individuals. In addition to the traditional at-risk groups for hepatitis B, patients with diabetes mellitus were recently identified as being at increased risk for HBV infection, and they should als... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4433888 Tue, 01 Feb 2011 08:39:51 +0100 4433888 http://www.medworm.com/index.php?rid=4442983&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fg4m1618611700144%2F Abstract  Long-term administration of oral anti-hepatitis B virus (HBV) nucleoside or nucleotide analogues therapy (NUC) is the first-line treatment option for most patients with chronic hepatitis B infection. Although NUC rapidly inhibits HBV replication in most patients, in the long term, this therapeutic regimen is challenged by the emergence of drug-resistant mutant virions, ultimately leading to treatment failure and liver disease progression. Indeed, viral resistance occurs most frequently in patients exposed to first-generation NUC (e.g., lamivudine), whereas second-generation regimens (e.g., adefovir and telbivudine) are definitively safer but still at risk of developing resistance. Third-generation NUCs (e.g., entecavir and tenofovir) are considered safe and unlike... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4442983 Tue, 01 Feb 2011 08:39:50 +0100 4442983 http://www.medworm.com/index.php?rid=4383808&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F7m0q55220102rx58%2F Non–liver-related malignancies are increasingly seen in patients infected with hepatitis C virus (HCV). Whether this phenomenon is related to the increasing prevalence of chronic hepatitis C (CHC) or to a direct causal role by HCV is unknown. Until recently, most of the evidence supporting the association between these cancers and HCV was based on small and heterogeneous epidemiologic studies. Recent studies addressing this issue are larger; however, they remain largely observational and have significant limitations. The precise mechanism by which HCV causes these malignancies is under investigation, but several studies demonstrated that antiviral therapy can reduce the risk of some malignancies and can increase tumor-free survival following successful tumor-directed therapy. Thus,... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4383808 Tue, 18 Jan 2011 19:38:31 +0100 4383808 http://www.medworm.com/index.php?rid=4383810&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F62474857u7116477%2F Given the limitations of pegylated interferon (IFN) and ribavirin (RBV) therapy for chronic hepatitis C virus (HCV) infection, new antiviral medication and treatment approaches are sought. Specifically targeted antiviral therapies for hepatitis C (STAT-C) refers to the use of these new inhibitors, either in combination with IFN and RBV or other STAT-C agents, to improve therapy for HCV. Although many classes of inhibitors are being developed, NS3 protease and NS5B polymerase inhibitors are likely to be among the first STAT-C agents approved. The preclinical and clinical characteristics of HCV protease and polymerase inhibitors are reviewed in this article. Strengths and weaknesses of each class in the context of developing future all–STAT-C regimens are explored, with a particular ... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4383810 Tue, 18 Jan 2011 19:38:28 +0100 4383810 http://www.medworm.com/index.php?rid=4383809&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fe275055818t1043q%2F Evidence is increasing that the hepatitis C virus (HCV) is neurovirulent. Neuroimaging studies suggest that individuals with HCV infection show alterations in the structure and function of several neural systems, most notably the frontostriatal circuits. Several studies also demonstrated evidence of cognitive impairment across a variety of ability areas in about 30% to 40% of HCV-infected individuals. Although certain comorbidities (eg, substance abuse, HIV coinfection, neuropsychiatric symptoms) may increase the risk of neurocognitive deficits in HCV-positive individuals, it appears that neurocognitive impairment is present in HCV-positive individuals without significant comorbidities. We provide an overview of the neurocognitive effects of HCV infection and present empirical eviden... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4383809 Tue, 18 Jan 2011 19:38:28 +0100 4383809 http://www.medworm.com/index.php?rid=4383811&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fm415g03680r68751%2F Non–organ-specific autoantibodies, including antinuclear antibodies, anti–smooth muscle antibodies, and anti–liver/kidney microsomal type 1 antibodies, are present in about one third of patients with chronic hepatitis C. Two theories of autoantibody generation in patients with hepatitis C are proposed. The first proposes that the binding of hepatitis C virus to CD81 on B-lymphocytes lowers the activation threshold of these cells, thus facilitating the production of autoantibodies. The second proposes that the autoantibodies are produced through molecular mimicry. Unfortunately, the pathogenic role of these autoantibodies remains controversial. In addition, whether the autoantibodies can adversely affect treatment outcomes when patients receive interferon-α is unclear. Although... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4383811 Tue, 18 Jan 2011 19:38:27 +0100 4383811 http://www.medworm.com/index.php?rid=4346148&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fb187w2u8uu0k306k%2F Content Type Journal ArticlePages 1-3DOI 10.1007/s11901-010-0082-yAuthors Arjmand Mufti, Department of Gastroenterology, University of Chicago Medical Center, 5841 South Maryland Avenue, Chicago, 60605 USA Journal Current Hepatitis ReportsOnline ISSN 1541-0706Print ISSN 1540-3416 (Source: Current Hepatitis Reports) Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4346148 Tue, 11 Jan 2011 07:34:25 +0100 4346148 http://www.medworm.com/index.php?rid=4346149&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr71g805rmhkw400l%2F Abstract  Hepatitis C-positive liver transplantation (LT) patients present significant problems in post-transplant management. These patients are known to have more rapid fibrosis progression, and outcomes are worsening in the population, compared to other indications for LT. Decisions regarding selection of immunosuppressants and treatment of rejection are different in these patients, because both may alter the course of progression. HCV recurs universally, and treatment of recurrence is fraught with difficulties in tolerability and low response rates. One option for treating these patients is retransplantation, but this option, too, is controversial. This review discusses each of these issues in detail. Content Type Journal ArticlePages 1-11DOI 10.1007/s11901-010-0079... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4346149 Mon, 10 Jan 2011 15:54:45 +0100 4346149 http://www.medworm.com/index.php?rid=4319496&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fdg0781138t627h23%2F Abstract  Chronic hepatitis C (CHC) is estimated to affect about 20% of the 34 million individuals currently living with HIV worldwide, with greater rates (~ 75%) in intravenous drug users or persons exposed to blood products. Individuals who are coinfected with HIV and hepatitis C virus (HCV) show an accelerated course of liver disease, with faster progression to cirrhosis and its clinical complications. The combination of pegylated interferon plus ribavirin given for 6–18 months leads to sustained HCV clearance in no more than half of HIV-HCV coinfected patients. Thus, new direct anti-HCV drugs are eagerly awaited for this population. Appropriate diagnosis and monitoring of CHC, including the use of noninvasive tools for assessing liver fibrosis (eg, elastometry) a... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4319496 Tue, 04 Jan 2011 17:55:22 +0100 4319496 http://www.medworm.com/index.php?rid=4302433&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fj663665662g411g7%2F Abstract  Hepatitis C virus (HCV) infection is the leading reason for liver transplant in North America. Combination therapy with pegylated interferon and ribavirin (RBV) is the standard of care for treatment of HCV infection. Unfortunately, this combination can lead to anemia, occasionally severe enough to precipitate discontinuation of therapy. Given that sustained viral response (SVR) is dependent upon duration of exposure to maximal dosages, especially of RBV, both discontinuation and dose reduction in RBV can affect SVR. Recombinant human erythropoietin (EPO) is used for hematologic support in a number of other conditions resulting in anemia. EPO has been increasingly used in HCV treatment to maintain RBV doses and support the HCV treatment regimen. Significant evidenc... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4302433 Thu, 30 Dec 2010 06:52:31 +0100 4302433 http://www.medworm.com/index.php?rid=4289268&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F15rv17132x3w51m8%2F This article identifies the most frequently described complications associated with pegylated interferon and ribavirin. The active management of these complications is discussed, including both preventive and empiric treatments. Content Type Journal ArticleDOI 10.1007/s11901-010-0078-7Authors Hubert Sung, Department of Surgery, University of California at Los Angeles, Los Angeles, CA USAMichael Chang, Department of Medicine, University of California at Los Angeles, Los Angeles, CA USASammy Saab, Department of Surgery, University of California at Los Angeles, Los Angeles, CA USA Journal Current Hepatitis ReportsOnline ISSN 1541-0706Print ISSN 1540-3416 (Source: Current Hepatitis Reports) Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4289268 Thu, 23 Dec 2010 06:56:25 +0100 4289268 http://www.medworm.com/index.php?rid=4273202&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fe784m6444112422h%2F Abstract  The treatment of chronic HCV has traditionally been for a fixed duration based on genotype. We now recognize that patients respond to treatment along different time lines. This appears to be secondary to various clinical, histologic, and genetic host factors. The time that it requires for a patient to become HCV RNA undetectable after initiating treatment is now recognized as one of the most important determinants of sustained virologic response. This information can be used to adjust the duration of peginterferon and ribavirin, either shorter or longer, and allows therapy to be tailored to the specific needs of each patient. This concept is referred to as response-guided therapy. Content Type Journal ArticleDOI 10.1007/s11901-010-0077-8Authors Mitchell L. S... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4273202 Thu, 16 Dec 2010 18:27:24 +0100 4273202 http://www.medworm.com/index.php?rid=4268165&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F93852848t41074jn%2F Abstract  Interferon (IFN) not only may have antiviral properties against hepatitis C, but also may reduce the risk of hepatocellular carcinoma (HCC) through anticarcinogenic properties or indirectly by antifibrotic effects. Because patients with chronic hepatitis C and cirrhosis are at risk for HCC, IFN was used to prevent or treat HCC in patients with hepatitis C. Studies demonstrate that the risk of HCC in hepatitis C patients who are sustained viral responders is substantially reduced but not eliminated. The Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis trial demonstrated that maintenance therapy with IFN does not reduce the risk of HCC in patients with bridging fibrosis or cirrhosis. Other studies suggest the risk of HCC is reduced with IFN maintenance th... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4268165 Wed, 15 Dec 2010 16:05:41 +0100 4268165 http://www.medworm.com/index.php?rid=4268164&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Frm117t7m57748p37%2F Abstract  Hepatitis C virus (HCV) is a leading cause of liver-related death worldwide. The evolution of hepatitis C therapy has made serologic eradication of HCV RNA a reality for many patients. Although it is debated whether undetectable virus in the serum represents a cure with complete clearance of viral RNA from the host, improved clinical outcomes have been shown after successful treatment in patients who achieve a sustained virologic response (SVR). Specifically, patients with SVR have longer survival, reduced progression and, in some cases, regression of fibrosis, decreased likelihood of developing hepatocellular carcinoma, and improvement of many extrahepatic manifestations of HCV. This review discusses viral kinetics on therapy leading to eradication, identificatio... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4268164 Wed, 15 Dec 2010 16:05:41 +0100 4268164 http://www.medworm.com/index.php?rid=4243059&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F6347450373rn2827%2F Abstract  Hepatitis C virus (HCV) is the most common blood-borne infection in the United States and is a leading cause of chronic liver disease worldwide. Extrahepatic manifestations of HCV infection occur frequently and are important to recognize as well as understand if they improve with antiviral therapy. This review summarizes the extrahepatic manifestations of HCV with particular emphasis on their degree of association and available treatment options. Content Type Journal ArticleDOI 10.1007/s11901-010-0062-2Authors Angelo H. Paredes, Gastroenterology Service, Department of Medicine, Walter Reed Army Medical Center, 6900 Georgia Avenue NW, Washington, DC 20307, USADawn M. Torres, Gastroenterology Service, Department of Medicine, Walter Reed Army Medical Center, 6900... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4243059 Mon, 06 Dec 2010 18:50:14 +0100 4243059 http://www.medworm.com/index.php?rid=4243061&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fv64451254905m610%2F Abstract  Hepatitis C virus infection remains a leading cause of liver disease worldwide and is currently the principal reason for liver transplantation in the United States. Although the prevalence of hepatitis C has decreased, it remains the most common blood-borne infection, and simulation studies project rising disease burden that peaks in the next decade from hepatic complications in those with long-standing disease. Over the past few years, incidence rates have remained constant, emphasizing the need to understand more completely the natural history and epidemiology of acute disease to improve preventive and screening practices. Recent advances in knowledge about interactions between the virus and host genetics offer a glimpse into future genomic-based medical treatme... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4243061 Mon, 06 Dec 2010 18:50:13 +0100 4243061 http://www.medworm.com/index.php?rid=4243060&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F5m8w4121321365jp%2F Abstract  Recently, single-nucleotide polymorphisms near the IL28B gene have been identified as important in predicting treatment response and spontaneous clearance of the hepatitis C virus (HCV). In the less than 12 months since the initial genetic discoveries, our knowledge base has rapidly expanded regarding the significance of the IL28B polymorphism in a variety of clinical settings. For genotype 1 HCV infection, it is clear that IL28B genotype has an important role in the prediction of treatment-induced and spontaneous clearance. This association remains important in the HIV/HCV-coinfected population. Host genotype adds further discriminatory information in HCV genotype 2/3 infection. IL28B genotype may remain significant with direct-acting antiviral therapy, althou... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4243060 Mon, 06 Dec 2010 18:50:13 +0100 4243060 http://www.medworm.com/index.php?rid=4229484&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fd9580008376128k3%2F Abstract  The hepatitis C virus (HCV) is a major public health concern and a leading cause of chronic liver disease and liver transplantation. If the virus is not eradicated before liver transplantation, HCV infection recurs in almost all patients. Recurrent HCV after liver transplantation has a variable clinical course. Rarely, a severe cholestatic form of recurrent HCV can occur, better known as fibrosing cholestatic hepatitis (FCH). This type of cholestasis can lead to fibrosis and graft dysfunction in an accelerated fashion and is associated with a high morbidity and mortality. It has been described in other organ transplant recipients and patients with HIV/HCV coinfection, suggesting that an immunocompromised state is necessary to develop FCH. Content Type Journal ... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=4229484 Thu, 02 Dec 2010 18:17:26 +0100 4229484 http://www.medworm.com/index.php?rid=3995865&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F3l27702x001267w5%2F Abstract  The use of hepatitis C–infected (HCV+) liver donors for HCV+ transplant recipients was previously controversial, but mounting evidence now supports this practice. HCV-related cirrhosis accounts for 45% of the liver transplants in the United States; however, these transplant recipients have worse transplant outcomes when compared to non–HCV infected (HCV-) recipients. The optimal utility of the donor graft is therefore decreased with transplantation of HCV+ recipients because the largest percentage of organs are transplanted into patients with inferior survival outcomes. Increased use of HCV+ livers, which can only be transplanted into HCV+ recipients, provides additional transplant liver allografts directly targeted to the recipient population at greatest need. ... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3995865 Wed, 22 Sep 2010 05:53:43 +0100 3995865 http://www.medworm.com/index.php?rid=3948475&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F98m4n1h81m1r4267%2F Abstract  All decisions about initiating, continuing, or stopping therapy of the hepatitis B virus (HBV) during pregnancy must include an analysis of the risks and benefits for mother and fetus. The trimester of the pregnancy and the stage of the mother’s liver disease are important factors. Treatment in the third trimester may be initiated to aid in preventing perinatal transmission, which appears to be most pronounced in mothers with high viral loads. Consideration of initiating treatment in the third trimester should occur after a high viral load is documented in the latter part of the second trimester, to allow adequate time for initiation of antiviral therapy with significant viral suppression before delivery. This discussion should include the topic of breastfeeding... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3948475 Wed, 08 Sep 2010 16:05:32 +0100 3948475 http://www.medworm.com/index.php?rid=3948476&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fg75r361uu6451040%2F Abstract  Following the discovery of the hepatitis D virus (HDV) in the late 1970s and the development of assays to diagnose its infection, epidemiologic studies indicated that hepatitis D was endemic worldwide, with its prevalence varying in different countries. In most patients, chronic hepatitis D ran a severe and progressive course; the clinical profile of the disease was characterized by the presence of hepatitis B surface antigen (HBsAg) in blood, elevated alanine transaminase (ALT), an aggressive hepatitis on histology, and markers of HDV replication with absent markers of HBV replication in serum. With reduction of adult-acquired HBV infection in the past 20 years, the prevalence of HDV has also declined significantly in Europe and the industrialized world, bec... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3948476 Tue, 07 Sep 2010 17:26:16 +0100 3948476 http://www.medworm.com/index.php?rid=3930789&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh626p50885658127%2F Abstract  Hepatitis B and hepatitis C are important causes of chronic liver disease globally. Although HBV/HCV coinfection is not uncommon, its epidemiology is poorly defined. Numerous studies provided evidence that coinfection accelerates liver disease progression and increases the risk of hepatocellular carcinoma. By applying new cell culture models to examine the interaction of both viruses, investigators concluded that HBV and HCV replicate in the same hepatocyte without interference. The roles of innate and adaptive immunity in determining the viral replication and disease outcomes still need rigorous investigation. To date, no standard-of-care recommendation exists for HBV/HCV coinfection. Pegylated interferon and ribavirin combination therapy demonstrated similar eff... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3930789 Thu, 02 Sep 2010 15:14:58 +0100 3930789 http://www.medworm.com/index.php?rid=3912442&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq13113p191423k37%2F Abstract  Cirrhosis secondary to infection with hepatitis C virus (HCV) is one of the leading causes of end-stage liver disease worldwide. The World Health Organization estimates that about 3% of the world population is chronically infected with HCV, with about 4 million infected individuals in the United States. Despite the declining US incidence of HCV, the complications of chronic HCV infection are rising rapidly. The cirrhosis can be classified as compensated or decompensated based on clinical complications. Compensated HCV-related cirrhosis can be treated safely per American Association for the Study of Liver Diseases guidelines. Treatment of decompensated HCV-related cirrhosis is challenging secondary to increased risk of complications and adverse effects during the c... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3912442 Fri, 27 Aug 2010 17:18:59 +0100 3912442 http://www.medworm.com/index.php?rid=3912443&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F543652472k7n7464%2F Abstract  Despite the introduction of new nucleos(t)ide analogues in recent years, peginterferon is still recommended as a potential first-line treatment option by current practice guidelines for the management of chronic hepatitis B. Peginterferon offers the advantage of higher sustained off-treatment response rates compared to nucleos(t)ide analogues because of its immunomodulatory effects. Sustained transition to the inactive hepatitis B surface antigen (HBsAg) carrier state can be achieved in about 30% of hepatitis B e antigen (HBeAg)–positive patients and 20% of HBeAg-negative patients. Recent studies have focused on identification of pretreatment and on-treatment factors that allow the selection of patients who are likely to achieve a sustained response to peginterf... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3912443 Thu, 26 Aug 2010 07:47:57 +0100 3912443 http://www.medworm.com/index.php?rid=3912444&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fl8r57836183v434m%2F Abstract  Chronic infection by hepatitis B virus (HBV) can result in cirrhosis, hepatic failure, and hepatocellular carcinoma (HCC) if left untreated. The extent of liver injury and the risk of HCC closely correlate with active viral replication, as indicated by high levels of circulating HBV DNA. Five oral antiviral agents, each targeting the viral DNA polymerase, are currently available in the United States to inhibit viral replication. Their effective use requires proper monitoring of drug resistance development. The current clinical guidelines recommend measuring “total” circulating HBV DNA to evaluate the efficacy of treatment and to serve as an indirect measure of drug-resistant mutant viruses. This may result in delayed identification of drug-resistant mutants th... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3912444 Thu, 26 Aug 2010 07:47:56 +0100 3912444 http://www.medworm.com/index.php?rid=3889870&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fk2l11061rquu6654%2F Abstract  Chronic hepatitis B is a dynamic disease with a very variable outcome ranging from mild, asymptomatic, nonprogressive disease to end-stage liver disease and/or hepatocellular carcinoma. Clinically significant endpoints take years or decades to develop and thus various biomarkers—ranging from clinical data to sophisticated virologic diagnostics—are used as surrogates for disease progression. Liver biopsy remains a robust indicator of disease severity; however, noninvasive markers may offer a useful alternative with some advantages. Clinical decisions are often made using alanine transaminase; however, it lacks adequate specificity to be used in isolation. Serologic markers (hepatitis B early antigen and hepatitis B surface antigen) provide information about the... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3889870 Fri, 20 Aug 2010 17:06:30 +0100 3889870 http://www.medworm.com/index.php?rid=3889871&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ft188473331u6t77j%2F Abstract  As a persistent virus, hepatitis B virus (HBV) is believed to be noncytopathic in most circumstances, with its disease pathogenesis mediated by host innate and adaptive immune responses. Although HBV may initially avoid activating critical innate intracellular defenses (eg, type I interferons), T cells exert both cytopathic and noncytopathic antiviral effects toward resolution of HBV infection. With chronic HBV infection, various immune regulatory or tolerance mechanisms are induced with varying degrees of effector T-cell dysfunction and liver inflammation, which contributes to liver disease progression. This review highlights some components of host immune response relevant for HBV infection, including the more recent appreciation of immune regulatory mechanisms ... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3889871 Fri, 20 Aug 2010 17:06:29 +0100 3889871 http://www.medworm.com/index.php?rid=3878600&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F9833272075162662%2F Abstract  Despite the adoption of universal vaccination in many countries, chronic hepatitis B virus (HBV) infection continues to be a global problem. Morbidity and mortality from this infection, although possibly declining, remains significant. Fortunately, our treatment armamentarium has expanded exponentially in the past decade. Newer antiviral agents are not only effective against HBV infection, but they also confer a lower risk for virologic resistance than the first-generation oral nucleoside, lamivudine. In this article, the long-term efficacy and safety of available antiviral therapy in the treatment of chronic hepatitis B are reviewed, and differences in drug potencies, side-effect profiles, and risks of development of virologic resistance are discussed to provide ... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3878600 Mon, 16 Aug 2010 18:08:08 +0100 3878600 http://www.medworm.com/index.php?rid=3708379&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F01726t1162v6733w%2F Abstract  Hepatitis C virus (HCV) is a major cause of chronic hepatitis worldwide. Iron may play a comorbid role in HCV disease and other liver diseases. Although adjunctive treatment of HCV disease with iron reduction is popular in east Asia, especially Japan, it is less popular in the United States. However, iron reduction may be of importance, especially for certain HCV patient subgroups that have not responded to or cannot tolerate standard therapy. This review focuses on recent advances in understanding how iron may influence HCV infection and vice versa. A key is effects on levels of expression of the hepcidin gene in hepatocytes, because hepcidin has emerged as the key regulator of iron homeostasis. This review also summarizes prior clinical studies involving iron re... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3708379 Sat, 26 Jun 2010 16:12:04 +0100 3708379 http://www.medworm.com/index.php?rid=3688852&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F876w77n100743716%2F This report discusses the current treatment options for liver transplant recipients with hepatitis C. Content Type Journal ArticleDOI 10.1007/s11901-010-0050-6Authors Nyingi M. Kemmer, University of Cincinnati 231 Albert Sabin Way, MSB Room 6363 Cincinnati OH 45267-0595 USATiffany E. Kaiser, University of Cincinnati 231 Albert Sabin Way, MSB Room 6363 Cincinnati OH 45267-0595 USAGuy W. Neff, University of Cincinnati 231 Albert Sabin Way, MSB Room 6363 Cincinnati OH 45267-0595 USA Journal Current Hepatitis ReportsOnline ISSN 1541-0706Print ISSN 1540-3416 (Source: Current Hepatitis Reports) Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3688852 Sun, 20 Jun 2010 23:09:32 +0100 3688852 http://www.medworm.com/index.php?rid=3677928&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fl6l2017136763jj9%2F Abstract  Hepatitis C virus (HCV) affects about 170 million people worldwide and is the most common chronic blood borne infection in the United States. Since the advent of blood screening protocols in the early 1990s, injection drug use has become the leading cause of infection. Hepatitis C can have both hepatic and nonhepatic manifestations of infection. Hepatic manifestations include hepatic fibrosis, cirrhosis, liver cancer, and liver failure. The standard treatment for chronic HCV is combination therapy with pegylated interferon-α and ribavirin. Although pegylated interferon and ribavirin has been used against HCV for close to a decade, advances in therapy have centered on doses and treatment durations. There has been increasing interest in applying on-treatment respon... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3677928 Fri, 18 Jun 2010 10:42:05 +0100 3677928 http://www.medworm.com/index.php?rid=3673896&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fam47447wr804g572%2F Abstract  Hepatitis C virus (HCV) infection and metabolic syndrome are common worldwide. Insulin resistance, an inherent part of metabolic syndrome, may result from HCV infection and has been shown to affect outcomes for chronic hepatitis C (CHC) virus infection. Various host and virally mediated factors contribute to insulin resistance and ultimately the metabolic syndrome. The metabolic derangements in combination with CHC virus affect disease natural history and treatment outcomes. The ideal treatment strategy for patients with features of metabolic syndrome and CHC virus infection is unknown, but most would agree to treat the components of the metabolic syndrome. Content Type Journal ArticleDOI 10.1007/s11901-010-0044-4Authors Paul Lamb, Gastroenterology and Hepat... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3673896 Thu, 17 Jun 2010 09:30:51 +0100 3673896 http://www.medworm.com/index.php?rid=3673897&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F2p317174k9745641%2F Abstract  Treatment for hepatitis C is aimed at eliminating the virus and thus preventing the development of cirrhosis. The effectiveness of antiviral therapy with pegylated interferon and ribavirin is based upon inhibition of viral replication and successful viral clearance while maintaining minimal toxicity. The treatment of hepatitis C has evolved to a response-guided paradigm based on viral kinetic response. Using response-guided therapy, duration of therapy as short as 12–16 weeks may be adequate for those with genotypes 2 or 3, and 24 weeks may be sufficient for those with genotype 1 and low viral load who achieve rapid virologic response. On the other hand, extension of therapy beyond 48 weeks may be beneficial for those with genotype 1 and slow resp... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3673897 Thu, 17 Jun 2010 09:30:50 +0100 3673897 http://www.medworm.com/index.php?rid=3668454&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F066v7383024n1558%2F Abstract  The global prevalence of hepatitis C virus (HCV) infection exceeds that of HIV but only has a 40% response rate to the currently available standard of care. In contrast to HIV infection, eradication of HCV is possible, with cure rather than viral suppression the goal of treatment. Specifically targeted antiviral therapy against hepatitis C (STAT-C) hopes to improve this low rate of response using small molecules designed to inhibit key viral processes. Protease and polymerase inhibitors are the most studied of the STAT-C small molecules with protease inhibitors being the closest to commercial availability. The most promising of these new approaches to therapy rely on a persistent need for pegylated interferon and ribavirin and may be limited by the development of ... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3668454 Wed, 16 Jun 2010 07:18:45 +0100 3668454 http://www.medworm.com/index.php?rid=3668455&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx4l0k1364kw323p1%2F This article reviews the current literature and society guidelines on HBV reactivation, risk factors, and prophylaxis for HBV reactivation in patients undergoing chemo-/immunosuppressive therapy. Content Type Journal ArticleDOI 10.1007/s11901-010-0048-0Authors Kavitha Gopal, Beth Israel Medical Center Division of Digestive Diseases First Avenue at 16th Street New York NY 10003 USAAlbert D. Min, Beth Israel Medical Center Division of Digestive Diseases First Avenue at 16th Street New York NY 10003 USA Journal Current Hepatitis ReportsOnline ISSN 1541-0706Print ISSN 1540-3416 (Source: Current Hepatitis Reports) Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3668455 Mon, 14 Jun 2010 13:52:43 +0100 3668455 http://www.medworm.com/index.php?rid=3650349&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fal02373715252g25%2F Abstract  The epidemics of hepatitis C virus (HCV) and HIV are major causes of morbidity and mortality worldwide; the 33 million individuals who are coinfected with HCV and HIV face an increased risk of complications and death from liver disease in light of the accelerated progression of hepatitis C to fibrosis and cirrhosis in HIV coinfection. The mechanisms by which HIV accelerates the progression of HCV are thought to be related to alterations in the immunologic milieu, which collectively act to promote fibrogenesis. The progression of liver disease is in large part related to immunodeficiency, and, as with monoinfected individuals, optimal management of HIV infection with HAART may be important for prevention of hepatic morbidity. Treatment of HCV with pegylated interfe... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3650349 Mon, 07 Jun 2010 17:16:00 +0100 3650349 http://www.medworm.com/index.php?rid=3523534&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fmq878853wp8jv63h%2F This article reviews the natural history of chronic hepatitis B, the evolving concept of a “normal”ALT level, and recent studies examining liver histology in patients with chronic HBV infection, high HBV DNA levels, and normal ALT levels. Content Type Journal ArticleDOI 10.1007/s11901-010-0040-8Authors Joseph K. Lim, Yale University School of Medicine Section of Digestive Diseases and Yale Liver Center New Haven CT USAWalid S. Ayoub, Stanford University Medical Center Division of Gastroenterology and Hepatology 750 Welch Road, Suite 210 Palo Alto CA 94304-1509 USAMindie H. Nguyen, Stanford University Medical Center Division of Gastroenterology and Hepatology 750 Welch Road, Suite 210 Palo Alto CA 94304-1509 USA Journal Current Hepatitis ReportsOnline ISSN 1541-0706Print... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3523534 Thu, 29 Apr 2010 21:28:56 +0100 3523534 http://www.medworm.com/index.php?rid=3492133&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp2457318812m1p44%2F Abstract  Although nucleosides and nucleotides have a good safety record for the treatment of hepatitis B, there have been no systematic reviews on this topic. We searched Medline to include studies of the oral antiviral agents for hepatitis B and adverse events, with at least 48 weeks of follow-up from the initiation of treatment with the drug. Important toxicities include nephrotoxicity, myopathy, and resistance. It is often difficult to ascertain whether an adverse effect is from the study drug or the natural progression of the disease. Further safety data are needed for the newer agents and for all agents with regard to patients with decompensated liver disease, renal dysfunction, the elderly, children, and pregnant women. Content Type Journal ArticleDOI 10.100... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3492133 Tue, 20 Apr 2010 11:21:31 +0100 3492133 http://www.medworm.com/index.php?rid=3481691&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Far8874q991838t10%2F Abstract  The emergence of new and more potent treatment options has markedly changed the treatment landscape of chronic hepatitis B. Both peginterferon and nucleos(t)ide analogues have considerable advantages and limitations, and current treatment guidelines refrain from clearly suggesting a first-line treatment option. Peginterferon offers the advantage of higher sustained response rates in both hepatitis B early antigen (HBeAg)-positive and HBeAg-negative patients, at the price of considerable side effects and high costs. Nucleos(t)ide analogues offer easy daily oral dosing, and newly registered agents can maintain viral suppression for prolonged treatment duration. However, relapse is common after therapy discontinuation and extended therapy therefore often necessary. P... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3481691 Wed, 14 Apr 2010 16:54:14 +0100 3481691 http://www.medworm.com/index.php?rid=3481693&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fhl3k6078274x0838%2F Abstract  Chronic hepatitis B is a leading cause of hepatocellular carcinoma globally. Liver cirrhosis, high viral load, positive hepatitis B e antigen, and elevated serum alanine aminotransferase are potentially modifiable risk factors for hepatocellular carcinoma with antiviral therapy. Patients achieving surrogate treatment end points (eg, histologic response and biochemical response) have reduced risk of hepatocellular carcinoma and liver-related complications. Animal studies, observational studies, and a few meta-analyses have shown the protective effect of antiviral therapy on hepatocellular carcinoma. On the other hand, there are few randomized controlled trials using hepatocellular carcinoma as the primary end point. In addition, the cost-effectiveness and long-term... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3481693 Wed, 14 Apr 2010 06:56:50 +0100 3481693 http://www.medworm.com/index.php?rid=3481692&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh1472w3327137213%2F Abstract  Persistently high levels of hepatitis B virus (HBV) DNA in patients with chronic HBV infection have been clearly implicated in an increased risk of liver cirrhosis and hepatocellular carcinoma. Hence, the primary objective of antiviral treatment is profound and lasting suppression of HBV DNA levels to improve long-term patient outcomes. Analyses of various patient and treatment characteristics have identified baseline and on-treatment factors that may be helpful in achieving this goal. In this article, the available data on baseline and on-treatment predictors of treatment outcomes in patients with chronic hepatitis B treated with both (pegylated) interferon and nucleos(t)ide analogues are reviewed. Content Type Journal ArticleDOI 10.1007/s11901-010-0036-4Auth... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3481692 Wed, 14 Apr 2010 06:56:50 +0100 3481692 http://www.medworm.com/index.php?rid=3478399&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr4m077m4u27mj331%2F This article reviews the recent knowledge of the pathogenesis and treatment of HBV-related membranous nephropathy, and discusses the management of hepatitis B in kidney transplant recipients, which is continuously evolving. Content Type Journal ArticleDOI 10.1007/s11901-010-0042-6Authors Tak Mao Chan, University of Hong Kong, Queen Mary Hospital Department of Medicine Pokfulam Hong Kong China Journal Current Hepatitis ReportsOnline ISSN 1541-0706Print ISSN 1540-3416 (Source: Current Hepatitis Reports) Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3478399 Tue, 13 Apr 2010 18:05:46 +0100 3478399 http://www.medworm.com/index.php?rid=3478400&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh6pm2151u0002385%2F Abstract  Hepatitis C virus (HCV) infection is common in the United States and affects all ethnic groups. Important ethnic disparities exist in HCV severity, response to treatment, and progression after liver transplantation. Among patients with chronic HCV, African Americans tend to have less severe disease histologically, whereas Hispanics appear to have a more aggressive disease course compared with non-Hispanic Whites. In contrast, new data suggest that African Americans have more rapid HCV progression after liver transplantation relative to other ethnic groups. African Americans and Hispanics have lower sustained virologic response rates to pegylated interferon and ribavirin compared with non-Hispanic Whites. Awareness of these differences will help clinicians counsel ... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3478400 Tue, 13 Apr 2010 06:50:56 +0100 3478400 http://www.medworm.com/index.php?rid=3451220&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ft168768446985273%2F Abstract  Depression and other influences on mental health can impact antiviral response rates during chronic hepatitis C treatment, the quality of life for these patients, and the risk for adverse outcomes such as suicide. Enhanced treatment outcomes for patients who are receiving interferon-α requires 1) addressing preexisting mental health problems, 2) alleviating psychiatric conditions that emerge during treatment, and 3) prediction and prevention of these conditions. Accumulating evidence indicates that these three goals are feasible. Collaborative involvement of psychiatric management may often be critical in this regard. Content Type Journal ArticleDOI 10.1007/s11901-010-0035-5Authors Francis Lotrich, University of Pittsburgh Medical Center Department of Psychi... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3451220 Mon, 05 Apr 2010 21:36:33 +0100 3451220 http://www.medworm.com/index.php?rid=3422429&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F35l2471221h56781%2F Abstract  Despite a decline in the annual incidence of hepatitis B virus (HBV) infection following the implementation of routine vaccination, a significant number of children remain infected. Unlike the infected adult population, who often demonstrate clinical symptoms or abnormalities on routine laboratory investigations, children are often silently infected due to immune tolerance to the virus. Few studies have addressed treatment of these immune-tolerant children because they are not believed to be at a high risk for developing disease sequela during this phase of infection. Although there remain several important unanswered questions, routine treatment of children in the immune-tolerant phase of HBV infection is not currently recommended. Content Type Journal Articl... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3422429 Mon, 29 Mar 2010 17:15:31 +0100 3422429 http://www.medworm.com/index.php?rid=3422428&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fb03p4q2457j30132%2F Abstract  Acute infection with the hepatitis B virus resolves in 95% of adults with no need for specific medical therapy. However, a few cases present as severe hepatitis or acute liver failure, which may require orthotopic liver transplantation or cause death. Under these circumstances, medical therapy that can improve the clinical outcome and improve spontaneous survival would be highly useful; yet, published data regarding the utility of antiviral therapy in acute hepatitis B is quite limited. In this paper, the efficacy and safety of oral nucleoside and nucleotide analogues in the treatment of acute hepatitis B are reviewed, and guidelines for treatment of these acute cases are revisited. Content Type Journal ArticleDOI 10.1007/s11901-010-0033-7Authors Helen S. Te... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3422428 Mon, 29 Mar 2010 17:15:31 +0100 3422428 http://www.medworm.com/index.php?rid=3296179&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh587268535522063%2F We present an overview of studies indicating sleep problems in patients with CHC, with about 60% to 65% of individuals reporting such complaints. Evidence suggests that impairments in sleep quality exist independent of antiviral therapy with interferon-α and prior to advanced stages of liver disease. Further investigation of sleep disturbance in CHC patients with a mild stage of liver disease may provide important information on disease course as well as allow additional opportunities for patient support. Content Type Journal ArticleDOI 10.1007/s11901-010-0030-xAuthors Meghan D. Carlson, University of California San Diego, 210 Dickinson Street, CTF-A Room 109 San Diego CA 92103-8423 USARobin C. Hilsabeck, University of California San Diego, 210 Dickinson Street, CTF-A Room 109 ... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3296179 Sat, 20 Feb 2010 06:57:49 +0100 3296179 http://www.medworm.com/index.php?rid=3274050&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx6114158u61jn70r%2F Abstract  It has long been suspected that host genetic factors influenced treatment outcome of hepatitis C virus (HCV) infection. Three independent genome-wide association studies have recently identified genetic variation in the IL28B gene (coding for IFN-λ3) that determines the outcome of interferon-α-based therapy for patients with genotype 1 chronic hepatitis C infection. These discoveries confirm the potential for a pharmacogenomics approach to personalizing anti-HCV treatment. Content Type Journal ArticleDOI 10.1007/s11901-010-0029-3Authors Alexander J. Thompson, Duke University Medical Center Duke Clinical Research Institute PO Box 17969 Durham NC 27715 USAJacques Fellay, Duke University Institute for Genome Sciences & Policy Center for Human Genome Variation Durh... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3274050 Sun, 14 Feb 2010 06:52:22 +0100 3274050 http://www.medworm.com/index.php?rid=3247965&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq20l015663668103%2F Abstract  Hepatitis C is not cured with liver transplantation. Patients with hepatitis C virus (HCV) infection have reduced graft and patient survivals compared with non-HCV patients following liver transplantation. Both HCV recurrence and fibrosis are accelerated under the influence of transplantation and immunosuppression. Antiviral therapy has been shown to reduce fibrosis progression and graft loss. The goal of therapy is sustained virologic response and reduction of damage. However, the optimal timing and treatment regimen for patients with HCV following transplant is unclear. Following transplant, sustained virologic response rates are reduced and patient tolerance is limited. Improved treatment strategies are needed to reduce patient side effects and increase efficac... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3247965 Fri, 05 Feb 2010 18:19:35 +0100 3247965 http://www.medworm.com/index.php?rid=3241422&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fw125r43m72v0t728%2F Abstract  The coexistence of chronic hepatitis C (CHC) and autoimmune hepatitis (AIH) creates a clinical dilemma. Histologic features may suggest the predominance of one versus the other. Nevertheless, histologic differences are not absolute. Immunosuppressive therapy may be used as frontline treatment for patients with predominant histologic features of AIH. In the absence of clinical and biochemical improvement, interferon should not be withheld and a trial of antiviral therapy should be considered. Interferon can be frontline therapy for patients with the overlap syndrome, if histologic features of CHC predominate, a low titer of autoantibodies is present, and coexistent autoimmune diseases are absent. No matter what treatment is offered, close monitoring during the cour... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3241422 Tue, 02 Feb 2010 07:01:00 +0100 3241422 http://www.medworm.com/index.php?rid=3224080&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fv76435671543171w%2F Abstract  Despite advances in hepatitis C therapy and better knowledge of viral/host factors related to disease progression, the hepatitis C virus remains the leading cause of chronic liver disease, causing progression to end-stage liver disease (ESLD) as well as the development of hepatocellular carcinoma. Because hepatitis C virus acquisition is linked to an addictive behavior (ie, injection drug use), any perceived dependence has been a major reason for treatment denial as well as exclusion from clinical trials. Of special interest are two such dependences: drinking alcohol and smoking marijuana (cannabis). We review the available evidence for the effects of alcohol and cannabis on liver disease progression in chronic hepatitis C, and conclude with recommendations regard... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3224080 Wed, 27 Jan 2010 20:01:35 +0100 3224080 http://www.medworm.com/index.php?rid=3224082&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fu461106563p4076j%2F Abstract  Hepatitis C virus (HCV) continues to represent a worldwide threat to the lives of millions of people chronically infected with the virus. Accurately identifying the virus in terms of genetic characteristics, as well as quantifying its replicative equilibrium both during steady state and in the presence of antiviral therapy, is critically important for providing optimal care and prognoses. Genotype testing continues to evolve; however, it is important to recognize its limitations, particularly as we enter the world of direct-acting antivirals, in which the precise subtyping of HCV may play an even more important role in guiding therapy. Polymerase chain reaction (PCR) has revolutionized the management of chronic viral illnesses, and the advent of real-time PCR has ... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3224082 Wed, 27 Jan 2010 20:01:34 +0100 3224082 http://www.medworm.com/index.php?rid=3224081&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fc1p078042m766t37%2F Abstract  Hepatitis C virus infection is more prevalent in patients with chronic kidney disease on hemodialysis than in the general population. Moreover, chronic hepatitis C virus infection in hemodialysis patients and renal transplant recipients is associated with significant morbidity and even mortality, including de novo diabetes mellitus, sepsis, and glomerulonephritis posttransplantation. Strategies to treat patients on hemodialysis and in the post-renal transplant setting are limited by drug-related toxicity, particularly ribavirin-related anemia, and induction of graft rejection. However, in hemodialysis patients who are candidates for renal transplantation, treatment with interferon or pegylated-interferon results in better sustained virologic responses (SVR) than t... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3224081 Wed, 27 Jan 2010 20:01:34 +0100 3224081 http://www.medworm.com/index.php?rid=3098244&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fb508phw424831g11%2F This article summarizes recent findings on clinical implications and treatment recommendations to avoid and manage viral resistance and suboptimal treatment success. Content Type Journal ArticleDOI 10.1007/s11901-009-0025-7Authors Christian Markus LangeBernd KronenbergerStefan Zeuzem, Klinikum der J. W. Goethe-Universität Frankfurt am Main Medizinische Klinik 1, Theodor-Stern-Kai 7 60590 Frankfurt am Main Germany Journal Current Hepatitis ReportsOnline ISSN 1541-0706Print ISSN 1540-3416 Journal Volume Volume 8 Journal Issue Volume 8, Number 4 / November, 2009 (Source: Current Hepatitis Reports) Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3098244 Mon, 09 Nov 2009 07:01:46 +0100 3098244 http://www.medworm.com/index.php?rid=3098246&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fj6477361605254v3%2F Abstract  Chronic hepatitis B virus (HBV) infection remains a major cause of liver disease and hepatocellular carcinoma worldwide. Although less prevalent in the United States than in other areas of the world, HBV infection results in a significant disease burden in many American immigrant communities. Seven treatments are approved by the US Food and Drug Administration for the treatment of chronic HBV infection: interferon-α (standard interferon-α2b or pegylated interferon-α2a), and the nucleos(t)ide analogues lamivudine, adefovir dipivoxil, entecavir, telbivudine, and tenofovir disoproxil fumarate. There is preliminary evidence that the disease burden from HBV infection may be diminishing in the United States, reflecting not only HBV vaccine progress but also more than... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3098246 Mon, 09 Nov 2009 07:01:45 +0100 3098246 http://www.medworm.com/index.php?rid=3098245&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ft68t744675723880%2F Abstract  Chronic hepatitis B infection remains a relatively common disease in European hepatology and gastroenterology practice. Current treatment guidelines in Europe discuss pegylated interferon-α or nucleoside analogues in treating chronic hepatitis B. The indications and the necessity for treatment are based mainly on the combination of three criteria: serum hepatitis B virus DNA concentrations, serum aminotransferase levels, and histologic grade and stage. The advent of potent nucleoside analogues with low rates of resistance has potentially simplified treatment. The pipeline of new agents to treat hepatitis B remains restricted, and cross-resistance is shared by several nucleosides. Thus, the guidelines emphasize the advantage and necessity of using potent agents wi... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3098245 Mon, 09 Nov 2009 07:01:45 +0100 3098245 http://www.medworm.com/index.php?rid=3098248&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fhn3mv57v0xg650k4%2F This article critically reviews the most recent data regarding the value of measurements of HBsAg concentrations in predicting response in patients with hepatitis B e antigen (HBeAg)-positive and HBeAg-negative CHB treated with different antiviral agents. Content Type Journal ArticleDOI 10.1007/s11901-009-0024-8Authors Emilia HadziyannisDimitrios VassilopoulosStephanos J. Hadziyannis, Henry Dunant Hospital Department of Medicine and Hepatology 107 Messogion Avenue 115 26 Athens Greece Journal Current Hepatitis ReportsOnline ISSN 1541-0706Print ISSN 1540-3416 Journal Volume Volume 8 Journal Issue Volume 8, Number 4 / November, 2009 (Source: Current Hepatitis Reports) Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3098248 Mon, 09 Nov 2009 07:01:43 +0100 3098248 http://www.medworm.com/index.php?rid=3098247&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr5260007p84r8284%2F Abstract  Currently, five published guidelines focus on the treatment of chronic hepatitis B endorsed by the Indian Association for the Study of the Liver (2002), the American Association for the Study of Liver Diseases (2007), the Asian Pacific Association for the Study of the Liver (updated 2008), the European Association for the Study of the Liver (updated 2009), and the National Institutes of Health consensus committee (2009). In addition, an algorithm developed by a panel of US hepatologists regarding the management of chronic hepatitis B was updated in 2008. The guidelines are based on published evidence, and the US algorithm includes expert opinion when available data were lacking. In this review, we discuss the important similarities and differences among the differ... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3098247 Mon, 09 Nov 2009 07:01:43 +0100 3098247 http://www.medworm.com/index.php?rid=3098249&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F10617311942t8610%2F Abstract  Chronic hepatitis B virus (HBV) infection is a major global health problem with potential adverse sequelae including liver cirrhosis and hepatocellular carcinoma. Of more than 350 million chronic HBV carriers, 75% reside in the Asian-Pacific region, where most countries have low-income economies. Better understanding of the natural history and immunopathogenesis of chronic HBV infection and the invention of powerful antiviral agents have improved the therapeutic strategy. Guidelines issued by major liver associations are basically similar. However, each country in the Asian-Pacific region has specific problems. Because cost is a main concern, drugs with low genetic barrier to resistance are still widely used in these countries. Modifications needed to accommodate ... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=3098249 Mon, 09 Nov 2009 07:01:41 +0100 3098249 http://www.medworm.com/index.php?rid=2642975&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh047x35441857371%2F Abstract  Chronic hepatitis B virus (HBV) infection remains an important cause of chronic liver disease worldwide and affects a disproportionate number of individuals from areas of high endemicity, where perinatal transmission is the predominant mode of infection. Introduction of a safe and effective hepatitis B vaccine has led to universal infant vaccination and resulted in a reduced rate of perinatal HBV transmission from infected mothers. With appropriate hepatitis B vaccination and passive immunoprophylaxis using hepatitis B immune globulin (HBIG), infants born to mothers with HBV infection have perinatal transmission rates between 5% and 10%. Management of pregnant women with chronic HBV infection is aimed primarily at counseling regarding maternal risk of infection, r... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2642975 Sat, 25 Jul 2009 08:59:17 +0100 2642975 http://www.medworm.com/index.php?rid=2642977&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fg212288732h0m7k5%2F Abstract  Hepatitis B virus (HBV) is a major cause of chronic liver disease worldwide. HBV reactivation with immunosuppressive treatments is thoroughly described, and is most widely reported in patients who have chronic HBV infection, when hepatitis B surface antigen (HBsAg) is positive, in connection with chemotherapy used to treat lymphoma. However, reactivation can also occur in patients who have prior resolved HBV infection, in whom HBsAg is negative but antibody to hepatitis B core antigen is positive. The antiviral drug lamivudine is highly efficacious in preventing HBV reactivation in these circumstances. Content Type Journal ArticleDOI 10.1007/s11901-009-0018-6Authors Winnie Yeo, Chinese University of Hong Kong, Prince of Wales Hospital Department of Clinical Onc... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2642977 Sat, 25 Jul 2009 08:59:16 +0100 2642977 http://www.medworm.com/index.php?rid=2642976&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fql3r360829l86574%2F Abstract  Hepatitis B virus (HBV) remains an important global pathogen. In countries of high endemicity, virus is typically acquired either vertically or during the preschool years, contributing to a large burden of pediatric infection. Seroconversion and progression to the inactive carrier phase of infection is associated with improved outcome and decreased rates of cirrhosis and hepatocellular carcinoma. Success in treating chronic HBV disease in children, as defined by hepatitis B e antigen (HBeAg) seroconversion, approaches only 25% to 30% with interferon-α, the most efficacious agent. Lamivudine and other nucleoside analogues achieve HBeAg seroconversion at slightly lower rates and are better tolerated. However, this class of medications is limited by the frequency of... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2642976 Sat, 25 Jul 2009 08:59:16 +0100 2642976 http://www.medworm.com/index.php?rid=2642979&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ffm66r1w1074q7676%2F This article reviews the current scientific literature designed to assess the prevalence, diagnostic evaluation, and clinical course of viral hepatitis in individuals with renal failure as well as current treatment options. Content Type Journal ArticleDOI 10.1007/s11901-009-0017-7Authors Elsa Marisol PichardoSonja OlsenRobert S. Brown, Columbia University College of Physicians and Surgeons Center for Liver Disease and Transplantation, New York-Presbyterian Hospital 622 West 168th Street, PH 14 Center New York NY 10032-3784 USA Journal Current Hepatitis ReportsOnline ISSN 1541-0706Print ISSN 1540-3416 Journal Volume Volume 8 Journal Issue Volume 8, Number 3 / August, 2009 (Source: Current Hepatitis Reports) Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2642979 Sat, 25 Jul 2009 08:59:14 +0100 2642979 http://www.medworm.com/index.php?rid=2642978&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fy8003744323v30m3%2F Abstract  HIV, hepatitis C virus (HCV), and hepatitis B virus (HBV) infections are major public health problems. Patients at risk for HIV infection are likely also at risk for HCV and HBV because of shared routes of transmission. HIV and antiretroviral therapy (ART) have a significant impact on HCV and HBV. HIV coinfection accelerates HCV and HBV natural history, leading to an increased incidence of cirrhosis, development of hepatocellular carcinoma (HCC), and death. Universal screening for HCV and HBV infections in HIV-infected patients is essential. Proper screening combined with up-to-date treatment strategies can prevent these complications. This review focuses on important aspects and recent developments in the rapidly evolving field of coinfection. Content Type Jour... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2642978 Sat, 25 Jul 2009 08:59:14 +0100 2642978 http://www.medworm.com/index.php?rid=2642981&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fn1q610rw3733kl30%2F Content Type Journal ArticleCategory Clinical Trials ReportDOI 10.1007/s11901-009-0019-5Authors Veronica TenCate, University of Illinois Chicago IL USAScott J. Cotler, University of Illinois Chicago IL USA Journal Current Hepatitis ReportsOnline ISSN 1541-0706Print ISSN 1540-3416 Journal Volume Volume 8 Journal Issue Volume 8, Number 3 / August, 2009 (Source: Current Hepatitis Reports) Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2642981 Sat, 25 Jul 2009 08:59:13 +0100 2642981 http://www.medworm.com/index.php?rid=2642980&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fxq76qj11801m2782%2F Abstract  Worldwide, chronic hepatitis B virus (HBV) infection is the most common cause of chronic liver disease. Concurrent hepatitis C (HCV) or hepatitis D (HDV) infection is common because of their shared routes of transmission. Studies show that concurrent HBV/HCV or HBV/HDV infections may be associated with a fulminant course of acute hepatitis, more severe forms of chronic liver disease, and higher risk for development of hepatocellular carcinoma. Virologic markers in HBV patients coinfected with HCV or HDV are dynamic and have different patterns. The replication of one virus may dominate the other and antiviral therapeutic strategies should target the dominant virus. Standard interferon-α or pegylated interferon is usually the treatment of choice for HBV/HCV and HBV... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2642980 Sat, 25 Jul 2009 08:59:13 +0100 2642980 http://www.medworm.com/index.php?rid=2400556&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fkt2762m063535x23%2F Abstract  Hepatitis C virus is a major public health issue and a leading cause of chronic liver disease. The current treatment—pegylated interferon and ribavirin—is associated with significant adverse events and sustained virologic response rates of only approximately 50% in genotype-1 patients. New drugs in development include novel interferons, ribavirin analogs, NS3 protease and NS5B polymerase inhibitors, and cyclophilin inhibitors. The primary goal of drug development is to improve efficacy; secondary goals include shortening the duration and increasing the tolerability of treatment. Viral resistance and toxicity must be overcome before acceptance of new drugs. Future therapy may likely be approved in the United States and European Union by 2011, including a combin... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2400556 Wed, 06 May 2009 06:06:28 +0100 2400556 http://www.medworm.com/index.php?rid=2400555&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fu2k78h00283h7547%2F This article discusses the latest clinical trial findings on the emerging STAT-C agents for the treatment of HCV, particularly the agents that have progressed to phase 2 and phase 3 in clinical trials. Content Type Journal ArticleDOI 10.1007/s11901-009-0011-0Authors Giuseppe Morelli, Shands Hospital, University of Florida Section of Hepatology and Gastroenterology 1600 Southwest Archer Road M440 Gainesville FL 32610 USADavid R. Nelson Journal Current Hepatitis ReportsOnline ISSN 1541-0706Print ISSN 1540-3416 Journal Volume Volume 8 Journal Issue Volume 8, Number 2 / May, 2009 (Source: Current Hepatitis Reports) Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2400555 Wed, 06 May 2009 06:06:28 +0100 2400555 http://www.medworm.com/index.php?rid=2400558&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fr5r195707412q798%2F Abstract  Despite the availability of antiviral treatment, chronic hepatitis C-related cirrhosis and hepatocellular carcinoma remain major indications for liver transplantation. Antiviral treatment should be administered to render the patient aviremic if possible before transplant. Hepatitis C recurrence after liver transplant is a major cause of morbidity, mortality, and graft loss, and treatment is problematic after transplant. Hence, treatment of the cirrhotic patient must be considered. However, this remains a challenge because cirrhotic patients tend to have a poorer response rate and their clinical condition limits the therapeutic doses that can be used. Other methods of treatment include low-dose maintenance therapy or low, escalating dose regimens. Sustained virolog... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2400558 Wed, 06 May 2009 06:06:25 +0100 2400558 http://www.medworm.com/index.php?rid=2400557&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fj43755578182w17q%2F Abstract  Predicting hepatitis C treatment outcomes is of great benefit to patient and clinician. Baseline predictors of response or failure can set the appropriate expectations for the patient and may aid in decision making about starting therapy. An accurate assessment of the potential for treatment success involves using rapid and early viral kinetics at weeks 4 and 12. These time points are useful to set up stopping rules and to provide motivation for the patient and health care provider to continue when appropriate. Relapse is an unfortunate consequence of therapy in a significant number of patients. Baseline and on-treatment viral assessments are useful in helping predict and perhaps reduce this phenomenon. Content Type Journal ArticleDOI 10.1007/s11901-009-0010-1Au... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2400557 Wed, 06 May 2009 06:06:25 +0100 2400557 http://www.medworm.com/index.php?rid=2400561&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq0j105312648r032%2F Abstract  The incidence of hepatocellular carcinoma (HCC) associated with chronic hepatitis C virus (HCV) infection doubled over the past 20 years in the United States because of an increase in cirrhosis related to HCV and other factors, including diabetes mellitus. Survival after HCC diagnosis remains relatively unchanged, with a persistently high mortality rate. Primary prevention of HCC by treatment of HCV is supported by multiple, large, retrospective studies. Despite significant methodologic limitations, the studies indicate a benefit of HCC reduction with therapy. Sustained virologic response appears to provide the greatest protection against HCC development. Alternatively, a large, randomized, controlled trial showed that maintenance HCV treatment in patients with ad... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2400561 Wed, 06 May 2009 06:06:24 +0100 2400561 http://www.medworm.com/index.php?rid=2400560&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F16x1k07261nr162q%2F Content Type Journal ArticleCategory Clinical Trials ReportDOI 10.1007/s11901-009-0006-xAuthors Darryn PotoskyCharles Howell Journal Current Hepatitis ReportsOnline ISSN 1541-0706Print ISSN 1540-3416 Journal Volume Volume 8 Journal Issue Volume 8, Number 2 / May, 2009 (Source: Current Hepatitis Reports) Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2400560 Wed, 06 May 2009 06:06:24 +0100 2400560 http://www.medworm.com/index.php?rid=2400559&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F97031966t162340n%2F Abstract  Hepatitis C is the leading cause of liver-related US morbidity and mortality. The ultimate goal of therapy is to prevent disease complications and improve life expectancy. Effective antiviral therapy uses pegylated interferon and ribavirin. Certain populations pose a significant challenge to treatment success. The likelihood of achieving sustained virologic response rates depends on host, viral, and treatment factors, with genotype the strongest predictor. The greatest impact in optimizing drug exposure can result from targeting modifiable factors and, in some instances, from extending treatment duration or increasing standard treatment doses. Adherence to treatment duration and administration is crucial in obtaining optimal sustained virologic responses. Accurate... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2400559 Wed, 06 May 2009 06:06:24 +0100 2400559 http://www.medworm.com/index.php?rid=2371230&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fgv6t507162212327%2F Abstract  Hepatitis C virus (HCV) infection has emerged as an important factor in determining the presence and severity of cognitive impairment among individuals infected with HIV. Studies have demonstrated that coinfected patients perform worse on neuropsychological testing than monoinfected patients, typically on tests of processing speed, psychomotor speed, and learning efficiency. The mechanisms associated with this increased severity of cognitive impairment have not been identified, though a number of candidates have been proposed. This review summarizes the current literature on HIV-HCV coinfection and cognitive impairment and describes possible mechanisms mediating this relationship. Special emphasis is placed on the presence of HCV in the brain and concomitant liver... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2371230 Sun, 26 Apr 2009 05:56:27 +0100 2371230 http://www.medworm.com/index.php?rid=2371232&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fy5174q22383q3620%2F Abstract  Chronic hepatitis C (CHC) and nonalcoholic fatty liver disease (NAFLD) are two frequently identified liver diseases worldwide. NAFLD is related to obesity and insulin resistance, which may also be a preexisting condition in patients with CHC. The complex relationship among obesity, steatosis, and insulin resistance as it pertains to the pathogenesis, treatment, and outcomes in CHC is discussed in this article. Content Type Journal ArticleDOI 10.1007/s11901-007-0015-6Authors Dawn M. TorresStephen A. Harrison, Brooke Army Medical Center Department of Gastroenterology 3851 Roger Brooke Drive Fort Sam Houston TX 78234 USA Journal Current Hepatitis ReportsOnline ISSN 1541-0706Print ISSN 1540-3416 Journal Volume Volume 6 Journal Issue Volume 6, Number 4... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2371232 Sun, 26 Apr 2009 05:56:26 +0100 2371232 http://www.medworm.com/index.php?rid=2371231&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F06376050780217hk%2F Abstract  Although clinicians recognize the importance of adherence to HCV therapy, little research has been conducted to determine actual adherence rates or predictors of adherence in this population. Adherence is a challenge in the HCV-infected individual because of the complexities of the drug regimen, side effects from the medication, frequency of clinical monitoring, variable response to therapy, and potential complications. However, because of the time-limited nature of the current medication therapies, multidisciplinary and multifactoral interventional strategies may be designed to positively influence adherence rates and, ultimately, treatment outcomes in this patient population. Content Type Journal ArticleDOI 10.1007/s11901-007-0019-2Authors Renee Pozza, South... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2371231 Sun, 26 Apr 2009 05:56:26 +0100 2371231 http://www.medworm.com/index.php?rid=2371233&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx215137371255096%2F Abstract  In March 2007, a systematic review was conducted of published research on the topic of health-related quality of life (HRQOL) in patients with hepatitis C virus (HCV) infection. Recent studies indicate that significant decrements in HRQOL exist for patients with HCV under many circumstances and arise from multiple sources. Future research is needed on finding interventions that address all sources of reduced HRQOL in patients with HCV, whether or not they are on treatment. It is also important to continue work on identifying the direct mechanisms behind lower HRQOL in patients with HCV. Content Type Journal ArticleDOI 10.1007/s11901-007-0020-9Authors Erik J. Groessl, VA San Diego Healthcare System Health Services Research and Development 3350 La Jolla Village D... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2371233 Sun, 26 Apr 2009 05:56:23 +0100 2371233 http://www.medworm.com/index.php?rid=2371240&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F428q16151846w1mx%2F Abstract  The prevalence of chronic infection with hepatitis C virus (HCV) is estimated to be 17 to 27 times higher among incarcerated individuals than in the general US population. To help stem the epidemic of HCV infection in the United States, correctional institutions and public health systems should be integrated. The incarcerated setting represents the first opportunity for many inmates to access health care. Correctional settings offer an important opportunity to diagnose, prevent, and treat HCV infection. In this article, we review HCV screening, testing, and treatment policies in US correctional institutions and discuss prison responses to the HCV epidemic and the feasibility of treatment within prisons and jails. Finally, we emphasize the importance of links to po... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2371240 Sun, 26 Apr 2009 05:56:21 +0100 2371240 http://www.medworm.com/index.php?rid=2371239&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F45873340q1885l24%2F Abstract  AbstractChronic infection with hepatitis C virus (HCV) and alcohol abuse are two of the most common causes of chronic liver disease in the United States. These two entities often coexist and contribute to accelerated development of liver fibrosis, cirrhosis, and hepatocellular carcinoma. Although the effect of one drink per day in the setting of chronic HCV infection is unclear, there is overwhelming evidence for the deleterious effects of heavy alcohol use on HCV liver disease. The mechanisms by which alcohol increases liver injury in hepatitis C are poorly understood. Potential pathways include impaired host immune systems and increased viral replication. Alcohol use may decrease the success of treatment. Physicians should encourage patients with chronic hepatit... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2371239 Sun, 26 Apr 2009 05:56:21 +0100 2371239 http://www.medworm.com/index.php?rid=2371238&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fl3q023264531000u%2F Abstract  The prevalence of chronic hepatitis C (CHC) is significantly higher in patients with end-stage renal disease undergoing hemodialysis than in the general population. CHC adversely affects survival in patients on hemodialysis and those who have undergone renal transplantation (RT); routine screening for hepatitis C virus infection is recommended for both groups. Treatment of CHC in post-RT patients and those undergoing hemodialysis remains challenging. Data on nonpegylated interferon alfa and pegylated interferon alfa monotherapies remain limited, and treatment-induced adverse effects are common. Ribavirin is contraindicated in these patients, but a combination of low-dose ribavirin with interferon is being assessed in clinical trials. Further studies are needed to ... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2371238 Sun, 26 Apr 2009 05:56:21 +0100 2371238 http://www.medworm.com/index.php?rid=2371237&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F527453uw11454242%2F Abstract  Depression and fatigue are two of the most common problems reported by patients with hepatitis C virus (HCV). Psychosocial and biological factors contribute to the etiology of these symptoms, but the exact pathogenesis of each is not well understood. Depression is managed effectively in most HCV patients using antidepressant medication, but management strategies for fatigue are lacking. Additional research is needed to refine the definition of fatigue and its measurement, as well as to identify the causes of these disabling symptoms, how they relate to other neuropsychiatric symptoms, and which interventions are most effective. Content Type Journal ArticleDOI 10.1007/s11901-007-0018-3Authors Robin C. Hilsabeck, South Texas Veterans Health Care System Psycholog... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2371237 Sun, 26 Apr 2009 05:56:21 +0100 2371237 http://www.medworm.com/index.php?rid=2371236&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fv15v1h45g817j037%2F Abstract  The risk of hepatocellular carcinoma (HCC) is greatly increased in patients with cirrhosis resulting from chronic hepatitis C infection. Diagnosis and treatment of HCC remain difficult and mortality is high. Surveillance of individuals who are at risk is recommended, and the risk of HCC can likely be reduced by treating the underlying hepatitis. Content Type Journal ArticleDOI 10.1007/s11901-007-0009-4Authors Benjamin H. LeachJonathan M. Schwartz, Oregon Health and Sciences University Department of Medicine, Division of Gastroenterology and Hepatology 3181 SW Sam Jackson Park Road, L461 Portland OR 97239 USA Journal Current Hepatitis ReportsOnline ISSN 1541-0706Print ISSN 1540-3416 Journal Volume Volume 6 Journal Issue Volume 6, Number 3 / August, ... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2371236 Sun, 26 Apr 2009 05:56:21 +0100 2371236 http://www.medworm.com/index.php?rid=2371235&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F51x0121055u11445%2F Abstract  Chronic hepatitis B with negative hepatitis B e antigen (HBeAg) is becoming a more prevalent form of chronic hepatitis B. This change is the result of selection pressure on the virus leading to a precore or double core promoter mutation of hepatitis B virus that either abolishes or downregulates synthesis of HBeAg. De novo acute infection with HBeAg-negative mutant virus rarely leads to chronic infection but usually results in acute hepatitis with a course ranging from benign to fulminant. Chronic HBeAg-negative hepatitis B is thought to evolve from wildtype HBeAg-positive chronic hepatitis B and is associated with a worse natural history than HBeAg-positive disease. Long-term treatment is required to maintain suppression of viral replication when using the oral n... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2371235 Sun, 26 Apr 2009 05:56:21 +0100 2371235 http://www.medworm.com/index.php?rid=2371234&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fdwuq3423021127kt%2F Abstract  An increasingly wide variety of extrahepatic manifestations have been reported in patients with chronic hepatitis C virus (HCV) infection. Many are immunologic in nature and may be precipitated by interferon-based therapy. Among these associations, mixed cryoglobulinemia is the most prevalent and best characterized. Additional HCV-related immunologic complications include autoantibody production, rheumatologic disorders, immune-mediated cytopenias, and lymphoproliferative disorders; the certainty of association varies for many of these conditions. The mechanisms through which HCV induces these complications are incompletely understood. In this review, we discuss the immunologic complications of HCV infection, focusing on their epidemiology, pathogenesis, and treat... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2371234 Sun, 26 Apr 2009 05:56:21 +0100 2371234 http://www.medworm.com/index.php?rid=2371241&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa2306x016057h36m%2F Content Type Journal ArticleDOI 10.1007/s11901-007-0008-5 Journal Current Hepatitis ReportsOnline ISSN 1541-0706Print ISSN 1540-3416 Journal Volume Volume 6 Journal Issue Volume 6, Number 3 / August, 2007 (Source: Current Hepatitis Reports) Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2371241 Sun, 26 Apr 2009 05:56:16 +0100 2371241 http://www.medworm.com/index.php?rid=2371242&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F1574x71h20156404%2F Abstract  Coinfection with HIV and viral hepatitis substantially alters the natural course of viral hepatitis as well as its management. Therapy for infection with hepatitis B virus (HBV) in HIV-coinfected patients requires consideration of several factors, such as whether the antiviral activity of a particular agent is specific for HBV or for both viruses, the potential for drug resistance and cross-resistance, and the potential for hepatotoxicity. In most trials, response to treatment for infection with the hepatitis C virus (HCV) seems to be lower in HCV/HIV-coinfected patients than in those infected with HCV alone. Despite the current recommendations for treating hepatitis C in the setting of HIV, a large percentage of patients do not receive therapy. Content Type Jou... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2371242 Sun, 26 Apr 2009 05:56:15 +0100 2371242 http://www.medworm.com/index.php?rid=2309712&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F945k151363h45l4k%2F Content Type Journal ArticleDOI 10.1007/s11901-007-0001-zAuthors Naishadh Raghuwanshi, MD, MBA Saint Louis University School of Medicine, Division of Gastroenterology and Hepatology, 3660 Vista Avenue, St. Louis, MO 63110, USA. Email: nraghuwa@slu.edu Journal Current Hepatitis ReportsOnline ISSN 1541-0706Print ISSN 1540-3416 Journal Volume Volume 6 Journal Issue Volume 6, Number 2 / May, 2007 (Source: Current Hepatitis Reports) Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2309712 Sat, 28 Mar 2009 09:16:35 +0100 2309712 http://www.medworm.com/index.php?rid=2309711&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh578gv6l1183w6tx%2F Abstract  Coinfection with hepatitis C virus (HCV) and HIV is common. Studies conducted prior to the advent of highly active antiretroviral therapy reported increased HCV liver disease severity in coinfected persons compared with those infected with HCV alone. In the current era, the influences of HIV and highly active antiretroviral therapy on the natural history of HCV liver disease are less well defined. Peginterferon alfa and ribavirin are the current standard of care in treating HCV, but HIV coinfection is associated with lower response rates to treatment. Further research is needed to enhance our understanding of the natural history and pathogenesis of HCV liver disease in the setting of HIV coinfection and to identify more effective HCV treatments. Content Type Jou... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2309711 Sat, 28 Mar 2009 09:16:35 +0100 2309711 http://www.medworm.com/index.php?rid=2309713&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fq74146m692680841%2F Abstract  Treatment for hepatitis C is aimed at eliminating the virus and thus preventing the development of cirrhosis. The effectiveness of antiviral therapy with pegylated interferon and ribavirin is based upon inhibition of viral replication and successful viral clearance while maintaining minimal toxicity. Therapy as short as 12 to 16 weeks duration may be adequate for those with genotypes 2 or 3, and 24 weeks may be sufficient for those with genotype 1 and low viral load who achieve rapid virologic response. On the other hand, extension of therapy beyond 48 weeks may be necessary for those with genotype 1 and slow response or those with a high pretreatment viral load who do not achieve rapid virologic response. As new viral kinetic data emerge with pegylated interferon... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2309713 Sat, 28 Mar 2009 09:16:33 +0100 2309713 http://www.medworm.com/index.php?rid=2309714&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F0v0521224qv0408r%2F Abstract  Persons who inject illicit drugs are the group most severely affected by the hepatitis C epidemic but the least likely to receive treatment. Controlling the epidemic will require developing strategies for effectively treating drug users. A growing number of reports have shown that a substantial proportion of drug users treated for hepatitis C can achieve sustained virologic responses even if they have psychiatric comorbidity and even if they continue to use drugs while receiving hepatitis C treatment. Successfully treating hepatitis C in injection drug users requires collaboration between those with expertise in hepatitis and those with expertise in caring for substance users. Careful attention to management of adverse effects and strong links with mental health s... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2309714 Sat, 28 Mar 2009 09:16:31 +0100 2309714 http://www.medworm.com/index.php?rid=2309717&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fe8w378n18ru71756%2F Abstract  Despite progressive advances, therapy with interferon and ribavirin has been the mainstay of treatment for chronic hepatitis C for over a decade. With the development of in vitro systems to study viral replication, there have been great advances in the understanding of hepatitis C biology, and these advances, in turn, are allowing the development of specifically targeted antiviral therapies. This review employs our current understanding of the hepatitis C replicative life cycle as a framework on which to discuss new antiviral agents under clinical investigation. Content Type Journal ArticleDOI 10.1007/s11901-007-0007-6Authors Ilan S. WeisbergSamuel H. Sigal, New York Presbyterian Hospital, Weill-Cornell Medical Center Division of Gastroenterology and Hepatology... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2309717 Sat, 28 Mar 2009 09:16:29 +0100 2309717 http://www.medworm.com/index.php?rid=2309716&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fn32p7643wj7k7732%2F Abstract  Alcohol consumption and hepatic steatosis interact synergistically with hepatitis C virus (HCV) to accelerate fibrosis progression and reduce the efficacy of standard antiviral therapies. Research aimed at delineating the viral and host interactions involved in the pathogenesis of steatosis in HCV infection may provide novel therapeutic strategies that can modify disease progression and improve treatment response. This review discusses the clinical aspects of HCV fibrosis progression and treatment response in the setting of alcohol use or hepatic steatosis. Content Type Journal ArticleDOI 10.1007/s11901-007-0002-yAuthors Sam GalhenageManal F. Abdelmalek, Duke University Medical Center Division of Gastroenterology, Hepatology & Nutrition P.O. Box 3913 Durham NC ... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2309716 Sat, 28 Mar 2009 09:16:29 +0100 2309716 http://www.medworm.com/index.php?rid=2309715&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fx88m208323q65123%2F Abstract  Patients with chronic hepatitis C infection who are viremic at the time of liver transplantation will have universal recurrence of the virus in the allograft. Long-term survival after transplantation in patients with chronic hepatitis C is diminished as compared with patients who undergo liver transplantation for other indications. The progression of HCV-related fibrosis and the development of cirrhosis appear to be accelerated in the presence of immunosuppression, compared with an immune-competent population. The primary aim of hepatitis C treatment in patients with recurrent hepatitis C infection in the allograft remains eradication of the virus to prevent the progression of liver disease. However, decisions regarding the timing, duration, and optimization of th... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2309715 Sat, 28 Mar 2009 09:16:29 +0100 2309715 http://www.medworm.com/index.php?rid=2173437&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F6w012632675l1516%2F Abstract  Although the increase in agents approved for treating chronic hepatitis B has expanded the therapeutic options for clinicians treating such patients, it also has made selecting the most appropriate agent in a particular clinical setting significantly more confusing. This review critiques the most recent data regarding the treatment options in different subsets of patients with chronic hepatitis B virus (ie, those with chronic hepatitis B, inactive hepatitis B surface antigen carriers, cirrhotics, patients with drug-resistant mutations) and proposes a therapeutic algorithm. Content Type Journal ArticleDOI 10.1007/s11901-009-0004-zAuthors Dimitrios VassilopoulosStephanos J. Hadziyannis, Henry Dunant Hospital Department of Medicine and Hepatology 107 Messogion Ave... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2173437 Sun, 08 Feb 2009 06:53:00 +0100 2173437 http://www.medworm.com/index.php?rid=2173438&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fm1h70v7271973w50%2F Abstract  The past two decades have seen tremendous advances in our ability to detect hepatitis B virus (HBV) infection. Newer, more sensitive serologic assays enable accurate detection of HBV markers of infection and enhance our understanding of the natural history of infection. In addition, the advent of molecular diagnostic assays such as polymerase chain reaction has led to the ability to directly determine and quantify HBV DNA in serum and tissue. This review explores the use of serologic and virologic tests in diagnosing HBV infection and presents an algorithm for using these tests to diagnose acute hepatitis, past infection, chronic infection, and occult infection. Content Type Journal ArticleDOI 10.1007/s11901-009-0003-0Authors Arema A. PereiraIra M. Jacobson, W... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2173438 Sun, 08 Feb 2009 06:52:59 +0100 2173438 http://www.medworm.com/index.php?rid=2173441&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fk15k809k4208x622%2F This article reviews the epidemiology, natural history, and treatment of hepatitis B in India and Indian Americans. Content Type Journal ArticleDOI 10.1007/s11901-009-0005-yAuthors Shiv K. Sarin, G.B. Pant Hospital Department of Gastroenterology Room No. 201, Academic Block New Delhi 110002 IndiaManoj Kumar Journal Current Hepatitis ReportsOnline ISSN 1541-0706Print ISSN 1540-3416 Journal Volume Volume 8 Journal Issue Volume 8, Number 1 / February, 2009 (Source: Current Hepatitis Reports) Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2173441 Sun, 08 Feb 2009 06:52:56 +0100 2173441 http://www.medworm.com/index.php?rid=2173440&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fu5224r08711530k4%2F Abstract  Although the incidence of hepatitis B virus (HBV) in the United States is decreasing, it remains an important health issue, with nearly 2 million people currently infected and a 7% to 30% lifetime mortality rate. Vaccination has markedly decreased the number of acute HBV cases, especially in children and adolescents; however, there continues to be a substantial incidence of new infections in intravenous drug users and persons with high-risk sexual behavior and of newly recognized disease in immigrants. Perinatal transmission has been significantly reduced with universal infant vaccination, and transfusion/iatrogenic infection has been nearly eradicated by screening blood products and vaccinating at-risk medical professionals. HBV infection rates vary with respect ... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2173440 Sun, 08 Feb 2009 06:52:56 +0100 2173440 http://www.medworm.com/index.php?rid=2173439&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F472870652t826515%2F Abstract  Chronic hepatitis B (CHB) is a disease of worldwide importance that carries considerable morbidity and mortality. The natural course of CHB is characterized by an initial hepatitis B e antigen (HBeAg)-positive phase marked by immunologic tolerance, high-level viremia, and histologic quiescence, followed by an immune elimination phase of variable duration that is associated with less viremia but increased disease activity, usually resulting in HBeAg clearance. The ensuing HBeAg-negative phase is characterized by even lower or undetectable viremia with biochemical and histologic quiescence. This inactive carrier state may be of short or lifelong duration and occasionally results in hepatitis B surface antigen clearance. Alternatively, the HBeAg-negative phase may de... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=2173439 Sun, 08 Feb 2009 06:52:56 +0100 2173439 http://www.medworm.com/index.php?rid=1985243&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Ft0q0777112760600%2F This article reviews the evidence regarding differences among ethnic and racial groups in CHC characteristics, progression of liver disease, efficacy of therapy, and genetic and immune factors that affect viral clearance and hepatic damage. It also discusses strategies to improve access to and efficacy of available and future CHC treatments for minority populations. Content Type Journal ArticleDOI 10.1007/s11901-008-0031-1Authors Maribel Rodríguez-Torres, Fundación de Investigación de Diego Avenue de Diego 359, Suite 302 Santurce 00909 Puerto Rico Journal Current Hepatitis ReportsOnline ISSN 1541-0706Print ISSN 1540-3416 Journal Volume Volume 7 Journal Issue Volume 7, Number 4 / November, 2008 (Source: Current Hepatitis Reports) Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=1985243 Sun, 23 Nov 2008 06:50:04 +0100 1985243 http://www.medworm.com/index.php?rid=1985242&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fb688l44q26h67152%2F Abstract  Hepatic steatosis is a frequent histologic finding in chronic hepatitis C (CHC) patients. Both host and viral factors contribute to steatogenesis. Recent literature has demonstrated the interaction of viral proteins with hepatic cellular components, resulting in oxidative stress, cytokine release, inflammation, insulin resistance, and disturbance in lipid and carbohydrate metabolism. These viral-induced hepatocellular abnormalities thus initiate development of steatosis, worsening fibrosis, poor therapeutic response, and carcinogenesis. Steatosis in hepatitis C appears to be genotype specific and is predominantly metabolic in genotype 1 and cytopathic in genotype 3. This review discusses the details of complex pathogenic mechanisms of steatosis in CHC patients. Th... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=1985242 Sun, 23 Nov 2008 06:50:04 +0100 1985242 http://www.medworm.com/index.php?rid=1985241&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fblt525323858t757%2F Abstract  Hepatitis C infection in children is a worldwide health problem with a significant economic burden. Chronic hepatitis C virus (HCV) infection can progress to cirrhosis and end-stage liver disease during childhood. Most new pediatric cases in the United States and Europe are transmitted vertically from HCV-infected mothers. Antiviral therapy with interferon and ribavirin should be considered in otherwise healthy children to delay disease progression. New diagnostic techniques and antiviral therapies are emerging and may have an impact on our approach to children with HCV infection. Content Type Journal ArticleDOI 10.1007/s11901-008-0029-8Authors Naim AlkhouriNizar N. Zein, The Cleveland Clinic Department of Gastroenterology and Hepatology 9500 Euclid Avenue Clev... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=1985241 Sun, 23 Nov 2008 06:50:04 +0100 1985241 http://www.medworm.com/index.php?rid=1985240&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F45m5jw773323686t%2F Abstract  African Americans, with treatment failure rates at about 80%, remain one of the most difficult patient groups in which to eradicate hepatitis C. Infection morbidity in this patient population is compounded by limitations on access to specialist care. Preliminary data regarding liver transplantation even suggest that African Americans, relative to Caucasians, have worse outcomes after liver transplantation. Hence, a priority in hepatitis C research remains studying the immunologic mechanisms that affect host-virus interaction and their relevance to viral persistence and interferon response. In this review, we emphasize recent literature related to the sociologic, immunologic, and metabolic mechanisms that underlie the racial decrements in hepatitis C outcomes in Af... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=1985240 Sun, 23 Nov 2008 06:50:04 +0100 1985240 http://www.medworm.com/index.php?rid=1985239&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fl1428l41117h4026%2F Content Type Journal ArticleDOI 10.1007/s11901-008-0027-x Journal Current Hepatitis ReportsOnline ISSN 1541-0706Print ISSN 1540-3416 Journal Volume Volume 7 Journal Issue Volume 7, Number 4 / November, 2008 (Source: Current Hepatitis Reports) Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=1985239 Sun, 23 Nov 2008 06:50:04 +0100 1985239 http://www.medworm.com/index.php?rid=1985244&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fa53657781332tw03%2F Abstract  Hepatic fibrogenesis is a dynamic process that reflects a balance between matrix synthesis and degradation. An accurate determination of hepatic fibrosis is important in determining prognosis, requirement for therapy, and disease progression in chronic hepatitis C infection. Histologic assessment relies on a liver biopsy, an invasive procedure associated with sampling error and inaccurate staging that provides only a semiquantitative and static measure of fibrosis and inflammatory activity. Several noninvasive tools initially developed and validated in chronic hepatitis C patients are now being applied to other chronic liver disease states. These noninvasive approaches include simple and complex serum biochemical marker algorithms, radiologic methods such as elast... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=1985244 Sun, 23 Nov 2008 06:50:03 +0100 1985244 http://www.medworm.com/index.php?rid=1886777&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F973g87748tl312vk%2F Abstract  Mathematical models of hepatitis C viral kinetics provide a means of estimating the antiviral effectiveness of therapy, the rate of virion clearance, and the rate of loss of hepatitis C virus (HCV)-infected cells. They have also proved useful in evaluating the extrahepatic contribution to HCV plasma viremia and have suggested mechanisms of action for interferon-α and ribavirin. Viral kinetic models can explain the observed HCV RNA profiles under treatment—for example, flat partial response, biphasic and triphasic viral decay, and viral rebound. Current therapy with (pegylated) interferon-α and ribavirin has poorer success in patients with insulin resistance, hepatic fibrosis, African American ethnicity, HCV/HIV-coinfection, HCV genotype 1, or high baseline vir... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=1886777 Thu, 16 Oct 2008 10:00:05 +0100 1886777 http://www.medworm.com/index.php?rid=1886776&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Frx37n2302750r56q%2F Content Type Journal ArticleDOI 10.1007/s11901-008-0021-3 Journal Current Hepatitis ReportsOnline ISSN 1541-0706Print ISSN 1540-3416 Journal Volume Volume 7 Journal Issue Volume 7, Number 3 / August, 2008 (Source: Current Hepatitis Reports) Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=1886776 Thu, 16 Oct 2008 10:00:05 +0100 1886776 http://www.medworm.com/index.php?rid=1886781&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F7826387p05465k72%2F Abstract  Hepatitis C virus (HCV) infection is commonly associated with hepatic steatosis, an important factor predicting disease severity in all genotypes. There appears to be a strong association between the presence of steatosis and insulin resistance (IR) in HCV infection, especially in genotype 1 infection. Obesity, hepatic steatosis, and IR all appear to negatively influence response to antiviral therapy. IR is important not only in the development of hepatic steatosis, but also in fibrosis severity. Recent studies also suggest that IR is a significant independent predictor of sustained virologic response to antiviral therapy, not only in genotype 1 infection but also in hepatitis C genotypes 2 and 3. It remains to be seen whether interventions such as weight loss, he... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=1886781 Thu, 16 Oct 2008 10:00:04 +0100 1886781 http://www.medworm.com/index.php?rid=1886780&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2F017858711t505342%2F This report reviews the current literature regarding acute and chronic viral infections among African Americans and makes recommendations for future public health and research initiatives to improve outcomes in this population. Content Type Journal ArticleDOI 10.1007/s11901-008-0025-zAuthors Andrea E. Reid, GI Unit GJ724, Massachusetts General Hospital 55 Fruit Street Boston MA 02114 USA Journal Current Hepatitis ReportsOnline ISSN 1541-0706Print ISSN 1540-3416 Journal Volume Volume 7 Journal Issue Volume 7, Number 3 / August, 2008 (Source: Current Hepatitis Reports) Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=1886780 Thu, 16 Oct 2008 10:00:04 +0100 1886780 http://www.medworm.com/index.php?rid=1886779&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fy741705011338x06%2F Abstract  Steatosis is a common histologic feature in chronic hepatitis C virus (HCV) infection. Viral steatosis, seen in genotype 3a, is strongly related to viral replication; metabolic steatosis, reported in genotype 1, has been associated with obesity, type 2 diabetes, and metabolic syndrome. HCV promotes lipid accumulation in hepatocytes, increasing free fatty acid synthesis and decreasing lipid oxidation and secretion. Several amino acid changes in core protein have been strongly related to steatosis development; for example, the Y164F change has been related to greater cumulative lipid droplets. Steatosis-induced HCV seems to act as an organelle supporting stable viral replication. HCV proteins promote insulin receptor substrate-1 (IRS-1) degradation by several mechan... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=1886779 Thu, 16 Oct 2008 10:00:04 +0100 1886779 http://www.medworm.com/index.php?rid=1886778&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fg51585643w5595x2%2F Abstract  Latinos with hepatitis C virus (HCV) infection have more rapid progression of fibrosis and decreased response to anti-HCV treatment. The high rates of metabolic syndrome, insulin resistance, and hepatic steatosis, as well as genetic differences, may explain the severity of chronic hepatitis C (CHC) in this population. In addition, Latinos encounter substantial barriers to medical care, including language, cultural differences, and socioeconomic factors such as lack of medical insurance. This article reviews evidence regarding the natural history of CHC in Latinos, efficacy of therapy, and possible strategies to improve outcomes. Content Type Journal ArticleDOI 10.1007/s11901-008-0023-1Authors Maribel Rodríguez-Torres, Fundación de Investigación de Diego Ave... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=1886778 Thu, 16 Oct 2008 10:00:04 +0100 1886778 http://www.medworm.com/index.php?rid=1815740&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fh827368131722281%2F Abstract  Over the past two decades, there have been significant improvements in the outcomes of liver transplantation for all indications. Liver transplantation for hepatitis B virus (HBV) infection, once considered a contraindication to transplantation, now achieves survival rates of 91% at 1 year, 81% at 5 years, and 73% at 10 years. This improvement in outcome has occurred largely with the introduction of therapies that prevent reinfection of the hepatic allograft and thus recurrent hepatitis B, cirrhosis, and graft failure. In the United States, it is estimated that 1.25 million people are chronically infected with HBV, resulting in approximately 5000 liver-related deaths and 250 liver transplantations annually. This review summarizes the important accomplishments in t... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=1815740 Sat, 20 Sep 2008 14:32:25 +0100 1815740 http://www.medworm.com/index.php?rid=1815741&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fqnh13h23x3106626%2F This article focuses on the disease course of such patients. Content Type Journal ArticleDOI 10.1007/BF02942175Authors Kaveh Hoda, Stanford University Medical Center Division of Gastroenterology and Hepatology 750 Welch Road, Suite 210 94304-1509 Palo Alto CA USAMindie H. Nguyen, Stanford University Medical Center Division of Gastroenterology and Hepatology 750 Welch Road, Suite 210 94304-1509 Palo Alto CA USA Journal Current Hepatitis ReportsOnline ISSN 1541-0706Print ISSN 1540-3416 Journal Volume Volume 6 Journal Issue Volume 6, Number 1 / February, 2007 (Source: Current Hepatitis Reports) Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=1815741 Sat, 20 Sep 2008 14:32:24 +0100 1815741 http://www.medworm.com/index.php?rid=1815742&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fg1573g674v2m6rk5%2F Abstract  Eight genotypes (A-H) of hepatitis B virus (HBV) have been identified. The epidemiology of HBV genotypes and their implications for the natural history of disease progression and response to antiviral therapy have become increasingly recognized. This article presents new lines of evidence regarding the clinical relevance of HBV genotypes and proposes important issues to be resolved in the future. Content Type Journal ArticleDOI 10.1007/BF02942174Authors Chun-Jen LiuJia-Horng Kao, National Taiwan University Hospital Hepatitis Research Center 1 Chang-Te Street Taipei 100 Taiwan Journal Current Hepatitis ReportsOnline ISSN 1541-0706Print ISSN 1540-3416 Journal Volume Volume 6 Journal Issue Volume 6, Number 1 / February, 2007 (Source: Current Hepatiti... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=1815742 Sat, 20 Sep 2008 14:32:23 +0100 1815742 http://www.medworm.com/index.php?rid=1815744&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fp474502736n38511%2F Abstract  Hepatitis B virus (HBV) is transmitted parenterally via infected blood or body fluids, including perinatal exposures. In the United States, the incidence of new HBV infection has decreased since the 1980s, primarily because of prevention programs such as immunization in children. Nonetheless, the prevalence and burden of chronic HBV infection remain substantial, especially among the Asian/Pacific Islander racial group. Public health efforts must continue to control transmission of HBV and minimize its future impact by identifying and providing effective interventions for individuals with chronic infection. Content Type Journal ArticleDOI 10.1007/BF02942172Authors W. Ray Kim, Mayo Clinic Gastroenterology and Hepatology (Plummer 6) 200 First Street SW 55905 Roche... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=1815744 Sat, 20 Sep 2008 14:32:21 +0100 1815744 http://www.medworm.com/index.php?rid=1815743&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fy1873287x37g2405%2F Abstract  Chronic hepatitis B frequently progresses to cirrhosis and hepatocellular carcinoma. An elevated serum level of hepatitis B virus DNA is a major risk factor for cirrhosis and hepatocellular carcinoma, and there is a dose-response relationship between the serum hepatitis B virus DNA level and the risk of these complications. To lower the viral load to its lowest level is the method of choice to prevent major liver complications in chronic hepatitis B. Content Type Journal ArticleDOI 10.1007/BF02942173Authors Chien-Jen Chen, Academia Sinica Genomics Research Center 128 Academia Road Section 2 115 Nankang, Taipei TaiwanUchenna H. Iloeje, Academia Sinica Genomics Research Center 128 Academia Road Section 2 115 Nankang, Taipei TaiwanHwai-I Yang, Academia Sinica Genom... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=1815743 Sat, 20 Sep 2008 14:32:21 +0100 1815743 http://www.medworm.com/index.php?rid=1482313&cid=s_35936_20_f&fid=35936&url=http%3A%2F%2Fwww.springerlink.com%2Fcontent%2Fl03pg822122436x1%2F Abstract  Coinfection with hepatitis B virus (HBV) and hepatitis C virus (HCV) is not uncommon, based on the high prevalence of both infections and their shared routes of transmission. Coinfected patients have higher rates of acute liver failure, decompensated cirrhosis, and hepatocellular carcinoma than do their monoinfected counterparts and therefore present a unique challenge to the clinician. The serology and virology of HBV and HCV in coinfection are dynamic and have many different patterns. Interestingly, both viruses interact such that each virus inhibits the other, usually with one virus being dominant. The dominant virus should generally be the target of antiviral therapeutic intervention. Studies with limited numbers of patients have assessed the success of treatm... Current Hepatitis Reports journals http://www.medworm.com/rss/comments.php?id=1482313 Thu, 29 May 2008 06:56:31 +0100 1482313