HBV Drug-Resistant Mutations and Vaccine Escape
Infectious Diseases
Summary and Comment
Nonsuppressive anti-HBV therapy may select for drug-resistant mutants that could escape vaccine-induced protection from infection.
By Rajesh T. Gandhi, MD
December 5, 2007
Covering:
Sheldon J et al., J Acquir Immune Defic Syndr 2007 Nov 1; 46:279
HBV Mutations in Mono- and Coinfected Patients
In a small Spanish study, patients with HBV genotype A were more likely than others to develop mutations as a result of 3TC treatment.
Postexposure Prophylaxis for Hepatitis A: Whats the Preferred Approach?
In a head-to-head comparison, hepatitis A vaccine was noninferior to immune globulin.
Eltrombopag for Thrombocytopenia in Cirrhotic Patients with HCV
Gastroenterology
Summary and Comment
Free
A thrombopoietin agonist raises platelet counts in HCV-positive patients who are undergoing antiviral therapy.
By Atif Zaman, MD, MPH
November 28, 2007
Covering:
McHutchison JG et al., N Engl J Med 2007 Nov 29; 357:2227
Hepatitis B Prophylaxis Is Cost-Effective in Lymphoma Patients Who Undergo Chemotherapy
Gastroenterology
Summary and Comment
Preventing HBV reactivation during chemotherapy results in fewer liver-related or cancer-related deaths.
Occult HBV Infection in HIV/HCV-Coinfected Patients
Although HBV DNA is frequently found in the liver of HIV/HCV-coinfected patients, the clinical implication of this finding is uncertain.
PEP for Hepatitis A: Revised Recommendations
Infectious Diseases
Summary and Comment
Hepatitis A vaccine is efficacious as postexposure prophylaxis, but IG is still preferred in some settings.
By Stephen G. Baum, MD
November 7, 2007
Covering:
Centers for Disease Control and Prevention (CDC)., MMWR Morb Mortal Wkly Rep 2007 Oct 19; 56:1080
Postexposure Vaccination Will Prevent Hepatitis A
General Medicine
Summary and Comment
Free
For some exposed individuals, it works as well as immune globulin injections.
By Abigail Zuger, MD
November 1, 2007
Covering:
Victor JC et al., N Engl J Med 2007 Oct 25; 357:1685
Baker CJ., N Engl J Med 2007 Oct 25; 357:1757
Hepatic-Fibrosis Progression in HIV/HCV-Coinfected Patients
Infectious Diseases
Summary and Comment
In an urban cohort, 24% of HIV/HCV-coinfected patients had significant progression of hepatic fibrosis in 3 years.
Postexposure Prophylaxis for Hepatitis A
Infectious Diseases
Summary and Comment
Free
Until now, researchers had never directly compared immune globulin with hepatitis A vaccine for postexposure prophylaxis.
By Larry M. Baddour, MD
October 18, 2007
Covering:
Victor JC et al., N Engl J Med 2007 Oct 25; 357:1685
Baker CJ., N Engl J Med 2007 Oct 25; 357:1757
New Recommendations for Use of Hepatitis A Vaccine in Children
Infectious Diseases
Clinical Practice Guideline Watch
Hepatitis A vaccination is now recommended for all children aged 1 year who do not have hypersensitivity to one of its components.
By Robert S. Baltimore, MD
October 3, 2007
Covering:
American Academy of Pediatrics Committee on Infectious Diseases., Pediatrics 2007 Jul; 120:189
Occult HBV Infection in HIV-Infected Women
In the Womens Interagency HIV Study, only 2% of HIV-infected women who tested positive for isolated antibody to hepatitis B core antigen had evidence of occult HBV infection.
By Rajesh T. Gandhi, MD
September 17, 2007
Covering:
Tsui JI et al., Clin Infect Dis 2007 Sep 15; 45:736
Absolute CD4-Cell Count vs. CD4-Cell Percentage: Which to Use in Patients with Liver Disease?
Investigators in Italy aimed to elucidate the role of absolute CD4-cell count and CD4-cell percentage in determining the risk for AIDS-defining illness among HIV-infected patients with liver disease, but their report falls short.
Acute Hepatitis E During Pregnancy
Women's Health
Summary and Comment
Women with HEV-associated acute hepatitis during late pregnancy had poor maternal and fetal outcomes.
By Anna Wald, MD, MPH
September 13, 2007
Covering:
Patra S et al., Ann Intern Med 2007 Jul 3; 147:28-33
Mycophenolate Mofetil for Autoimmune Hepatitis Patients Who Cant Tolerate Azathioprine
Gastroenterology
Summary and Comment
Free
A small retrospective study suggests that such patients benefit from switching to MMF.
By Atif Zaman, MD, MPH
August 30, 2007
Covering:
Inductivo-Yu I et al., Clin Gastroenterol Hepatol 2007 Jul; 5:799-802
Normal ALT Levels and Advanced Fibrosis in HCV/HIV-Coinfected Patients
HIV/AIDS Clinical Care
Summary and Comment
Free
In a cohort of coinfected patients, 9% had persistently normal ALT levels; of those, nearly one quarter had advanced liver fibrosis.
By Philippe J. Zamor, MD, and Kenneth E. Sherman, MD, PhD
August 27, 2007
Covering:
Maida I et al., AIDS Res Hum Retroviruses 2007 Jun; 23:801-4
The Benefits of Treating HCV Infection in HIV-Infected Patients
Infectious Diseases
Summary and Comment
Free
Among HIV/HCV-coinfected patients, risk for ART-associated hepatotoxicity was lower among those who had responded to HCV therapy than among those who had not.
By Daniel J. Diekema, MD, MS
August 22, 2007
Covering:
Labarga P et al., J Infect Dis 2007 Sep 1; 196:670-6
Cooper CL., J Infect Dis 2007 Sep 1; 196:656-8
Long-Term Outcomes in Overlap Syndrome of Primary Biliary Cirrhosis and Autoimmune Hepatitis
Gastroenterology
Summary and Comment
Varices, GI bleeding, ascites, and the composite outcome of liver transplant or death were all more common among patients with both PBC and probable AIH than among those with PBC alone.
By Atif Zaman, MD, MPH
August 17, 2007
Covering:
Silveira MG et al., Am J Gastroenterol 2007 Jun; 102:1244-50
Using Liver Stiffness to Measure Portal Hypertension Noninvasively
Gastroenterology
Summary and Comment
Transient elastography could be a noninvasive way of identifying cirrhotic patients with clinically significant portal hypertension.
By Atif Zaman, MD, MPH
August 3, 2007
Covering:
Vizzutti F et al., Hepatology 2007 May; 45:1290-7
Histologic Findings and Outcomes in HBV-Positive Patients in the Immunotolerant Phase
Gastroenterology
Summary and Comment
Liver biopsy might not be necessary in immunotolerant patients, but follow-up is.
By Atif Zaman, MD, MPH
August 3, 2007
Covering:
Andreani T et al., Clin Gastroenterol Hepatol 2007 May; 5:636-41
Label Change for Entecavir
On July 24, 2007, the FDA approved revised labeling for entecavir. Consistent with a recent change in U.S. Department of Health and Human Services treatment . . .
Relapse After Treatment Withdrawal in Patients with Autoimmune Hepatitis
Gastroenterology
Summary and Comment
Free
Serum AST, -globulin, and IgG levels, but not liver histology, predicted risk for relapse.
By Atif Zaman, MD, MPH
July 27, 2007
Covering:
Montano-Loza AJ et al., Am J Gastroenterol 2007 May; 102:1005-12
Maintenance Interferon Therapy for Patients with Chronic Hepatitis C Infections
Gastroenterology
Summary and Comment
Two years of maintenance monotherapy in high-risk HCV-positive cirrhotic patients is ineffective for lengthening complication-free survival.
By Atif Zaman, MD, MPH
July 27, 2007
Covering:
Fartoux L et al., Clin Gastroenterol Hepatol 2007 Apr; 5:502-7
The Predictive Value of Rapid Virologic Response to HCV Therapy in Coinfected Patients
Retrospective data indicate that, in coinfected patients, rapid virologic response to HCV therapy might predict sustained virologic response.
HCV Treatment How Short Can We Go?
Infectious Diseases
Summary and Comment
Free
For genotypes 2 and 3, 24-week treatment is more effective than 16-week treatment.
By Richard T. Ellison III, MD
July 11, 2007
Covering:
Shiffman ML et al., N Engl J Med 2007 Jul 12; 357:124-34
Liang TJ., N Engl J Med 2007 Jul 12; 357:176-8