A Paradigm Shift in Treating Patients with Cirrhosis
Gastroenterology Summary and Comment
Instead of treating complications as they arise, clinicians should prevent them from starting — particularly while cirrhosis is in the compensated phase.
By Atif Zaman, MD, MPH
November 30, 2012
Covering:
Tsochatzis EA et al., Hepatology 2012 Nov; 56:1983
A Novel, Noninvasive Marker for Portal Hypertension in Cirrhosis?
Gastroenterology Summary and Comment
The von Willebrand factor antigen performed well in diagnosing portal hypertension and predicting decompensation outcomes and mortality in patients with cirrhosis.
By Atif Zaman, MD, MPH
November 9, 2012
Covering:
Ferlitsch M et al., Hepatology 2012 Oct; 56:1439
Vasoconstrictors Not Superior to Albumin for Use after Large-Volume Paracentesis
Gastroenterology Summary and Comment
A combination of octreotide and midodrine after large-volume paracentesis was not superior to albumin in delaying time to ascites recurrence in patients with cirrhosis.
By Atif Zaman, MD, MPH
November 9, 2012
Covering:
Bari K et al., Clin Gastroenterol Hepatol 2012 Oct; 10:1169
Azathioprine Metabolite Predicts Remission Maintenance in Autoimmune Hepatitis
Gastroenterology Summary and Comment
Patients who maintained remission had significantly higher levels of the metabolite thioguanine nucleotide than those who relapsed.
By Atif Zaman, MD, MPH
October 26, 2012
Covering:
Dhaliwal HK et al., Hepatology 2012 Oct; 56:1401
Triple Therapy for Chronic HCV Infection Is Cost-Effective in Some Patients
Gastroenterology Summary and Comment
Exceptions are patients without rapid viral response to boceprevir or the IL28B genotype, for whom dual therapy is still best.
Proton-Pump Inhibitors Increase Serious Infection Rates in Decompensated Cirrhosis
Gastroenterology Summary and Comment
However, H2 receptor antagonists did not increase risk for infections and offer a reasonable alternative.
By Atif Zaman, MD, MPH
October 5, 2012
Covering:
Bajaj JS et al., Aliment Pharmacol Ther 2012 Sep 11
Use of Vaptans Is Not Recommended for Hyponatremia in Cirrhosis
Gastroenterology Summary and Comment
These costly drugs did not reduce mortality in a meta-analysis of randomized, controlled trials.
By Atif Zaman, MD, MPH
September 28, 2012
Covering:
Dahl E et al., Aliment Pharmacol Ther 2012 Oct; 36:619
Next-Generation Protease Inhibitor Effective for HCV Infection
Gastroenterology Summary and Comment
Free
Patients who received vaniprevir achieved higher rapid virologic response rates than those who received placebo.
By Atif Zaman, MD, MPH
September 28, 2012
Covering:
Manns MP et al., Hepatology 2012 Sep; 56:884
Improved Criteria for Identifying Transplant Candidates with Hepatocellular Carcinoma
Gastroenterology Summary and Comment
Free
A new model that includes alpha-fetoprotein level predicts 5-year recurrence of posttransplant HCC better than the standard Milan criteria.
By Atif Zaman, MD, MPH
September 28, 2012
Covering:
Duvoux C et al., Gastroenterology 2012 Oct; 143:986
Tenofovir for Hepatitis B in HIV-Coinfected Patients
Tenofovir therapy is associated with a significant decrease in hepatitis B surface antigen levels, but very few patients completely clear surface antigen, even with years of therapy.
By Helmut Albrecht, MD
September 24, 2012
Covering:
Zoutendijk R et al., J Infect Dis 2012 Sep 15; 206:974
Hepatitis C Is an Emerging Infection Among HIV-Infected MSM
HIV/AIDS Clinical Care Summary and Comment
Free
During the past 13 years, the incidence of HCV infection among men who have sex with men increased 18-fold in the Swiss HIV Cohort Study.
By Carlos del Rio, MD
September 24, 2012
Covering:
Wandeler G et al., Clin Infect Dis 2012 Sep 12
Renal Safety of Treatment for Chronic HBV Infection
Gastroenterology Summary and Comment
Nephrotoxicity was similar with tenofovir or entecavir.
By Atif Zaman, MD, MPH
September 21, 2012
Covering:
Gish RG et al., Clin Gastroenterol Hepatol 2012 Aug; 10:941
Which Is Worse, Hepatitis B or Hepatitis C?
General Medicine Summary and Comment
Free
Chronic hepatitis B infection was associated with higher liver-related mortality.
By Abigail Zuger, MD
September 20, 2012
Covering:
Falade-Nwulia O et al., Clin Infect Dis 2012 Aug 15; 55:507
Response to Interferon-α/Ribavirin Does Not Decrease on Retreatment of Hepatitis C
Infectious Diseases Summary and Comment
Among study participants with the same end-of-study response status, HCV RNA declines at 4 weeks were similar between treatment-naive patients and treatment-experienced ones.
By Neil M. Ampel, MD
September 19, 2012
Covering:
Liu J et al., Clin Infect Dis 2012 Sep 1; 55:639
Retinopathy Is Common with Interferon Therapy for HCV Infection
Gastroenterology Summary and Comment
Ophthalmologic screening is warranted in patients with hypertension.
By Atif Zaman, MD, MPH
September 14, 2012
Covering:
Vujosevic S et al., Hepatology 2012 Aug; 56:455
On HCV, These Questions Three
Dr. Paul Sax ponders the future of HCV treatment in his blog HIV and ID Observations .
HBV or HCV Infection: Which Is Worse?
Infectious Diseases Summary and Comment
In a cohort of men who have sex with men, hepatitis B virus infection conferred a higher risk for liver-related mortality than did hepatitis C virus infection.
By Rajesh T. Gandhi, MD
August 22, 2012
Covering:
Falade-Nwulia O et al., Clin Infect Dis 2012 Aug 15; 55:507
Moderate Alcohol Consumption Might Prevent Steatohepatitis
Gastroenterology Summary and Comment
In a cross-sectional study of patients with NAFLD, moderate drinking was associated with a 50% reduced risk for steatohepatitis.
Baseline Liver Fibrosis Stage and ART Use Predict Clinical Outcomes in HIV/HCV-Coinfected Patients
Higher baseline fibrosis stages were associated with higher all-cause mortality and liver-related mortality, whereas ART use was associated with lower mortality.
Lactulose and Probiotics Are Effective in Preventing Recurrent Hepatic Encephalopathy
Gastroenterology Summary and Comment
Free
Both treatments were significantly more effective than placebo.
By Atif Zaman, MD, MPH
August 10, 2012
Covering:
Agrawal A et al., Am J Gastroenterol 2012 Jul; 107:1043
Prophylactic Treatment for Depression with Interferon Therapy for Chronic Hepatitis C
Gastroenterology Summary and Comment
Among HCV-infected adults without previous psychiatric disease, prophylactic antidepressant use significantly decreased the incidence and severity of interferon-associated depression.
By Atif Zaman, MD, MPH
August 10, 2012
Covering:
Schaefer M et al., Ann Intern Med 2012 Jul 17; 157:94
Antiviral Therapy Safely Stopped in HBeAg-Negative Patients with Hepatitis B Infection
Gastroenterology Summary and Comment
Discontinuing adefovir did not lead to any adverse events during 5.5 years of follow-up.
By Atif Zaman, MD, MPH
August 3, 2012
Covering:
Hadziyannis SJ et al., Gastroenterology 2012 Jun 4
Management of Hepatitis B Virus–Infected Healthcare Workers: New CDC Recommendations
Infectious Diseases Clinical Practice Guideline Watch
Routine disclosure of a healthcare worker's status to patients is no longer recommended.
By Rajesh T. Gandhi, MD
August 1, 2012
Covering:
Centers for Disease Control and Prevention (CDC)., MMWR Recomm Rep 2012 Jul 6; 61:1
A Debate on Liver Fibrosis Progression in HIV/HCV-Coinfected Patients
The rate of fibrosis progression is high early in the course of HCV infection, but whether it later declines is unclear.
Silymarin Is Ineffective for Chronic Hepatitis C Virus Infection
Gastroenterology Summary and Comment
Free
In the most rigorous trial to date, oral silymarin was not superior to placebo in decreasing disease activity.
