Detecting #hepatitis B virus in surgical #smoke emitted during laparoscopic surgery
http://m.oem.bmj.com/content/early/2016/08/02/oemed-2016-103724
Conclusions HBV is detectable in surgical smoke. This study provides preliminary data in the investigation of airborne HBV infection.
http://m.oem.bmj.com/content/early/2016/08/02/oemed-2016-103724
Conclusions HBV is detectable in surgical smoke. This study provides preliminary data in the investigation of airborne HBV infection.
MONITORING PATIENTS WHO ARE STARTING #HEPATITIS C TREATMENT, ARE ON TREATMENT, OR HAVE COMPLETED #THERAPY
http://www.hcvguidelines.org/full-report/monitoring-patients-who-are-starting-hepatitis-c-treatment-are-treatment-or-have
This section provides guidance on monitoring patients with chronic hepatitis C who are starting treatment, are on treatment, or have completed treatment. The section is divided into three parts: pretreatment and on-treatment monitoring, posttreatment follow-up for persons in whom treatment has failed to clear virus, and posttreatment follow-up for those who achieved a sustained virologic response (SVR; virologic cure).
http://www.hcvguidelines.org/full-report/monitoring-patients-who-are-starting-hepatitis-c-treatment-are-treatment-or-have
This section provides guidance on monitoring patients with chronic hepatitis C who are starting treatment, are on treatment, or have completed treatment. The section is divided into three parts: pretreatment and on-treatment monitoring, posttreatment follow-up for persons in whom treatment has failed to clear virus, and posttreatment follow-up for those who achieved a sustained virologic response (SVR; virologic cure).
Association of #Hepatitis B Core-Related Antigen With Hepatitis B Virus #Reactivation in Occult Viral Carriers Undergoing High-Risk Immunosuppressive Therapy
http://www.nature.com/ajg/journal/vaop/ncurrent/full/ajg2016436a.html
CONCLUSIONS:
Serum HBcrAg positivity is a significant risk factor of HBV reactivation in HBsAg-negative, anti-HBc-positive patients undergoing high-risk immunosuppressive therapy and can potentially have a role in identifying patients who will best benefit from prophylactic nucleoside analogue treatment.
http://www.nature.com/ajg/journal/vaop/ncurrent/full/ajg2016436a.html
CONCLUSIONS:
Serum HBcrAg positivity is a significant risk factor of HBV reactivation in HBsAg-negative, anti-HBc-positive patients undergoing high-risk immunosuppressive therapy and can potentially have a role in identifying patients who will best benefit from prophylactic nucleoside analogue treatment.
Viral #hepatitis and #Parkinson disease
A national record-linkage study
http://m.neurology.org/content/early/2017/03/29/WNL.0000000000003848
Conclusions: We report strong evidence in favor of an elevation of rates of subsequent PD in patients with hepatitis B and hepatitis C. These findings may be explained by factors peculiar to viral hepatitis, but whether it reflects consequences of infection, shared disease mechanisms, or the result of antiviral treatment remains to be elucidated. Further work is needed to confirm this association and to investigate pathophysiologic pathways, potentially advancing etiologic understanding of PD more broadly.
A national record-linkage study
http://m.neurology.org/content/early/2017/03/29/WNL.0000000000003848
Conclusions: We report strong evidence in favor of an elevation of rates of subsequent PD in patients with hepatitis B and hepatitis C. These findings may be explained by factors peculiar to viral hepatitis, but whether it reflects consequences of infection, shared disease mechanisms, or the result of antiviral treatment remains to be elucidated. Further work is needed to confirm this association and to investigate pathophysiologic pathways, potentially advancing etiologic understanding of PD more broadly.
Extracorporeal cellular therapy (#ELAD) in severe alcoholic #hepatitis: A multinational, prospective, controlled, randomized trial
http://onlinelibrary.wiley.com/doi/10.1002/lt.24986/abstract
Hepatoblastoma-derived C3A cells express anti-inflammatory proteins and growth factors and were tested in an extracorporeal cellular therapy (ELAD) study to establish their effect on survival for subjects with sAH. Adults with sAH, bilirubin ≥8 mg/dL, Maddrey's discriminant function ≥ 32, and Model for End-Stage Liver Disease (MELD) score ≤ 35 were randomized to receive standard of care (SOC) only or 3-5 days of continuous ELAD treatment plus SOC. After a minimum follow-up of 91 days, overall survival (OS) was assessed by using a Kaplan-Meier survival analysis. A total of 203 subjects were enrolled (96 ELAD and 107 SOC) at 40 sites worldwide. Comparison of baseline characteristics showed no significant differences between groups and within subgroups. There was no significant difference in serious adverse events between the 2 groups. In an analysis of the intent-to-treat population, there was no difference in OS (51.0% versus 49.5%). The study failed its primary and secondary end point in a population with sAH and with a MELD ranging from 18 to 35 and no upper age limit. In the prespecified analysis of subjects with MELD < 28 (n = 120), ELAD was associated with a trend toward higher OS at 91 days (68.6% versus 53.6%; P = .08). Regression analysis identified high creatinine and international normalized ratio, but not bilirubin, as the MELD components predicting negative outcomes with ELAD. A new trial investigating a potential benefit of ELAD in younger subjects with sufficient renal function and less severe coagulopathy has been initiated
http://onlinelibrary.wiley.com/doi/10.1002/lt.24986/abstract
Hepatoblastoma-derived C3A cells express anti-inflammatory proteins and growth factors and were tested in an extracorporeal cellular therapy (ELAD) study to establish their effect on survival for subjects with sAH. Adults with sAH, bilirubin ≥8 mg/dL, Maddrey's discriminant function ≥ 32, and Model for End-Stage Liver Disease (MELD) score ≤ 35 were randomized to receive standard of care (SOC) only or 3-5 days of continuous ELAD treatment plus SOC. After a minimum follow-up of 91 days, overall survival (OS) was assessed by using a Kaplan-Meier survival analysis. A total of 203 subjects were enrolled (96 ELAD and 107 SOC) at 40 sites worldwide. Comparison of baseline characteristics showed no significant differences between groups and within subgroups. There was no significant difference in serious adverse events between the 2 groups. In an analysis of the intent-to-treat population, there was no difference in OS (51.0% versus 49.5%). The study failed its primary and secondary end point in a population with sAH and with a MELD ranging from 18 to 35 and no upper age limit. In the prespecified analysis of subjects with MELD < 28 (n = 120), ELAD was associated with a trend toward higher OS at 91 days (68.6% versus 53.6%; P = .08). Regression analysis identified high creatinine and international normalized ratio, but not bilirubin, as the MELD components predicting negative outcomes with ELAD. A new trial investigating a potential benefit of ELAD in younger subjects with sufficient renal function and less severe coagulopathy has been initiated
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Increased #Mortality Among Patients With vs Without Cirrhosis and Autoimmune #Hepatitis
https://www.cghjournal.org/article/S1542-3565(18)31078-4/fulltext
... Patients with AIH and cirrhosis had significantly higher mortality than the general population (SMR, 1.9; 95% CI, 1.2–3.4), whereas patients without cirrhosis did not (SMR, 1.2; 95% CI, 0.8–1.8). Patients with AIH-PSC had the largest increase in mortality, compared to the general population (SMR, 4.7; 95% CI, 1.5–14.6), of all groups analyzed. Mortality in patients with AIH and primary biliary cholangitis was not greater than the general population. Four or more relapses per decade or not achieving remission was associated with an increase in liver-related death or liver transplantation. Nine patients underwent liver transplantation; 2 died from non-liver related causes. Four of 9 patients on the waitlist for transplantation died before receiving a donated liver.
Conclusion
In an analysis of data from a large national cohort of patients with AIH, we found increased mortality of patients with cirrhosis, but not of patients without cirrhosis, compared to the general Dutch population. Survival was significantly reduced in patients with AIH and features of concurrent PSC.
Increased #Mortality Among Patients With vs Without Cirrhosis and Autoimmune #Hepatitis
https://www.cghjournal.org/article/S1542-3565(18)31078-4/fulltext
... Patients with AIH and cirrhosis had significantly higher mortality than the general population (SMR, 1.9; 95% CI, 1.2–3.4), whereas patients without cirrhosis did not (SMR, 1.2; 95% CI, 0.8–1.8). Patients with AIH-PSC had the largest increase in mortality, compared to the general population (SMR, 4.7; 95% CI, 1.5–14.6), of all groups analyzed. Mortality in patients with AIH and primary biliary cholangitis was not greater than the general population. Four or more relapses per decade or not achieving remission was associated with an increase in liver-related death or liver transplantation. Nine patients underwent liver transplantation; 2 died from non-liver related causes. Four of 9 patients on the waitlist for transplantation died before receiving a donated liver.
Conclusion
In an analysis of data from a large national cohort of patients with AIH, we found increased mortality of patients with cirrhosis, but not of patients without cirrhosis, compared to the general Dutch population. Survival was significantly reduced in patients with AIH and features of concurrent PSC.
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Extrahepatic #cancers are the leading cause of death in patients achieving hepatitis B virus control or #hepatitis C virus eradication
https://aasldpubs.onlinelibrary.wiley.com/doi/10.1002/hep.30034
Data on extrahepatic cancers (EHCs) in compensated viral cirrhosis are limited.
complications including primary liver cancer (PLC).
After a median follow‐up of 59.7 months, 227 PLCs were diagnosed (5‐year cumulative incidence CumI 13.4%) and 93 patients developed EHC (14 patients with lymphoid or related tissue cancer and 79 with solid tissue cancer; 5‐year EHC CumI, 5.9%). Compared to the general French population, patients were younger at cancer diagnosis, with significantly higher risk of EHC in HCV patients (SMR, 1.31; 95 confidence interval CI, 1.04‐1.64; P = 0.017) and after SVR (SMR = 1.57; 95% CI, 1.08‐2.22; P = 0.013). EHC was the fourth leading cause of death in the whole cohort and the first in patients with viral control/eradication.
Conclusion: Compared to the general French population, HCV cirrhosis is associated with a higher risk of EHC and the first cause of death in patients with viral cirrhosis who achieve virological control/eradication
Extrahepatic #cancers are the leading cause of death in patients achieving hepatitis B virus control or #hepatitis C virus eradication
https://aasldpubs.onlinelibrary.wiley.com/doi/10.1002/hep.30034
Data on extrahepatic cancers (EHCs) in compensated viral cirrhosis are limited.
complications including primary liver cancer (PLC).
After a median follow‐up of 59.7 months, 227 PLCs were diagnosed (5‐year cumulative incidence CumI 13.4%) and 93 patients developed EHC (14 patients with lymphoid or related tissue cancer and 79 with solid tissue cancer; 5‐year EHC CumI, 5.9%). Compared to the general French population, patients were younger at cancer diagnosis, with significantly higher risk of EHC in HCV patients (SMR, 1.31; 95 confidence interval CI, 1.04‐1.64; P = 0.017) and after SVR (SMR = 1.57; 95% CI, 1.08‐2.22; P = 0.013). EHC was the fourth leading cause of death in the whole cohort and the first in patients with viral control/eradication.
Conclusion: Compared to the general French population, HCV cirrhosis is associated with a higher risk of EHC and the first cause of death in patients with viral cirrhosis who achieve virological control/eradication
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The Impact of Autoimmune #Hepatitis and Its Treatment on #Health Utility
https://aasldpubs.onlinelibrary.wiley.com/doi/10.1002/hep.30031
Patient reporting suggests that the physical and psychological effects of autoimmune hepatitis (AIH) can be substantial. However, health‐related quality of life (HRQOL) in patients with AIH remains incompletely characterized, and health utility remains to be explored.
HRQOL, measured by the EQ‐5D‐5L utility index, is shown to be significantly impaired in our cohort of AIH patients compared with population norms. Within the AIH cohort, corticosteroid use was found to be significantly associated with impaired HRQOL, even when controlling for biochemical disease activity status. Conclusion: Our data show evidence of HRQOL impairment in a large cohort of AIH patients compared with the general population. Furthermore, corticosteroid use is strongly associated with decreased HRQOL, independent of remission status. This highlights the need for better corticosteroid‐free therapy approaches and it emphasizes the need for future novel therapeutic trials in AIH.
The Impact of Autoimmune #Hepatitis and Its Treatment on #Health Utility
https://aasldpubs.onlinelibrary.wiley.com/doi/10.1002/hep.30031
Patient reporting suggests that the physical and psychological effects of autoimmune hepatitis (AIH) can be substantial. However, health‐related quality of life (HRQOL) in patients with AIH remains incompletely characterized, and health utility remains to be explored.
HRQOL, measured by the EQ‐5D‐5L utility index, is shown to be significantly impaired in our cohort of AIH patients compared with population norms. Within the AIH cohort, corticosteroid use was found to be significantly associated with impaired HRQOL, even when controlling for biochemical disease activity status. Conclusion: Our data show evidence of HRQOL impairment in a large cohort of AIH patients compared with the general population. Furthermore, corticosteroid use is strongly associated with decreased HRQOL, independent of remission status. This highlights the need for better corticosteroid‐free therapy approaches and it emphasizes the need for future novel therapeutic trials in AIH.
Hepatic decompensation in #cirrhotic patients receiving antiviral therapy for chronic #hepatitis B
https://2medical.news/2020/09/11/hepatic-decompensation-in-cirrhotic-patients-receiving-antiviral-therapy-for-chronic-hepatitis-b/
It is unclear if anti-hepatitis B virus (HBV) treatment can eliminate incident hepatic decompensation. Here we report the incidence and predictors of hepatic decompensation among cirrhotic patients receiving antiviral therapy for chronic hepatitis B.. ..818 patients (mean age, 54.9 years; 519 male [63.4%]) were included in the final analysis. During a mean follow-up of 58.1 months, 32 (3.9%) patients developed hepatic decompensation, among whom 34% …
https://2medical.news/2020/09/11/hepatic-decompensation-in-cirrhotic-patients-receiving-antiviral-therapy-for-chronic-hepatitis-b/
It is unclear if anti-hepatitis B virus (HBV) treatment can eliminate incident hepatic decompensation. Here we report the incidence and predictors of hepatic decompensation among cirrhotic patients receiving antiviral therapy for chronic hepatitis B.. ..818 patients (mean age, 54.9 years; 519 male [63.4%]) were included in the final analysis. During a mean follow-up of 58.1 months, 32 (3.9%) patients developed hepatic decompensation, among whom 34% …
Is an 8‐week regimen of glecaprevir/pibrentasvir sufficient for all #hepatitis C virus infected patients in the real‐world experience?
https://2medical.news/2020/12/02/is-an-8%E2%80%90week-regimen-of-glecaprevir-pibrentasvir-sufficient-for-all-hepatitis-c-virus-infected-patients-in-the-real%E2%80%90world-experience/
The revolution of the antiviral treatment of hepatitis C virus (HCV) infection resulting in higher effectiveness came with the introduction of direct‐acting antivirals with pangenotypic regimens as a final touch. Among them, the combination of glecaprevir (GLE) and pibrentasvir (PIB) provides the opportunity for shortening therapy to 8 weeks in the majority of patients. Because of still insufficient evaluation of this regimen in the real‐world …
https://2medical.news/2020/12/02/is-an-8%E2%80%90week-regimen-of-glecaprevir-pibrentasvir-sufficient-for-all-hepatitis-c-virus-infected-patients-in-the-real%E2%80%90world-experience/
The revolution of the antiviral treatment of hepatitis C virus (HCV) infection resulting in higher effectiveness came with the introduction of direct‐acting antivirals with pangenotypic regimens as a final touch. Among them, the combination of glecaprevir (GLE) and pibrentasvir (PIB) provides the opportunity for shortening therapy to 8 weeks in the majority of patients. Because of still insufficient evaluation of this regimen in the real‐world …
Serum hepatitis B #core‐related antigen level stratifies risk of disease progression in chronic #hepatitis B patients with intermediate viral load
https://2medical.news/2021/01/28/serum-hepatitis-b-core%E2%80%90related-antigen-level-stratifies-risk-of-disease-progression-in-chronic-hepatitis-b-patients-with-intermediate-viral-load/
Patients with chronic hepatitis B virus (HBV) infection are at risk of developing liver disease. Serum hepatitis B core‐related antigen (HBcrAg) is a new biomarker for intrahepatic templates for HBV replication.. ..A total of 1673 treatment‐naïve, non‐cirrhotic patients with negative hepatitis B e antigen (HBeAg) and alanine aminotransferase (ALT) level <40 U/L at baseline were enrolled. We explored the relationship between baseline levels of HBcrAg …
https://2medical.news/2021/01/28/serum-hepatitis-b-core%E2%80%90related-antigen-level-stratifies-risk-of-disease-progression-in-chronic-hepatitis-b-patients-with-intermediate-viral-load/
Patients with chronic hepatitis B virus (HBV) infection are at risk of developing liver disease. Serum hepatitis B core‐related antigen (HBcrAg) is a new biomarker for intrahepatic templates for HBV replication.. ..A total of 1673 treatment‐naïve, non‐cirrhotic patients with negative hepatitis B e antigen (HBeAg) and alanine aminotransferase (ALT) level <40 U/L at baseline were enrolled. We explored the relationship between baseline levels of HBcrAg …
Comparison of Novel Biomarkers with Conventional #HBV Markers among Untreated Adults with Chronic #Hepatitis B in North America
https://2medical.news/2021/06/22/comparison-of-novel-biomarkers-with-conventional-hbv-markers-among-untreated-adults-with-chronic-hepatitis-b-in-north-america/
https://2medical.news/2021/06/22/comparison-of-novel-biomarkers-with-conventional-hbv-markers-among-untreated-adults-with-chronic-hepatitis-b-in-north-america/
2Medical.News
Comparison of Novel Biomarkers with Conventional #HBV Markers among Untreated Adults with Chronic #Hepatitis B in North America
The clinical utility of two novel biomarkers, hepatitis B virus (HBV) RNA and hepatitis B core-related antigen (HBcrAg), as compared to conventional markers of HBV replication and disease activity …
Auto-immune #hepatitis following #COVID vaccination
https://2medical.news/2021/07/14/auto-immune-hepatitis-following-covid-vaccination/
https://2medical.news/2021/07/14/auto-immune-hepatitis-following-covid-vaccination/
2Medical.News
Auto-immune #hepatitis following #COVID vaccination
Unprecedented loss of life due to the COVID pandemic has necessitated the development of several vaccines in record time. Most of these vaccines have received approval without being extensively whe…
The changing characteristics of patients infected with chronic hepatitis #C virus from 2014 to 2019: Real-world data from the German #Hepatitis C-Registry (DHC-R)
https://2medical.news/2021/08/07/the-changing-characteristics-of-patients-infected-with-chronic-hepatitis-c-virus-from-2014-to-2019-real-world-data-from-the-german-hepatitis-c-registry-dhc-r/
https://2medical.news/2021/08/07/the-changing-characteristics-of-patients-infected-with-chronic-hepatitis-c-virus-from-2014-to-2019-real-world-data-from-the-german-hepatitis-c-registry-dhc-r/
2Medical.News
The changing characteristics of patients infected with chronic hepatitis #C virus from 2014 to 2019: Real-world data from the German…
The number of patients diagnosed with hepatitis C virus (HCV) is markedly higher than the number initiating treatment indicating gaps in the care cascade, likely centered around reaching at-risk po…