Archives - 2015: Fibrosis/Cirrhosis/Liver Cancer/Transplants
2016 NEWS AND UPDATES
Fibrosis and Cirrhosis: Progression to cirrhosis is usually clinically silent and a wide range of fibrosis rates occur. Annual rates of progression to cirrhosis increase with older age at the time of infection and longer duration of infection but the relationship is not linear. It is estimated that approximately 20 to 30% of those infected with HCV will develop cirrhosis during the 20 to 30 year-period after becoming chronically infected. This progression, however, is variable and it is impossible to predict the expected outcome for an individual early in the course of their disease. There are no predictive models that can accurately estimate the risk of disease progression.
Factors Impacting Rate of Progression of Fibrosis Age: Older persons appear to have more severe disease than younger persons with the same duration of hepatitis C infection. In addition, acquisition of HCV after age 40 is associated with a more rapid fibrosis progression rate. In one study, progression to cirrhosis over a 20-year period occurred in only 2% of subjects infected before the age of 20 and in 63% of subjects infected after the age of 50
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Weekend Reading: Talking About HCV Treatment - "Can Hepatitis C Be Cured" or "Am I in remission?"
2014 - Fibrosis / Cirrhosis / Liver Cancer / Transplants
2013 - Fibrosis / Cirrhosis / Liver Cancer / Transplants
Liver Cancer - AASLD/2011
Management of Hepatocellular Carcinoma: An Update
Links Of Interest
FDA approved hepatitis C treatments.
I Help C - Your Best Friends Guide to Hepatitis C and Cirrhosis
Guidance for the treatment of hepatitis C
The new guidelines will have a complex algorithm for practitioners around the country to follow and see whats the right treatment, for the right patients, for the right about of time.
Click here to begin reading...
HCV Treatment Guideline Update
Breaking down the changes in the new hep C treatment guidelines.
Hepatitis C Online Course
A self-study, interactive course on Hepatitis C infection.
Archives - 2015 News and Updates
Elsewhere on the site
2016 Rsearch News - Fibrosis/Cirrhosis/Liver Cancer/Transplants
Improved Fibrosis Staging in Patients With Liver Disease
Liver International, December 23, 2015
Fighting liver fibrosis, the wound that never heals
Scientists at the Salk Institute have identified a drug that halts this unchecked accumulation of scar tissue in the liver. The small molecule, called JQ1, prevented as well as reversed fibrosis in animals and could help the millions of people worldwide affected by liver fibrosis and cirrhosis, caused by alcoholism and diseases like hepatitis. These results were published in PNAS the week of December 7, 2015.
Watch Patients Treated For Hepatitis C: Studying possible regression in cirrhosis/ fibrosis
A considerable amount of research has been done looking at how liver disease can progress in patients, but a recent study looked at possible regression in conditions like cirrhosis and fibrosis.
SVR associated with improvement in fibrosis, cirrhosis
SAN FRANCISCO — Sixty percent of patients who reached SVR after treatment for hepatitis C virus infection demonstrated improvement in fibrosis or cirrhosis, according to findings presented at The Liver Meeting 2015.
Ana Maria Crissien, MD, of the departments of gastroenterology and hepatology at Scripps Clinic and Green Hospital in La Jolla, Calif., and colleagues, proposed that curing HCV could yield a regression of advanced fibrosis and/or cirrhosis. Additionally, she said FibroScan (EchoSens) may be a tool to determine the reversal of fibrosis..
Coffee Consumption Decreases Risks for Hepatic Fibrosis and Cirrhosis: A Meta-Analysis
Previous studies have demonstrated that coffee consumption may be inversely correlated with hepatic fibrosis and cirrhosis. However, the reported results have been inconsistent. To summarize previous evidences quantitatively, a meta-analysis was performed.
Early HCV fibrosis suggests need for early treatment
NEW YORK (Reuters Health) - In the early stages of chronic infection with hepatitis C virus (HCV), fibrosis stage on biopsy may help predict which patients should be treated promptly and which can wait, according to researchers at the Centers for Disease Control and Prevention (CDC).
Common risk factors of fibrosis progression in chronic hepatitis C
A study in the most recent issue of Gut evaluates the impact of common risk factors of fibrosis progression in chronic hepatitis C.
Hepatitis C - Fibrosis index based on four factors better predicts advanced fibrosis or cirrhosis than aspartate aminotransferase/platelet ratio index
Hepatic fibrosis is one of the important factors associated with the long-term prognosis of CHC patients. If noninvasive methods could accurately predict the severity of hepatic fibrosis, the majority of liver biopsies could be avoided.
Fatty Liver and Diabetes Increase Liver Fibrosis Risk
Justified granulation aided noninvasive liver fibrosis classification system
Liver biopsy provides a high accuracy diagnosis, however it is painful and invasive procedure. Recently, we witness an outburst of non-invasive tests (biological and physical ones) aiming to define severity of liver fibrosis, but commonly used FibroTest®, according to an independent research, in some cases may have accuracy lower than 50 %. In this paper a data mining and classification technique is proposed to determine the stage of liver fibrosis using easily accessible laboratory data.
Liver fibrosis regression after hepatitis C treatment linked to reduced
Over years or decades, chronic hepatitis C virus (HCV) infection can lead to liver fibrosis (build-up of collagen and other scar material), cirrhosis ...
Noninvasive Assessment of Liver Fibrosis
Current Opinion in Gastroenterology, June 17, 2015
Hepatitis C Resource Center Blog - Coffee Decreases HCV Advanced Fibrosis Risk
New study indicates that an average daily intake of an estimated 100 mg of caffeine from coffee, tea, or soda is associated with an approximately one-third reduction in odds of advanced fibrosis, although higher intake does not seem to confer any additional benefit. Interestingly, tea intake in those who do not consume coffee may also be associated with a decreased risk of advanced fibrosis. Study authors noted an average of 100 mg or more of caffeine daily from sodas and teas does not have the same protective effect as 100 mg or more of caffeine daily from combined sources (coffee, tea, soda) or from coffee alone, suggesting that caffeine alone may not entirely explain the effect of coffee on liver disease.
"Hepatic Fibrosis: Concept to treatment"
Prof. Scott Friedmann present his article "Hepatic Fibrosis: Concept to treatment". Part of the Journal of Hepatology's 30 yr anniversary supplement "Emerging Trends in Hepatology
The Severity of Steatosis Influences Liver Stiffness Measurement in Patients with Nonalcoholic Fatty Liver Disease
Steatosis can lead to overestimation of fibrosis
Does FibroScan Accurately Assess Liver Fibrosis?
Fibroscan vs histology for liver fibrosis analysis
A study in this month's Clinical Gastroenterology & Hepatology evaluates the accuracy of Fibroscan, compared with histology, in analysis of liver fibrosis in patients with Hepatitis B or C.
Diagnostic Performance of Magnetic Resonance Elastography in Staging Liver Fibrosis: A Systematic Review and Meta-analysis of Individual Participant Data
Intercept Announces New Data Analyses From FLINT Trial of Obeticholic Acid in NASH
Progression to severe fibrosis or cirrhosis is common among baby boomers with hepatitis C in the US
Severity of liver disease among chronic hepatitis C patients: An observational study of 4594 patients in five European countries
Assessment of the severity of liver disease following infection with hepatitis C virus (HCV) is important in treatment selection and prognosis. As invasive liver biopsy procedures are regarded as the reference method to assess the stage of fibrosis, it is important to identify patient characteristics that are predictive of liver fibrosis severity. The aim of the study was to describe the distribution of liver severity scores, clinical characteristics, and physicians' assessment of fibrosis among HCV patients in five European countries. **43% had mild fibrosis
Strategies for Slowing the Progression of Liver Fibrosis in Hepatitis C
In 2 recent studies, statins and aspirin have been associated with lower rates of progression of liver fibrosis in patients with hepatitis C. Strategies for slowing the rate of progression of liver fibrosis are important for these reasons: (1) the high cost of treatment for hepatitis C; and (2) updated guidelines that recommend prioritizing treatment to sicker patients and postponing treatment in other groups
Liver Fibrosis Starts Early After Hepatitis C Infection
MedicalResearch.com Interview with:
Adeel A. Butt, MD, MS, FACP, FIDSA
Adjunct Associate Professor of Medicine and Clinical and Translational Science
University of Pittsburgh School of Medicine
MedicalResearch: What is the background for this study? What are the main findings?
Dr. Butt: Studying clinical consequences of hepatitis C virus (HCV) infection is often limited by the lack of knowledge of actual time of infection. We used the Electronically Retrieved Cohort of HCV-Infected Veterans (ERCHIVES), a well-established national cohort of HCV infected veterans and corresponding HCV-uninfected controls, to identify patients with a known time frame for HCV infection. Our primary aim was to determine the rate of liver fibrosis progression among HCV-infected persons over time, with and to determine factors associated with development of cirrhosis and hepatic decompensation among these persons.
Among 1840 persons who were HCV+ and 1840 HCV− controls, we found that fibrosis progression started early after HCV infection tapered off after 5 years. After 10 years of follow-up, 18.4% of HCV+ and 6.1% of HCV- persons developed liver cirrhosis. Nine years after diagnosis of cirrhosis, only 1.8% of HCV+ and 0.3% of HCV- persons had developed hepatic decompensation.
MedicalResearch: What clinicians and should patients take away from your report?
Dr. Butt: The main messages are that liver fibrosis starts early after Hepatitis C infection, though progression is still slow over time. Hence screening for liver fibrosis or liver damage should start early.
MedicalResearch: What recommendations do you have for future research as a result of this study?
Dr. Butt: We need to design studies to find out if clinical consequences, e.g. liver failure, liver cancer, death, etc. can be prevented or delayed using early interventions like newly approced HCV therapies.
Liver Fibrosis Progression in Hepatitis C Virus Infection After Seroconversion
Butt AA1, Yan P2, Lo Re V 3rd3, Rimland D4, Goetz MB5, Leaf D5, Freiberg MS1, Klein MB6, Justice AC7, Sherman KE8; for the ERCHIVES (Electronically Retrieved Cohort of HCV Infected Veterans) Study Team.
JAMA Intern Med. 2015 Feb 1;175(2):178-185. doi: 10.1001/jamainternmed.2014.6502.
Gilead Sciences Announces Acquisition of Phenex Pharmaceuticals’ Development Program for Non-Alcoholic Steatohepatitis (NASH) and Other Liver Diseases
Liver fibrosis develops early, progresses quickly after hepatitis C virus seroconversion
"If newer treatments demonstrate slowing or reversal of fibrosis progression and delaying development of cirrhosis, our data would suggest treating early in the course of infection," the authors conclude. "On the other hand, if the cirrhosis has already set in, treatment may be helpful in preventing hepatic decompensation in only a small number of those with cirrhosis, since the number who go on to develop this complication is small."
Dr. Marc G. Ghany from the National Institute of Diabetes and Digestive and Kidney Diseases in Bethesda, Maryland, addressed the ongoing debate of whom to treat for chronic HCV in a related editorial.
"All patients with chronic HCV infection should be considered candidates for therapy, and mild liver disease is not a reason to deny a patient therapy who otherwise qualifies for treatment," he told Reuters Health by email...
VIEKIRA Pak (ombitasvir, paritaprevir, ritonavir fixed dose combination tablets copackaged with dasabuvir tablets) for use with or without ribavirin for the treatment of patients with genotype 1 chronic hepatitis C virus (HCV) infection including those with compensated cirrhosis....
Scientists discover a potential treatment for cirrhosis
A study by IRB Barcelona and IDIBAPS reveals a therapeutic target to prevent the development of the many abnormal blood vessels that cause gastrointestinal bleeding—the main complication in cirrhosis
Statin use may reduce risk for cirrhosis in patients with HCV
The use of statin therapy among patients with hepatitis C virus infection reduced their risk for developing cirrhosis, according to published findings.
Daclatasvir/Sofosbuvir Improves Liver Parameters in HCV, Advanced Cirrhosis
By Da Hee Han, PharmD
Patients from the advanced cirrhosis cohort of the Phase 3 ALLY-1 study had high rates of sustained virologic response (SVR12) when treated with daclatasvir/sofosbuvir/ribavirin, as well as improved clinical and biochemical indicators of liver disease, investigators reported at The Liver Meeting® 2015.
PPIs Reduce Rebleeding in Patients with Cirrhosis, Acute Variceal Bleeding
By Bryant Furlow November 14, 2015
Proton pump inhibitors (PPIs) are safe and effective in reducing the rate of recurrent bleeding among patients with cirrhosis and acute variceal bleeding, according to a single-institution case-control study reported at the The Liver Meeting® 2015.
Sofosbuvir-Based Therapy Leads to Rapid LOXL2 Decline in Cirrhosis
By Bryant Furlow
November 17, 2015
A rapid decline in serum/plasma lysyl oxidase-like-2 (LOXL2) levels was seen in cirrhotic patients treated with sofosbuvir (SOF)-based therapy, reported authors of a new study presented at The Liver Meting® 2015.
Lactulose Improves QoL in Patients with Minimal Hepatic Encephalopathy
By Da Hee Han, PharmD
November 16, 2015
In patients with minimal hepatic encephalopathy, prophylactic lactulose treatment improves cognition, quality of life, and intestinal microbiota, results of a multicenter, randomized, controlled trial presented at The Liver Meeting® 2015 have shown.
FDA Approves New Indications for Harvoni®, Gilead's Once-Daily Single Tablet Regimen for Chronic Hepatitis C
Gilead Sciences, Inc. (Nasdaq: GILD) today announced that the U.S. Food and Drug Administration (FDA) has approved Harvoni® (ledipasvir/sofosbuvir) for expanded use in patients with genotype 4, 5 and 6 chronic hepatitis C virus (HCV) infection and in patients co-infected with HIV. In addition, Harvoni plus ribavirin (RBV) for 12 weeks was approved as an alternate therapy to 24 weeks of Harvoni for treatment-experienced, genotype 1 patients with cirrhosis. Harvoni received regulatory approval for the treatment of chronic HCV genotype 1 infection in adults in the United States in October 2014.
by Alan Franciscus
This article discusses various aspects of cirrhosis, focusing on it's relationship to hepatitis C.
Efficacy and Safety of Ombitasvir, Paritaprevir, and Ritonavir in an Open-Label Study of Patients With Genotype 1b Chronic Hepatitis C Virus Infection With and Without Cirrhosis
An interferon- and ribavirin-free regimen of ombitasvir, paritaprevir, and ritonavir, achieved high rates of SVR12 in patients with HCV GT1b infection with and without cirrhosis. This regimen was well tolerated and was associated with low rates of treatment discontinuation
View all full text articles available elsewhere on the site, here.
Liver Cirrhosis Treatment May Curb Cerebral Edema
Lactulose and rifaximin treatment of cirrhosis patients with minimal hepatic encephalopathy (MHE) reverses low-grade cerebral edema, according to researchers from India.
Full Text: HCV targeting of patients with cirrhosis
Previously difficult to treat patients by IFN-containing treatments can now be treated safely by IFN-free therapies. More than 90% of hepatitis C genotype 1 and 4 patients with compensated cirrhosis or after orthotopic liver transplantation (OLT) can be cured by sofosbuvir combined with simeprevir, daclatasvir or ledipasvir, or by the paritaprevir/ritona-vir/ombitasvir/±dasabuvir (3D) combination
Treatment of Chronic HCV in Patients With Cirrhosis
The American Journal of Gastroenterology
The availability of INF-free oral antiviral therapies allows for the first time many patients with cirrhosis, including those with hepatic decompensation and other contraindications to PEGINF, to receive highly effective HCV treatment.
Conatus Announces emricasan Phase 2 study reduces liver portal hypertension predominantly due to NASH or HCV
Emricasan Significantly Lowered Portal Pressure in Patients With Severe Portal Hypertension
An Algorithm to Predict HCC in Those With HCV and Cirrhosis
Prevalence of Cirrhosis in Hepatitis C Patients
The American Journal of Gastroenterology
Olysio/Sovaldi combination yields high SVR12 in Child-Pugh A cirrhosis
In a new clinical study, researchers found that Olysio combined with Sovaldi with or without ribavirin had a higher efficacy rate and lower rate of adverse events among patients with Child-Pugh A cirrhosis vs. patients with Child-Pugh B/C cirrhosis.
Ledipasvir-sofosbuvir plus ribavirin in advanced HCV does well
Key clinical point: Ledipasvir-sofosbuvir plus ribavirin for 12 weeks achieved high SVR rates among patients with hepatitis C virus infection and advanced liver disease.
Prevalence of Insomnia and Sleep Patterns among Liver Cirrhosis Patients
Few studies are available regarding the prevalence of sleep disturbance in cirrhotic patients without overt hepatic encephalopathy. This study aimed to assess the prevalence of insomnia in stable liver cirrhosis patients who are attending the outpatient clinics at King Abdulaziz Medical City, Riyadh (KAMC-KFNGH).
Researchers find survival increased over time for patients with cirrhosis admitted to ICU
In a retrospective study, researchers found that survival in patients with cirrhosis following admission to an intensive care unit increased over the last decade, and sequential organ failure assessment and chronic liver failure-sequential organ failure assessment scores were similar in predicting patient survival, according to published findings.
Liver Biopsies Miss 75 % of Hep C-Related Cirrhosis Cases
Relying solely on a liver biopsy to diagnose cirrhosis among people with hepatitis C virus (HCV) likely misses three in four cases of the advanced stage of liver disease, Reuters reports.
The epidemiology of cirrhosis in the USA
A team of doctors estimated the prevalence of cirrhosis in the general US population, as published in this month's Journal of the Clinical Gastroenterology.
Causes of death in people with liver cirrhosis
August's issue of the American Journal of Gastroenterology evaluates causes of death in people with liver cirrhosis in England compared with the general population.
Olysio/Sovaldi combo yields high SVR in HCV with advanced cirrhosis
In a study published in the American Journal of Gastroenterology, a combination regimen of Olysio and Sovaldi showed high sustained virologic response rates in patients with hepatitis C virus infection genotype 1 with advanced cirrhosis.
Two DAA regimen in cirrhotic HCV GT1b patients
New Phase 2 clinical trial results indicate that an all-oral interferon- and ribavirin-free regimen of ombitasvir, paritaprevir, and ritonavir is generally well tolerated and associated with high rates of SVR12 in both cirrhotic and noncirrhotic patients with HCV genotype 1b infection who were treatment-naive or treatment experienced, including prior null responders, a population for whom antiviral treatment information has been lacking.
Must Watch: HCV Virtual Patient Check out "ViralEd" to view "HCV Virtual Patient" an easy to follow video CME with a look at different case scenarios in patients with HCV.
This activity is a helpful starting point for people who failed treatment, have cirrhosis or want to learn more about current treatment options for various HCV genotypes.
After each detailed case is discussed a list of multiple choice questions will appear, in order to move forward the question must be answered correctly, if you don't know the answer click on the "curbside consult" button located in the bottom corner of the presentation. Instructions will be explained after launching the program.
Check it out here.....
Weekend Reading - Natural history of hepatitis C: An Updated Look at the Rate of Progression to Cirrhosis and the Incidence of Decompensation
We begin with a commentary titled, "Hepatitis C: 25 Years Old, and Fading," written by William F. Balistreri, MD., recently published over at Medscape. The good doctor writes about a study presented last month at "Digestive Disease Week," which suggested the rate of developing cirrhosis and decompensation in people with HCV is higher than previously thought....
Viekira Pak - AbbVie hepatitis C cocktail succeeds in late-stage study
3b Results in Genotype 1b Chronic Hepatitis C Patients with Compensated Liver Cirrhosis
- 100 percent SVR(12) rate achieved with VIEKIRAX® (ombitasvir/paritaprevir/ritonavir tablets) + EXVIERA® (dasabuvir tablets) without ribavirin(1)
Effects of delaying Hepatitis C treatment
David Rowlands' latest poll examines the issues around treating earlier or waiting.
Deferring antiviral therapy for HCV until a person progresses to advanced liver disease has clear drawbacks, including lower treatment effectiveness and an increased risk of clinical events and death, according to a study of US veterans presented at the European Association for the Study of the Liver (EASL) 50th International Liver Congress in Vienna recently.
Cold compresses and hot soups
Peginterferon-Ribavirin, Failed it twice. Incivek, Failed it. Sovaldi Olysio, failed it. Harvoni, failed it... Hopefully we can find a new treatment, Otherwise i'll be transplant bound.
Every time I go under for an upper endoscopy there's always some type of clarity that happens the following day. I typically sleep so soundly, It's hard to describe, but it's a mental calm. A lot of the constant stresses aren't as intense. It's a nice pause, for what it is. While they test for RAVs and see what they can do for me, I wait and see.
New at Clinical Care Options
Audio - HCV Experienced Patients: Resistance testing, Cirrhosis and Genotype 3 Infection
Topics In This Webinar Include;
HCV therapy in the setting of renal impairment, resistance testing in DAA experienced patients, and the best approach to treat patients with cirrhosis or experienced patients who have genotype 3 infection.
May 1 2015
Sorting out cirrhosis: Mechanisms of non-response to hepatitis C therapy
Although cirrhosis has long been recognized as an important negative predictor of treatment response for hepatitis C virus (HCV) therapy, the mechanisms underlying this association remain relatively poorly understood.
Slides @ NATAP
The Value of Survival Benefits from Treating Hepatitis C at Different Fibrosis Stages with All-Oral, Interferon-Free Therapy Relative to 'Watchful Waiting'
HCV-TARGET - Two Regimens Compared in HCV With Decompensated Cirrhosis
View Slides @ NATAP
All Oral HCV Therapy is Safe and Effective in Patients with Decompensated Cirrhosis: Report from HCV-TARGET
What Could The Mouth, Gut Tell Us About Cirrhosis?
Science World Report
A recent study conducted by researchers at the Virginia Commonwealth University School of Medicine predicted thatcirrhosis patients would suffer inflammations and need hospitalization after analyzing saliva via a new target for research in a disease ...
Weekend Reading: Expert Commentary On Two Regimens To Treat Cirrhotic HCV GT1 Patients
Quality of care standards appear unmet in patients hospitalized for decompensated cirrhosis
Cirrhosis better treated without ribavirin/All-oral simeprevir-sofosbuvir beat interferon-based regimen for HCV
Using Ledipasvir/Sofosbuvir in Cirrhotic, Treatment-Experienced GT1 Patients: 12 Weeks With Ribavirin or 24 Weeks Without?
Hepatitis C - Recent Clinical Data
IDSE Staff Reports
The patient with a hard-to-treat hepatitis C infection is becoming harder to find. The fixed-dose combination of ledipasvir and sofosbuvir (Harvoni, Gilead) is effective in patients with the hepatitis C virus (HCV) who until now have been considered difficult to treat, according to new data presented at the 2014 Liver Meeting of the American Association for the Study of Liver Diseases.
March 19, 2015
Olysio/Sovaldi found effective in treating HCV patients with cirrhosis
Combination treatment with Olysio and Sovaldi was more effective in treating patients with hepatitis C-related Child’s Class A cirrhosis vs. treatment with pegylated interferon, ribavirin and Sovaldi, according to study data published in Gastroenterology.
Rebooting Cell Programming Can Reverse Liver Failure, Says Children’s Hospital/Pitt Study
PITTSBURGH, March 16, 2015 – It might be possible to heal cirrhotic liver disease by rebooting the genes that control liver cell function, according to researchers at Children’s Hospital of Pittsburgh of UPMC and the University of Pittsburgh School of Medicine. If validated in human studies, the game-changing strategy, described today in the online version of the Journal of Clinical Investigation, could potentially treat patients who are too sick for liver transplantation and, in the future, reduce the need for transplants....
Ledipasvir-sofosbuvir with or without ribavirin to treat patients with HCV genotype 1 infection and cirrhosis non-responsive to previous protease-inhibitor therapy: a randomised, double-blind, phase 2 trial (SIRIUS)
Screening for Zinc Deficiency in Patients with Cirrhosis: When Should We Start?
Cirrhosis Regression in HCV Patients After Antiviral Therapy
Liver International, March 2, 2015
Threefold increase in cirrhosis risk with HCV
Key clinical point: Individuals with hepatitis C infection are three times more likely to develop cirrhosis than are those who are hepatitis C negative.
Patterns of drinking and liver cirrhosis – what do we know and where do we go?
Daily drinking was associated with the highest risk for liver cirrhosis; second, from a lifetime perspective, recent drinking as operationalized in the last decade, was more important compared to earlier drinking; and third, wine may have been associated with lower risk given the same amount of alcohol compared to beer or spirits.
Low Salt Diet in Cirrhosis and Liver Disease: Advise to Patients and Family
by Dr. Joe Galati
In those patients with liver disease and cirrhosis, maintaining a diet low in salt (also knows as sodium) can be difficult at times. With all the eating out that America does, this processed food is overloaded with salt and sodium. Thus, it is nearly impossible to maintain a diet low in sodium. Usually, the target goal is to consume less than 2,000 mg per day.
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Jan 4 2015
Hepatic Encephalopathy Symptoms
Hepatic Encephalopathy Symptoms Youtube for help with confusion, slow speech or movements, can't sleep, anger, or sweet breath. A family or friend who is a caregiver can help by going to the doctor with you. Xifaxan or lactulose may be necessary. For more on HE and liver disease from NASH or Hepatitis C, go to Your Best Friend's Guide to Hepatitis C and Cirrhosis, Hepatocellular Carcinoma (HCC)
Liver Cirrhosis More Common Than Previously Thought, Study Finds
Citations the Journal of Clinical Gastroenterology.
Newswise — MAYWOOD, Il. (Jan. 5, 2014) – Cirrhosis of the liver is more common than previously thought, affecting more than 633,000 adults yearly, according to a study published in the Journal of Clinical Gastroenterology.
And surprisingly, 69 percent of the adults identified as possibly having cirrhosis may not know they have this disease.
GENFIT: GFT505 treatment prevents evolution to cirrhosis
Many hepatitis C patients with cirrhosis or advanced fibrosis face liver failure and liver cancer
Hep C-Related Liver Disease Differs by Race
If you have hep C virus (HCV), your likelihood of developing cirrhosis or liver cancer may be linked to your race. To determine this connection, researchers examined Veterans Administration records of those confirmed to have hep C between 2000 and 2009; they also looked at cases of liver cancer and cirrhosis among the HCV-positive population through early 2010.
High SVR12 With Ledipasvir/Sofosbuvir + Ribavirin Despite Transplant Status
By Debra Hughes, MS
November 16, 2015
Ledipasvir/sofosbuvir with ribavirin treatment for 12 or 24 weeks in patients with decompensated cirrhosis or recurrent hepatitis C virus (HCV) was effective, with low relapse rates, Edward J. Gane, MBChB, MD, from the University of Auckland, Auckland, New Zealand, presented at The Liver Meeting® 2015.
3D + R Lowers Liver Morbidity, Mortality Risks in HCV GT1 Post-Transplant
By Debra Hughes, MS
November 16, 2015
Patients with recurrent hepatitis C virus (HCV) genotype 1 (GT1) infection treated with the "3D+R" regimen post-transplant have a substantially lower likelihood of experiencing compensated or decompensated cirrhosis and death compared with the standard of care, 48 weeks of pegylated interferon plus ribavirin, or no treatment, a study reported at The Liver Meeting® 2015.
Impact of Immunosuppressants on HCV SVR in Post-Transplant Patients
By Da Hee Han, PharmD
November 16, 2015
Tania M. Welzel, MD, of the Department of Medicine, JW Goethe University Hospital in Frankfurt am Main, Germany, reported, "Among liver transplant recipients treated with LDV/SOF + RBV, similar rapid declines in HCV RNA were observed irrespective of whether patients received CyA or TAC for immunosuppression," at The Liver Meeting® 2015.
Antivirals May Reduce the Need for Recurrent Transplants in HCV
Transient Elastography in Assessing Liver Fibrosis
Early changes in dynamic biomarkers of liver fibrosis in hepatitis C virus-infected patients treated with sofosbuvir
This is the first study investigating the effects of a sofosbuvir-based, highly efficient antiviral therapy for CHC on early changes in parameters of liver fibrosis progression. The non-invasive serological and ultrasound-based markers ELF and LSM suggest a significant regression of liver fibrosis at SVR12 compared to baseline
Slower Fibrosis Progression Among Liver Transplant Recipients With Sustained Virological Response After Hepatitis C Treatment
Interferon-free regimens for the treatment of hepatitis C virus in liver transplant candidates or recipients
Treatment against hepatitis C virus has dramatically improved with the novel direct-acting antivirals (DAAs). The currently available DAAs are sofosbuvir, simeprevir, daclatasvir, ledipasvir/sofosbuvir, paritaprevir/ombitasvir and dasabuvir. IFN-free combinations of these novel DAAs with or without ribavirin give excellent sustained virological response in patients with decompensated cirrhosis awaiting liver transplantation and those with recurrence of hepatitis C post liver transplantation. More data regarding the safety and efficacy of these new DAAs are needed, but ongoing clinical trials and real life data will clarify better these issues.
LT recipient characteristics predict worse outcomes after transplant
In a retrospective cohort study, researchers in Brazil found that liver transplant recipient characteristics have a greater impact on patient outcomes compared with donor characteristics, according to study data.
How I Expect Evolving Options for HCV Therapy Will Affect Posttransplant Management
Will we finally have options to prevent posttransplantation HCV recurrence across the spectrum of genotypes?
HCV at a Crossroads:The Pre- or Post-Transplant Treatment Debate
SATURN: Simeprevir, Daclatasvir Show Efficacy in Transplant Population
Post-transplant patients responded favorably to treatment with Olysio and daclatasvir plus ribavirin, according to findings presented at the 2015 International Liver Congress.
FDA Okays Hep-C Investigational Combo for Post-Transplant Patients
Based on favorable results from the ALLY-1 trial, the US Food and Drug Administration (FDA) has amended its breakthrough therapy designation for a hepatitis-C drug combo.
The change means that daclatasvir (Daklinza/ Bristol-Myers Squibb) and sofosbuvir (Sovaldi/Gilead ) may now be given to patients who have hepatitis C infections with either advanced cirrhosis or infections that have come back after patients received a liver transplant.
Coming Home After My Liver Transplant
Study results promising for hepatitis C patients awaiting or completing liver transplant
Pain Management: HepC Stigma Remains
By Transplanted—April 22, 2015
Weekend Reading - EASL Updates and CCO Article:When Should Patients on the Liver Transplant Waitlist Receive HCV Therapy?
Hepatitis C virus recurrence after liver transplantation: A 10-year evaluation
Who is on the Liver Transplant Waitlist?
The number of adults with nonalcoholic steatohepatitis (NASH) waiting for liver transplants has almost tripled in the last 10 years, researchers report in the March issue of Gastroenterology. NASH is now the second leading liver disease of adults awaiting liver transplantation in the United States, the researchers found. The prevalence of nonalcoholic fatty
Assessment of nutritional status and health-related quality of life before and after liver transplantation
New machine-perfusion organ preservation system keeps livers healthier for transplant
Interferon-Free Combination Therapy Prevents Recurrence of HCV After Liver Transplantation
Sofosbuvir and ribavirin critical to preventing posttransplantation HCV recurrence
“In clinical trials, administration of sofosbuvir with ribavirin was associated with rapid decreases of HCV RNA to undetectable levels in patients with HCV genotype 1, 2, 3, 4, and 6 infections,” wrote lead author Dr. Michael P. Curry of the Beth Israel Deaconess Medical Center in Boston, and his coauthors on the first of these two studies. “In more than 3,000 patients treated to date, sofosbuvir has been shown to be safe, viral breakthrough during treatment has been rare (and associated with nonadherence), and few drug interactions have been observed.”
An Interferon-free Antiviral Regimen for HCV after Liver Transplantation
We evaluated the interferon-free regimen of the NS5A inhibitor ombitasvir coformulated with the ritonavir-boosted protease inhibitor ABT-450 (ABT-450/r), the nonnucleoside NS5B polymerase inhibitor dasabuvir, and ribavirin in liver-transplant recipients with recurrent HCV genotype 1 infection.
Optimal therapy in hepatitis C virus liver transplant patients with direct acting antivirals
Article first published online: 22 DEC 2014
(November 2014) - Gilead Announces Harvoni Study Results in Chronic Hepatitis C Patients with Advanced Liver Disease and Those Who Failed Prior Treatment
Statins Users Have Lower Risk of Developing HCC, Study Finds
By Da Hee Han, PharmD
November 17, 2015
Statin use and liver cancer were independently associated with older age, race, higher prevalence of diabetes, liver cirrhosis, smoking, BMI, and more total healthcare utilization, a study reported at The Liver Meeting® 2015.
Modest Survival Benefit With Sorafenib in Advanced HCC Patients
By Da Hee Han, PharmD
November 15, 2015
Sorafenib was associated with a modest survival benefit in patients with advanced hepatocellular carcinoma (HCC), particiularly in patients with decompensation, data presented at The Liver Meeting® 2015 presented.
Does Antiplatelet Therapy Cut Liver Cancer Risk in Patients with Hep B?
By Da Hee Han, PharmD
Aspirin and clopidogrel therapy are associated with reduced risk of hepatocellular carcinoma (HCC) among patients with chronic hepatitis B infection, according to a study reported at the The Liver Meeting® 2015.
Risk of HCC in Chronic HCV Patients With New Onset Diabetes
Alimentary Pharmacology & Therapeutics, October 26, 2015
OCT/NOV 2015 American Liver Foundation Newsletter: Focus on liver cancer
Diabetes, Hypertension Raise Risk for Liver Cancer
Preventing Liver Cancer Among People With Hepatitis C
by Benjamin Ryan
Hepatitis C dramatically raises the risk of liver cancer. Here are some tips to lower that increased risk.
HCV Weekend Reading - Diet, nutrition, physical activity, and liver cancer
In honor of Liver Cancer Awareness Month, we focus today on lifestyle choices and liver cancer, using research that has established an association between the two, as well as disease progression in HCV.
Global Patterns of Hepatocellular Carcinoma Management From Diagnosis to Death
How is hepatocellular cancer treated around the world, and how do treatment patterns affect outcomes?
Cigarette smoking increases the risk of mortality from liver cancer
A study in October's issue of the Journal of Gastroenterology & Hepatology evaluates the association between smoking and liver cancer mortality.
FDA Grants Fast Track Designation to Can-Fite's CF102 in the Treatment of Liver Cancer
Hepatocellular carcinoma risk in Hep C with new onset diabetes
An Algorithm to Predict HCC in Those With HCV and Cirrhosis
A Promising Alternative Therapy for Advanced Liver Cancer
Increased risk of hepatocellular carcinoma in chronic HCV patients with new onset diabetes
31 July 2015
A study published ahead of print the Alimentary Pharmacology & Therapeutics reports an increased risk of hepatocellular carcinoma in chronic HCV patients with new onset diabetes.
Hepatocellular carcinoma: From diagnosis to treatment
Hepatocellular carcinoma (HCC) is a rising cause of cancer related mortality and viral causes of cirrhosis appear to be a major cause. Surveillance helps to detect early stage disease and treatment options are determined by stage of presentation. Three potentially curative options are radiofrequency ablation, liver transplantation and tumor resection. Emerging therapies such as drug-eluting beads-transarterial chemoembolization or sorafenib will continue to advance treatment options in HCC. The following will provide a concise review of HCC from prevention to treatment.
Variations in liver cancer attributable to hepatitis virus variations
Significant clinical variations exist among patients with the most common type of liver cancer called hepatocellular carcinoma (HCC), depending on the viral cause of the disease -hepatitis B virus (HBV) or hepatitis C virus (HCV). These differences suggest that hepatitis status should be considered when developing treatment plans for newly diagnosed patients, according to researchers at The University of Texas MD Anderson Cancer Center.
FDA, SillaJen agree to begin phase 3 liver cancer trial
SillaJen, Inc. has reached an agreement with the FDA on a Special Protocol Assessment for a phase 3 clinical trial of its drug Pexa-Vec for the treatment of advanced liver cancer and will begin enrolling patients later this year, according to a press release.
Can-Fite Applies for Orphan Drug Designation in Europe for CF102 in the Treatment of Liver Cancer
Management of hepatitis C infection before and after liver
Aggressive treatment of hepatitis C virus (HCV) infection before cirrhosis development or decompensation may reduce LT need.
AFP/ultrasound ameliorates surveillance of HCC
In a new study, alpha-fetoprotein measurement in combination with ultrasound improved surveillance effectiveness in patients with cirrhosis, according to published data in The American Journal of Gastroenterology.
Treatment of early stage hepatocellular carcinoma
May's issue of the Scandanavian Journal of Gastroenterology compares radiofrequency ablation with resection for the treatment of early stage hepatocellular carcinoma
Challenges, Need for New Therapies Remain in HCC
World Cancer Research Fund International (WCRF)
LIVER CANCER REPORT 2015
Regular Coffee Intake Could Prevent Liver Cancer in Alcohol Drinkers
By Judy Lawrence
A new study suggests that regular coffee consumption could reduce the risk of liver cancer among people who, on a regular basis, drink more than safe amount of alcohol. London-based World Cancer Research Fund International (WCRF) has released the new study which discusses the probable causes and prevention of liver cancer. Previously coffee has been also proved to be associated with a number of health and cognitive benefits.
34 previous studies have been analyzed in detail, which included 8 million people, by the WCRF team, along with a team from the American Institute for Cancer Research for Continuous Update Project (CUP), for determining the risk factors for liver cancer. The study aimed at determining the impact of physical activity, diet and weight on liver cancer risk.
It was found that more than 45 ml of daily alcohol intake is associated with the higher risk of liver cancer among people having higher body mass index (BMI). The risk of liver cancer increases with alcohol consumption but more than three drinks per day can increase the risk dramatically. Consumption of foods contaminated by aflatoxins (toxins produced by fungi) also leads to higher risk of liver cancer. The foods which may get affected by aflatoxins include spices, Brazil nuts, figs, black pepper and cereals.
The panel of international experts from the WCRF, who carried out the research, reported that even a single cup of coffee per day is effective in reducing the risk of liver cancer in those who consume more than 45 ml of alcohol a day, which is roughly equivalent to three drinks. However, the researchers could not provide any reason behind the observation that coffee consumption lowers liver cancer risk. The new study also suggests that the daily intake of alcohol must be restricted to two drinks for men and one drink for women. Maintaining a healthy weight may also be helpful in reducing the risk.
Article Source Daily Science Journal
Download Report From WCRF - LIVER CANCER REPORT 2015
Liver-sparing operation associated with higher survival rates in cancer patients
Liver cancer Australia's most deadly cancer
Liver cancer looms as Australia's greatest cancer challenge, new analysis shows, with one Australian dying of liver cancer for every Australian who is diagnosed with the disease.
Hot on the Trail of Hepatitis-Liver Cancer Connection
Using whole genomic sequencing, scientists have for the first time demonstrated the profound effect that chronic hepatitis infection and inflammation can have on the genetic mutations found in tumors of the liver, potentially paving the way to a better understanding of the mechanisms through which these chronic infections can lead to cancer.
How common is it for people with chronic hepatitis C to need a liver transplant?
Answers from James M. Steckelberg, M.D.
Liver failure due to hepatitis C is the most common reason for liver transplantation in the United States. But because most infected people don't know about their condition until it's advanced, researchers can provide only rough estimates of the risk and rate of progression to liver failure in chronic hepatitis C.
Without treatment, most people who get hepatitis C remain infected for life. Infections that persist in this way are called chronic.
Chronic hepatitis C infection causes ongoing liver inflammation that leads to scarring (fibrosis). As fibrosis progresses, scars gradually replace healthy liver tissue.
In response to tissue loss, the liver goes into growth mode, increasing cell production and forming new blood vessels. Instead of repairing the damage, though, these changes cause new problems that are more likely to lead to liver failure than is fibrosis alone. This stage of liver damage is known as cirrhosis. Hepatitis C-related liver failure is usually a result of cirrhosis.
The Centers for Disease Control and Prevention (CDC) reports that out of 100 people infected with hepatitis C, approximately 60 to 70 will develop chronic liver disease — specifically, hepatitis and fibrosis — and 5 to 20 will develop cirrhosis. An estimated 1 to 5 out of 100 people with chronic hepatitis C will die of liver failure or liver cancer resulting from the infection.