From the Journals

Hepatitis Outlook: March 2017


 

If you work on the front lines of medical care, treating patients with hepatitis, you may not have time to review all the hepatitis research that enters the medical literature every month. Here’s a quick look at some notable news items and journal articles published over the past month, covering the major hepatitis viruses.

Preliver transplant treatment with a highly effective, all-oral direct-acting antiviral agent regimen provides the best health outcomes and is the most cost-effective strategy for the treatment of patients with hepatitis C virus with hepatocellular carcinoma or decompensated cirrhosis who are waitlisted for liver transplant, a study in Hepatology revealed.

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In patients with chronic HCV treatment-naïve genotype 1, starting treatment with ledipasvir/sofosbuvir in patients with the absence of fibrosis or with mild fibrosis, compared with those with advanced fibrosis, reduces disease burden and is associated with cost savings, according to a Spanish study in the Journal of Viral Hepatitis.

A recent study in the Journal of Viral Hepatitis found that patients with chronic HCV and compensated or decompensated cirrhosis who achieve sustained viral response can have clinically meaningful reductions in hepatic venous pressure gradient at long-term follow-up.

The hepatic expressions of cannabinoid receptor 1 and cannabinoid receptor 2 play important roles during the progression of fibrosis induced by chronic hepatitis B virus, according to a study in the International Journal of Infectious Diseases.

A study in the Journal of Viral Hepatitis found that the Pooled Cohort atherosclerotic cardiovascular disease risk equation overestimated the risk of cardiovascular disease among lower-risk patients and underestimated risk among higher-risk patients in both HCV-infected and uninfected groups.

A multinational study in Hepatology found that hemoglobin levels and international normalized ratio values were similar in patients with inherited bleeding disorders and HCV infection who received elbasvir/grazoprevir and placebo.

The number of HBV patients in the United States requiring liver transplantation remained stable, according to a recent study in the Journal of Viral Hepatitis, but the proportion of HBV patients with hepatocellular carcinoma continues to rise.

A research letter in the Morbidity and Mortality Weekly Report reported the transmission of HCV from the inappropriate reuse of saline flush syringes for multiple patients in an acute care hospital in Texas.

A large German study in the Journal of Viral Hepatitis found that ombitasvir/paritaprevir/ritonavir plus/minus dasabuvir plus/minus ribavirin for treatment of HCV genotype 1 and genotype 4 infection was effective and generally well tolerated in clinical practice.

A study, conducted in South Korea, in Hepatology found that monotherapy with tenofovir disoproxil fumarate was efficacious and safe for up to 144 weeks in heavily pretreated patients with multidrug-resistant HBV infection.

Overt and occult HBV infection of children was more serious in underdeveloped northwest regions of China, a study in the Journal of Viral Hepatitis found, suggesting that HBV neonatal immunization and catch-up programs should be strengthened and supplemented.

A study in Hepatology found that long-term entecavir monotherapy is highly effective in preventing HBV reactivation after liver transplantation for chronic HBV, with a durable HBV surface antigen seroclearance rate of 92%, undetectable HBV DNA rate of 100% at 8 years, and excellent long-term survival of 85% at 9 years.

An Italian study in the Journal of Viral Hepatitis found that treatment with direct-acting antivirals was effective and well tolerated in people who inject drugs, although cirrhotic subjects with Model For End-Stage Liver Disease scores greater than 10 and albumin levels below 3 g/dL showed a higher risk of developing serious adverse events and treatment failure.

Direct-acting antiviral–based treatments for severe posttransplant HCV recurrence, comprising fibrosing cholestatic hepatitis, significantly improves liver function even without viral clearance and permits excellent long-term survival, according to a study in the Journal of Viral Hepatitis.

On Twitter @richpizzi

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