PKIDs’ Hepatitis News

March 21, 2008

Liver Transplantation in Patients With Hepatitis C Virus

http://cme.medscape.com/viewprogram/7779?src=0_nl_mp_mad

Articles from Amedeo

Atazanavir crystal nephropathy.
AIDS. 2007;21:2357-8.
http://amedeo.com/p2.php?id=18090291&s=hep

Incidence of HAV and HBV infections and vaccination rates in patients with autoimmune liver diseases.
Am J Gastroenterol. 2008;103:138-46.
http://amedeo.com/p2.php?id=17970833&s=hep
ABSTRACT available

Acute hepatitis following assumption of a herbal remedy.
Eur J Gastroenterol Hepatol. 2008;20:364-5.
http://amedeo.com/p2.php?id=18334885&s=hep

Ciliated hepatic foregut cyst discovered after kidney transplantation in a hepatitis C virus-infected patient: a report of one case and review of the literature.
Eur J Gastroenterol Hepatol. 2008;20:359-61.
http://amedeo.com/p2.php?id=18334883&s=hep
ABSTRACT available
Estimating the future health burden of chronic hepatitis B and the impact of therapy in Spain.
Eur J Gastroenterol Hepatol. 2008;20:320-326.
http://amedeo.com/p2.php?id=18334876&s=hep
ABSTRACT available

Leptin, a possible cause for regulatory T cell loss in fatty liver?
Hepatology. 2008;47:764.
http://amedeo.com/p2.php?id=18220305&s=hep

The future is around the corner: Noninvasive diagnosis of progressive nonalcoholic steatohepatitis.
Hepatology. 2008;47:373-375.
http://amedeo.com/p2.php?id=18220279&s=hep

Transient elastography is unreliable for detection of cirrhosis in patients with acute liver damage.
Hepatology. 2007;.
http://amedeo.com/p2.php?id=18098325&s=hep
ABSTRACT available

The causes of primary biliary cirrhosis: Convenient and inconvenient truths.
Hepatology. 2007;.
http://amedeo.com/p2.php?id=18098322&s=hep
ABSTRACT available

Noninvasive markers of fibrosis in nonalcoholic fatty liver disease: Validating the European Liver Fibrosis Panel and exploring simple markers.
Hepatology. 2008;47:455-60.
http://amedeo.com/p2.php?id=18038452&s=hep
ABSTRACT available

Diacylglycerol acyltranferase 1 anti-sense oligonucleotides reduce hepatic fibrosis in mice with nonalcoholic steatohepatitis.
Hepatology. 2007;.
http://amedeo.com/p2.php?id=18000880&s=hep
ABSTRACT available

Hepatitis B testing and vaccination in patients recently diagnosed with HIV infection.
Int J STD AIDS. 2008;19:83-4.
http://amedeo.com/p2.php?id=18334058&s=hep
ABSTRACT available

Impact of hepatitis B virus rtA181V/T mutants on hepatitis B treatment failure.
J Hepatol. 2008;.
http://amedeo.com/p2.php?id=18331765&s=hep
ABSTRACT available

Combination therapy for chronic hepatitis B: Ready for prime time?
J Hepatol. 2008;.
http://amedeo.com/p2.php?id=18331764&s=hep

Hepatic gene expression and prediction of therapy response in chronic hepatitis C patients.
J Hepatol. 2008;.
http://amedeo.com/p2.php?id=18329749&s=hep
ABSTRACT available

Lamivudine compared with lamivudine and adefovir dipivoxil for the treatment of HBeAg-positive chronic hepatitis B.
J Hepatol. 2008;.
http://amedeo.com/p2.php?id=18329126&s=hep
ABSTRACT available

The presence of steatosis and elevation of alanine aminotransferase levels are associated with fibrosis progression in chronic hepatitis C with non-response to interferon therapy.
J Hepatol. 2008;.
http://amedeo.com/p2.php?id=18329125&s=hep
ABSTRACT available

In vivo confocal laser laparoscopy allows real time subsurface microscopy in animal models of liver disease.
J Hepatol. 2008;48:91-7.
http://amedeo.com/p2.php?id=18022725&s=hep
ABSTRACT available

Eltrombopag in thrombocytopenia.
N Engl J Med. 2008;358:1072.
http://amedeo.com/p2.php?id=18322290&s=hep

A Parkinsonian syndrome in methcathinone users and the role of manganese.
N Engl J Med. 2008;358:1009-17.
http://amedeo.com/p2.php?id=18322282&s=hep
ABSTRACT available

Long-term antibody persistence induced by a combined hepatitis A and B vaccine in children and adolescents.
Vaccine. 2008;26:1759-1763.
http://amedeo.com/p2.php?id=18336963&s=hep
ABSTRACT available

Six Medical Offices Raided in Probe into Hepatitis C Outbreak

Las Vegas Review-Journal     (03.11.08):: Brian Haynes

Officials seized patient records and other documents at six valley clinics Monday as part of a joint criminal investigation into a hepatitis C outbreak. The sites were all affiliated the Gastroenterology Center of Nevada (GCN) and include the Endoscopy Center of Southern Nevada (ECSN), where a state health investigation found at least six patients were infected when nurse anesthetists reused syringes and medicine vials. Participating in the raids were the FBI, the Las Vegas police, and investigators for the state attorney general and Department of Health and Human Services.

“We wanted to ensure that records weren’t destroyed,” said Deputy Chief Kathy Suey, who manages the city police Criminal Intelligence Section.

Authorities first searched ECSN, 700 Shadow Lane, and the Desert Shadow Endoscopy Center, 4275 Burnham Ave. Both facilities house an office of GCN. Officials then searched the GCN sites at 3150 N. Tenaya Way, 5915 S. Rainbow Blvd., 2610 W. Horizon Ridge Parkway in Henderson and 1815 E. Lake Meade Blvd. in North Las Vegas.

Police are expected to focus on possible medical negligence, and state and federal officials are looking into possible insurance fraud, Suey said.

The FBI has posted its “most seasoned agents” to the investigation, which will cover “anything and everything,” said Special Agent Joseph Dickey. “It’s a complex case, but that’s our specialty at the FBI.”

By Friday, police plan to announce how patients may obtain copies of their medical records. In the meantime, investigators will begin perusing billing records before deciding which angle each agency will pursue.

Peginterferon-Ribavirin Safe, Effective for Children With HCV

NEW YORK (Reuters Health) Mar 06 - Treatment with pegylated interferon alfa-2b (PEG-IFN-alpha-2b) plus ribavirin results in virologic control in children with chronic hepatitis C virus (HCV) infection and is “reasonably well-tolerated,” a Spanish team reports in the February issue of The Pediatric Infectious Disease Journal.

Article

The Burden of Disease and the Evolving Landscape in Hepatitis C Therapy

http://www.medscape.com/viewprogram/8607?src=mp

Hepatitis B: Advances in Screening, Diagnosis, and Clinical Management

http://www.medscape.com/viewprogram/8810?src=mp

Extended Interferon Therapy in HCV-Positive Slow Responders

Sustained virologic response was significantly higher among slow responders who were treated with 72 weeks of pegylated interferon plus ribavirin.

Data from retrospective studies suggest that hepatitis C virus (HCV) genotype 1–positive patients who are slow responders to pegylated interferon plus fixed-dose ribavirin regimens have significantly higher rates of sustained virologic response (SVR) when they are treated for 72 weeks rather than the standard 48 weeks (Hepatology 2003; 37:1226). Now, researchers have validated this hypothesis by using pegylated interferon and weight-based ribavirin dosing.

One hundred one HCV genotype 1–positive patients with slow response to therapy (minimum 2-log decrease in HCV RNA from baseline, detectable HCV RNA at 12 weeks, and undetectable HCV RNA at 24 weeks) were recruited from a single Atlanta center. Participants were randomized to receive either 48 weeks or 72 weeks of pegylated interferon alfa-2b (1.5 µg/kg weekly) plus weight-based ribavirin (800–1400 mg daily). Overall, 26% of participants had advanced fibrosis, 77% had high viral loads ( 800,000 IU/mL), 34% were overweight (body-mass indexes >30 kg/m2), and 48% were black. Intent-to-treat analysis, concealed allocation, and blinded data collection were used. Because a formal a priori sample-size calculation was not performed, only nonparametric statistics were reported.

End-of-treatment viral responses were similar between the two treatment arms (45% in participants who were treated for 48 weeks [standard-duration arm] and 48% in those who were treated for 72 weeks [extended-duration arm]). However, SVR was significantly more common in the extended-duration arm than in the standard-duration arm (38% vs. 18%; P=0.026). This improved SVR rate was due to a lower relapse rate in the extended-duration arm compared with the standard-treatment arm (20% vs. 59%). Dose reductions and treatment discontinuations were similar in both arms.

Comment: This study’s data add to the growing body of literature showing that extended 72-week therapy in HCV genotype 1–positive patients with initial slow response produces significantly higher SVR rates than does standard 48-week therapy. The major strengths of this study were its prospective design and the inclusion of weight-based ribavirin dosing. Importantly, the study’s findings also demonstrated that extended therapy did not lead to excess adverse events or therapy discontinuations. Although we are awaiting results from larger studies to verify these findings, enough evidence has accumulated to consider 72 weeks of therapy in HCV genotype 1 slow responders who tolerate therapy and exhibit substantial histologic damage.

— Atif Zaman, MD, MPH
Published in Journal Watch Gastroenterology March 7, 2008
Citation(s):
Pearlman BL et al. Treatment extension to 72 weeks of peginterferon and ribavirin in hepatitis C genotype 1–infected slow responders. Hepatology 2007 Dec; 46:1688.
Medline abstract (Free)

February 29, 2008

Chronic Hepatitis E?

Investigators in France provide convincing evidence of chronic HEV infection in organ-transplant recipients.
Hepatitis E virus (HEV) is a well-recognized cause of acute hepatitis. Although two previous cases of persistent HEV infection have been reported, the virus has been thought to cause only acute disease. A descriptive case series, however, suggests that chronic infection does occur in organ-transplant recipients.

Article

Chronic HBV Infection with Persistently Normal ALT Levels

Researchers find marked histologic damage in HBV-infected patients with persistently normal alanine aminotransferase levels. Patients with chronic hepatitis B virus (HBV) infection and persistently normal alanine aminotransferase (ALT) levels currently are not considered candidates for HBV treatment, in part because of the belief that these patients have mild histologic damage, especially if their disease is in the immune-tolerant phase.

Article

Hepatitis E in England and Wales

Abstract
In 2005, 329 cases of hepatitis E virus infection were confirmed in England and Wales; 33 were confirmed indigenous infections, and a further 67 were estimated to be indigenous infections. Hepatitis E should be considered in the investigation of patients with hepatitis even if they have no history of travel.

Article