0000000000212333
AUTHOR
V Di Marco
LIVER RELATED EVENTS AND SURVIVAL IN PATIENTS WITH COMPENSATED HCV CIRRHOSIS: THE ROLE OF SUSTAINED VIROLOGICAL RESPONSE TO PEG-IFN BASED THERAPY AND PORTAL HYPERTENSION
Impact of non-alcoholic fatty liver disease on cardiovascular risk in a general population
Background and aim: Nonalcoholic fatty liver (NAFL) is a major cause of liver disease worldwide leading also to a higher risk of cardiovascular events. We aimed to evaluate the impact of fatty liver and fibrosis on cardiovascular risk factors in a general population. Materials and methods: 604 subjects included in the communitybased ABCD (Alimentazione, Benessere Cardiovascolare e Diabete) study were recruited. Steatosis (CAP >288 dB/m) and fibrosis (>8.7 KPa by M and >7.2 KPa by XL probe) were assessed with FibroScan. Cardiovascular risk was evaluated by the Atherosclerotic Cardiovascular Disease (ASCVD) risk estimator and defined low if <5%, borderline if 5%-7.4%, intermediate…
Randomised study comparing 48 and 96 weeks peginterferon α-2a therapy in genotype D HBeAg-negative chronic hepatitis B
Treatment with peginterferon α-2a (PegIFN) for 48 weeks is the standard of care for selected HBeAg-negative patients chronically infected with hepatitis B virus (HBV), but with limited treatment efficacy. A study was undertaken to investigate whether treatment extension to 96 weeks improves the outcome in this patient population.128 HBeAg-negative patients (120 genotype D) were randomised to weekly 180 μg PegIFN for 48 weeks (group A, n=51), 180 μg PegIFN for 48 weeks followed by 135 μg weekly for an additional 48 weeks (group B, n=52) or 180 μg PegIFN plus lamivudine (100 mg/day) for 48 weeks then 135 μg PegIFN for 48 weeks (group C, n=25). Endpoints were alanine aminotransferase normalisa…
Practice guidelines for the treatment of hepatitis C: recommendations from an AISF/SIMIT/SIMAST Expert Opinion Meeting.
It is increasingly clear that a tailored therapeutic approach to patients with hepatitis C virus infection is needed. Success rates in difficult to treat and low-responsive hepatitis C virus patients are not completely satisfactory, and there is the need to optimise treatment duration and intensity in patients with the highest likelihood of response. In addition, the management of special patient categories originally excluded from phase III registration trials needs to be critically re-evaluated. This article reports the recommendations for the treatment of hepatitis C virus infection on an individual basis, drafted by experts of three scientific societies.
Treatment of hepatitis C virus infection with direct-acting antiviral drugs is safe and effective in patients with hemoglobinopathies.
HCV NS3 sequencing as a reliable and clinically useful tool for the assessment of genotype and resistance mutations for clinical samples with different HCV-RNA levels
OBJECTIVES: This study aims to evaluate the reliability and clinical utility of NS3 sequencing in hepatitis C virus (HCV) 1-infected patients who were candidates to start a PI-containing regimen. METHODS: NS3 protease sequencing was performed by in-house-developed HCV-1 subtype-specific protocols. Phylogenetic analysis was used to test sequencing reliability and concordance with previous genotype/subtype assignment by commercial genotyping assays. RESULTS: Five hundred and sixty-seven HCV plasma samples with quantifiable HCV-RNA from 326 HCV-infected patients were collected between 2011 and 2014. Overall, the success rate of NS3 sequencing was 88.9%. The success rate between the two subtype…
PHYLOGENETIC ANALYSIS OF HBV INFECTION IN SICILY: IS THE EPIDEMIOLOGY CHANGING?
Lack of correlation between serum anti-HBcore detectability and hepatocellular carcinoma in patients with HCV-related cirrhosis
BACKGROUND: While the likelihood of developing hepatocellular carcinoma (HCC) in patients coinfected with both HBV and HCV is increased, the role of previous exposure to HBV as a risk factor associated with tumor occurrence in subjects with HCV-related cirrhosis has not been fully investigated. AIM: To assess whether serum anti-HBc positivity, as a marker of previous HBV exposure, is associated with HCC development in HCV-related positive, hepatitis B surface antigen (HBsAg) negative patients with cirrhosis treated with alfa-interferon (IFN) monotherapy. PATIENTS AND: A database including 883 consecutive patients (557 men, mean age 54.7 yr) with histologically METHODS: proven cirrhosis trea…
INSULIN RESISTANCE, STEATOSIS AND PROGRESSION OF FIBROSIS IN PATIENTS WITH GENOTYPE 1 CHRONIC HEPATITIS C
Background and aim: Insulin resistance (IR) and steatosis have been associated with fibrosis severity in chronic hepatitis C (CHC), but only few studies investigate their role as predictors of disease evolution. We aimed to assess in patients with CHC if IR and steatosis are linked to progression of fibrosis over time. Material and methods: 86 consecutive G1 HCV infected patients with two paired liver biopsies over a period 67±30 months (range, 13-135), were evaluated at baseline by anthropometric and metabolic measurements, including IR (IR= HOMA-IR >2.7). All biopsies were scored by one pathologist for staging and grading (Scheuer). Steatosis was considered significant if =10. Results: At…
Prophylaxis and treatment of hepatitis B in immunocompromised patients
LOW VITAMIN D SERUM LEVEL IS RELATED TO RAPID, EARLY AND SUSTAINED VIROLOGICAL RESPONSE TO IFN-BASED THERAPY IN GENOTYPE 1 CHRONIC HEPATITIS C
Prophylaxis and treatment of hepatitis B in immunocompromised patients.
The literature on hepatitis B virus (HBV) in immunocompromised patients is heterogeneous and referred mainly to the pre-antivirals era. Today a rational approach to the problem of hepatitis B in these patients provides for: (a) the evaluation of HBV markers and of liver condition in all subjects starting immunosuppressive therapies (baseline), (b) the treatment with antivirals (therapy) of active carriers, (c) the pre-emptive use of antivirals (prophylaxis) in inactive carriers, especially if they are undergoing immunosuppressive therapies judged to be at high risk, (d) the biochemical and hepatitis B surface antigen (HBsAg) monitoring (or universal prophylaxis, in case of high risk immunos…