Hepatic Medicine : Evidence and Research最新文献

{"title":"Perspectives on Sarcopenia as a Predictor for Outcomes in Pediatric Patients with Chronic Liver Disease.","authors":"Connie Chen,&nbsp;Mary Ayers,&nbsp;Judy H Squires,&nbsp;James E Squires","doi":"10.2147/HMER.S348888","DOIUrl":"https://doi.org/10.2147/HMER.S348888","url":null,"abstract":"<p><p>Sarcopenia, a pathologic deficiency of muscle mass and function, has emerged as an important secondary feature of many chronic disease states. For adults with end stage liver disease, there are multiple mechanisms which contribute to sarcopenia and its presence has proven to be an important predictor of morbidity and mortality. In children, there are only a limited number of reports which investigate the role of sarcopenia in liver disease. These studies, which are discussed and summarized in this review, report small, single-center analyses with dissimilar study cohorts and varying clinical definitions. Still, children meeting the study entry criteria have sarcopenia with a reported prevalence of 24-70%. When assessed, sarcopenia appears to be associated with more severe disease but is independent of the Pediatric End-Stage Liver Disease (PELD) score and does not correlate with age, gender, or traditional anthropometric measures such as weight, height, weight-for-height, or body mass index (BMI). While individual studies may identify sarcopenia as a statistically significant risk factor for certain post-transplant outcomes such as longer ICU stay, longer duration of intubation, repeat operation, development of serious infection, longer hospital stay, death, or long-term growth failure, such associations are not consistently replicated across studies. Finally, although various methods of muscle mass quantification are utilized, the most reported is the total psoas muscle surface area (tPMSA) on computed tomography. This method, along with others such as skeletal muscle area and skeletal muscle index, have had normative values recently defined and these collective efforts should enable researchers a common basis of comparison when delineating sarcopenia, and its impact, across various study populations in future investigations - including in children with liver disease.</p>","PeriodicalId":12917,"journal":{"name":"Hepatic Medicine : Evidence and Research","volume":" ","pages":"173-183"},"PeriodicalIF":2.1,"publicationDate":"2022-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2a/c7/hmer-14-173.PMC9618237.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40661450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Factors Associated with Hepatitis B Infection Among Outpatient Adults in South-Western Uganda.","authors":"Elias Rugaatwa Ndibarema,&nbsp;Ronald Olum,&nbsp;David Ayebare,&nbsp;Jerome Kabakyenga","doi":"10.2147/HMER.S381809","DOIUrl":"https://doi.org/10.2147/HMER.S381809","url":null,"abstract":"<p><strong>Background: </strong>About 2 billion people in the world are exposed to hepatitis B virus. Africa contributes 25% of the global Hepatitis B burden and prevalence in Uganda is 4.3%. Routine testing to establish the burden, improve prevention and control through early diagnosis and management are rare in hospital settings. We aimed at establishing the prevalence and factors associated with hepatitis B infection among adults attending outpatient clinic at Mbarara Regional Referral Hospital (MRRH) in Uganda.</p><p><strong>Methods: </strong>A hospital-based cross-sectional study was conducted among outpatients attending MRRH. Consecutive sampling method was used to recruit participants. Interviewer-administered questionnaires were used to collect data. Blood samples were collected to test HBsAg. Summary statistics were used to describe the socio-demographic characteristics of study participants and the proportion of Serostatus for hepatitis B infection. Bivariate followed by multivariate logistic regression analysis was conducted to assess the factors associated with hepatitis B infections. All independent variables with <i>p</i>-values <0.2 were entered into a multivariate model to adjust for confounding. A p value <0.05 was considered statistically significant.</p><p><strong>Results: </strong>A total of 400 participants were recruited. 64.5% were females (n=258) and aged 18-29 years (48.5%, n=193). Overall, 22(5.5%) participants were found to be seropositive for hepatitis B infection. Residing in Kiruhura district (AOR = 11.9, 95% CI: 2.40-59.25, <i>p</i><0.003) was significantly associated with hepatitis B infection while being female (AOR = 0.3, 95% CI: 0.11-0.88, <i>p</i><0.018) was protective.</p><p><strong>Conclusion: </strong>Prevalence of hepatitis B infection among adult patients attending outpatient clinic at MRRH was 5.5% with male gender and residing in Kiruhura district as factors associated with high prevalence of hepatitis B infection. Ministry of Health should scale up hepatitis B routine testing and treatment at MRRH and its catchment area, with special control programs such as screening, vaccination, and sensitization involving men.</p>","PeriodicalId":12917,"journal":{"name":"Hepatic Medicine : Evidence and Research","volume":" ","pages":"163-172"},"PeriodicalIF":2.1,"publicationDate":"2022-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/66/6a/hmer-14-163.PMC9592731.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40653303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polycystic Liver Disease: Pathophysiology, Diagnosis and Treatment.","authors":"Luiz Fernando Norcia,&nbsp;Erika Mayumi Watanabe,&nbsp;Pedro Tadao Hamamoto Filho,&nbsp;Claudia Nishida Hasimoto,&nbsp;Leonardo Pelafsky,&nbsp;Walmar Kerche de Oliveira,&nbsp;Ligia Yukie Sassaki","doi":"10.2147/HMER.S377530","DOIUrl":"https://doi.org/10.2147/HMER.S377530","url":null,"abstract":"<p><p>Polycystic liver disease (PLD) is a clinical condition characterized by the presence of more than 10 cysts in the liver. It is a rare disease Of genetic etiology that presents as an isolated disease or associated with polycystic kidney disease. Ductal plate malformation, ciliary dysfunction, and changes in cell signaling are the main factors involved in its pathogenesis. Most patients with PLD are asymptomatic, but in 2-5% of cases the disease has disabling symptoms and a significant reduction in quality of life. The diagnosis is based on family history of hepatic and/or renal polycystic disease, clinical manifestations, patient age, and polycystic liver phenotype shown on imaging examinations. PLD treatment has evolved considerably in the last decades. Somatostatin analogues hold promise in controlling disease progression, but liver transplantation remains a unique curative treatment modality.</p>","PeriodicalId":12917,"journal":{"name":"Hepatic Medicine : Evidence and Research","volume":"14 ","pages":"135-161"},"PeriodicalIF":2.1,"publicationDate":"2022-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/bc/12/hmer-14-135.PMC9528914.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33490332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Histopathological Evaluation of Ethanolic Leaf Extract of <i>Lippia adoensis</i> on Liver, Kidney, and Biochemical Parameters in Swiss Albino Mice.","authors":"Abayneh Tunta Boye,&nbsp;Peter Etim Ekanem,&nbsp;Tesfamichael Berhe Hailu,&nbsp;Ifa Dereje Hordofa,&nbsp;Mulu Shiferaw Asfaw","doi":"10.2147/HMER.S370927","DOIUrl":"https://doi.org/10.2147/HMER.S370927","url":null,"abstract":"<p><strong>Background: </strong>Eighty percent of Ethiopians use traditional medicine, one of which is the leaf of <i>Lippea adoensis</i>.</p><p><strong>Objective: </strong>To investigate subacute toxicity of aqueous extracts of <i>L. adoensis</i> leaves on the liver and kidney and biochemical parameters in Swiss albino mice.</p><p><strong>Methods: </strong>LD₅₀ was assessed with nine experimental groups and one control group of adult female Swiss albino mice (five in each group). In the subacute study, 40 mice of both sexes were randomly divided into four groups of ten mice (both sexes) per group. Group I served as controls and received distilled water and feed only. Groups II-IV were used as treatment groups. They received calculated doses of aqueous leaf extracts orally at doses of 500 mg/kg, 1000 mg/kg, and 2000 mg/kg body weight, respectively.</p><p><strong>Results: </strong>Since 80% of deaths occurred at the 10,000 mg/kg body-weight dose in this experiment, LD₅₀ was considered to be <10,000 mg/kg. In the subacute test, general signs of toxicity like hypoactivity, piloerection, lethargy, and a single episode of convulsion were observed at the 2000 mg/kg dose. Beginning from the third week of administration, both male and female mice receiving 500 mg/kg and 2000 mg/kg and all treatment groups in the fourth week showed significant (<i>P</i><0.05) weight loss compared to controls. Biochemical parameters were found to increase in all groups treated with ethanolic leaf extracts. Several histopathological changes like congestion, hemorrhage, severe necrosis, and infiltration of inflammatory cells in both liver and kidney in the <i>L. adoensis</i>-treated rats were observed at all doses.</p><p><strong>Conclusion: </strong>In the present study, the ethanolic leaf extracts of <i>L. adoensis</i> produced dose-dependent weight loss and histopathological and biochemical changes in Swiss albino mice.</p>","PeriodicalId":12917,"journal":{"name":"Hepatic Medicine : Evidence and Research","volume":" ","pages":"123-133"},"PeriodicalIF":2.1,"publicationDate":"2022-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/2c/14/hmer-14-123.PMC9512065.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40381502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical, Laboratory and Bacterial Profile of Spontaneous Bacterial Peritonitis in Vietnamese Patients with Liver Cirrhosis.","authors":"Long Cong Nguyen,&nbsp;Thuy Thi-Bich Lo,&nbsp;Huong Dieu La,&nbsp;Ha Thi-Ngoc Doan,&nbsp;Ngoan Tran Le","doi":"10.2147/HMER.S369966","DOIUrl":"https://doi.org/10.2147/HMER.S369966","url":null,"abstract":"<p><strong>Aim: </strong>To determine several clinical and laboratory features as well as the bacterial profile of spontaneous bacterial peritonitis (SBP) in 58 Vietnamese patients admitted to a single center due to liver cirrhosis.</p><p><strong>Methods: </strong>We retrospectively analyzed bacteriological, clinical and laboratory characteristics of patients with SBP admitted to the Gastroenterology and Hepatology Center from July 2019 to July 2020.</p><p><strong>Results: </strong>Out of a total 58 SBP patients, 41 (70.9%) had culture-negative neutrocytic ascites. The majority of patients experienced abdominal pain (93,1%) and large ascites (65,5%). Gram-negative bacteria formed the main pathogens (14/17). <i>Escherichia coli</i> (9/17) was the predominant cause followed by <i>Burkholderia cepacia</i> (2/17). Antibiotic sensitivity rate of <i>E. coli</i> for third generation cephalosporin was low but high for aminoglycoside and carbapenem antibiotics. The resistance of <i>E. coli</i> was significant against fluoroquinolones (100%). All 3 cases of gram-positive bacteria were sensitive to vancomycin.</p><p><strong>Conclusion: </strong>Our study reported the bacteriological and clinical characteristics of patients with SBP and compared these findings between two groups: positive ascitic fluid culture and negative fluid culture. Ascitic fluid culture can guide for the right antibiotic choice since resistance to commonly prescribed antibiotics is common in SBP patients.</p>","PeriodicalId":12917,"journal":{"name":"Hepatic Medicine : Evidence and Research","volume":" ","pages":"101-109"},"PeriodicalIF":2.1,"publicationDate":"2022-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3c/4f/hmer-14-101.PMC9348134.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40688119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Perspectives on Nucleos(t)ide Analogue Therapy for the Long-Term Treatment of Hepatitis B Virus.","authors":"Teresa Broquetas,&nbsp;José A Carrión","doi":"10.2147/HMER.S291976","DOIUrl":"https://doi.org/10.2147/HMER.S291976","url":null,"abstract":"<p><p>The hepatitis B virus (HBV) infection remains a global public health problem. This review presents updated recommendations for the optimal current treatment of choice with nucleos(t)ide analogues (NA). Current clinical practice guidelines on the management of chronic hepatitis B (CHB) by the Asian Pacific Association for the Study of the Liver, the European Association for the Study of the Liver and the American Association for the Study of Liver Diseases have been considered. Patients with chronic HBV infection are at increased risk of liver disease progression to cirrhosis and hepatocellular carcinoma (HCC) development. The main goal of therapy is to improve survival preventing disease progression and HCC. The induction of long-term suppression of HBV replication represents the main endpoint of current treatment strategies, while hepatitis B surface antigen (HBsAg) loss is the optimal endpoint. The typical indication for treatment requires elevated HBV desoxyribonucleic acid (DNA), elevated alanine aminotransferase and/or at least moderate histological lesions, while all cirrhotic patients with detectable HBV DNA should be treated. The long-term administration of a potent NA with high barrier to resistance, ie, entecavir, tenofovir disoproxil fumarate or tenofovir alafenamide, represents the treatment of choice. However, HBsAg seroclearance is anecdotal with NA. Treated patients should be monitored for therapy response, adherence, risk of disease progression, and risk of HCC development. This review aims to assess the evolving trends on the potent NA and the new perspectives on finite therapy.</p>","PeriodicalId":12917,"journal":{"name":"Hepatic Medicine : Evidence and Research","volume":" ","pages":"87-100"},"PeriodicalIF":2.1,"publicationDate":"2022-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/1c/1d/hmer-14-87.PMC9346298.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40688118","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-Marketing Surveillance Study of the Safety and Efficacy of Nalfurafine (Capsules 2.5 μg, Oral Dispersing Tablets 2.5 μg) in 1186 Patients with Chronic Liver Disease and Intractable Pruritus","authors":"H. Yoshitani, Junko Ito, H. Kozono","doi":"10.2147/HMER.S352775","DOIUrl":"https://doi.org/10.2147/HMER.S352775","url":null,"abstract":"Background Nalfurafine (Remitch®, Toray Industries, Inc.) is a selective κ-receptor agonist approved in Japan for the improvement of pruritus in patients with chronic liver diseases (only when existing treatments bring insufficient efficacy) in May 2015. Methods A post-marketing Specific Drug Use Survey was conducted in Japan (March 1, 2016 to June 30, 2020) of the safety and efficacy of nalfurafine for the improvement of pruritus in patients with chronic liver disease. Results Among 1186 cases analyzed for safety, the incidence of adverse drug reactions was 9.4% (112/1186 cases), lower than 61.4% reported in pre-marketing surveillance (297/484 cases). No specific safety issues were found and no cases of concern for drug dependence identified. Efficacy (itch improvement) was demonstrated in 73.16% (815/1114 cases; 12-week analysis set) and in 85.67% (520/607; general assessment of itch improvement at 1-year analysis set). A significant difference was found in 4 items of itch improvement at 12 weeks and 8 items of itch improvement at 1 year. No noteworthy issues were identified. Mean Visual Analog Scale (VAS) values after 12 weeks and 1 year after the first dose were significantly lower than the baseline (p < 0.0001 for both treatment durations). Mean severity scores (Kawashima’s classification scheme) were significantly lower than the pretreatment score at 12 weeks and 1 year after the first dose (both p < 0.0001). No concerns were identified in the efficacy and safety of nalfurafine in patients with specific background, ie, the elderly (aged ≥ 65 years), those with renal impairment, and those on long-term treatment (≥ 365 days) compared with patients without corresponding background. Conclusion No new safety issues of concern or cases of insufficient efficacy were identified in this Specific Drug Use Survey of the safety and efficacy of nalfurafine for the improvement of pruritus in patients with chronic liver diseases.","PeriodicalId":12917,"journal":{"name":"Hepatic Medicine : Evidence and Research","volume":"14 1","pages":"37 - 66"},"PeriodicalIF":2.1,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42328252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of HIV and Its Co-Infection with Hepatitis B/C Virus Among Chronic Liver Disease Patients in Ethiopia","authors":"Yayehyirad Tassachew, T. Abebe, Yeshambel Belyhun, Tezazu Teffera, A. Shewaye, H. Desalegn, H. Andualem, Abiy Kinfu, A. Mulu, A. Mihret, R. Howe, A. Aseffa","doi":"10.2147/HMER.S365443","DOIUrl":"https://doi.org/10.2147/HMER.S365443","url":null,"abstract":"Background The efficient use of antiretroviral drugs has significantly reduced AIDS-related morbidities and mortalities; however, mortality due to non-AIDS-related end-stage liver diseases is escalating in those living with HIV. Objective The study was designed to determine the prevalence of HIV and its co-infection with HBV and HCV among chronic liver disease (CLD) patients in Ethiopia. Methods Three hundred and forty-five CLD patients were included in this study in two groups: Hepatocellular carcinoma (HCC) (n=128) and non-HCC (n=217) patients. The non-HCC group comprised patients with advanced liver disease (n=98) and chronic hepatitis (n=119). Enzyme immunoassays were used to determine HBV and HCV infection markers. In addition, a serial rapid HIV testing algorithm was employed to screen HIV infection. Results Regardless of the stage of liver disease, the overall frequency of HIV was 4.3% (15/345), with a 2% (7/345) and 0.3% (1/345) of HIV/HBV and HIV/HCV co-infection rate. Of all HIV-infected patients (n=15), 46.7% (7/15) and 6.7% (1/15) were co-infected with HBV (HBsAg+HBcAb+) and HCV (anti-HCV+ HCV-RNA+), respectively, and 86.7% (13/15) exhibited a marker of HBV exposure (total HBcAb+). Overall, the frequency of HIV and its co-infection with HBV was more noticeable among HCC than non-HCC patients [8.6% (11/128) vs 1.8 (4/217), p=0.005 and 3.9% (5/128) vs 0.9% (2/217), p=0.1]. The rate of HIV mono-infection was 3.9% (5/128) vs 0.9% (2/217) among HCC and non-HCC patients. Conclusion The frequency of HIV and its co-infections with HBV/HCV exhibited an increasing pattern with the severity of the liver disease. Thus, screening all HIV-positive patients for HBV and HCV infection and all CLD patients for HIV infection and taking necessary preventive measures would be an essential strategy to prevent the progression of CLD and death related to liver disease in people living with HIV.","PeriodicalId":12917,"journal":{"name":"Hepatic Medicine : Evidence and Research","volume":"14 1","pages":"67 - 77"},"PeriodicalIF":2.1,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43958268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Splenectomy Combined with Endoscopic Variceal Ligation (EVL) versus EVL Alone for Secondary Prophylaxis of Variceal Bleeding in Hepatosplenic Schistosomiasis: A Retrospective Case–Control Study","authors":"J. Rakotomalala, C. Razafindrazoto, N. H. Randriamifidy, B. Ralaizanaka, Sonny Maherison, D. H. Hasina Laingonirina, Mialitiana Rakotomaharo, A. Rasolonjatovo, Mamisoa Anicet Rakotovao, A. Rakotozafindrabe, T. Rabenjanahary, Rija Fanantenantsoa, S. Razafimahefa, R. Ramanampamonjy","doi":"10.2147/HMER.S367849","DOIUrl":"https://doi.org/10.2147/HMER.S367849","url":null,"abstract":"Background Hepatosplenic schistosomiasis (HSS) is one of the most common causes of portal hypertension in developing countries. Variceal bleeding is the most common cause of mortality during HSS. The objective of this study was to evaluate the efficacy of splenectomy associated with endoscopic variceal ligation (EVL) compared with EVL alone in preventing variceal bleeding in patients with HSS. Methods This was a single-center, retrospective, case–control study. Between January 2015 and December 2019, a total of 59 patients with HSS who had at least one variceal bleeding episode and received EVL with or without splenectomy were identified and stratified. In this case–control design, 22 patients had splenectomy + EVL (case group) and 37 patients had EVL alone (control group). The main endpoints were the rate of variceal rebleeding and the mortality rate between the two groups. Results The mean age of our patients was 39.92 ± 13.4 (19–75) years with a sex ratio of 1.8. The recurrence rate of variceal bleeding was significantly lower in the case group (splenectomy + EVL) than in the control group (EVL alone) (4.45% vs 27.2%, p = 0.041). There was no significant difference between the two groups in terms of mortality (4.54 vs 2.7%, p = 1.00). Conclusion Splenectomy combined with EVL was effective than EVL alone in preventing variceal rebleeding in patients with HSS.","PeriodicalId":12917,"journal":{"name":"Hepatic Medicine : Evidence and Research","volume":"14 1","pages":"79 - 85"},"PeriodicalIF":2.1,"publicationDate":"2022-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47936579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Special Considerations in the Management of HIV and Viral Hepatitis Coinfections in Liver Transplantation","authors":"Josiah D. McCain, D. Chascsa","doi":"10.2147/HMER.S282662","DOIUrl":"https://doi.org/10.2147/HMER.S282662","url":null,"abstract":"Abstract Modern therapies for hepatitis B virus, hepatitis C virus, and human immunodeficiency virus have become so effective that patients treated for these conditions can have normal life-expectancies. Suitable livers for transplantation remain a scarce and valuable resource. As such, significant efforts have been made to expand donation criteria at many centers. This constant pressure, coupled with the increasing effectiveness of antiviral therapies, has meant that more and more patients infected with hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) may be considered appropriate donors in the right circumstances. Patients with these infections are also more likely to be considered appropriate transplantation recipients than in the past. The treatment of HBV, HCV, and HIV after liver transplantation (LT) can be challenging and complicated by viral coinfections. The various pharmaceutical agents used to treat these infections, as well as the immunosuppressants used post-LT must be carefully balanced for maximum efficacy, and to avoid resistance and drug–drug interactions.","PeriodicalId":12917,"journal":{"name":"Hepatic Medicine : Evidence and Research","volume":"14 1","pages":"27 - 36"},"PeriodicalIF":2.1,"publicationDate":"2022-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48507492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}