Publications by authors named "Jose A Carrion"

Article Synopsis
  • This study investigates the relationship between hepatic venous pressure gradient (HVPG) and direct portal pressure (DPP) in cirrhosis patients who still have esophageal varices (EV) after treatment to remove the underlying cause, even when HVPG is low (<10 mmHg).
  • Ten patients with hepatitis C virus (HCV) or alcohol-related cirrhosis were examined, showing that HVPG correlates well with portal pressure measurements but doesn't fully explain the persistence of varices post-treatment.
  • The research suggests that while HVPG reflects overall portal pressure accurately, the presence of varices after treatment needs further exploration, indicating a gap in understanding the benefits of treatment for patients with EV but low HVPG.
View Article and Find Full Text PDF
Article Synopsis
  • Chronic hepatitis D (CHD) affects about 5% of hepatitis B patients in Spain, with a significant portion having pre-existing conditions like cirrhosis and coinfections.
  • A study involving 329 patients revealed that 62% tested positive for HDV-RNA and that persistence of this viremia is linked to faster liver disease progression, with one-third already having cirrhosis at diagnosis.
  • Key challenges in managing these patients include delays in accessing new antiviral treatments and difficulties in accurately assessing HDV-RNA levels locally.
View Article and Find Full Text PDF

Patients with advanced chronic liver disease (ACLD) or cirrhosis undergoing surgery have an increased risk of morbidity and mortality in contrast to the general population. This is a retrospective, observational study to evaluate the predictive capacity of surgical risk scores in European patients with ACLD. Cirrhosis was defined by the presence of thrombocytopenia with <150,000/uL and splenomegaly, and AST-to-Platelet Ratio Index >2, a nodular liver edge seen via ultrasound, transient elastography of >15 kPa, and/or signs of portal hypertension.

View Article and Find Full Text PDF

The estimated world prevalence of hepatitis B virus (HBV) infection is 316 million. HBV infection was identified in 1963 and nowadays is a major cause of cirrhosis and hepatocellular carcinoma (HCC) despite universal vaccination programs, and effective antiviral therapy. Long-term administration of nucleos(t)ide analogues (NA) has been the treatment of choice for chronic hepatitis B during the last decades.

View Article and Find Full Text PDF

(1) Background: Patients with advanced chronic liver disease (ACLD) are living longer with more comorbidities because of improved medical and surgical management. However, patients with ACLD are at increased risk of perioperative morbidity and mortality; (2) Methods: We conducted a comprehensive review of the literature to support a narrative clinical guideline about the assessment of mortality risk and management of perioperative morbidity in patients with ACLD undergoing surgical procedures; (3) Results: Slight data exist to guide the perioperative management of patients with ACLD, and most recommendations are based on case series and expert opinion. The severity of liver dysfunction, portal hypertension, cardiopulmonary and renal comorbidities, and complexity of surgery and type (elective versus emergent) are predictors of perioperative morbidity and mortality.

View Article and Find Full Text PDF
Article Synopsis
  • Transient elastography (TE) has been widely used for nearly 20 years to diagnose liver fibrosis and has now expanded to include population screening and assessment of liver complications.
  • A working group of doctors and nurses conducted an online survey to create updated guidelines, using a structured approach to ensure comprehensive evaluation.
  • The updated document, backed by the Catalan Society of Gastroenterology, emphasizes TE as a reliable method for evaluating liver health and managing cirrhosis complications.
View Article and Find Full Text PDF
Article Synopsis
  • * Findings reveal that 28% of patients experienced acute decompensation, with ascites being the most common issue, alongside other complications like hepatic encephalopathy and variceal bleeding.
  • * The research identifies factors such as low albumin levels and the presence of ischemic heart disease that increase the risk of decompensation and highlights a notable incidence of cancers among these patients, with 18% developing hepatocellular carcinoma or extrahepatic cancers.
View Article and Find Full Text PDF

Background & Aims: The COVID-19 pandemic has had a major negative impact on health systems and many chronic diseases globally. We aimed to evaluate the impact of the first year of the pandemic on the outcomes of people with NAFLD cirrhosis.

Methods: We conducted a before-after study in four University hospitals in Catalonia, Spain.

View Article and Find Full Text PDF

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.

View Article and Find Full Text PDF

Abnormal liver function tests (A-LFTs) during admission for coronavirus disease-19 (COVID-19) are frequent, but its evolution after COVID-19 resolution remains unexplored. We evaluated factors related to A-LFTs during COVID-19 and assessed the liver outcome after patients' discharge. This is a observational study including: (1) retrospective analysis of variables related to A-LFTs during COVID-19; and (2) follow-up evaluation with blood test, transient elastography and liver biopsy in those with persistent A-LFTs.

View Article and Find Full Text PDF

Isolated extrapulmonary involvement in sarcoidosis is uncommon and reported in 5-9% of systemic sarcoidosis, this constitutes a clinical challenge due to its extensive differential diagnosis. Extrapulmonary sarcoidosis affecting more than three organs is rarely reported and there are scarce literature data published on diagnosis, clinical course and management in those cases. We hereby discuss a case of a 41-year-old female with systemic non-pulmonary sarcoidosis affecting lacrimal gland, peripheral lymph nodes, parotid gland and the liver.

View Article and Find Full Text PDF

Background: Nucleos(t)ide analogues withdrawal may improve HBsAg loss rates. However, conditions to select patients are not well established.

Aims: to evaluate the impact of HBsAg kinetics before treatment interruption on post-treatment response.

View Article and Find Full Text PDF

Microwave (MWA) and radiofrequency ablation (RFA) are main ablative techniques for hepatocellular carcinoma (HCC) and colorectal liver metastasis (MT). This randomized phase 2 clinical trial compares the effectiveness of MWA and RFA as well as morphology of corresponding ablation zones. HCC and MT patients with 1.

View Article and Find Full Text PDF

Background: Liver fibrosis and transient elastography (TE) correlation in hepatitis C virus (HCV)-infected patients with compensated advanced chronic liver disease (cACLD) after the sustained virological response (SVR) is unknown.

Aims: To evaluate TE accuracy at identifying cirrhosis 3 years after HCV-eradication.

Methods: Prospective, multi-centric study including HCV-cACLD patients before direct-acting antivirals (DAA).

View Article and Find Full Text PDF

Isolated extrapulmonary involvement in sarcoidosis is uncommon and reported in 5-9% of systemic sarcoidosis, this constitutes a clinical challenge due to its extensive differential diagnosis. Extrapulmonary sarcoidosis affecting more than three organs is rarely reported and there are scarce literature data published on diagnosis, clinical course and management in those cases. We hereby discuss a case of a 41-year-old female with systemic non-pulmonary sarcoidosis affecting lacrimal gland, peripheral lymph nodes, parotid gland and the liver.

View Article and Find Full Text PDF
Article Synopsis
  • Direct-acting antivirals (DAAs) effectively cure chronic HCV infections in over 95% of patients; however, some patients experience treatment failure due to resistance-associated substitutions (RAS).
  • Triple therapy using sofosbuvir, velpatasvir, and voxilaprevir is the recommended approach for retreatment if initial DAA therapy fails, though rare treatment failures with this combination do occur.
  • An analysis of five male patients revealed specific RAS profiles, including substitutions like Y56F and Y93H, with successful salvage treatment achieved in one patient using a combination of sofosbuvir, glecaprevir/pibrentasvir, and ribavirin.
View Article and Find Full Text PDF

Background: Obeticholic acid (OCA) was recently approved as the only on-label alternative for patients with primary biliary cholangitis (PBC) with intolerance or suboptimal response to ursodeoxycholic acid (UDCA). However, few data are available outside clinical trials.

Aim: To assess the effectiveness and safety of OCA in a real-world cohort of patients with non-effective UDCA therapy.

View Article and Find Full Text PDF

Background: Hepatitis B e antigen-negative chronic hepatitis B patients under nucleos(t)ids analogues (NAs) rarely achieve hepatitis B surface antigen (HBsAg) loss.

Aim: To evaluate if the addition of pegylated interferon (Peg-IFN) could decrease HBsAg and hepatitis B core-related antigen (HBcrAg) levels and increase HBsAg loss rate in patients under NAs therapy.

Methods: Prospective, non-randomized, open-label trial evaluating the combination of Peg-IFN 180 µg/week plus NAs during forty-eight weeks NAs in monotherapy.

View Article and Find Full Text PDF

Background And Aim: Patients with chronic hepatitis C (CHC) frequently associated comorbidities and concomitant medication. Sustained virological response (SVR12) has been related to an increase in cholesterol serum levels and in peripheral vascular resistance. Our aim was to evaluate the impact of SVR12 on the use of concomitant medication and serum lipid profile.

View Article and Find Full Text PDF

Background & Aims: Glecaprevir/pibrentasvir is approved for treating adults infected with HCV genotypes 1-6. In clinical trials, glecaprevir/pibrentasvir was associated with high rates of sustained virologic response at post-treatment week 12 (SVR12) and was well tolerated. A systematic review and meta-analysis of the real-world effectiveness and safety of glecaprevir/pibrentasvir were undertaken.

View Article and Find Full Text PDF

Background And Aim: Accurate information on the epidemiology of hepatitis C and B infection is mandatory to establish a national/regional plan. We aim to update the prevalence of hepatitis C and B infection in Catalonia using point-of-care tests to analyze the risk factors related and to implement a linkage-to-care circuit.

Methods: This is a community-based study.

View Article and Find Full Text PDF
Article Synopsis
  • * Researchers applied a new testing protocol to analyze samples from 220 patients across various Spanish hospitals, finding that 88.6% had at least one RAS, with specific patterns linked to different HCV subtypes.
  • * The findings reveal that certain patients had RAS not affected by the drugs they received, indicating the necessity for thorough RAS testing, especially since ribavirin treatment did not impact RAS diversity or type.
View Article and Find Full Text PDF