While immune checkpoint inhibitors have evolved into the standard of care for advanced melanoma, 40-50% of melanoma cases progress while on therapies. The relationship between bacterium and carcinogenesis is well founded, such as in in gastric cancers, and in colorectal cancers. This interplay between dysbiosis and carcinogenesis questions whether changes in the microbiome could affect treatment.
View Article and Find Full Text PDFThe hepatitis C virus (HCV) is a common cause of chronic liver disease and liver cancer worldwide. Despite advances in curative therapies for HCV, the incidence of new infections is not decreasing at the expected rate to hit the World Health Organization (WHO) target for the elimination of HCV by 2030. In fact, there are still more new cases of infection in the United States and worldwide than are being cured.
View Article and Find Full Text PDFClin Gastroenterol Hepatol
January 2022
Alpha1-antitrypsin deficiency (A1ATD) is an inherited cause of chronic liver disease. It is inherited in an autosomal codominant pattern with each inherited allele expressed in the formation of the final protein, which is primarily produced in hepatocytes. The disease usually occurs in pediatric and elderly populations.
View Article and Find Full Text PDFHepatobiliary Surg Nutr
August 2019
Hepatitis B is a widespread disease which affects millions of people worldwide. Chronic hepatitis B (CHB) can lead to significant morbidity and mortality due to complications such as cirrhosis and hepatocellular carcinoma. The pathophysiology of hepatitis is critical to diagnosing CHB.
View Article and Find Full Text PDFPurpose Of Review: This review will summarize the use of obeticholic acid (OCA) in treatment of primary biliary cholangitis (PBC). It seeks to discuss the mechanism of action, evidence for use, appropriate clinical use, and common adverse effects of OCA.
Recent Findings: PBC is a chronic, progressive cholestatic liver disease that is a chronic progressive that may lead to end-stage liver disease and need for liver transplantation.
Since the introduction of direct-acting antivirals (DAAs), the outcomes of hepatitis C (HCV) treatment have shown an improvement in cure rates with minimal side effects. However, to date, the safety and efficacy of DAAs have not been specifically examined in elderly patients. The treatment of HCV in the era of pegylated interferon and ribavirin was more challenging among elderly patients due to the increased prevalence of multiple comorbid conditions associated with an increased risk of side effects, including anemia, and high rates of discontinuation, likely as a result of poor tolerability, resulting in lower rates of sustained virologic response (SVR).
View Article and Find Full Text PDFClin Liver Dis
February 2018
Nonalcoholic fatty liver disease (NAFLD) encompasses a spectrum of liver disorders ranging from hepatic steatosis to nonalcoholic steatohepatitis (NASH) and ultimately may lead to cirrhosis. Hepatic steatosis or fatty liver is defined as increased accumulation of lipids in hepatocytes and results from increased production or reduced clearance of hepatic triglycerides or fatty acids. Fatty liver can progress to NASH in a significant proportion of subjects.
View Article and Find Full Text PDFThe Braden Scale is a standardized tool to assess pressure ulcer risk that is reported for all hospitalized patients in the United States per requirements of the Center for Medicare and Medicaid Services. Previous data have shown the Braden Scale can predict both frailty and mortality risk in patients with decompensated cirrhosis. Our aim was to evaluate the association of the Braden Scale score with short-term outcomes after liver transplantation (LT).
View Article and Find Full Text PDFNonalcoholic fatty liver disease (NAFLD) is a serious public health concern that affects almost one third of the US population. The prevalence of NAFLD varies among ethnic/racial groups, with the Latin American population being affected disproportionately. The severity of NAFLD also may be greater in the Latino population.
View Article and Find Full Text PDFCirrhosis affects millions of people throughout the world. Two of the most serious complications of liver cirrhosis are ascites and spontaneous bacterial peritonitis (SBP). The development of ascites is related to the severity of portal hypertension and is an indicator of increased mortality.
View Article and Find Full Text PDFJ Clin Gastroenterol
October 2014
Introduction: Cirrhosis is a major milestone in patients with chronic liver disease because of its impact on patient morbidity and mortality. Chronic hepatitis B (CHB) and hepatitis C (CHC) are important causes of cirrhosis. This systematic review examines the relevant literature and evidence to assess whether cirrhosis can be reversible in patients with cirrhosis from viral hepatitis through long viral suppression.
View Article and Find Full Text PDFGastroenterol Hepatol (N Y)
March 2014
Hepatitis B virus (HBV) infection is an international public health concern, and chronic infection can lead to the development of cirrhosis, liver failure, or hepatocellular carcinoma as well as the need for liver transplantation. The recurrence of HBV infection following liver transplantation was disproportionately high prior to the introduction of proper prophylactic treatment. Risk factors associated with the recurrence of HBV infection post-transplant include hepatitis B e antigen positivity, high levels of serum HBV DNA, and the presence of an antiviral drug-resistant strain prior to transplantation.
View Article and Find Full Text PDFBackground & Aims: Chronic hepatitis C may be associated with cirrhosis, liver failure and hepatocellular carcinoma. Studies have demonstrated improved clinical outcome in patients who achieved a sustained viral response (SVR).
Methods: A systematic literature search was performed to identify studies that assessed the association between SVR and cirrhosis regression.
Clin Gastroenterol Hepatol
October 2014
Background & Aims: Infection increases mortality in patients with alcoholic hepatitis (AH). Little is known about the association between Clostridium difficile infection (CDI) and AH. We examined the prevalence and effects of CDI in patients with AH, compared with those of other infections.
View Article and Find Full Text PDFBackground: There has been increasing interest in using protease inhibitors with pegylated interferon and ribavirin to treat recurrent hepatitis C (HCV) disease in liver transplant recipients.
Methods: We retrospectively evaluated the safety and efficacy in liver transplant recipients treated for recurrent hepatitis C genotype 1 with the combination of peginterferon, ribavirin and boceprevir.
Results: Twenty liver transplant recipients were treated for recurrent hepatitis C.
Approximately 2.7 to 4.1 million people have chronic hepatitis C (HCV) in the United States.
View Article and Find Full Text PDFUndernutrition and obesity are at opposite ends of a spectrum that has an enormous impact on all aspects of liver diseases. The myriad effects of the opposing ends of the nutrition spectrum have led to a wealth of research aimed at elucidating the exact mechanisms of how they cause liver damage. In this article, the role of the liver in nutrient and energy metabolism is discussed, as well as the known and possible effects of specific nutrient deficiencies and obesity.
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