Hepatitis B and hepatocellular carcinoma

Adrian M. Di Bisceglie – 27 April 2009 – Chronic infection with the hepatitis B virus has been linked epidemiologically to the development of hepatocellular carcinoma for more than 30 years. Although the mechanisms by which chronic hepatitis B viral infection results in hepatocellular carcinoma are unclear, there is good evidence that the virus itself exerts a direct hepatocarcinogenic effect, and this has implications for prevention. First, programs of universal infant vaccination have been shown to be effective in reducing the rate of hepatocellular carcinoma among children.

Benefits and risks of interferon therapy for hepatitis B

Robert Perrillo – 27 April 2009 – Alpha interferon is the only licensed drug for hepatitis B with immunomodulatory as well as viral inhibitory properties. Potential advantages of interferon compared to nucleoside analogs include a lack of drug resistance, a finite and defined treatment course, and a higher likelihood for hepatitis B surface antigen (HBsAg) clearance.

Reactivation of hepatitis B

Jay H. Hoofnagle – 27 April 2009 – Reactivation of hepatitis B refers to the abrupt increase in hepatitis B virus (HBV) replication in a patient with inactive or resolved hepatitis B. Reactivation can occur spontaneously, but more typically is triggered by immunosuppressive therapy of cancer, autoimmune disease, or organ transplantation. Reactivation can be transient and clinically silent, but often causes a flare of disease that can be severe resulting in acute hepatic failure.

Benefits and risks of nucleoside analog therapy for hepatitis B

Jules L. Dienstag – 27 April 2009 – Five oral agents have been approved for the treatment of chronic hepatitis B, ranging in virological potency, clinical efficacy, barrier to resistance, and side‐effect profile. The degree of histological, biochemical, and serological improvement with therapy generally corresponds to the degree of suppression of serum hepatitis B virus (HBV) DNA achieved with therapy. Conversely, for agents with a low barrier to resistance, the profundity of HBV DNA suppression in individual patients correlates inversely with the likelihood of resistance.

Acute kidney injury following liver transplantation: Definition and outcome

Yousri M. Barri, Edmund Q. Sanchez, Linda W. Jennings, Larry B. Melton, Steven Hays, Marlon F. Levy, Goran B. Klintmalm – 27 April 2009 – The incidence of acute kidney injury (AKI) has been reported to vary between 17% and 95% post–orthotopic liver transplantation. This variability may be related to the absence of a uniform definition of AKI in this setting. The purpose of this study was to identify the degree of AKI that is associated with long‐term adverse outcome.

Reply:

M. Isabel Lucena, Carmen Martínez, Raúl J. Andrade, Elena García‐Martín, Eugenia Ulzurrun, José A. G. Agúndez – 27 April 2009

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