Hepatitis C virus persisting after clinically apparent sustained virological response to antiviral therapy retains infectivity in vitro

Sonya A. MacParland, Tram N. Q. Pham, Clifford S. Guy, Tomasz I. Michalak – 27 April 2009 – Hepatitis C virus (HCV) can persist in the liver, lymphoid cells, and serum of individuals with apparently complete spontaneous or therapy‐induced resolution of hepatitis C and can replicate in vivo and in vitro in human T cells. The current study was aimed at assessing the infectivity of HCV persisting at very low levels using the previously established HCV infection system in human T cells.

Improved outcome of adult recipients with a high model for end‐stage liver disease score and a small‐for‐size graft

Nam‐Joon Yi, Kyung‐Suk Suh, Hae Won Lee, Woo Young Shin, Juhyun Kim, Won Kim, Yoon Jun Kim, Jung‐Hwan Yoon, Hyo‐Suk Lee, Kuhn Uk Lee – 27 April 2009 – Although adult‐to‐adult living donor liver transplantation (ALDLT) has shown comparable outcomes to deceased donor liver transplantation, the outcome of patients with a high MELD score (>25) and a small‐for‐size graft (SFSG<0.8% of graft‐to‐recipient weight ratio) is not known. For 7 years, 167 consecutive hepatitis B virus‐infected recipients underwent ALDLT at our institution.

Endpoints of therapy in chronic hepatitis B

Jordan J. Feld, David K. H. Wong, E. Jenny Heathcote – 27 April 2009 – Because clearance of hepatitis B virus (HBV) infection is rarely, if ever, achievable, the goals of therapy necessarily focus on prevention of bad clinical outcomes. Ideally, therapies would be shown to prevent tangible clinical endpoints like development of cirrhosis, end‐stage liver disease and hepatocellular carcinoma. However, these endpoints typically take years or decades to occur and are therefore impractical targets for clinical trials which last only 1‐2 years.

The natural history of chronic hepatitis B virus infection

Brian J. McMahon – 27 April 2009 – Chronic hepatitis B virus (HBV) infection has a complicated course. Three phases are identified: an immune tolerant phase with high HBV DNA and normal alanine aminotransferase (ALT) levels associated with minimal liver disease; an immune active phase with high HBV DNA and elevated ALT levels with active liver inflammation; and an inactive phase with HBV DNA levels < 2000 IU/mL and normal ALT levels with minimal inflammation and fibrosis on liver biopsy. Affected persons can move progressively from one phase to the next and may revert backward.

Endotoxin uptake in mouse liver is blocked by endotoxin pretreatment through a suppressor of cytokine signaling‐1–dependent mechanism

Melanie J. Scott, Shubing Liu, Richard A. Shapiro, Yoram Vodovotz, Timothy R. Billiar – 27 April 2009 – The liver is the main organ that clears lipopolysaccharide (LPS) and hepatocytes are a major cell‐type involved in LPS uptake. LPS tolerance, or desensitization, is important in negative regulation of responses to LPS, but little is known about its mechanisms in hepatocytes. Primary isolated C57BL/6 hepatocytes, and liver in vivo, internalized fluorescent LPS, and this was dependent on Toll‐like receptor 4 (TLR4) at the cell surface but not on TLR4‐TIR signaling through MyD88.

Pioglitazone promotes survival and prevents hepatic regeneration failure after partial hepatectomy in obese and diabetic KK‐Ay mice

Tomonori Aoyama, Kenichi Ikejima, Kazuyoshi Kon, Kyoko Okumura, Kumiko Arai, Sumio Watanabe – 27 April 2009 – Pathogenesis of metabolic syndrome–related nonalcoholic steatohepatitis (NASH) involves abnormal tissue‐repairing responses in the liver. We investigated the effect of pioglitazone, a thiazolidinedione derivative (TZD), on hepatic regenerative responses in obese, diabetic KK‐Ay mice. Male KK‐Ay mice 9 weeks after birth underwent two‐thirds partial hepatectomy (PH) after repeated intragastric injections of pioglitazone (25 mg/kg) for 5 days.

Postreperfusion syndrome during liver transplantation for cirrhosis: Outcome and predictors

Catherine Paugam‐Burtz, Juliette Kavafyan, Paul Merckx, Souhayl Dahmani, Daniel Sommacale, Michael Ramsay, Jacques Belghiti, Jean Mantz – 27 April 2009 – During orthotopic liver transplantation (OLT), a marked decrease in blood pressure following unclamping of the portal vein and liver reperfusion is frequently observed and is termed postreperfusion syndrome (PRS). The predictive factors and clinical consequences of PRS are not fully understood.

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