scholarly journals Barriers Preventing Liver Transplantation in Canadians with HIV Infection – Perceptions of HIV Specialists

2007 ◽  
Vol 21 (3) ◽  
pp. 179-182 ◽  
Author(s):  
Curtis L Cooper ◽  
Joanne DeForest ◽  
John Gill ◽  
Richard Lalonde ◽  
Keyword(s):  
Liver Transplantation ◽  
Hepatitis C Virus ◽  
Liver Disease ◽  
Hepatitis C ◽  
Liver Transplant ◽  
Life Saving ◽  
B Virus ◽  
Key Issues ◽  
End Stage ◽  
Living With Hiv

Liver transplantation is a life-saving procedure with demonstrated utility. There are accumulating data indicating that this procedure is helpful in HIV-infected patients as well. Liver transplantation is currently largely unavailable to those living with HIV in Canada. Understanding the obstacles to this procedure is the first step to increasing access. Between August 2005 and November 2005, HIV physicians, one from each Canadian HIV Trials Network site, were asked to complete a quantitative questionnaire on adult liver transplant access and need. Forty-six per cent (16 of 35) of sites responded. A median 20% of the nearly 12,700 HIV patients followed at these sites had concurrent liver disease (20% caused by hepatitis C virus, 5% caused by hepatitis B virus and 5% were alcohol-related). On average, two patients per site were thought to be appropriate candidates for liver transplant evaluation. Eighty per cent of respondents anticipated increased need for liver transplantation over the next five years. Organ supply was universally identified as the chief obstacle to transplantation in patients with HIV. Other key issues included risk of hepatitis C virus reinfection and transplant surgical team willingness. Based on these data, it is believed that these issues should be the focus of efforts designed to increase access to transplantation in Canadians with end-stage liver disease and concurrent HIV.

scholarly journals HIV and Liver transplantation: The British Columbia Experience, 2004 to 2013

2014 ◽  
Vol 25 (3) ◽  
pp. 159-162 ◽  
Author(s):  
Clara Tan-Tam ◽  
Pamela Liao ◽  
Julio S Montaner ◽  
Mark W Hull ◽  
Charles H Scudamore ◽  
...  
Keyword(s):  
British Columbia ◽  
Liver Transplantation ◽  
Hepatitis C Virus ◽  
Liver Disease ◽  
Hepatitis C ◽  
Liver Transplant ◽  
Clinical Outcomes ◽  
Disease Status ◽  
Transplant Program ◽  
End Stage

BACKGROUND: The demand for definitive management of end-stage organ disease in HIV-infected Canadians is growing. Until recently, despite international evidence of good clinical outcomes, HIV-infected Canadians with end-stage liver disease were ineligible for transplantation, except in British Columbia (BC), where the liver transplant program of BC Transplant has accepted these patients for referral, assessment, listing and provision of liver allograft. There is a need to evaluate the experience in BC to determine the issues surrounding liver transplantation in HIV-infected patients.METHODS: The present study was a chart review of 28 HIV-infected patients who were referred to BC Transplant for liver transplantation between 2004 and 2013. Data regarding HIV and liver disease status, initial transplant assessment and clinical outcomes were collected.RESULTS: Most patients were BC residents and were assessed by the multidisciplinary team at the BC clinic. The majority had undetectable HIV viral loads, were receiving antiretroviral treatments and were infected with hepatitis C virus (n=16). The most common comorbidities were anxiety and mood disorders (n=4), and hemophilia (n=4). Of the patients eligible for transplantation, four were transplanted for autoimmune hepatitis (5.67 years post-transplant), nonalcoholic steatohepatitis (2.33 years), hepatitis C virus (2.25 years) and hepatitis B-delta virus coinfection (recent transplant). One patient died from acute renal failure while waiting for transplantation. Ten patients died during preassessment and 10 were unsuitable transplant candidates. The most common reason for unsuitability was stable disease not requiring transplantation (n=4).CONCLUSIONS: To date, interdisciplinary care and careful selection of patients have resulted in successful outcomes including the longest living HIV-infected post-liver transplant recipient in Canada.

scholarly journals Hepatitis

2001 ◽  
Vol 12 (6) ◽  
pp. 329-331 ◽  
Author(s):  
Mel Krajden
Keyword(s):  
Public Health ◽  
Liver Transplantation ◽  
Liver Disease ◽  
Hepatitis C ◽  
Public Health Perspective ◽  
End Stage Liver Disease ◽  
B Virus ◽  
At Risk Populations ◽  
Chronic Hbv ◽  
End Stage

Worldwide, approximately 170 million people are chronically infected with hepatitis C virus (HCV) and another 350 million individuals are chronically infected with hepatitis B virus (HBV) (1,2). Canada is estimated to have 240,000 to 300,000 HCV and 200,000 to 280,000 HBV chronic carriers (3,4). Without intervention, over multiple decades, approximately 15% to 30% of chronic HBV- and HCV-infected individuals will develop cirrhosis, end-stage liver disease or liver cancer, or will require liver transplantation (1,2,5). From a public health perspective, the major challenge is how best to avoid acute (incident) infections in at-risk populations, and for those already chronically infected, how to prevent consequent morbidity and mortality.

scholarly journals Lipid profile in cirrhotic patients and its relation to clinical outcome

2015 ◽  
Vol 28 (2) ◽  
pp. 132-135 ◽  
Author(s):  
Laura BOEMEKE ◽  
Lilian BASSANI ◽  
Cláudio Augusto MARRONI ◽  
Catarina Bertaso Andreatta GOTTSCHALL
Keyword(s):  
Liver Transplantation ◽  
Hepatitis C Virus ◽  
Liver Disease ◽  
Hepatitis C ◽  
Clinical Outcome ◽  
Liver Transplant ◽  
Lipid Profile ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
Cirrhotic Patients

BACKGROUND: Carriers of hepatitis C virus have lower levels of total cholesterol, high density lipoprotein-cholesterol, low density lipoprotein- cholesterol and triglycerides compared to uninfected patients. With the progression of liver disease, the values for cholesterol and its fractions reduce linearly, with reduction ratio of lipid profile and markers Child-Pugh and MELD. AIM: To determine the relationship between decrease dlipid profile with clinical outcome presented (liver transplantation or death pre-transplant). METHODS: Was conducted a cross sectional analytical study of a follow-up study performed by reviewing medical records. Cirrhotic patients treated at theClinic of Gastroenterology from a large tertiary hospital with cirrhosis of viral etiology and/or alcohol were studied. The clinical characteristics (gender, age and etiology of cirrhosis) and lipid profile data from150 patients were collected in the year 2010.To analyze the occurrence of clinical outcomes (liver transplantation or death pre-transplant) patients were evaluated after four years. RESULTS: The prevalent cause was hepatitis C virus (53,3%), followed by alcohol (32%) and hepatitis C and alcohol (14,6%). Males represented 62% of the sample and the average age was 63.1±9.11 years. The prevalent lipid changes were hypocholesterolemia associated with hypotriglyceridemia (36,6%) and isolated hypocholesterolemia (34,6%). Analyzing groups of patients that showed abnormalities related to lipid profile, was identified a significant association between isolated hypocholesterolemia and clinical outcome-liver transplant(p <0.025) and 18% probability of performing liver transplantation in this group of patients. There was no association between decreased lipid profile and death. CONCLUSION: Isolated hypocholesterolemia contributes to assess the progression of liver disease, because of the association between lowering cholesterol and its fractions and the clinical outcome - liver transplant

Position Paper on Treatment of Hepatitis C in Romania, 2017. Part One

2017 ◽  
Vol 26 (2) ◽  
pp. 171-181 ◽  
Author(s):  
Liana Gheorghe ◽  
Ioan Sporea ◽  
Speranţa Iacob ◽  
Roxana Şirli ◽  
Anca Trifan ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Liver Disease ◽  
Hepatitis C ◽  
Limit Of Detection ◽  
Position Paper ◽  
Hcv Infection ◽  
Fixed Dose ◽  
Diagnostic Tools ◽  
End Stage Liver Disease ◽  
End Stage

Background & Aims: Hepatitis C Virus (HCV) infection is a common condition with endemic prevalence in some areas of the world. In Romania, the mean prevalence is about 3%. New treatments became available on the market in recent years and new drugs are in the pipeline. A re-evaluation of HCV therapy was considered mandatory. The Romanian Society of Gastroenterology and Hepatology undertook this task for the practitioners of this country.Methodology: A group of recognized experts was created who screened the available literature and the major available guidelines. A list of items requiring attention has been created. These items were discussed and rated. Decisions were taken by consensus.Recommendations: We present here the first of the two parts of our Society’s recommendations for chronic HCV infection treatment. An agreement was reached regarding the diagnostic tools, the assessment of severity and the up-dated therapy schedules.Conclusions: This Position Paper represents a guide for the assessment and the therapy of HCV infection. The recommendations are in concordance with other guidelines but are applied to the real-life conditions in this country.Abbreviations: DAAs: Direct-acting antivirals; DDIs: Drug-drug interactions; ESLD: End-stage liver disease; ESRD: End-stage renal disease; eGFR: Estimated glomerular filtration rate; EASL: European Association for the Study of the Liver; EMA: European Medicines Agency; FDA: US Food and Drug Administration; FDC: Fixed-dose combination; GT: Genotype; GRADE: Grading of Recommendations Assessment, Development and Evaluation; HCV: Hepatitis C virus; HCC: Hepatocellular carcinoma; LT: Liver transplantation; LLD: Lower limit of detection; MELD score: Mayo-Clinic End-Stage Liver Disease score; ANMDM: National Agency of Medicines and Medical Devices; PPIs: Proton pump inhibitors; PWID: People who inject drugs; RCT: Randomized controlled trial; RDT: Rapid diagnostic test; RAS: Resistance-associated substitution; SRGH: Romanian Society of Gastroenterology and Hepatology; SAE: serious adverse events; SPC: Summary of Product Characteristics; SVR: Sustained virologic response.

Position Paper on Treatment of Hepatitis C in Romania 2017. Part Two

2017 ◽  
Vol 26 (3) ◽  
pp. 309-317 ◽  
Author(s):  
Liana Gheorghe ◽  
Ioan Sporea ◽  
Speranța Iacob ◽  
Roxana Șirli ◽  
Anca Trifan ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Liver Disease ◽  
Hepatitis C ◽  
Sustained Virologic Response ◽  
Real Life ◽  
Virologic Response ◽  
Position Paper ◽  
Hcv Infection ◽  
End Stage Liver Disease ◽  
End Stage

Background & Aims: Hepatitis C virus (HCV) infection is a common condition with endemic prevalence in some areas of the world. In Romania, the mean prevalence is about 3%. New treatments have become available on the market in recent years and new drugs are in the pipeline. A re-evaluation of HCV therapy was considered mandatory. The Romanian Society of Gastroenterology and Hepatology undertook this task for the practitioners of this country.Methodology: A group of recognized experts was created who screened the available literature and the major available guidelines. A list of items requiring attention was created and these were discussed and rated. Decisions were taken by consensus.Recommendations: We present here the second part of the Society’s recommendations for chronic HCV infection treatment. An agreement between experts was reached regarding the therapy of the special categories of patients infected with HCV, complications and monitoring of the therapy, follow-up of the patients who reached sustained virologic response and re-treatment of the patients with therapy failure.Conclusions: This Position Paper represents a guide for the assessment and the therapy of HCV infection. The recommendations are in concordance with other guidelines but are applied to real-life conditions in Romania. Abbreviations: CKD: Chronic kidney disease; DAAs: Direct-acting antivirals; DDIs: Drug-drug interactions; ESDL: End-stage liver disease; FCH: Fibrosing cholestatic hepatitis; GT: Genotype; HCV: Hepatitis C virus; HCC: Hepatocellular carcinoma; LT: Liver transplantation; MELD score: Mayo-Clinic End-Stage Liver Disease score; PDC: Premature discontinuation; PWID: Persons who inject drugs; RASs: Resistance associated substitutions; RBV: Ribavirin; RCT: Randomized controlled trial; SAE: Serious adverse events; SRGH: Romanian Society of Gastroenterology and Hepatology; SVR: Sustained virologic response.

Proportion of Nonalcoholic Steatohepatitis in Patients with Chronic Liver Disease

2021 ◽  
Vol 15 (6) ◽  
pp. 1272-1274
Author(s):  
H.A. Abro ◽  
B. A. Shaikh ◽  
A. H. Mugheri ◽  
I. A. Ansari ◽  
Z. A. Shaikh ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Hepatitis C Virus ◽  
Liver Disease ◽  
Hepatitis C ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Nonalcoholic Steatohepatitis ◽  
Smoking Status ◽  
Virus Hepatitis ◽  
B Virus

Aim: To determine the frequency of nonalcoholic steatohepatitis in patients with liver cirrhosis. Study Design: Retrospective/observational Place and Duration of Study: Department of Medicine, Chandka Medical College Hospital, Larkana from 1st July 2020 to 31st March 2021. Methodology: One hundred and twenty patients of both genders presented with liver cirrhosis were enrolled in this study. Patient’s detailed demographics including age, sex, body mass index, smoking status, alcohol consumption and family history of liver disease were recorded after taking written informed consent. Laboratory examination was done to examine the proportion of hepatitis B virus, hepatitis C virus and nonalcoholic steatohepatitis. Results: There were 68 (56.67%) males and 52 (43.33%) were females with mean age 45.74±10.54 years. Among all the patients hepatitis C virus was found in 62 (51.67%) patients, 15 (12.5%) had hepatitis B virus, 17 (14.17%) had hepatitis B virus + hepatitis C virus and nonalcoholic steatohepatitis was found in 26 (21.67%) patients. Conclusion: Nonalcoholic steatohepatitis was the major cause of liver cirrhosis in Pakistani population. The proportion of NASH in liver cirrhosis patients was 21.67%. Keywords: Nonalcoholic steatohepatitis (NASH), Liver Cirrhosis, Hepatitis B virus, Hepatitis C virus

scholarly journals Hepatitis C virus or hepatitis B virus coinfection and lymphoma risk in people living with HIV

AIDS ◽  
2020 ◽  
Vol 34 (4) ◽  
pp. 599-608 ◽  
Author(s):  
Caroline Besson ◽  
Nicolas Noel ◽  
Remi Lancar ◽  
Sophie Prevot ◽  
Michele Algarte-Genin ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
People Living With Hiv ◽  
B Virus ◽  
Living With Hiv ◽  
Lymphoma Risk
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