scholarly journals The role of antiviral therapy in the management of patients with liver cirrhosis associated with chronic HBV and HCV infection

2021 ◽  
Vol 66 (5) ◽  
pp. 331-339
Author(s):  
D. V. Garbuzenko
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Antiviral Therapy ◽  
Fatal Outcome ◽  
Antiviral Drug ◽  
Hcv Infection ◽  
Modern Concept ◽  
Pubmed Database ◽  
Chronic Hbv

The formation of the liver cirrhosis (LC) is an unfavorable event of the natural history of chronic liver diseases being accompanied by complications that often cause a fatal outcome. The study of the effectiveness of drugs that affect various etiopathogenetic mechanisms of this condition is an urgent problem of modern hepatology.The aim of the review was to show the role of antiviral therapy (AVT) in the management of patients with LC associated with chronic HBV (hepatitis B virus) and HCV (hepatitis C virus) infection.PubMed database, Google Scholar search engine, Cochrane Systematic Reviews, eLIBRARY.RU electronic scientific library, as well as the reference lists of articles were used to search for scientific articles. The relevant objectives of the review of the publications were identified for the period since 2000 up to 2021 by the search queries as following: «liver cirrhosis», «liver fibrosis», «chronic HBV infection», «chronic HCV infection», «portal hypertension», «treatment». The inclusion criteria were restricted to the management of patients with LC associated with chronic HBV and HCV infection.Current guidelines recommend indefinite treatment of patients with HBV-associated LC with nucleos(t)ide analogues regardless of serum HBV DNA levels, while the modern concept of using direct-acting antiviral drug combinations has become the standard treatment for HCV-associated cirrhosis. Studies have shown the ability of AVT to inhibit and reverse fibrotic processes in LC associated with chronic HBV and HCV infection. It has also been reported that HBV/HCV eradication prior to orthotopic liver transplantation improves long-term overall survival.This, in turn, can reduce the severity of portal hypertension and decrease the risk of associated complications, as well as normalize liver function. Thus, ensuring the availability of drugs for those in need of AVT will not only help prevent the development of LC, but also improve the quality of life and increase its expectancy of patients suffering from this disease.

Principles of primary prophylaxis of bleeding from oesophagealvaricies in patients with liver cirrhosis

2016 ◽  
Vol 94 (7) ◽  
pp. 503-509
Author(s):  
Dmitry V. Garbuzenko
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Primary Prevention ◽  
Esophageal Varices ◽  
Retrieval System ◽  
Primary Prophylaxis ◽  
Inclusion Criteria ◽  
Cochrane Reviews ◽  
Pubmed Database ◽  
Endoscopic Ligation

The principles of primary prevention of bleeding from esophageal varices in patients with liver cirrhosis are discussed with reference to the stage ofportal hypertension. The information was collectedfrom the PubMed database, Google Scholar retrieval system, Cochrane reviews, and lists of references from relevant publications for 1980-2015 using the key words «bleeding from esophageal varices», «prophylaxis», «portal hypertension». Inclusion criteria were confined to primary prophylaxis of bleeding from esophageal varices in patients with liver cirrhosis. The analysis showed that the drugs of choice for primary prophylaxis of bleeding from esophageal varices in patients with liver cirrhosis are non-selective beta-adrenoblockers, but their application is indicated only in case of clinicallyl significant portal hypertension in patients with large and mediumsize esophageal varices. When the use of these drugs is contraindicated, endoscopic ligation of esophageal varices can be recommended.

Role of immigration in chronic HBV and HCV infection in our environment. Origin and characteristics of the patients

2020 ◽  
Vol 73 ◽  
pp. S793
Author(s):  
Ángela Suárez-Noya ◽  
Celia Del Caño Cerdán ◽  
Alejandro Nieto Jara ◽  
Victor J Beltrán ◽  
Pablo Florez Díez ◽  
...  
Keyword(s):  
Hcv Infection ◽  
Chronic Hbv

Significance of serum WFA+-M2BP level as a marker of liver fibrosis in patients with chronic hepatitis C

2020 ◽  
Vol 18 (4) ◽  
pp. 80-84
Author(s):  
N.N. Volkova ◽  
◽  
N.S. Ibadullaeva ◽  
M.U. Asilova ◽  
E.I. Musabaev ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Liver Fibrosis ◽  
Antiviral Therapy ◽  
Chronic Hepatitis C ◽  
Treatment Initiation ◽  
Serum Levels ◽  
Serum Marker

Objective. To evaluate the role of dynamics of WFA+-M2BP, a serum marker of liver fibrosis, in patients with chronic hepatitis C (CHC). Patients and methods. We examined 56 CHC patients who received antiviral therapy. The severity of liver fibrosis was assessed using indirect elastometry. There were 8 patients with F0 fibrosis, 17 patients with F1 fibrosis, 6 patients with F2 fibrosis, 12 patients with F3 fibrosis, and 13 patients with F4 fibrosis. The level of WFA+-M2BP was measured prior to treatment initiation, then 1 month after treatment initiation, and 3 months after treatment completion. Results. We found that both CHC patients and patients with HCV-induced liver cirrhosis demonstrated a decrease in the serum level of WFA+-M2BP in response to antiviral therapy. Mean levels of WFA+-M2BP in individuals with F3 and F4 fibrosis were significantly higher than those in patients with F0 fibrosis (p < 0.01). Conclusion. Higher grades of liver cirrhosis were associated with higher serum levels of WFA+-M2BP, while antiviral therapy led to a decrease in the concentration of this biomarker. The assessment of WFA+-M2BP dynamics will help to detect early stages of liver fibrosis and also to monitor it in patients receiving antiviral therapy. Key words: chronic hepatitis C, liver cirrhosis caused by HCV, biomarker, WFA+-M2BP, liver fibrosis, antiviral therapy

Role of endothelium in the abnormal response of mesenteric vessels in rats with portal hypertension and liver cirrhosis

1996 ◽  
Vol 111 (6) ◽  
pp. 1627-1632 ◽  
Author(s):  
NM Atucha ◽  
V Shah ◽  
G Garcia-Cardena ◽  
WE Sessa ◽  
RJ Groszmann
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Abnormal Response ◽  
Mesenteric Vessels

scholarly journals Prospects of Antiangiogenic Therapy for Portal Hypertension in Liver Cirrhosis

2018 ◽  
Vol 28 (5) ◽  
pp. 35-45
Author(s):  
D. V. Garbuzenko
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Kinase Inhibitors ◽  
Antiangiogenic Therapy ◽  
Relevant Literature ◽  
Experimental Studies ◽  
Reference List ◽  
Action Mechanisms ◽  
Key Points

Aim.This paper is aimed at reviewing existing literature that investigates the role of angiogenesis in portal hypertension pathogenesis in liver cirrhosis and the possibilities of its antiangiogenic therapy, along with the description of angiogenesis inhibiting drugs and their action mechanisms.Key points. A relevant literature and reference list search was performed using PubMed and RSCI and Google Scholar, and covered the 2000–2017 period. The following keywords were used: liver cirrhosis, portal hypertension, pathogenesis, angiogenesis, antiangiogenic therapy. The inclusion criteria were limited to the antiangiogenic therapy of portal hypertension. Angiogenesis is shown to play an important role in the pathogenesis of liver cirrhosis. Angiogenesis is the basis for the development of associated portal hypertension that causes its characteristic complications. The experimental studies reviewed in this paper investigate the action mechanism of angiogenesis inhibiting drugs and their effect on portal hypertension. It is shown that, so far, only tyrosine kinase inhibitors have been tested in patients with liver cirrhosis as an antiangiogenic therapy for portal hypertension.Conclusion.Antiangiogenic therapy, selectively directed at unusually growing newly-formed vessels, can be a pathogenetically justified method for treating portal hypertension in liver cirrhosis on its subclinical stage. 

scholarly journals Differential diagnostics and correction of metabolic and immunological disorders in patients with hepatic cirrhosis, complicated hepatosplenomegalia and portal hypertension

2019 ◽  
Keyword(s):  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Varicose Veins ◽  
Clinical Manifestations ◽  
Well Being ◽  
Differential Diagnostics ◽  
Recurrent Bleeding ◽  
Group I ◽  
Group Ii

The study of the role of the spleen in the pathogenesis of liver cirrhosis is important for treatment. Currently available literature data indicate the role of altered spleen functions in the pathogenesis of liver cirrhosis. The aim of this study was to clarify the features of the etiology and pathogenetic disorders in patients with hepatosplenomegaly. Materials and methods. We investigated the uniform elements of blood and blood serum from 58 patients with hepatosplenomegaly amid cirrhosis, portal hypertension complicated. Patients were divided into two groups depending on the antigenic load: I - patients with liver cirrhosis against the background of hepatitis viruses HBV/HCV and II - patients with autoimmune hepatitis against the background of herpes viruses CMV/VEB. Treatment of patients included the use of antiherpetic immunoglobulins and hematopoietic cord blood progenitor cells. Results. In patients of group I was detected an increase in the spontaneous oxidative activity of neutrophils and depletion of the oxidative reserve in oxygen-dependent phagocytosis. It activated the signaling pathways of pro-inflammatory cytokines IL-6 (an increase of 60 times). We found an increased content of CD22+ -plasma B-lymphocyte that elevated synthesized concentrations of IgA. In patients of group II were found an increase in the activity of C3 and a decrease in the C4-components of complement; thrombocytopenia due to the presence of platelet autoantibodies; increased synthesis of immunoglobulins IgM, IgG, increased synthesis of IFN-. All patients showed disturbances in the metabolism of amino acids in various metabolic cycles - ornithine, which disrupted the formation of urea and indicates the accumulation of ammonia, which can enhance the cytotoxic effect in group I; methionine with a violation of the formation of cystine from cysteine and the accumulation of homocysteine, which enhances the synthesis of IFN-γ, which was increased in group II by 4 times. Conclusions. Some etiological and pathogenetic features of the formation of liver cirrhosis complicated by portal hypertension and recurrent bleeding from varicose veins of the esophagus were revealed. The immunological and metabolic changes verified by us correlated with the disappearance of the clinical manifestations of the disease, improved well-being, and the absence of recurrence of bleeding.

scholarly journals EVALUATION OF THE METHODS OF IMAGING IN THE DIAGNOSIS OF LIVER CIRRHOSIS AND PORTAL HYPERTENSION

2016 ◽  
pp. 21-25
Author(s):  
A. N. Lyzikov ◽  
A. G. Skuratov ◽  
Yu. P. Shpakovsky
Keyword(s):  
Computed Tomography ◽  
Liver Cirrhosis ◽  
Portal Hypertension ◽  
Multislice Computed Tomography ◽  
3D Visualization ◽  
Umbilical Vein ◽  
Therapeutic Agents ◽  
Portal System ◽  
Combined Use

Objective: to evaluate the prospects and role of the methods of imaging (ultrasound and CT) in the diagnosis of the pathogenic aspects of the development and correction of portal hypertension in liver cirrhosis. Material and methods. Patients with liver cirrhosis and portal hypertension, Doppler ultrasound, multislice computed tomography. Conclusion. The combined use of ultrasound and computed tomography facilitates tracing of the dynamics of the disclosure of portocaval anastomoses and predict the course of liver cirrhosis and portal hypertension. The application of the integrated ultrasound to determine the rate of blood flow volume in vessels of portal system and portocaval anastomosis will enable development of differential diagnostic criteria for the early diagnosis of portal hypertension. The detection of recanalized umbilical vein by means of 3D-visualization of its anatomy makes it possible to use it for delivering of therapeutic agents to the liver in its pathology.

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