Biomarkers can provide non-invasive estimates of liver fibrosis to address the large number of undiagnosed cases. Liver biopsy has limitations as a gold standard due to sampling error and inter-observer variability. New methods show that biopsy has a "gray zone" for intermediate fibrosis stages, while biomarkers like FibroTest have a smaller gray zone and similar diagnostic accuracy to biopsy. Guidelines now recommend the use of validated biomarkers and elastography to diagnose liver fibrosis given biopsy's limitations.
This document discusses the long-term benefits of antiviral treatment for hepatitis B. It provides information on different phases of hepatitis B infection and when treatment is indicated. It also summarizes the approved antiviral drugs for treating chronic hepatitis B, including nucleoside analogs, nucleotide analogs, and cytokines. The document discusses the differences in lifecycles and mechanisms of HIV, HBV, and HCV. It then reviews the efficacy and resistance profiles of different antiviral drugs over time, highlighting the low resistance of tenofovir.
This document discusses treatment of hepatitis B and long-term benefits. It begins by outlining the different phases of hepatitis B infection and when treatment is indicated. The goals of treatment are virological suppression, normalization of liver enzymes, prevention of disease progression, and seroconversion from HBeAg to anti-HBe and from HBsAg to anti-HBs. Approved antiviral drugs for hepatitis B include lamivudine, entecavir, telbivudine, adefovir, tenofovir, interferon alfa, and pegylated interferon alfa-2a. Combination therapies and management of resistance are also discussed.
This document discusses hepatitis C recurrence after liver transplantation. It notes that hepatitis C recurrence is a major issue, accounting for two-thirds of graft loss. Five years post-transplant, 30% of patients have cirrhosis of the graft. The document examines factors that influence recurrence like fibrosis stage and viral load at one year post-transplant. It also discusses using antiviral treatment before and after transplant to improve outcomes.
This document discusses optimal strategies for preventing hepatitis B virus (HBV) recurrence after liver transplantation. It reviews evidence that combination prophylaxis with hepatitis B immunoglobulin (HBIG) and nucleoside/nucleotide analogues (NUCs) is most effective at preventing early HBV reinfection. For long-term prophylaxis, low-dose HBIG or HBIG discontinuation combined with lifelong NUC therapy may be sufficient for patients at low risk of recurrence. Factors such as HBV DNA level pre-transplant, hepatocellular carcinoma, and HBV/HIV coinfection increase risk of recurrence and require continued HBIG plus NUC prophylaxis.
Biomarkers can provide non-invasive estimates of liver fibrosis to address the large number of undiagnosed cases. Liver biopsy has limitations as a gold standard due to sampling error and inter-observer variability. New methods show that biopsy has a "gray zone" for intermediate fibrosis stages, while biomarkers like FibroTest have a smaller gray zone and similar diagnostic accuracy to biopsy. Guidelines now recommend the use of validated biomarkers and elastography to diagnose liver fibrosis given biopsy's limitations.
This document discusses the long-term benefits of antiviral treatment for hepatitis B. It provides information on different phases of hepatitis B infection and when treatment is indicated. It also summarizes the approved antiviral drugs for treating chronic hepatitis B, including nucleoside analogs, nucleotide analogs, and cytokines. The document discusses the differences in lifecycles and mechanisms of HIV, HBV, and HCV. It then reviews the efficacy and resistance profiles of different antiviral drugs over time, highlighting the low resistance of tenofovir.
This document discusses treatment of hepatitis B and long-term benefits. It begins by outlining the different phases of hepatitis B infection and when treatment is indicated. The goals of treatment are virological suppression, normalization of liver enzymes, prevention of disease progression, and seroconversion from HBeAg to anti-HBe and from HBsAg to anti-HBs. Approved antiviral drugs for hepatitis B include lamivudine, entecavir, telbivudine, adefovir, tenofovir, interferon alfa, and pegylated interferon alfa-2a. Combination therapies and management of resistance are also discussed.
This document discusses hepatitis C recurrence after liver transplantation. It notes that hepatitis C recurrence is a major issue, accounting for two-thirds of graft loss. Five years post-transplant, 30% of patients have cirrhosis of the graft. The document examines factors that influence recurrence like fibrosis stage and viral load at one year post-transplant. It also discusses using antiviral treatment before and after transplant to improve outcomes.
This document discusses optimal strategies for preventing hepatitis B virus (HBV) recurrence after liver transplantation. It reviews evidence that combination prophylaxis with hepatitis B immunoglobulin (HBIG) and nucleoside/nucleotide analogues (NUCs) is most effective at preventing early HBV reinfection. For long-term prophylaxis, low-dose HBIG or HBIG discontinuation combined with lifelong NUC therapy may be sufficient for patients at low risk of recurrence. Factors such as HBV DNA level pre-transplant, hepatocellular carcinoma, and HBV/HIV coinfection increase risk of recurrence and require continued HBIG plus NUC prophylaxis.