R K Sterling

..This study assessed HRQOL and sexual health in patients with advanced fibrosis or cirrhosis in the HALT-C Trial...

..This article highlights the pathophysiology and clinical manifestations of these disorders...

..Abnormal liver enzymes (LFTs) are frequently seen in HIV patients. Because HCV and HBV overshadow other possible variables, little is known about the prevalence and predictive factors of abnormal LFTs in the absence of viral hepatitis...

....

..Differences in hepatitis C virus (HCV)-related liver disease between Caucasians and African Americans remain controversial...

....

..These data support the hypothesis that HIV accelerates fibrosis progression in those coinfected with HCV and highlights the importance of liver histology in this population...

..Mycophenolate mofetil is a potent immunosuppressant that is now widely used in organ transplantation...

..However, there remain important questions and controversies related to adequately determining the histological severity of liver disease and the role of liver biopsy in HIV-HCV-coinfected patients...

..In conclusion, noninvasive tests can accurately predict hepatic fibrosis and may reduce the need for liver biopsy in the majority of HIV/HCV-coinfected patients...

..The spectrum of liver disease in coinfection includes a significant proportion of patients with normal ALT values, and excluding these patients from previous studies has led to an overestimation of HCV disease severity...

..Until further clinical trials become available, TIPS should be considered as a therapeutic option for the treatment of refractory variceal hemorrhage and refractory ascites in selected patients...

..The most frequent disorders encountered are related to medications, infections, and exacerbations of pre-existing gastrointestinal pathology...

..Several novel approaches have been developed to address the growing disparity between the limited supply and excessive demand for suitable organs...

..Histological improvement is observed in some nonresponders. We conducted a randomized, controlled trial to determine if maintenance interferon therapy could prevent histological progression in this subset of nonresponders...

..Persons with chronic HCV infection and persistently normal serum ALT levels have milder liver disease than, and respond to IFN therapy similarly to, persons with elevated ALT levels...

..Despite the frequent histological recurrence of disease, clinical outcomes are similar to those of other groups of patients undergoing OLT...

..The new HE classification has emphasised assessment of orientation. The modified-orientation log (MO-log, eight questions, scores 0-24; 24 normal) is adapted from a validated brain injury measure...

..The impact of virologic response on hepatic function has not been previously defined...

..Biliary complications were more common in A2ALLTx but were not associated with increased graft loss compared to ADDLTx...

..56%) and in patients with a virus titer < 2 x 10(6) copies/mL (93% vs. 43%). The results indicate that continuing ribavirin monotherapy after achieving a virologic response does not improve sustained virologic response...

..To determine the accuracy of magnetic resonance (MR) cholangiography for detection of primary sclerosing cholangitis (PSC) and localization of PSC in the biliary tract...

..Whether long-term antiviral therapy can prevent progressive liver disease in such patients remains uncertain...

..The present study describes our experience of treating HCV in the inmate population of the Virginia Department of Corrections...

..However, complications associated with sepsis, not recurrent cirrhosis, was the most common cause of death in patients with recurrent HCV and this was similar in patients with or without advanced fibrosis...

..As part of the HALT-C trial we evaluated genetic associations among patients infected with HCV genotype 1 who had failed previous interferon treatment...

..The spectrum of functional impairment in patients with compensated chronic hepatitis C is incompletely defined...

..Advanced fibrosis in such patients is related to weight, presence of diabetes, and presence and degree of cytological ballooning...

....

..The aim of this prospective study was to compare the clinical utility of AFP-L3% with that of total AFP in North American patients...

..Maintaining a serum anti-HB surface level above a minimum arbitrary titre of 200 pg/mL did not appear to be necessary for effective HBIG prophylaxis...

..We evaluated the Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis (HALT-C) cohort for the incidence of HCC and associated risk factors...

..These results suggest that African Americans have a global defect in their ability to eradicate HCV infection following treatment with interferon and ribavirin which transcends across all genotypes...

..Decreased alcohol intake and improved metabolic parameters are associated with a decline in steatosis and may modulate hepatitis C progression...

..In conclusion, a model based on standard laboratory test results can be used to predict histological cirrhosis with a high degree of accuracy in 50% of patients with CHC...

....

..Non-invasive methods of assessing fibrosis have been developed to reduce the need for biopsy...

..Although this regimen achieves remission in approximately 80%, some patients are intolerant or do not respond. Mycophenolate mofetil (MMF) is a potent immunosuppressant. However, its utility in AIH is not well-defined...

..We assessed serum AFP among patients with chronic hepatitis C and advanced fibrosis to establish predictors of AFP elevations and changes with antiviral therapy...

..The aim of this study was to compare the accuracy of alpha-fetoprotein (AFP) and des-gamma-carboxy prothrombin (DCP) in the early diagnosis of HCC...

..This study examined the association between hepatic iron grade and hepatocellular carcinoma in patients with end-stage liver disease of diverse aetiologies...

..However, DCL is most strongly associated with severity of steatohepatitis. WC and BMI added modestly to the contribution of DCL to severity of nonalcoholic steatohepatitis...

..Measurement of portal inflow and portal-systemic shunt using cholate clearances could be useful in monitoring patients with liver disease...

..In patients with cirrhosis, hepatic encephalopathy (HE) has acute but reversible as well as chronic components. We investigated the extent of residual cognitive impairment following clinical resolution of overt HE (OHE)...

..In contrast to classical autoimmune hepatitis, histological features of AI-ALF predominate in the centrilobular zone...

..Biliary complications were more common in A2ALLTx but were not associated with increased graft loss compared to ADDLTx...

....

..This study evaluated their utility, alone or in combination, in a North American population...

..We hypothesized that the quality of surveillance for hepatocellular carcinoma influences prognosis by affecting access to liver transplantation...

..The present study was performed to evaluate the impact of the international unit standard for measuring HCV RNA in the management of patients with chronic hepatitis C virus (HCV) infection...

..Although we did identify genotype 3, increased BMI, and diabetes as risk factors, we found no independent association with antiretroviral therapy...

..In contrast, a higher starting dose of RVN was associated with a lower relapse rate and higher rate of SVR...

..This study aimed to evaluate the outcomes of our HCV+/end-stage renal disease (ESRD) patient population based on the therapeutic option including KTx or continuation in dialysis...

..9, compared with 59% with fibrosis and a mean score of.9 after LDLT. In conclusion, these data strongly suggest that fibrosis progression from recurrent HCV is not more severe in patients after LDLT...

..In conclusion, interferon treatment of recurrent hepatitis C does not consistently improve histologic disease after virologic response, and it may increase the risk of allograft rejection...

..The goal of this study was to evaluate a multidrug approach that would reduce both early and long-term morbidity related to immunosuppression while maintaining an acceptable freedom from rejection...

..It is also associated with a lower rate of development of ascites, hyperbilirubinemia, and hepatocellular carcinoma. However, cardiovascular mortality is greater in patients with NASH...

....

..However, no studies have directly compared fibrosis progression by paired liver biopsy between patients infected with HIV and HCV versus those infected with only HCV...

..We evaluated whether performance on a driving simulator improves in patients with MHE after treatment with rifaximin...

..CAT presents five to seven questions/domain depending on the patient's response, from large validated question banks. This provides brevity and precision equivalent to the entire question bank...

..ICT, but not SPT performance is significantly associated with prior and future crashes and violations. There was an excellent agreement between self- and DOT-reports...

..Conclusions: Although increased lipogenesis, desaturases, and LOX activities characterize NAFL and NASH, impaired peroxisomal polyunsaturated fatty acid (PUFA) metabolism and nonenzymatic oxidation is associated with progression to NASH...

..Aims: To assess impact of pretransplant hyponatraemia on post-transplant outcomes...

..This increase in progression of liver disease and its subsequent increased mortality have spurred research into the optimization of evaluation and management of the HIV-HCV coinfected patient...

..Efforts to modify those factors that contribute to PLOS may reduce this event, improve survival, and reduce OLT-associated costs...

....

..No incidental HCC group post-OLT patient has died or had HCC recurrence at mean follow-up of 24 +/- 14 months. This neoadjuvant protocol is safe and effective in reducing HCC recurrence prior to and after OLT and resection...

..However, without larger randomized studies, no pharmacological treatments can be recommended at this time...

..The only proven therapy for those who are unlikely to recover is liver transplantation. Therefore, recognition of ALF is paramount, and urgent referral to a transplant center is critical to assess transplantation status...

..PRCA caused by the development of erythropoietin antibodies is a potentially life-threatening complication of administering epoetin alfa to prevent the anemia associated with antiviral therapy in patients with chronic hepatitis C...

..Rapamycin is an effective replacement agent as primary immunosuppressive therapy following withdrawal of CNIs in liver transplant patients with CNI-induced chronic nephrotoxicity...

..Nelson-Aalen cumulative hazard estimates for the different race and dose combinations revealed that Caucasians who received daily interferon were most likely to have an initial response (logrank, P < 0.001)...

..The stronger correlation of the serum markers with Ishak scores suggests that serum fibrosis markers reflect the pattern of fibrosis more closely than the quantity of hepatic collagen...

....

..HIV-infected patients now live longer and often have complications of liver disease, especially with hepatitis B or C virus coinfection. Limited data are available on those with hepatocellular carcinoma (HCC)...

..If our hypothesis is correct, this work could result in a dramatic change in the long-term care of the over 1 million HIV infected individuals in the US. ..

..The K-23 award will protect this candidates time and help him mature into a senior investigator in Hepatology. ..