National Institutes of Health consensus development conference statement: Management of hepatitis B
Michael F. Sorrell,Edward A. Belongia,Jose Costa,Ilana F. Gareen,Jean L. Grem,John M. Inadomi,Earl R. Kern,James A. McHugh,Gloria M. Petersen,Michael F. Rein,Doris B. Strader,Hartwell T. Trotter +11 more
TLDR
Questions remain about which groups of patients benefit from therapy and at which point in the course of disease this therapy should be initiated, and limited rigorous evidence exists demonstrating the effect of these therapies on important long-term clinical outcomes.Abstract:
National Institutes of Health (NIH) consensus and stateof-the-science statements are prepared by independent panels of health professionals and public representatives on the basis of 1) the results of a systematic literature review prepared under contract with the Agency for Healthcare Research and Quality (AHRQ); 2) presentations by investigators working in areas relevant to the conference questions during a 2-day public session; 3) questions and statements from conference attendees during open discussion periods that are part of the public session; and 4) closed deliberations by the panel during the remainder of the second day and morning of the third. This statement is an independent report of the panel and is not a policy statement of the National Institutes of Health or the U.S. government. The statement reflects the panel’s assessment of medical knowledge available at the time the statement was written. Thus, it provides a “snapshot in time” of the state of knowledge on the conference topic. When reading the statement, keep in mind that new knowledge is inevitably accumulating through medical research. Hepatitis B is a major cause of liver disease worldwide, ranking as a substantial cause of cirrhosis and hepatocellular carcinoma. The development and use of a vaccine for hepatitis B virus (HBV) has resulted in a substantial decline in the number of new cases of acute hepatitis B among children, adolescents, and adults in the United States. However, this success has not yet been duplicated worldwide, and both acute and chronic HBV infection continue to represent important global health problems. Seven treatments are currently approved for adult patients with chronic HBV infection in the United States: interferon-, pegylated interferon-, lamivudine, adefovir dipivoxil, entecavir, telbivudine, and tenofovir disoproxil fumarate. Interferon- and lamivudine have been approved for children with HBV infection. Although available randomized, controlled trials (RCTs) show encouraging short-term results— demonstrating the favorable effect of these agents on such intermediate markers of disease as HBV DNA level, liver enzyme tests, and liver histology— limited rigorous evidence exists demonstrating the effect of these therapies on important long-term clinical outcomes, such as the development of hepatocellular carcinoma or a reduction in deaths. Questions therefore remain about which groups of patients benefit from therapy and at which point in the course of disease this therapy should be initiated.read more
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Diagnosis, management, and treatment of hepatitis C: An update
TL;DR: This document has been approved by the AASLD, the Infectious Diseases Society of America, and the American College of Gastroenterology.
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TL;DR: The most recent version of the guidelines for the prevention and treatment of opportunistic infections (OI) in HIV-infected adults and adolescents was published in 2002 and 2004, respectively as mentioned in this paper.
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Peginterferon alfa-2b or alfa-2a with ribavirin for treatment of hepatitis C infection.
John G. McHutchison,Eric Lawitz,Mitchell L. Shiffman,Andrew J. Muir,Greg Galler,Jonathan McCone,L. Nyberg,William M. Lee,Reem Ghalib,Eugene R. Schiff,Joseph S. Galati,Bruce R. Bacon,M. Davis,Pabak Mukhopadhyay,Kenneth Koury,Stephanie Noviello,Lisa D. Pedicone,Clifford A. Brass,Janice K. Albrecht,Mark S. Sulkowski +19 more
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A variant upstream of IFNL3 (IL28B) creating a new interferon gene IFNL4 is associated with impaired clearance of hepatitis C virus
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TL;DR: RNA sequencing in primary human hepatocytes activated with synthetic double-stranded RNA to mimic HCV infection provides new insights into the genetic regulation of HCV clearance and its clinical management.
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Performance of the aspartate aminotransferase‐to‐platelet ratio index for the staging of hepatitis C‐related fibrosis: An updated meta‐analysis
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TL;DR: The large meta‐analysis suggests that APRI can identify hepatitis C‐related fibrosis with a moderate degree of accuracy and may decrease the need for staging liver biopsy specimens among chronic hepatitis C patients.
References
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