Update on the Treatment of Chronic Viral Hepatitis - Gastroenterology Clinics of North America Vol 33 Issue 3

Cover......Page 1
Preface......Page 2
Epidemiology and transmission......Page 5
Serologic and virologic tests......Page 7
Natural history......Page 9
Laboratory evaluation and histology......Page 10
Radiographic tests......Page 11
Antiviral therapy......Page 12
Nutrition......Page 13
Over the counter medications/vitamins......Page 15
Summary......Page 16
References......Page 17
Treatment of the hepatitis C virus in patients coinfected with HIV......Page 20
Hepatitis C virus viral replication in the setting of HIV......Page 21
Impact of hepatitis C virus on HIV infection: implications for hepatitis C virus therapy......Page 22
Priority of antiviral therapy in the hepatitis C virus/HIV coinfected individuals......Page 24
Hepatitis C virus therapy in HIV coinfected individuals......Page 25
Interferon monotherapy......Page 26
Standard interferon and ribavirin combination therapy......Page 27
Pegylated interferon (peginterferon) and ribavirin combination therapy......Page 28
Liver transplantation in HIV/hepatitis C virus coinfected individuals......Page 30
References......Page 31
Antiviral therapy for treatment naive patients with hepatitis C virus......Page 38
Historical perspective......Page 39
Combination therapy of interferon with ribavirin......Page 41
Pegylated alfa interferon monotherapy......Page 42
Pegylated interferon and ribavirin combination therapy......Page 44
Early virological response......Page 45
Adherence to treatment......Page 47
Adverse effect management......Page 49
References......Page 50
Rates of relapse......Page 53
Mechanisms of relapse......Page 54
Retreatment of interferon monotherapy relapsers with interferon and ribavirin......Page 55
Factors predicting sustained virologic response in prior relapsers......Page 57
Treatment of patients who have relapsed after interferon and ribavirin combination therapy......Page 58
Adjunctive therapies for patients who have relapsed after interferon and ribavirin combination therapy......Page 60
Approach to the retreatment of patients who relapse after interferon and ribavirin combination therapy......Page 61
Treatment of patients who have relapsed after pegylated interferon and ribavirin combination therapy......Page 62
Summary......Page 63
References......Page 64
Antiviral therapy in previously untreated patients......Page 67
Identification of prior nonresponders......Page 68
Predictors of response to combination antiviral therapy......Page 69
Selection of prior nonresponders for retreatment......Page 71
Pegylated interferon and ribavirin in prior nonresponders......Page 72
Natural history of nonresponders......Page 74
Maintenance pegylated interferon in prior nonresponders......Page 75
Maintenance pegylated interferon trials......Page 78
Antifibrotics......Page 80
Antitumor necrosis factor antibodies......Page 81
Protease and polymerase inhibitors......Page 82
References......Page 83
Hepatitis C virus antiviral therapy in patients with cirrhosis......Page 88
Influence of antiviral therapy on fibrosis progression......Page 89
Antiviral therapy in patients with compensated hepatitis c-related cirrhosis......Page 90
Safety of antiviral therapy in patients with compensated cirrhosis......Page 94
Antivirals in decompensated hepatitis C-related cirrhosis......Page 95
Antiviral therapy for hepatitis C virus recurrence after liver transplantation......Page 97
Summary......Page 98
References......Page 99
Natural history......Page 102
Assessment and monitoring......Page 105
Selection of patients for treatment......Page 106
Role of hepatitis B virus genotypes......Page 107
Screening for hepatocellular carcinoma......Page 109
Treatment goals......Page 110
Tenofovir......Page 111
Amdoxovir......Page 113
Summary......Page 114
References......Page 115
Antiviral therapy for treatment-naıve hepatitis B virus patients......Page 119
Definitions of responses to antiviral therapy......Page 120
Hepatitis B e antigen-positive patients......Page 121
Hepatitis B e antigen-negative patients......Page 122
Lamivudine (3TC, Epivir)......Page 123
Hepatitis B e antigen-positive chronic hepatitis B......Page 124
Hepatitis B e antigen-negative chronic hepatitis B......Page 125
Lamivudine resistance......Page 126
Hepatitis B e antigen-positive chronic hepatitis B......Page 128
Hepatitis B e antigen-negative chronic hepatitis B......Page 129
Combination therapy......Page 130
Combined nucleoside/nucleotide analogues......Page 131
Current treatment recommendations......Page 132
References......Page 134
Defining nonresponders......Page 138
Interferon......Page 139
Lamivudine......Page 140
Combination interferon and ribavirin......Page 142
Combination lamivudine and interferon......Page 143
Therapy for patients with lamivudine-resistant mutants......Page 145
Interferon......Page 146
Entecavir......Page 147
Summary......Page 148
References......Page 149
Treatment of hepatitis B virus infection in patients coinfected with HIV......Page 154
Interferon alfa......Page 155
Lamivudine......Page 156
Tenofovir disoproxil fumarate......Page 159
Summary......Page 161
References......Page 162
Antiviral therapy in patients with chronic hepatitis B and cirrhosis......Page 165
Interferon-alfa......Page 166
Interferon-alfa for hepatitis B e antigen-positive compensated cirrhosis......Page 167
Interferon-alfa for hepatitis B e antigen-negative, hepatitis B virus DNA-positive (precore mutant) compensated cirrhosis......Page 168
Impact of interferon-alfa on preventing hepatocellular carcinoma......Page 170
Interferon-alfa in patients with chronic hepatitis B virus and decompensated liver disease......Page 172
Lamivudine......Page 175
Lamivudine for compensated hepatitis b virus-related cirrhosis......Page 176
Lamivudine in decompensated cirrhosis and impact on need for liver transplantation......Page 177
Lamivudine as part of combination prophylaxis in liver transplant recipients......Page 181
Adefovir dipivoxil in hepatitis B virus-related liver disease......Page 182
New antiviral agents......Page 183
Summary......Page 184
References......Page 185
Hepatitis B......Page 191
Hepatitis C......Page 193
Therapy of hepatitis C in dialysis patients......Page 195
Therapeutic options for hepatitis C virus-related liver disease in dialysis population......Page 196
Role of peginterferon......Page 197
Treatment of hepatitis C in renal transplant candidates: results after renal transplant......Page 198
Treatment of hepatitis B-related liver disease in dialysis patients......Page 199
Treatment of hepatitis B-related liver disease after renal transplant......Page 200
Treatment of hepatitis C virus-associated cryoglobulinemic glomerulonephritis......Page 201
References......Page 204
Identification of \"at-risk\" population......Page 207
Chronic hepatitis B......Page 208
Chronic hepatitis C......Page 209
Treated chronic viral hepatitis......Page 210
Serological tests......Page 211
Surveillance interval......Page 213
Investigation of abnormal surveillance results......Page 214
Tissue diagnosis......Page 215
Algorithm for investigation of initially abnormal surveillance tests......Page 216
Enhanced follow-up......Page 217
Resection......Page 218
Local ablation......Page 219
Liver transplantation......Page 220
Palliative therapy......Page 221
References......Page 222
Antiviral therapy: role in the management of extrahepatic diseases......Page 228
Glomerulonephritis......Page 229
Cryoglobulinemia......Page 231
Lymphoma......Page 232
Diabetes mellitus......Page 234
Porphyria cutanea tarda......Page 235
Thyroid disorder......Page 236
Summary......Page 237
References......Page 238
Preface......Page 244
Treating hepatitis C: the state of the art......Page 246
Current treatment recommendations......Page 247
Side effects of treatment......Page 248
Summary......Page 251
References......Page 252
Adherence to combination therapy: influence on sustained virologic response and economic impact......Page 255
Effect of adherence and dose maintenance on sustained virologic response......Page 256
Dose reduction and discontinuation because of side effects......Page 259
Improving treatment adherence in clinical practice......Page 261
Relationship between sustained virologic response and quality of life......Page 263
Evaluating cost effectiveness of anti-hepatitis C virus therapy......Page 264
Summary......Page 265
References......Page 266
Role of epoetin alfa in maintaining ribavirin dose......Page 269
Thrombocytopenia......Page 271
Anemia......Page 272
Treatment adherence and sustained virologic response......Page 274
Epoetin alfa and treatment-induced anemia......Page 275
References......Page 277
Neuropsychiatric side effects of HCV therapy and their treatment: focus on IFN alpha-induced depression......Page 280
Hepatitis C and depression......Page 281
Interferon alpha-induced depression......Page 282
Etiology of interferon alpha-induced depression......Page 284
Treatment of interferon alpha-induced depression......Page 286
Interferon alpha treatment in patients who have active psychiatric illnesses......Page 287
Veterans Administration hepatitis C treatment recommendations......Page 288
Summary......Page 290
References......Page 291
Future trends in managing hepatitis C......Page 294
Adherence and viral testing......Page 295
Novel interferons/cytokines and interferon delivery methods......Page 296
Inosine 5\'-monophosphate dehydrogenase inhibitors......Page 297
Other adjuvant immunomodulatory agents......Page 298
Hepatitis C virus enzyme inhibitors......Page 299
Short interfering RNAs......Page 300
Vaccines......Page 301
References......Page 302