Incidence of hepatocellular carcinoma in patients with chronic liver disease due to hepatitis B or C and coinfected with the human immunodeficiency virus: A retrospective cohort study

World J Gastroenterol. Feb 7, 2018; 24(5): 613-622
Published online Feb 7, 2018. doi: 10.3748/wjg.v24.i5.613

Incidence of hepatocellular carcinoma in patients with chronic liver disease due to hepatitis B or C and coinfected with the human immunodeficiency virus: A retrospective cohort study
Patrícia dos Santos Marcon, Cristiane Valle Tovo, Dimas Alexandre Kliemann, Patrícia Fisch, Angelo Alves de Mattos

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Abstract

AIM

To assess the incidence of hepatocellular carcinoma (HCC) in chronic liver disease due to hepatitis B virus (HBV) or hepatitis C virus (HCV) coinfected with human immunodeficiency virus (HIV).

METHODS
A retrospective cohort study was performed, including patients with chronic liver disease due to HBV or HCV, with and without HIV coinfection. Patients were selected in the largest tertiary public hospital complex in southern Brazil between January 2007 and June 2014. We assessed demographic and clinical data, including lifestyle habits such as illicit drug use or alcohol abuse, in addition to frequency and reasons for hospital admissions via medical records review.

RESULTS
Of 804 patients were included (399 with HIV coinfection and 405 monoinfected with HBV or HCV). Coinfected patients were younger (36.7 ± 10 vs 46.3 ± 12.5, P < 0.001). Liver cirrhosis was observed in 31.3% of HIV-negative patients and in 16.5% of coinfected (P < 0.001). HCC was diagnosed in 36 patients (10 HIV coinfected and 26 monoinfected). The incidence density of HCC in coinfected and monoinfected patients was 0.25 and 0.72 cases per 100 patient-years (95%CI: 0.12-0.46 vs 0.47-1.05) (long-rank P = 0.002), respectively. The ratio for the HCC incidence rate was 2.98 for HIV-negative. However, when adjusting for age or when only cirrhotic are analyzed, the absence of HIV lost statistical significance for the development of HCC.

CONCLUSION
In this study, the presence of HIV coinfection in chronic liver disease due to HBV or HCV showed no relation to the increase of HCC incidence.

Continue to article: https://www.wjgnet.com/1007-9327/full/v24/i5/613.htm

Long-term consumption of sunflower and fish oils damages the liver

Long-term consumption of sunflower and fish oils damages the liver

An international group of scientists led by the University of Granada (UGR) has demonstrated that the long-term intake of sunflower or fish oils damages the liver and can cause a series of alterations in it, giving rise to non-alcoholic steatohepatitis (NASH).

Of the three dietary fats studied (olive, sunflower and fish oil), virgin olive oil was ranked as the dietary fat source that best preserves the liver during the ageing process.

NASH, which causes inflammation of the liver that is not caused by alcohol abuse, is a very serious condition and can act as a catalyst for the onset of other diseases such as cirrhosis and liver cancer. Its prevalence in the general population increases with age: it affects 1% to 3% of children, 5% of teenagers, 18% of those aged between 20 and 40, 39% of those aged between 40 and 50, and more than 40% of those over 70.

The research, recently published in the prestigious Journal of Nutritional Biochemistry, analysed how the long-term consumption of different dietary fat sources such as olive, sunflower and fish oil affects the liver of rats. UGR researchers conducted a series of comprehensive analyses, including studies of pathological anatomy, ultrastructural analyses using electron microscopes, sophisticated bioenergy techniques, telomere length measurements, and oxidative stress. Most importantly, they conducted a comprehensive study of the liver genome in order to establish how it evolved in line with the consumption of the different oils.

As José Luis Quiles Morales, Full Professor of Physiology at the UGR explains: “[the research] demonstrates that fat accumulates in the liver with age, but the most striking finding is that the type of fat accumulated differs depending on the oils consumed and this means that, regardless of this accumulation, some livers age in a healthier way than others and with a greater or lesser predisposition to certain diseases.”

Three dietary fats (virgin olive oil, sunflower oil and fish oils) were studied and virgin olive oil was shown to the best of the three for preserving the liver throughout life. The research also revealed that sunflower oil induced fibrosis, ultrastructural alterations, gene expression blockades and high oxidation. Meanwhile, fish oil intensified oxidation associated with ageing, lowered mitochondrial electron transport chain activity and altered the relative telomere length. Telomeres are the ends of chromosomes, the shortening of which can cause cell ageing and the lengthening of which can cause cancer.

“The alterations caused by the long-term consumption of sunflower and fish oils make the liver susceptible to non-alcoholic steatohepatitis, a very serious disease that may act as a catalyst for other liver diseases such as cirrhosis and liver cancer”, Prof. Quiles notes. In light of the results, he also points out that: “virgin olive oil is the healthiest option, which has already been proven in relation to diverse aspects of health.”

According to Prof. Quiles, the most innovative aspect of this study is “how it reveals the mechanisms by which virgin olive oil provides these benefits and why the over-consumption of other dietary fats is dangerous. We believe that this study will be very useful in preventing and treating diverse liver diseases.”

Researchers from other institutions, such as the Hospital Complex of Jaen, the Marche Polytechnic University (UNIVPM) in Ancona, Italy, the Pfizer-University of Granada-Andalusian Government Centre for Genomics and Oncological Research (GENYO) and the National Cancer Institute (NCI) of the United States, have also participated in this research project.

Bibliographical reference:
Varela-Lopez A, Pérez-López MP, Ramirez-Tortosa CL, Battino M, Granados-Principal S, Ramirez-Tortosa MDC, Ochoa JJ, Vera-Ramirez L, Giampieri F, Quiles JL. Gene pathways associated with mitochondrial function, oxidative stress and telomere length are differentially expressed in the liver of rats fed lifelong on virgin olive, sunflower or fish oils. Journal of Nutritional Biochemistry. 2017 Sep 20; 52:36-44. doi: 10.1016/j.jnutbio.2017.09.007.

https://www.ugr.es/en/about/news/long-term-consumption-sunflower-and-fish-oils-damages-liver

Clinical predictors of liver fibrosis in patients with chronic hepatitis B virus infection from children to adults

The Journal of Infectious Diseases, jiy048, https://doi.org/10.1093/infdis/jiy048

Accepted ManuscriptClinical predictors of liver fibrosis in patients with chronic hepatitis B virus infection from children to adults
Jia-Feng Wu Shih-Hsi Song Chee-Seng Lee Huey-Ling Chen Yen-Hsuan Ni Hong-Yuan Hsu Tzee-Chung Wu Mei-Hwei Chang

Published: 30 January 2018

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Abstract

Background
This study aimed to elucidate predictors of liver fibrosis in chronic hepatitis B virus (HBV)-infected subjects.

Methods
Transient elastography was performed to define liver fibrosis in 533 chronic HBV-infected patients at 30.72 ± 0.57 years of age. Protein array was performed on serum samples and lysates of Huh7 cells transfected with HBV mutants; the results were confirmed by ELISA. Single nucleotide polymorphisms in the interleukin-1β gene were examined chronic HBV-infected patients with and without liver fibrosis.

Results
Male gender, > 18 years old, and serum alpha-fetoprotein level > 3.6 ng/mL were independent predictors of a liver stiffness measurement of ≥ 7 kPa (P = 0.005, 0.019, and < 0.001, respectively). HBeAg-negative hepatitis is associated with increased liver stiffness (P<0.001). Elevation of serum interleukin-1β was demonstrated in subjects with liver fibrosis. Interleukin-1β was upregulated in Huh7 cells transfected with HBeAg-negative hepatitis-related mutants. The AA genotype at rs16944 and the CC genotype at rs1143627 of the interleukin-1β gene were associated with higher serum interleukin-1β levels and liver fibrosis.

Conclusions
Male gender, beyond childhood, elevated alpha-fetoprotein level, and HBeAg-negative hepatitis are risk factors for liver fibrosis. Interleukin-1β is involved in the progression of liver fibrosis in subjects with HBeAg-negative hepatitis.

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Evaluation of dried blood spot samples for screening of hepatitis C and human immunodeficiency virus in a real-world setting

Scientific Reports

volume 8, Article number: 1858 (2018)
doi:10.1038/s41598-018-20312-5

Evaluation of dried blood spot samples for screening of hepatitis C and human immunodeficiency virus in a real-world setting
Sonia Vázquez-Morón, Pablo Ryan, Beatriz Ardizone-Jiménez, Dolores Martín, Jesus Troya, Guillermo Cuevas, Jorge Valencia, María A. Jimenez-Sousa, Ana Avellón & Salvador Resino

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https://www.nature.com/articles/s41598-018-20312-5

Abstract
Both hepatitis C virus (HCV) infection and human immunodeficiency virus (HIV) infection are underdiagnosed, particularly in low-income countries and in difficult-to-access populations. Our aim was to develop and evaluate a methodology for the detection of HCV and HIV infection based on capillary dry blood spot (DBS) samples taken under real-world conditions. We carried out a cross-sectional study of 139 individuals (31 healthy controls, 68 HCV-monoinfected patients, and 40 HCV/HIV-coinfected patients). ELISA was used for anti-HCV and anti-HIV antibody detection; and SYBR Green RT-PCR was used for HCV-RNA detection. The HIV serological analysis revealed 100% sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). The HCV serological analysis revealed a sensitivity of 92.6%, specificity of 100%, PPV of 100%, and NPV of 79.5%. Finally, the HCV-RNA detection test revealed a detection limit of 5 copies/µl with an efficiency of 100% and sensitivity of 99.1%, specificity of 100%, PPV of 100%, and NPV of 96.9%. In conclusion, our methodology was able to detect both HCV infection and HIV infection from the same DBS sample with good diagnostic performance. Screening for HCV and HIV using DBS might be a key strategy in the implementation of national programs for the control of both infections.

Continue to article: https://www.nature.com/articles/s41598-018-20312-5

Top 5 stories about HCV: Long-term effects of DAAs, AASLD critical of Cochrane review of HCV drugs & more

Top 5 stories about HCV
January 30, 2018

Report raises questions about long-term effects of DAAs for HCV
The changing HCV treatment cascade
Sharing injection paraphernalia does not lead to HCV transmission
Women injecting drugs at higher risk for HCV than men
IDSA, AASLD critical of Cochrane review of HCV drugs

Continue reading: https://www.healio.com/infectious-disease/hepatitis-c/news/online/%7B7ff1f624-9247-4f0b-aaf7-814ed4193ef0%7D/top-5-stories-about-hcv

Global cancer survival rates improve, but wide gaps remain

Global cancer survival rates improve, but wide gaps remain
Last Updated: 2018-01-31
By Kate Kelland

LONDON (Reuters) - Cancer patients' survival prospects are improving, even for some of the deadliest types such as lung cancer, but there are huge disparities between countries, particularly for children, according to a study published on Wednesday.

In the most up-to-date study of cancer survival trends - between 2010 and 2014 - covering countries that are home to two-thirds of the world's people, researchers found some significant progress, but also wide variations.

While brain tumor survival in children has improved in many countries, the study showed that for children diagnosed as recently as 2014, five-year survival is twice as high in Denmark and Sweden, at around 80%, as it is in Mexico and Brazil, at less than 40%.

This gap was most likely due to variations in the availability and quality of cancer diagnosis and treatment services, the researchers said.

Continue reading: http://www.chronicliverdisease.org/reuters/article.cfm?article=20180131Other2056791260

Non-invasive assessments for liver fibrosis – the crystal ball we long for

Solicited Review

J Gastroenterol Hepatol. 2018 Jan 30. doi: 10.1111/jgh.14103. [Epub ahead of print]

Non-invasive assessments for liver fibrosis - the crystal ball we long for.
Wong GL

Accepted manuscript online: 30 January 2018

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Abstract
Non-invasive assessment of liver fibrosis has been one of the most rapidly advancing fields in hepatology in the last decade. Progressive liver fibrosis results in cirrhosis, hepatocellular carcinoma (HCC) and various liver-related complications in essentially all chronic liver diseases. Assessment of liver fibrosis allows clinicians to determine the prognosis, need of treatment, disease progression and response to treatment in patients with chronic liver disease. Liver biopsy has been the gold standard in last few decades and most adopted diagnostic tool in clinical trials. Nonetheless, it is impractical to apply the test in a large number of patients or to do it serially. Hence, various non-invasive assessments have been developed and adopted in some international management guidelines. Liver stiffness measurement (LSM) with transient elastography one of the most widely validated non-invasive assessments for liver fibrosis. It is an accurate and reproducible method to predict advanced fibrosis in chronic hepatitis B. Using transient elastography, it is possible to perform repeated liver fibrosis assessments on a large number of asymptomatic patients. The key challenge of his tool is the confounding effect of alanine aminotransferase (ALT) level, such that decrease in LSM may only reflect ALT normalization, hence not accurate enough to indicate regression of liver fibrosis. This may be partially handled by combining LSM with a serum-based formula which is independent of ALT such as the Forns index and Enhanced Liver Fibrosis test. A LSM-based HCC risk score (LSM-HCC score) is useful to prioritize patients for HCC surveillance.

Continue to article: http://onlinelibrary.wiley.com/doi/10.1111/jgh.14103/epdf

Efficacy of Generic Oral Directly Acting Agents in Patients with Hepatitis C Virus Infection.

J Viral Hepat. 2018 Jan 28. doi: 10.1111/jvh.12870. [Epub ahead of print]

Efficacy of Generic Oral Directly Acting Agents in Patients with Hepatitis C Virus Infection.
Gupta S1, Rout G1, Patel AH2, Mahanta M1, Kalra N1, Sahu P1, Sethia R1, Agarwal A1, Ranjan G1, Kedia S1, Acharya SK1, Nayak B1, Shalimar1.


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Abstract
Novel direct-acting antivirals (DAAs) are now the standard of care for the management of Hepatitis C virus (HCV) infection. Branded DAAs are associated with high sustained virological response at 12 weeks post-completion of therapy (SVR12), but are costly. We aimed to assess the efficacy of generic oral DAAs in a real life clinical scenario. Consecutive patients with known HCV infection who were treated with generic-oral DAA regimens (May 2015 to January 2017) were included. Demographic details, prior therapy and SVR12 were documented. 490 patients (mean age: 38.9±12.7years) were treated with generic DAAs in the study time period. Their clinical presentations included chronic hepatitis (CHC) in 339 (69.2%) of cases, compensated cirrhosis in 120 (24.48%) cases, and decompensated cirrhosis in 31 (6.32%) cases. Genotype 3 was most common (n=372, 75.9%) followed by genotype 1 (n=97, 19.8%). Treatment naïve and treatment-experienced (defined as having previous treatment with peginterferon and ribavirin) were 432 (88.2%) and 58 (11.8%) respectively. Generic DAA treatment regimens included sofosbuvir in combination with ribavirin (n=175), daclatasvir alone (n=149), ribavirin and peginterferon (n=80), ledipasvir alone (n=43), daclatasvir and ribavirin (n=37), and ledipasvir and ribavirin (n=6). Overall SVR12 was 95.9% (470/490) for all treatment regimens. SVR12 for treatment-naïve and experienced patients was 97.0% (419/432) and 87.9% (51/58) respectively, P=0.005. High SVR12 was observed with various regimens, irrespective of genotype and underlying liver disease status. There were no differences in SVR12 with 12 weeks or 24 weeks therapy. No major adverse event occurred requiring treatment stoppage. Generic oral DAAs are associated with high SVR rates in patients with HCV infection in a real life clinical scenario.

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Continue to article: https://jumpshare.com/v/mKWNPYZU3hXMw3WB2Cb2

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Effectiveness & safety of original & generic SOF for the treatment of chronic #hepatitis C: a real-world study→https://t.co/ZtCkZkX3Zm @AAEEH5 #HCV #HepC #HepatitisC 🇦🇷

First prospective study assessing effectiveness & safety of generic SOF in Latin America @richmond_lab 🌎 pic.twitter.com/3UOqZl4meY

— Henry E. Chang (@HenryEChang) January 29, 2018