Hepatitis: Planet Earth

Husa P, Plísek S, Sperl J, Urbánek P, Galský J, Hůlek P, Kümpel P, Nemecek V, Volfová M, Anonymous00254. · Klinika infekcnich chorob Lékarské fakulty MU a FN Brno, pracoviste Bohunice, prednosta. · Klin Mikrobiol Infekc Lek. · Pubmed #18459234 No free full text.

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Anonymous00059. · No affiliation provided · Kidney Int Suppl. · Pubmed #18382440 No free full text.

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Colle I, Adler M, Brenard R, Henrion J, Langlet P, Michielsen P, Orlent H, Reynaert H, Sprengers D, Stärkel P, Van Damme P, Verslype C, Delwaide J, Anonymous00199. · Department of Hepatology and Gastroenterology, Ghent University Hospital, Ghent, De Pintelaan 185, 9000 Gent, Belgium. · Acta Gastroenterol Belg. · Pubmed #18330099 No free full text.

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Husa P, Plísek S, Sperl J, Urbánek P, Galský J, Hůlek P, Kümpel P, Nemecek V, Volfová M, Anonymous00156. · Klinika infekcních chorob Lékarské fakulty MU a FN Brno, pracoviste Bohunice. · Vnitr Lek. · Pubmed #18277633 No free full text.

Abstract: Chronic hepatitis B is one of the world's most common infectious diseases. In the Czech Republic it has a prevalence of 0.56%. Antiviral therapy for chronic hepatitis B demonstrably increases quality of life and where indication criteria are met and standard therapeutic procedures are followed, it is clearly cheaper than treatment for the complications of advanced cirrhosis of the liver or hepatocellular carcinoma. At the time of issuing of this recommendation, 4 medicines were classified for the treatment of chronic hepatitis B in the Czech Republic--pegylated interferon (IFN) alpha-2a, conventional IFN alpha, lamivudine (LAM) and adefovir dipivoxil (ADV). In a number of other developed states, entecavir (ETV) and telbivudine (LdT) have also been approved for treatment. The most effective treatment available at present is pegylated IFN alpha-2a, which should be the medication of first choice for initial treatment of hepatitis B, HBeAg positive and negative forms, provided that there are no contraindications for IFN alpha treatment. Conventional (standard, classical) IFN alpha can also be used, though clinical studies have shown it to be less effective than pegylated IFN alpha-2a. The main advantage of interferon compared to other commercially available medications is its relatively shorter and more clearly defined treatment period, the high probability of permanent suppression of virus replication and seroconversion of HBeAg/anti-HBe (in HBeAg positive forms of the illness) and the non-creation of mutant strains of HBV resistant to IFN in the course of treatment. If there are contraindications for IFN alpha (pegylated or conventional) or it is ineffective or poorly tolerated, ADV, ETV, LAM or LdT can be used. LAM and LdT treatments are often accompanied by the appearance of mutant strains of HBV, that are resistant to lamivudine or LdT and therefore they are not preferred.

Rockstroh JK, Bhagani S, Benhamou Y, Bruno R, Mauss S, Peters L, Puoti M, Soriano V, Tural C, Anonymous00076. · Department of Medicine I, University of Bonn, Bonn, Germany. · HIV Med. · Pubmed #18257771 No free full text.

Abstract: OBJECTIVES: With the decline in HIV-associated morbidity and mortality following the introduction of highly active antiretroviral therapy (HAART), liver disease has emerged as a major cause of death in HIV/hepatitis B virus (HBV) and HIV/hepatitis C virus (HCV) coinfected persons. Therefore, screening for underlying viral hepatitis coinfection and the provision of management and treatment recommendations for patients with chronic viral hepatitis are of great importance in preventing, as far as possible, the development of liver disease. With the introduction of new agents for the treatment of hepatitis B and increased knowledge of how best to manage hepatitis C, an update of current guidelines for management of HBV and HCV coinfection with HIV is warranted. SUMMARY: Clearly, all HIV-infected patients should be screened for hepatitis A, B and C, taking into account shared pathways of transmission. Patients who are seronegative for hepatitis A and B should be considered for vaccination. In HIV-infected patients with chronic hepatitis B, the first important differentiation is whether HAART is required or not. In the setting of stable HIV infection, with no need for HAART, several treatment options are available, namely treatment with interferon, early initiation of HAART, or selective non-HIV active anti-HBV nucleoside therapy, with the aim of achieving undetectable HBV DNA levels. In most cases, undetectable HBV DNA can only be achieved with combination therapy. With regard to hepatitis C, individualized tailoring of the duration of HCV therapy is advisable, taking into account rapid or delayed virological response. In patients who do not achieve at least a 2 log drop in HCV RNA at week 12, treatment can be terminated because of the low probability of achieving sustained virological response. Overall, with the currently available treatment algorithms, HCV can be eradicated in over 50% of patients. Therefore, HCV therapy should be considered and discussed with the patient if an indication for HCV therapy (elevated liver enzymes, positive HCV RNA and >F1 fibrosis) is present. CONCLUSIONS: Management of underlying hepatitis B and/or C in patients with HIV infection is of great importance in preventing liver disease-associated morbidity and mortality.

Dalmi L, Gervain J, Horváth G, Hunyady B, Ibrányi E, Makara M, Pár A, Szalay F, Tornai I, Telegdy L, Anonymous00498, Anonymous00499. · No affiliation provided · Orv Hetil. · Pubmed #18194921 No free full text.

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Bernaola Iturbe E, Giménez Sánchez F, Baca Cots M, de Juan Martín F, Díez Domingo J, Garcés Sánchez M, Gómez-Campderá A, Martinón Torres F, Picazo JJ, Pineda Solás V, Anonymous00469. · Comité Asesor de Vacunas de la Asociación Española de Pediatría, España. · An Pediatr (Barc). · Pubmed #18194631 links to  free full text

Abstract: The Vaccine Advisory Committee of the Spanish Association of Pediatrics provides information on the new developments in vaccines that have taken place in 2007, based on the available evidence, and discusses these developments. Certain modifications to the Immunization Schedule for 2008 are recommended. A second varicella vaccine booster dose, administered together with the booster dose of the measles-mumps-rubella (MMR) vaccine when children start school (3-4 years), is recommended to avoid vaccine failures against the varicella-zoster virus. Based on current scientific evidence, the importance of universal heptavalent conjugate pneumococcal vaccination, as carried out in most similar European countries and in the autonomous community of Madrid in Spain, is stressed. Human papilloma virus vaccine is included in the Immunization Schedule for girls from 11 years old, and initially, at least up to the age of 16 years. Vaccination against rotavirus in children starting at 6 weeks and completing the series before 6 months is recommended. Other recommendations included in this year's Immunization Schedule are vaccination against influenza and hepatitis A virus in risk groups and at the pediatrician's discretion, as a first step toward the future recommendation of universal immunization.

Anonymous00214, Anonymous00215. · No affiliation provided · Chin Med J (Engl). · Pubmed #18167196 links to  free full text

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Cornberg M, Protzer U, Dollinger MM, Petersen J, Wedemeyer H, Berg T, Jilg W, Erhardt A, Wirth S, Schirmacher P, Fleig WE, Manns MP. · Abteilung Gastroenterologie, Hepatologie und Endokrinologie, Medizinische Hochschule Hannover. · Z Gastroenterol. · Pubmed #18080231 No free full text.

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Anonymous00395. · No affiliation provided · Kinderkrankenschwester. · Pubmed #17983011 No free full text.

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Thomsen HS, Anonymous00278. · Department of Diagnostic Radiology, Copenhagen University Hospital, Herlev, Denmark. · Eur Radiol. · Pubmed #17977076 No free full text.

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Alvarez Pasquín MJ, Batalla Martínez C, Comín Bertrán E, Gómez Marco JJ, Pericas Bosch J, Pachón del Amo I, Rufino González J, Mayer Pujadas MA, Martín Martín S, Agustí Morató ML, Puig Barberá J, Anonymous00076. · Grupo de Prevención de Enfermedades Infecciosas. · Aten Primaria. · Pubmed #19288697 links to  free full text

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de Araújo ES, Mendonça JS, Barone AA, Gonçales FL, Ferreira MS, Focaccia R, Pawlotsky JM. · No affiliation provided · Braz J Infect Dis. · Pubmed #17962867 links to  free full text

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Daruich J, Gadano A, Fainboim H, Pessoa M, Cheinquer H. · Sección Hepatología, Hospital de Clínicas, Universidad de Buenos Aires, Argentina. · Acta Gastroenterol Latinoam. · Pubmed #17955728 No free full text.

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Anonymous00345. · No affiliation provided · MMWR Morb Mortal Wkly Rep. · Pubmed #17947967 links to  free full text

Abstract: In 1995, highly effective inactivated hepatitis A vaccines were first licensed in the United States for preexposure prophylaxis against hepatitis A virus (HAV) among persons aged > or =2 years. In 2005, vaccine manufacturers received Food and Drug Administration approval for use of the vaccines in children aged 12-23 months.

Anonymous00350. · No affiliation provided · Obstet Gynecol. · Pubmed #17906043 No free full text.

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Dao H, Mofenson LM, Ekpini R, Gilks CF, Barnhart M, Bolu O, Shaffer N. · Centers for Disease Control and Prevention, National Center for HIV, Hepatitis, STD, TB Prevention, Atlanta, GA, USA. · Am J Obstet Gynecol. · Pubmed #17825650 No free full text.

Abstract: The World Health Organization recommends that countries adopt more effective antiretroviral regimens to increase the effectiveness of the prevention of mother-to-child human immunodeficiency virus (HIV) transmission programs. The 2006 guidelines recommend a tiered approach for the delivery of antiretroviral to pregnant women who are infected with HIV and include triple-drug antiretroviral treatment for those women who are eligible. Those women who are not eligible for antiretroviral treatment should receive a combination prophylaxis antiretroviral regimen, preferably zidovudine from 28 weeks of gestation; zidovudine, lamivudine, and a single dose of nevirapine during delivery; and zidovudine and lamivudine for 7 days after delivery to reduce the development of nevirapine resistance. Newborn infants should receive a single dose of nevirapine and 1-4 weeks of zidovudine, depending on the duration of the regimen received by the mother. Although steps are being taken to provide more effective regimens, the use of single-dose nevirapine alone should still be used in situations in which more effective regimens are not yet feasible or available. HIV transmission through breastfeeding remains a problem, and several interventions are under evaluation that include maternal and/or infant antiretroviral prophylaxis during breastfeeding.

Wolf SJ, Heard K, Sloan EP, Jagoda AS, Anonymous00079. · No affiliation provided · Ann Emerg Med. · Pubmed #17709050 No free full text.

Abstract: This clinical policy focuses on critical issues concerning the management of patients presenting to the emergency department (ED) with acetaminophen overdose. The subcommittee reviewed the medical literature relevant to the questions posed. The critical questions are: 1. What are the indications for N-acetylcysteine (NAC) in the acetaminophen overdose patient with a known time of acute ingestion who can be risk stratified by the Rumack-Matthew nomogram? 2. What are the indications for NAC in the acetaminophen overdose patient who cannot be risk stratified by the Rumack-Matthew nomogram? Recommendations are provided on the basis of the strength of evidence of the literature. Level A recommendations represent patient management principles that reflect a high degree of clinical certainty; Level B recommendations represent patient management principles that reflect moderate clinical certainty; and Level C recommendations represent other patient management strategies that are based on preliminary, inconclusive, or conflicting evidence, or based on committee consensus. This guideline is intended for physicians working in EDs.

Anonymous00223. · No affiliation provided · Pediatrics. · Pubmed #17606579 links to  free full text

Abstract: Since licensure in 1995 of a hepatitis A vaccine, the Centers for Disease Control and Prevention and the American Academy of Pediatrics have been implementing an incremental hepatitis A immunization strategy for children. In 1996, children living in populations with the highest rates of disease were targeted for immunization, and in 1999 the program was expanded to immunization of children 2 years and older living in states and counties with rates of hepatitis A that historically have been higher than the national average. The 1999 program has been successful; the current rate of hepatitis A is the lowest ever reported in the United States. Regional, ethnic, and racial differences in the incidence of hepatitis A have been eliminated. The incidence of hepatitis A in adults in immunizing states has decreased significantly, suggesting a strong herd-immunity effect associated with immunization. In 2005, the US Food and Drug Administration changed the youngest approved age of administration of hepatitis A vaccine from 24 to 12 months of age, which facilitated incorporation of the vaccine into the recommended childhood immunization schedule. As the next step in the implementation of the incremental vaccine immunization strategy, the American Academy of Pediatrics now recommends routine administration of a Food and Drug Administration-licensed hepatitis A vaccine to all children 12 to 23 months of age in all states according to a Centers for Disease Control and Prevention-approved immunization schedule. Available data suggest that hepatitis A vaccine can be coadministered with other childhood vaccines without decreasing immunogenicity. Hepatitis A vaccines have proven to be extremely safe. In prelicensure clinical trials of both Havrix (GlaxoSmithKline, Rixensart, Belgium) and Vaqta (Merck & Co Inc, Whitehouse Station, NJ), adverse events were uncommon and mild when they occurred, with resolution typically in less than 1 day. Hepatitis A vaccine is contraindicated in people with a history of severe allergic reaction to a previous dose of hepatitis A vaccine or to a vaccine component. Because the hepatitis A vaccine is an inactivated product, no special precautions are needed for administration to people who are immunocompromised. No data exist about administration of the hepatitis A vaccine to pregnant women, but because it is not a live vaccine, the risk to mother and fetus should be extremely low to nonexistent.

Cornberg M, Protzer U, Dollinger MM, Petersen J, Wedemeyer H, Berg T, Jilg W, Erhardt A, Wirth S, Schirmacher P, Fleig WE, Manns MP. · Die Institutsangaben sind am Ende des Beitrags gelistet. · Z Gastroenterol. · Pubmed #17554641 No free full text.

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Fontaine H, Petitprez K, Roudot-Thoraval F, Trinchet JC, Anonymous00285, Anonymous00286, Anonymous00287, Anonymous00288, Anonymous00289, Anonymous00290, Anonymous00291. · Unité d'Hépatologie Médicale, Hôpital Cochin, Paris, France. · Gastroenterol Clin Biol. · Pubmed #17541342 No free full text.

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Ishibashi H, Komori A, Shimoda S, Gershwin ME. · Clinical Research Center, National Hospital Organization (NHO), Nagasaki Medical Center, and Department of Hepatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. · Semin Liver Dis. · Pubmed #17520519 No free full text.

Abstract: The principle of therapy for chronic inflammatory liver diseases is the removal of causal agents. For autoimmune liver diseases, however, total removal of causal agents and immune cells is impossible. Therefore, autoimmune liver diseases are presently treated by suppression of the immune response. Autoimmune hepatitis is characteristically responsive to corticosteroids, often used in combination with azathioprine to obtain a steroid-sparing effect. For primary biliary cirrhosis, ursodeoxycholic acid is safe and is the first choice for treatment. Treatment of this autoimmune liver disease should also address various symptoms and complications arising from any associated autoimmune diseases, particularly cholestasis and cirrhosis-related complications. For primary sclerosing cholangitis there are no established immunomodulatory therapies, but medical, endoscopic, and surgical treatments are applicable to this disease. Liver transplantation becomes indicated during the eventual end stages of each of these immune-mediated liver diseases.

Anonymous00371, McCaughan GW, Omata M, Amarapurkar D, Bowden S, Chow WC, Chutaputti A, Dore G, Gane E, Guan R, Hamid SS, Hardikar W, Hui CK, Jafri W, Jia JD, Lai MY, Wei L, Leung N, Piratvisuth T, Sarin S, Sollano J, Tateishi R. · Centenary Research Institute, AW Morrow Gastroenterology and Liver Centre, Royal Prince Alfred Hospital, University of Sydney, NSW 2006, Australia. · J Gastroenterol Hepatol. · Pubmed #17444847 No free full text.

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Markowitz LE, Dunne EF, Saraiya M, Lawson HW, Chesson H, Unger ER, Anonymous00118, Anonymous00119. · Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention (proposed), Atlanta, GA 30333, USA. · MMWR Recomm Rep. · Pubmed #17380109 links to  free full text

Abstract: These recommendations represent the first statement by the Advisory Committee on Immunization Practices (ACIP) on the use of a quadrivalent human papillomavirus (HPV) vaccine licensed by the U.S. Food and Drug Administration on June 8, 2006. This report summarizes the epidemiology of HPV and associated diseases, describes the licensed HPV vaccine, and provides recommendations for its use for vaccination among females aged 9-26 years in the United States. Genital HPV is the most common sexually transmitted infection in the United States; an estimated 6.2 million persons are newly infected every year. Although the majority of infections cause no clinical symptoms and are self-limited, persistent infection with oncogenic types can cause cervical cancer in women. HPV infection also is the cause of genital warts and is associated with other anogenital cancers. Cervical cancer rates have decreased in the United States because of widespread use of Papanicolaou testing, which can detect precancerous lesions of the cervix before they develop into cancer; nevertheless, during 2007, an estimated 11,100 new cases will be diagnosed and approximately 3,700 women will die from cervical cancer. In certain countries where cervical cancer screening is not routine, cervical cancer is a common cancer in women. The licensed HPV vaccine is composed of the HPV L1 protein, the major capsid protein of HPV. Expression of the L1 protein in yeast using recombinant DNA technology produces noninfectious virus-like particles (VLP) that resemble HPV virions. The quadrivalent HPV vaccine is a mixture of four HPV type-specific VLPs prepared from the L1 proteins of HPV 6, 11, 16, and 18 combined with an aluminum adjuvant. Clinical trials indicate that the vaccine has high efficacy in preventing persistent HPV infection, cervical cancer precursor lesions, vaginal and vulvar cancer precursor lesions, and genital warts caused by HPV types 6, 11, 16, or 18 among females who have not already been infected with the respective HPV type. No evidence exists of protection against disease caused by HPV types with which females are infected at the time of vaccination. However, females infected with one or more vaccine HPV types before vaccination would be protected against disease caused by the other vaccine HPV types. The vaccine is administered by intramuscular injection, and the recommended schedule is a 3-dose series with the second and third doses administered 2 and 6 months after the first dose. The recommended age for vaccination of females is 11-12 years. Vaccine can be administered as young as age 9 years. Catch-up vaccination is recommended for females aged 13--26 years who have not been previously vaccinated. Vaccination is not a substitute for routine cervical cancer screening, and vaccinated females should have cervical cancer screening as recommended.

Dalmi L, Gervain J, Hunyady B, Ibrányi E, Makara M, Pár A, Szalay F, Tornai I, Telegdy L. · No affiliation provided · Orv Hetil. · Pubmed #17378168 No free full text.

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