Oktober 2011

DocTop Publications October 2011

Efficacy of chronic hepatitis C therapy with pegylated interferon and ribavirin in patients on methadone maintenance treatment.
Neukam K, Mira JA, Gilabert I, Claro E, Vázquez MJ, Cifuentes C...
Eur J Clin Microbiol Infect Dis. 2011 Oct 6. [Epub ahead of print]
Rating & Commentary
** Many CHC patients were infected during i.v.drug use, and a considerable part of the HCV infected population uses methadone maintenance treatment at the time antiviral therapy is considered. This study suggests that the efficacy of pegylated interferon and ribavirin is equal for CHC patient who do and those who do not use methadone.

Dual therapy with the NS5A inhibitor BMS-790052 and the NS3 protease inhibitor BMS-650032 in HCV genotype 1b-infected null responders.
Chayama K, Takahashi S, Toyota J, Karino Y, Ikeda K, Ishikawa H...
Hepatology. 2011 Oct 10. [Epub ahead of print]
Rating & Commentary
** Milestone single center study showing the great potential of dual therapy of polymerase and protease inhibitors in chronic hepatitis C genotype1. In 10 patients 2-24 weeks of combination therapy was associated with 100% SVR.

Response-guided telaprevir combination treatment for hepatitis C virus infection.
Sherman KE, Flamm SL, Afdhal NH, Nelson DR, Sulkowski MS, Everson GT...
N Engl J Med. 2011 Sep 15; 365:1014-24
Rating & Commentary
** Pivotal study in 560 treatment-naive patients with chronic hepatitis C genotype 1 treated with telaprevir, peginterferon and ribavirin for 12 weeks, followed by dual peginterferon-ribavirin. Sustained Viral Response was observed in 65%.Side-effects were not negligible.

Association of caffeine intake and histological features of chronic hepatitis C.
Costentin CE, Roudot-Thoraval F, Zafrani ES, Medkour F, Pawlotsky JM...
J Hepatol. 2011 Jun; 54:1123-9
Rating & Commentary
** Prior reports indicate a relation between coffee intake and the stage of chronic hepatitis. This study in 238 treatment-naïve patients with histologically-documented  chronic hepatitis C showed a significant inverse relationship between daily caffeine consumption and activity grade. Caffeine consumption 3 cups or more appears to be hepatoprotective.

A prospective study of the rate of progression in compensated, histologically advanced chronic hepatitis C.
Dienstag JL, Ghany MG, Morgan TR, Di Bisceglie AM, Bonkovsky HL, Kim HY...
Hepatology. 2011 Aug; 54:396-405
Rating & Commentary
** Landmark study on the ‘natural history’ of advanced fibrosis and cirrhosis due to chronic hepatitis C in 1050 non-responders to peginterferon-ribavirin in the USA. Among patients with fibrosis, the incidence of cirrhosis was 10% per year. Among subjects with cirrhosis, Child-Pugh score ≥7 occurred in 7 % per year. Following a CTP score≥7, the rate of death was 10% per year. During the 8 years of follow-up, death or liver transplantation occurred among 12 % of patients with advanced fibrosis and 31 % of those with cirrhosis.

Systematic review: outcome of compensated cirrhosis due to chronic hepatitis C infection.
Alazawi W, Cunningham M, Dearden J, Foster GR.
Aliment Pharmacol Ther. 2010 Aug; 32:344-55
Rating & Commentary
* Systematic review of the outcome of 2386 HCV mono-infected patients with cirrhosis. The estimated annual rate of death/transplantation is 4.6 %, that of decompensation is 6.4% per year and that of HCC, 3.4%. Studies that included treated patients reported lower annual percentage rates of HCC (2.5% vs. 4.8), of decompensation (5.3% vs. 7.9%) and death/transplantation (3.8 vs. 4.6%).

Factors that affect risk for hepatocellular carcinoma and effects of surveillance.
Yang JD, Harmsen WS, Slettedahl SW, Chaiteerakij R, Enders FT...
Clin Gastroenterol Hepatol. 2011 Jul; 617-23
Rating & Commentary
** Single-center study of 460 patients with HCC ( 365 HCV related) showing that HCCs detected during surveillance were of less advanced stage, and those patients were more likely to receive treatment that prolonged their survival. This finding supports potential benefits of surveillance.

Comparison of Transient Elastography and Acoustic Radiation Force Impulse for Non-Invasive Staging of Liver Fibrosis in Patients With Chronic Hepatitis C.
Rizzo L, Calvaruso V, Cacopardo B, Alessi N, Attanasio M, Petta S...
Am J Gastroenterol. 2011 Oct 4. [Epub ahead of print]
Rating & Commentary
** Two-center study in 139 patients with CHC showing that acoustic radiation force impulse (ARFI, a module which can be added to a regular ultrasound machine) was more accurate than Fibroscan (a separate machine measuring liver elasticity) for the non-invasive staging of  liver fibrosis

Randomised clinical trial: escitalopram for the prevention of psychiatric adverse events during treatment with peginterferon-alfa-2a and ribavirin for chronic hepatitis C.
de Knegt RJ, Bezemer G, Van Gool AR, Drenth JP, Hansen BE...
Aliment Pharmacol Ther. 2011 Oct 17. [Epub ahead of print]
Rating & Commentary
* Multicenter randomized controlled trial showing that prophylactic treatment with escitalopram significantly reduces the rate of psychiatric side-effects of interferon-based treatment of hepatitis C from 35 to 12 %.

Impact of patatin-like phospholipase-3 (rs738409 C>G) polymorphism on fibrosis progression and steatosis in chronic hepatitis C.
Trépo E, Pradat P, Potthoff A, Momozawa Y, Quertinmont E, Gustot T...
Hepatology. 2011 Jul; 54:60-9.
Rating & Commentary
* This study shows that a SNP (rs738409) in the PNPLA3 gene, which was previously associated with hepatic steatosis and fibrosis in NAFLD, also has an independent association with steatosis (odds ratio 2.55), fibrosis (OD 3.13) and fibrosis progression (OR 2.64) in chronic hepatitis C patients.