The only evidence-based book to approach viral liver disease by focusing exclusively on the clinical dilemmas encountered by hepatologists and their medical teams
Although viral hepatitis is a growing public health risk around the world, the World Health Organization (WHO) views the elimination of hepatitis infection over the next several as an achievable goal. Effective pharmaceutical therapies are now available, yet medical teams caring for patients with viral hepatitis are challenged when looking for answers to specific questions in the current medical literature. The second edition of Clinical Dilemmas in Viral Liver Disease provides evidence-based guidance for medical teams involved in diagnosing, treating, and managing patients with viral liver disease.
This fully updated book explores developments in new treatments and new diagnostic approaches that are contributing to WHO goals of viral elimination. Brief, easily referenced chapters examine clearly defined topics, addressing the clinical questions and difficulties encountered by medical teams in day-to-day practice. Contributions by an international team of investigators and clinicians address clinical questions and issues which are seldom found in standard textbooks and online repositories. Offering practical guidance on the specific challenges and dilemmas of treating viral liver disease, this unique volume:
- Provides practical, evidence-based guidance on topical and controversial issues
- Addresses understudied questions that arise in day-to-day clinical practice
- Discusses the challenges surrounding global elimination programs
- Presents focused approach that is supported by current literature and expert opinion
The second edition of Clinical Dilemmas in Viral Liver Disease is required reading for practicing and trainee hepatologists, gastroenterologists, transplant surgeons, virologists, and other practitioners involved in caring for patients with liver disease.
Table of Contents
List of Contributors vii
Preface xi
Part I: Investigating the Liver
1 Noninvasive markers of fibrosis: how reliable are they? 3
Laurent Castera
2 Liver biopsy in chronic viral hepatitis: is there still life left in it? 9
Jaspreet Suri and Michael P. Curry
3 Screening for hepatocellular carcinoma in viral liver disease: any new biomarkers on the horizon? 15
Saroja Bangaru, Jorge A. Marrero, and Amit G. Singal
4 Realistic estimates of hepatitis C virus and hepatitis B virus disease burden 19
Homie Razavi
Part II: Today’s Therapies
Section 1: HCV
5 Acute hepatitis C: treat immediately or give a chance to spontaneously clear? 29
David E. Kaplan
6 Is ribavirin alive or dead in the current era of HCV therapy? 35
Vijay Prabhakar and Paul Y. Kwo
7 Hepatitis C virus genotype and viral testing, and on‐treatment monitoring: necessary or overkill? 41
Sirina Ekpanyapong and K. Rajender Reddy
8 Treatment of hepatitis C virus in renal disease: can we use all the drugs without additional monitoring? 48
Stanislas Pol
9 Does directly acting antiviral therapy improve quality of life? 54
Daniel M. Forton
10 Morbid obesity and hepatitis C: treat as normal or are there additional issues to consider? 59
María Fernanda Guerra, Javier Ampuero, and Manuel Romero‐Gómez
11 Generic direct‐acting antiviral agents: do they work well? 66
Omar Salim Al Siyabi and Seng‐Gee Lim
12 Impact and management of patients with multiple hepatitis C virus genotypes 74
Peter Ferenci
13 Hepatitis C virus and injecting drug use: what are the challenges? 78
Olav Dalgard
14 Hepatitis B virus reactivation while on hepatitis C virus direct‐acting antiviral therapy: is that a real concern and when is it a concern? 82
Marina Serper
15 Drug-drug interactions with direct‐acting antivirals: when do we need to care? 86
Fiona Marra and David Back
16 Treatment of hepatitis C in children 94
Maureen M. Jonas
17 While direct‐acting antivirals are effective, are there any unique safety considerations? 97
Olivia Pietri, Félix Trottier‐Tellier, and Marc Bourlière
18 Harm reduction strategies to prevent new infections and reinfections among people who inject drugs: how effective are they? 106
Jason Grebely and Marianne Martinello
19 Hepatitis C virus therapy in advanced liver disease: treat or transplant and treat? 112
Chalermrat Bunchorntavakul and K. Rajender Reddy
20 Hepatocellular carcinoma and hepatitis C virus: which should be treated first? 117
Mario U. Mondelli, Andrea Lombardi, and Massimo Colombo
21 Should we incentivize patients to take hepatitis C virus therapy? 122
Ed Gane
22 Treating prisoners with hepatitis C: should we do it and how? 125
Seth Francis‐Graham and William Rosenberg
23 Use of hepatitis C virus‐positive organs for uninfected recipients in the era of effective and safe direct‐acting antivirals: pros and cons 132
Sirina Ekpanyapong and K. Rajender Reddy
24 Is real‐life hepatitis C virus therapy as effective as in clinical trials? 138
Jessica Su and Joseph K. Lim
Section 2: HBV, HDV, and HEV
25 Management of acute hepatitis B infection: when should we offer antiviral therapy? 145
Emma Hathorn and David J. Mutimer
26 Rethinking the inactive carrier state: management of patients with low‐replicative HBeAg‐negative chronic hepatitis B and normal liver enzymes 150
María Buti, Mar Riveiro‐Barciela, and Rafael Esteban
27 Hepatitis B e antigen‐positive chronic hepatitis B infection with minimal changes on liver biopsy: what to do next 156
Apostolos Koffas and Patrick T. Kennedy
28 The management of hepatitis B virus in pregnancy 160
Henry L.Y. Chan
29 Treatment of hepatitis B in children 164
Maureen M. Jonas
30 Hepatitis B vaccine failures: how do we handle them? 169
Daniel Shouval
31 The stopping rules in hepatitis B virus therapy: can we provide any guidance? 175
Florian van Bömmel and Thomas Berg
32 Hepatitis C and hepatitis B coinfection 182
Chun‐Jen Liu and Jia‐Horng Kao
33 Chronic hepatitis E virus infection: is it reality or hype and where does it matter? 189
Nassim Kamar and Jacques Izopet
34 Hepatitis E virus vaccines: have they arrived - when, where and for whom? 193
Amit Goel and Rakesh Aggarwal
Part III: Clinical Set‐up and the Future
35 Do we need expert hepatitis C virus treaters or are amateur treaters good enough? 203
Shyamasundaran Kottilil and Poonam Mathur
36 Hepatitis C vaccines: how close are we to the promised land? 208
Timothy Donnison, Senthil Chinnakannan, Paola Cicconi, and Eleanor Barnes
37 Elimination of hepatitis C virus in high‐prevalence, low‐income countries: is it feasible? 216
Mahmoud Abdo and Hadeel Gamal Eldeen
38 Hepatitis B virus diagnostics: anything new? 220
Dina Ginzberg, Robert J. Wong, and Robert G. Gish
Part IV: Ongoing Controversies
39 Is hepatocellular carcinoma risk impacted favorably or unfavorably by hepatitis C virus therapy with direct‐acting antivirals? 233
Giuseppe Cabibbo, Calogero Cammà, and Antonio Craxì
40 Global elimination of hepatitis C virus by 2030: the optimistic view 238
Gregory J. Dore and Marianne Martinello
41 Global elimination of hepatitis C virus by 2030: the pessimistic view 244
Thomas G. Cotter and Michael Charlton
Index 250
