Hospital Ramón y Cajal: Rosario González-Alonso, Fernando Liaño, Cristina Martín, Beatriz Peñas.
UCL Institute of Hepatology: Pamela Leckie, Rajeshwar P. Mookerjee, Lisa Cheshire. Charite University Hospital Berlin Germany: Silja BTK inhibitor Gläser. University Hospital Bonn Germany: Beate Appenrodt. Notfallzentrum Barmherzige Brüder Regensburg: Felix Rockmann, Jürgen Schölmerich. University Hospital Gasthuisberg Leuven: Pieter Evenepoel, Greet Hermans, Philippe Meersseman, Joost Wauters. Hôpital Paul Brousse: Philippe Ichaï, Didier Samuel and Magali Belnard. UGC Digestivo Hospital Universitario Reina Sofía: Juan Carlos Pozo, Jose Luis Montero. Hospital Clinic Barcelona: Angels Escorsell, Antoni Mas. “
“Evidence of hepatic
injury on routine biochemical evaluation should prompt a rapid decision-making process in the clinician. Elevations of hepatocellular injury tests (AST, ALT) should mTOR inhibitor be evaluated with an eye to the relative magnitude, pace of elevation and relative increase over other markers. This way, appropriate resources can be devoted to rapid evaluation. Increases in cholestatic injury tests (Alkaline phosphatase liver fraction, γ-glutamyl transpeptidase and bilirubin) should prompt assessment of biliary tree anatomy and consideration of autoimmune, metabolic or toxic injury of the liver. Finally, the liver’s ability to synthesize factors such as albumin and factor V is a very quick gauge of the extent of the liver injury. “
“Background and Aim: Despite that 60–90% of injection drug users (IDUs) are infected with hepatitis C virus (HCV) infection, IDUs are often denied therapy based on concerns of reinfection following treatment. However, there are little data in this regard. We evaluated HCV re-infection Thymidylate synthase following sustained virologic response (SVR) among HCV-infected IDUs having received HCV treatment in a multidisciplinary program. Methods: Following treatment, participants were encouraged to return at follow-up intervals of 1 year and illicit drug use histories were obtained. In those with SVR, HCV RNA testing by PCR
was performed to determine if relapse or reinfection occurred. Results: Among 58 receiving HCV treatment between January 2002 and December 2006, 60% (35 of 58) achieved an SVR. Patients were followed for a median of 2.0 years following SVR (range, 0.4–5.0 years), with ongoing illicit and injection drug use reported in 54% (19 of 35) and 46% (16 of 35). Of the 35 with SVR, 28 remained HCV RNA negative during follow-up (80%), with four lost to follow-up and one dying of hepatocellular carcinoma and two cases of reinfection were observed (2 of 35). The rates of reinfection were 3.2 per 100 p-y (95% CI:0.4, 11.5) overall and 5.3 per 100 p-y (95% CI:0.6, 19.0) among those reporting injecting following SVR (n = 16). One of two participants with HCV re-infection spontaneously cleared virus following reinfection.