Update on HIV-HCV Epidemiology and Natural History
|
|
- Samson Shelton
- 6 years ago
- Views:
Transcription
1 Update on HIV-HCV Epidemiology and Natural History Jennifer Price, MD Assistant Clinical Professor of Medicine University of California, San Francisco
2 Learning Objectives Upon completion of this presentation, learners should be better able to: Describe the burden of liver disease related to HCV among HIV-infected individuals Identify the factors influencing liver disease progression among HIV-HCV coinfected patients
3 Faculty and Planning Committee Disclosures Please consult your program book. Off-Label Disclosure There will be no off-label/investigational uses discussed in this presentation.
4 Causes of Death Among HIV+ 40% 35% 30% 25% 20% Chronic viral hepatitis 15% 10% 5% 0% AIDS Liver Cardiac Cancer Other Causes of death in 33,308 HIV+ adults followed prospectively in the Data Collection on Adverse Events of Anti-HIV Drugs (D:A:D) study. Adapted from D:A:D Study Group.AIDS 2010, 24:
5 Chronic HCV Epidemiology Worldwide: ~3% (170 million) chronically infected Global prevalence varies depending on area Up to 20% in highly endemic areas such as Nile Delta 5 million are HIV-HCV coinfected United States: % ( million) chronically infected with HCV 8% are HIV-infected 25-30% of HIV+ in US are also HCV+: prevalence varies by transmission risk factor WHO: CDC: Lavanchy D. Clin Microbiol Infect. 2011;17: Ghany, et al. Hepatology.2009;49:
6 Global Prevalence of HCV 2.9% % % <1.0% No data
7 Global Prevalence of HCV 1>2,3 1>2>3 1>3>2 2>1 4 3>1,2 1>2>6 2.9% % % <1.0% No data 5 1>3,6>2 1>2,3
8 Which of the following is the most efficient mode of HCV transmission? 1. Heterosexual contact 2. Injection drug use 3. Maternal-child transmission 4. Male homosexual contact
9 Transmission of HCV Transfusion (before screening) 10% Other* 5% Unknown 10% Sexual 15% Injection drug use 60% * Iatrogenic; health-care work; perinatal Mother-child transmission 2-5% if mother is HCV-monoinfected and 5 x higher if mother is HIV- HCV-coinfected CDC: Yeong et al.. Hepatology. 2001;34(2):223. Mast et al.. J Infect Dis. 2005;192:
10 Anti-HCV+, % Prevalence of HIV-HCV by HIV Risk Factor % Injection Drug Use 14.3% Heterosexual Contact Sulkowski and Thomas. Ann Intern Med. 2003;138: % Male Homosexual Contact 45.1% Entire Cohort
11 Reported cases/100,000 population 3 Incidence of Acute HCV by Age Group- United States, yrs yrs yrs yrs yrs 60 yrs Year Source: National Notifiable Diseases Surveillance System (NNDSS)
12 Acute HCV Among HIV+ MSM 2004/2005: Clusters of acute HCV in HIV+ MSM reported in Northern Europe Ulcerative STI s more common in HCV incident cases Molecular genetics more similar to each other than in IDU-associated HCV isolates Linkages made to high-risk sexual behavior (fisting, group sex, traumatic and receptive intercourse) and recreational (not-injected) drugs Browne et al. Sex Transm Infect 2004; 80: Gilleece et al. J Acquir Immune Defic Syndr 2005; 40: Gambotti, et al. Euro Surveill 2005; 10: Ghosn, et al. HIV Med 2004; 5: Gotz et al. AIDS 2005; 19: Luetkemeyer et al. J Acquir Immune Defic Syndr 2006; 41: Fierer, et al. J Infect Dis 2008; 198:
13 Acute HCV Among HIV+ MSM Clusters of acute HCV among HIV+ MSM reported in both US and Australia Northern Europe cohort studies suggests increased HCV incidence since 2000 Short time frame (<2 years) between HIV diagnosis and HCV seroconversion Browne et al. Sex Transm Infect 2004; 80: Gilleece et al. J Acquir Immune Defic Syndr 2005; 40: Gambotti, et al. Euro Surveill 2005; 10: Ghosn, et al. HIV Med 2004; 5: Gotz et al. AIDS 2005; 19: Luetkemeyer et al. J Acquir Immune Defic Syndr 2006; 41: Fierer, et al. J Infect Dis 2008; 198:
14 ALT (IU/L) Course of Acute HCV Infection HCV RNA positive Anti-HCV Symptoms Weeks Months Time After Exposure 7 Normal ALT Hoofnagle, Hepatology. 1997;26:15S. Carithers, et al. Semin Liver Dis. 2000;20: Pawlosky, Hepatology. 2002;36(suppl 1):S65-S73. NIH Management of Hepatitis C Consensus Conference Statement. June 10-12, 2002.
15 HIV impacts which of the following among HCV-infected individuals? 1. Clearance of acute HCV infection 2. Progression to cirrhosis 3. Survival after development of cirrhosis 4. Graft and patient survival after liver transplant 5. All of the above
16 Natural History of HCV Lower rates of spontaneous clearance Acute HCV Resolved 15-40% Chronic HCV 60-85% Stable 85-90% Cirrhosis 10-15% Slowly progressive 75% HCC Liver failure 25% (2-4%) NIH Management of Hepatitis C Consensus Conference Statement. June 10-12, 2002.
17 Percent Influence of HIV on Spontaneous Clearance of HCV % % 8.6% 6 5.0% HIV Negative HIV+ (CD4 500) HIV+ (CD ) HIV+ (CD4 <200) Thomas et al. JAMA 2000; 284:
18 Natural History of HCV Acute HCV Resolved 15-40% Stable 85-90% Chronic HCV 60-85% Cirrhosis 10-15% Accelerated fibrosis progression Increased risk of cirrhosis, liver decompensation Slowly progressive 75% HCC Liver failure 25% (2-4%) NIH Management of Hepatitis C Consensus Conference Statement. June 10-12, 2002.
19 Increased Risk of Cirrhosis and ESLD Due to HIV-HCV Coinfection Makris (UK) Soto (Spain) Pol (France) Benhamou (France) Combined Histologic Cirrhosis Relative Risk Decompensated Liver Disease Eyster (USA) Telfer (UK) Makris (UK) Lesens (Canada) Combined Relative Risk HCV HIV-HCV Only HCV HIV-HCV Only Graham et al.. Clin Infect Dis. 2001;33:
20 Incidence density rate of HCC, cases per 1000 person years Hepatocellular Carcinoma in HIV-HCV Coinfected Patients Merchante et al. Clin Infect Dis. 2013;56: Ioannou et al. Hepatology. 2013;57:
21 Natural History of HCV Acute HCV Resolved 15-40% Chronic HCV 60-85% Stable 85-90% Cirrhosis 10-15% Slowly progressive 75% HCC Liver failure 25% (2-4%) Liver Transplant Death Shorter survival after decompensation
22 Survival (%) HIV-HCV Coinfected Patients with Decompensated Cirrhosis Shorter Survival HCV-monoinfected 5-Year Cumulative Survival Decompensation Compensated Retrospective study of 1,037 HCV monoinfected and 180 HIV-HCV coinfected subjects with decompensated cirrhosis Median survival HCV monoinfected: 48 months HIV-HCV coinfected: 16 months Relative risk of death HIV: 2.26 [ ] Fattovich et al. Gastroenterology. 1997;112: Pineda et al. Hepatology. 2005;41:
23 Natural History of HCV Acute HCV Resolved 15-40% Chronic HCV 60-85% Stable 85-90% Cirrhosis 10-15% Slowly progressive 75% HCC Liver failure 25% (2-4%) Liver Transplant Poorer outcomes after liver transplant Death
24 Patient Survival Patient Survival Liver Transplant and HIV-HCV Graft and patient survival is decreased among HCV+ transplant recipients. Further reduced among HIV-HCV coinfected recipients HCV HCV p= HIV-HCV p<0.001 HIV-HCV Spain Multi-site study HIV-HCV: n=84 US Multi-site study HIV-HCV: n=89 Miro et al, A J Transplant 2012; 12: Terrault, et al. Liver Transpl. 2012; 18:
25 Which of the following factors has NOT been associated with higher risk of cirrhosis in HCV-infected individuals? A. HCV Genotype B. Alcohol use C. Marijuana use D. Post-menopausal status E. Older age at time of HCV exposure
26 Risk Factors for Disease Progression in HCV-monoinfection Alcohol use Daily marijuana use Elevated BMI, obesity, insulin resistance Longer duration of infection Age >40 at time of infection Male gender, post-menopausal women Host genetic factors Organ transplantation Coinfections: HBV, HIV, Schistosomiasis Poynard, et al. Lancet 1997;349:825-32; Mathurin, et al. Hepatology 1998; 27: Benhamou, et al. Hepatology 1999; 30:1054-8; Kamal, et al. Hepatology 2006;43: Asselah, et al. Gut 2006; 55: Ishida, et al. Clin Gastro Hepatology 2008;6:69-7.
27 Predictors of Severe Liver Fibrosis in HIV-HCV Coinfected Patients Variable OR (95% CI) Age at biopsy >35 years 2.95 ( ) Alcohol >50 g/day 1.61 ( ) CD4 count <500 cells/mm ( ) Male sex 1.26 ( ) 914 HIV-HCV coinfected patients with elevated ALT who underwent liver biopsy between Route of transmission, HCV genotype, HCV viral load, and ART were not associated with liver fibrosis severity Martin-Carbonero, et al. Clin Infect Dis. 2004;38:
28 Alcohol and Liver Disease in HIV+ Patients Percent of deaths due to ESLD Percent of ESLD deaths with history of excessive alcohol* % 40 44% 31% % 62% % 2% % Salmon-Ceron. J Hepatol. 2005; 42: *men >30 g/day, women >20 g/day
29 Hepatic Steatosis is Common in HIV- HCV Coinfected Patients Prevalence estimates range from 23-72% Factors associated with increased prevalence of hepatic steatosis in HIV-HCV coinfected patients: Variable OR (95% CI) BMI 1.13 (1.07, 1.19) Diabetes Mellitus 2.32 (1.32, 4.07) Elevated ALT 1.28 (1.02, 1.61) Fibrosis 1.67 (1.20, 2.34) Necroinflammation 1.72 (1.11, 2.67) Machado, et al. Hepatology. 2010; 52:71-78.
30 Ishak Fibrosis Units/yr Ishak Fibrosis Units/yr Impact of ART on Fibrosis Progression Rate (FPR) in HIV-HCV CD4 <500/mm 3 CD4 500/mm HIV- HIV RNA <400 HIV RNA K HIV RNA 100K 0.08 HIV RNA <400 HIV RNA 400 HIV RNA <400 HIV RNA 400 FPR similar among HIV-HCV coinfected patients with suppressed HIV replication on ART and HCV-monoinfected FPR accelerated among HIV viremic patients with CD4 counts < 500/mm 3 Brau, et al. J Hepatol. 2006;44:47-55.
31 Impact of ART on Survival with Decompensated Cirrhosis Prospective study of 153 HIV-HCV coinfected subjects with decompensated cirrhosis Median survival: 13 months Independent predictors of mortality: Variable HR (95% CI) Child-Pugh score 1.22 ( ) Encephalopathy 2.45 ( ) CD4 count <100 cells/µl 2.48 ( ) HAART during following up 0.57 ( ) Cumulative 3-year survival: 18% off HAART, 40% on HAART Merchante, et al. AIDS.2006;20:49-57.
32 Impact of HIV on HCV Disease Progression in the ART-Era HIV-HCV HCV Predicted fibrosis scores +/- HIV holding constant race, sex, alcohol use, BMI, HBsAg status, HCV RNA level HIV-HCV have liver fibrosis equivalent to HCV-mono 9.2 yrs older on average Kirk, et al. Ann Intern Med. 2013; Feb 26 [Epub ahead of print].
33 Summary HCV coinfection is common among HIV+ Prevalence varies by population HIV+ MSM are new high risk group HIV influences the natural history of HCVrelated liver disease Beneficial impact of potent ART
34 Summary Other modifiable risk factors include: Alcohol abuse Marijuana use Obesity and insulin resistance
Healthy Liver Cirrhosis
Gioacchino Angarano Clinica delle Malattie Infettive Università degli Studi di Foggia Healthy Liver Cirrhosis Storia naturale dell epatite HCVcorrelata in assenza di terapia Paestum 13-15 Maggio 24 The
More informationViral Hepatitis. Dr Melissa Haines Gastroenterologist Waikato Hospital
Viral Hepatitis Dr Melissa Haines Gastroenterologist Waikato Hospital Viral Hepatitis HAV HBV HCV HDV HEV Other viral: CMV, EBV, HSV Unknown Hepatitis A Hepatitis A Transmitted via the faecal-oral route
More informationEvaluating HIV Patient for Liver Transplantation. Marion G. Peters, MD Professor of Medicine University of California San Francisco USA
Evaluating HIV Patient for Liver Transplantation Marion G. Peters, MD Professor of Medicine University of California San Francisco USA Slide 2 ESLD and HIV Liver disease has become a major cause of death
More informationHepatitis B. ECHO November 29, Joseph Ahn, MD, MS Associate Professor of Medicine Director of Hepatology Oregon Health & Science University
Hepatitis B ECHO November 29, 2017 Joseph Ahn, MD, MS Associate Professor of Medicine Director of Hepatology Oregon Health & Science University Disclosures Advisory board Gilead Comments The speaker Joseph
More informationProfessor Norbert Bräu
Sixth Annual BHIVA Conference for the Management of HIV/Hepatitis Co-Infection in collaboration with BASL and BVHG Professor Norbert Bräu James J Peters VA Medical Center, New York, USA COMPETING INTEREST
More informationMeet the Professor: HIV/HCV Coinfection
Meet the Professor: HIV/HCV Coinfection Vincent Lo Re, MD, MSCE Assistant Professor of Medicine and Epidemiology Division of Infectious Diseases Center for Clinical Epidemiology and Biostatistics University
More informationThe Impact of HBV Therapy on Fibrosis and Cirrhosis
The Impact of HBV Therapy on Fibrosis and Cirrhosis Jordan J. Feld, MD, MPH Associate Professor of Medicine University of Toronto Hepatologist Toronto Centre for Liver Disease Sandra Rotman Centre for
More informationAcute hepatitis C The European Experience
Acute hepatitis C The European Experience Dr Emma Page MBBS MRCP MD(Res) Chelsea and Westminster Hospital, London AHC the European Experience 1. Epidemic 2. CNS sequelae 3. Incidence 4. Re-infection Reports
More informationStrategies to Address HCV
Strategies to Address HCV HIV Programs & U.S. Viral Hepatitis Action Plan Corinna Dan, RN, M.P.H. Viral Hepatitis Policy Advisor Office of HIV/AIDS and Infectious Disease Policy September 10, 2015 1 The
More informationHIV coinfection and HCC
HIV coinfection and HCC 3 rd APASL STC on HCC 21 st -23 rd Nov 2013 Cebu, Phillippines George KK Lau MBBS (HK), MRCP(UK), FHKCP, FHKAM (GI), MD(HK), FRCP (Edin, Lond) Consultant, Humanity and Health GI
More informationEpidemiology and Screening for Hepatitis C Infection
Epidemiology and Screening for Hepatitis C Infection Atif Zaman, MD MPH Oregon Health & Science University Professor of Medicine Division of Gastroenterology and Hepatology Epidemiology/Screening for Hepatitis
More informationHBV in HIV Forgotten but not Gone
Activity Code FA376 HBV in HIV Forgotten but not Gone Richard K. Sterling, MD, MSc VCU Hepatology Professor of Medicine Chief, Section of Hepatology Virginia Commonwealth University Learning Objectives
More informationHIV/HCV co-infected patients should be prioritised for HCV treatment. Sanjay Bhagani Royal Free Hospital/UCL London
HIV/HCV co-infected patients should be prioritised for HCV treatment Sanjay Bhagani Royal Free Hospital/UCL London Also requires other resources What should a prioritisation process Life-saving at this
More informationNumbers HCV and HIV Epidemiology in the US
By The Numbers HCV and HIV Epidemiology in the US Coinfection Fridays Session 1 18 January 2019 Christopher B. Hurt, MD Associate Professor of Medicine Co-Director, North Carolina AIDS Training & Education
More informationViral hepatitis and Hepatocellular Carcinoma
Viral hepatitis and Hepatocellular Carcinoma Hashem B. El-Serag, MD, MPH Dan L. Duncan Professor of Medicine Chief, Gastroenterology and Hepatology Houston VA & Baylor College of Medicine Houston, TX Outline
More informationHepatitis C. Core slides
Hepatitis C Core slides This material was prepared by the Viral Hepatitis Prevention Board The slides (or subsets) can be reproduced for educational use only, with reference to the original source and
More informationThe Effect of Antiviral Therapy on Liver Fibrosis in CHC. Jidong Jia Beijing Friendship Hospital, Capital Medical University
The Effect of Antiviral Therapy on Liver Fibrosis in CHC Jidong Jia Beijing Friendship Hospital, Capital Medical University 2016-5-29 1 Disclosure Consultation for Abbvie, BMS, Gilead, MSD, Novartis and
More informationHCV care after cure. This program is supported by educational grants from
HCV care after cure This program is supported by educational grants from Raffaele Bruno,MD Department of Infectious Diseases, Hepatology Outpatients Unit University of Pavia Fondazione IRCCS Policlinico
More informationViral Hepatitis The Preventive Potential of Antiviral Therapy. Thomas Berg
Viral Hepatitis The Preventive Potential of Antiviral Therapy Thomas Berg Therapeutic and preventive strategies in patients with hepatitis virus infection Treatment of acute infection Treatment of chronic
More informationManagement of HIV / HCV Coinfection
Advances in HCV 2015 Albany Medical College & Erie County Medical Center Buffalo, New York 24 June 2015 Management of HIV / HCV Coinfection Norbert Bräu, MD, MBA Prof. of Medicine, Icahn School of Medicine
More informationMortality and Causes of Death Among HIV/HCV Co-Infected Persons in the Eastern European Country of Georgia
Mortality and Causes of Death Among HIV/HCV Co-Infected Persons in the Eastern European Country of Georgia Akaki Abutidze, 1 Natalia Bolokadze, 1 Nino Rukhadze, 1 Natia Dvali, 1 Lali Sharvadze, 1,2 Tengiz
More informationManagement of HIV / HCV Coinfection
Bronx VA Medical Center Mount Sinai School of Medicine Advances in HCV 2015 Albany Medical College & Erie County Medical Center Buffalo, New York 24 June 2015 Management of HIV / HCV Coinfection Norbert
More informationAntiretroviral Therapy in HIV and Hepatitis Coinfection: What Do We Need to Consider?
Antiretroviral Therapy in HIV and Hepatitis Coinfection: What Do We Need to Consider? Saturday 22nd March 2014, Mumbai, India Jürgen K. Rockstroh Department of Internal Medicine I University Hospital Bonn,
More informationAssessing the patient with a new diagnosis of Hepatitis C LAUREN MYERS MMSC, PA-C OREGON HEALTH & SCIENCE UNIVERSITY
Assessing the patient with a new diagnosis of Hepatitis C LAUREN MYERS MMSC, PA-C OREGON HEALTH & SCIENCE UNIVERSITY Disclosures Nothing to Disclose Assessing the patient with a new diagnosis of Hepatitis
More informationHepatocellular Carcinoma in HIV-infected Patients A Growing Complication of Coinfection with HCV or HBV Mon, 31 May 2010
Bronx VA Medical Center Mount Sinai School of Medicine Hepatocellular Carcinoma in HIV-infected Patients A Growing Complication of Coinfection with HCV or HBV Mon, 31 May 2010 Norbert Bräu, MD, MBA Associate
More informationLiver stiffness predicts liver related events and mortality in HIV/HCV coinfected patients
Liver stiffness predicts liver related events and mortality in HIV/HCV coinfected patients José Vicente Fernández-Montero, Pablo Barreiro, Eugenia Vispo, Pablo Labarga, Francisco Blanco, Fernanda Rick,
More informationEnd Stage Liver Disease & Disease Specific Indications for Liver Transplant. Susan Kang, RN, MSN, ANP-BC
End Stage Liver Disease & Disease Specific Indications for Liver Transplant Susan Kang, RN, MSN, ANP-BC Introduction (https://www.srtr.org) What does the liver do? STORAGE METABOLIC DETOXIFICATION SYNTHETIC
More informationEnd Stage Liver Disease & Disease Specific Indications for Liver Transplant Susan Kang, RN, MSN, ANP BC
End Stage Liver Disease & Disease Specific Indications for Liver Transplant Susan Kang, RN, MSN, ANP BC Introduction (https://www.srtr.org) 1 What does the liver do? STORAGE METABOLIC DETOXIFICATION SYNTHETIC
More informationNatural History of Chronic Hepatitis B
Natural History of Chronic Hepatitis B Anna SF Lok, MD Alice Lohrman Andrews Professor in Hepatology Director of Clinical Hepatology Assistant Dean for Clinical Research University of Michigan Ann Arbor,
More informationcoinfected patients predicts HBsAg clearance during long term exposure to tenofovir
Measurement of serum HBsAg in HIV/HBV coinfected patients predicts HBsAg clearance during long term exposure to tenofovir Zulema Plaza 1, Antonio Aguilera 2, Alvaro Mena 3, Luz Martín-Carbonero 1, Eugenia
More informationNIH Consensus Conference Statement. Management of Hepatitis C. March 24-26, NIH Web site. Available at:
ABC s of Hepatitis C Treatment Today Elizabeth N. Britton, MSN, FNP-BC Hepatology Services Louisiana State University Health Sciences Center ebritt@lsuhsc.edu ANAC CONFERENCE -TUCSON NOV 2012 Hepatitis
More informationWorldwide Causes of HCC
Approach to HCV Treatment in Patients with HCC Mark W. Russo, MD, MPH, FACG Carolinas HealthCare System Charlotte Worldwide Causes of HCC 60% 50% 40% 30% 20% 10% 0% 54% 31% 15% Hepatitis B Hepatitis C
More informationHepatitis B. Epidemiology and Natural History and Implications for Treatment
Hepatitis B Epidemiology and Natural History and Implications for Treatment Norah Terrault, MD Professor of Medicine and Surgery Director, Viral Hepatitis Center University of California San Francisco
More informationSHOULD EVERYONE WITH HCV/HIV COINFECTION BE TREATED NOW?
SHOULD EVERYONE WITH HCV/HIV COINFECTION BE TREATED NOW? Kenneth E. Sherman, MD, PhD Gould Professor of Medicine Director, Division of Digestive Diseases University of Cincinnati College of Medicine Disclosures
More informationManagement of Hepatitis C in Primary Care BABAFEMI ONABANJO, MD & BEN ALFRED, FNP UMASS FAMILY HEALTH CENTER WORCESTER
Management of Hepatitis C in Primary Care BABAFEMI ONABANJO, MD & BEN ALFRED, FNP UMASS FAMILY HEALTH CENTER WORCESTER Objective Epidemiology Screening criteria Appropriate work up Treatment Guidelines
More informationWorldwide Causes of HCC
Approach to HCV Treatment in Patients with HCC JORGE L. HERRERA, MD, MACG UNIVERSITY OF SOUTH ALABAMA COLLEGE OF MEDICINE Worldwide Causes of HCC 60% 50% 40% 54% 30% 20% 10% 31% 15% 0% Hepatitis B Hepatitis
More informationHepatitis Alert: Management of Patients With HCV Who Have Achieved SVR
Hepatitis Alert: Management of Patients With HCV Who Have Achieved SVR This program is supported by educational grants from AbbVie, Gilead Sciences, and Merck About These Slides Please feel free to use,
More informationSteatosi epatica ed HCV
Steatosi epatica ed HCV Malattie delle vie biliari ed Epatologia Rho, Auditorium Padri Oblati, 11 Novembre 2006 Piero L. Almasio Università di Palermo HISTOPATHOLOGY Steatosis and accelerated fibrogenesis:
More informationHIV-HBV coinfection: Issues with treatment in 2018
HIV-HBV coinfection: Issues with treatment in 2018 Pr Karine Lacombe, INSERM UMR-S1136, IPLESP Infectious Diseases Dpt, St Antoine, AP-HP Sorbonne Université, Paris, France Global epidemiology Same routes
More informationANTIVIRAL THERAPY FOR HCV. Alfredo Alberti
CLINICAL IMPACT OF SVR AFTER ANTIVIRAL THERAPY FOR HCV Alfredo Alberti Department of Histology,Microbiology and Medical Biotechnologies Molecular Hepatology Unit Venetian Institute of Molecular Medicine
More informationNatural History of HBV Infection
Natural History of HBV Infection Joseph JY Sung MD PhD Institute of Digestive Disease Department of Medicine & Therapeutics Prince of Wales Hospital The Chinese University of Hong Kong HBV Infection 2
More informationAn Update HBV Treatment
An Update HBV Treatment Epidemiology Natural history Treatment Daryl T.-Y. Lau, MD, MPH Associate Professor of Medicine Director of Translational Liver Research Division of Gastroenterology BIDMC, Harvard
More informationHepatitis C. David Byers, MD, FACP Senior Medical Director for Infectious Diseases and Wound Healing Services Southern Ohio Medical Center
Hepatitis C David Byers, MD, FACP Senior Medical Director for Infectious Diseases and Wound Healing Services Southern Ohio Medical Center DISCLOSURE The speaker and members of the planning committee do
More informationHepatitis B in Africa: Epidemiology, Pathophysiology and Challenges
Gilead-sponsored symposium at the 11th INTEREST Workshop 2017 Hepatitis B in Africa: Epidemiology, Pathophysiology and Challenges Ponsiano Ocama Department of Medicine Makerere University College of Health
More informationCIRROSI E IPERTENSIONE PORTALE NELLA DONNA
Cagliari, 16 settembre 2017 CIRROSI E IPERTENSIONE PORTALE NELLA DONNA Vincenza Calvaruso, MD, PhD Ricercatore di Gastroenterologia Gastroenterologia & Epatologia, Di.Bi.M.I.S. Università degli Studi di
More informationHCV elimination : lessons from Scotland
HCV elimination : lessons from Scotland Sharon Hutchinson Glasgow Caledonian University / Health Protection Scotland BHIVA Hepatology Highlights, Edinburgh, 17 th April 2018 Disclosures Honoraria from
More informationEPIDEMIOLOGY, CLINICAL FEATURES AND OUTCOME OF ACUTE HEPATITIS C IN HIV-POSITIVE PATIENTS: PRESENTATION OF OUR EXPERIENCE
EPIDEMIOLOGY, CLINICAL FEATURES AND OUTCOME OF ACUTE HEPATITIS C IN HIV-POSITIVE PATIENTS: PRESENTATION OF OUR EXPERIENCE E. Angeli, A. Mainini, C. Atzori, G. Gubertini and G. Rizzardini II Dept. Infectious
More informationConsensus AASLD-EASL HBV Treatment Endpoint and HBV Cure Definition
Consensus AASLD-EASL HBV Treatment Endpoint and HBV Cure Definition Anna S. Lok, MD, DSc Alice Lohrman Andrews Professor in Hepatology Director of Clinical Hepatology Assistant Dean for Clinical Research
More informationHepatitis C Management and Treatment
Hepatitis C Management and Treatment Kaya Süer Near East University Faculty of Medicine Infectious Diseases and Clinical Microbiology 1 Discovery of Hepatitis C Key facts Hepatitis C: the virus can cause
More informationDr David Rowbotham NHS. The Leeds Teaching Hospitals. NHS Trust
Dr David Rowbotham The Leeds Teaching Hospitals NHS Trust NHS Nurses Update June 2010 Chronic Hepatitis HBV / HCV David Rowbotham Clinical Director & Consultant Gastroenterologist Dept of Gastroenterology
More informationThe impact of the treatment of HCV in developing Hepatocellular Carcinoma
The impact of the treatment of HCV in developing Hepatocellular Carcinoma Paul Y Kwo, MD Professor of Medicine Medical Director, Liver Transplantation Gastroenterology/Hepatology Division Indiana University
More informationHepatitis B: A Preventable Cause of Liver Cancer. Saira Khaderi MD, MPH Assistant Professor of Surgery Associate Director, Project ECHO June 17, 2016
Hepatitis B: A Preventable Cause of Liver Cancer Saira Khaderi MD, MPH Assistant Professor of Surgery Associate Director, Project ECHO June 17, 2016 Overview Epidemiology HBV and cancer Screening, Diagnosis
More informationOutline. Updates in the Clinical Management of Hepatitis B and C. Who should be screened for HBV? Chronic Hepatitis B 10/7/2018
Outline Updates in the Clinical Management of Hepatitis B and C Jennifer C. Lai, MD, MBA Transplant Hepatologist Associate Professor of Medicine In Residence University of California, San Francisco Initial
More informationHepatocellular Carcinoma: Can We Slow the Rising Incidence?
Hepatocellular Carcinoma: Can We Slow the Rising Incidence? K.Rajender Reddy M.D. Professor of Medicine Director of Hepatology Medical Director of Liver Transplantation University of Pennsylvania Outline
More informationViral hepatitis in patients living with HIV: can we still speak of special population?
Viral hepatitis in patients living with HIV: can we still speak of special population? Maurizio Bonacini, M.D., A.G.A.F. Mission Gastroenterology and Hepatology San Francisco, CA YES for HBV Excluded by
More informationThere are three types of people
There are three types of people People who don t learn from their mistakes People who do learn from their mistakes People who learn from the mistakes of others Treat Now Summary of EASL 2014 100% 100
More informationChronic viral hepatitis and liver disease in Belgium Pierre Deltenre
Chronic viral hepatitis and liver disease in Belgium Pierre Deltenre Brussels, November 7, 2017 Hepatitis B and C in Belgium What we need to know 1. Who is at risk of infection? 2. What is the natural
More informationProfessor Vincent Soriano
Five Nations Conference on HIV and Hepatitis in partnership with Professor Vincent Soriano Hospital Carlos III, Madrid, Spain Professor Vincent Soriano in partnership with Hospital Carlos III, Madrid,
More informationHepatitis B Treatment Pearls. Agenda
Hepatitis B Treatment Pearls Fredric D. Gordon, MD Vice Chair Dept. of Transplantation and Hepatobiliary Diseases Lahey Hospital & Medical Center Associate Professor of Medicine Tufts Medical School Boston,
More informationEpatite Cronica C Definizione dei Prototipi Clinici per la Personalizzazione Terapeutica Genotipo 4. Gloria Taliani Sapienza Università di Roma
Epatite Cronica C Definizione dei Prototipi Clinici per la Personalizzazione Terapeutica Genotipo 4 Gloria Taliani Sapienza Università di Roma Genotype 4 HCV Virus Predictors of SVR IL28B, Insulin Resistance,
More informationHepatitis C Virus (HCV) & Infectious Disease 101 for Hubs & Spokes April 24, :00 pm 1:00 pm
Hepatitis C Virus (HCV) & Infectious Disease 101 for Hubs & Spokes April 24, 2018 12:00 pm 1:00 pm Presenters: Thomas E. Freese, PhD, Larissa Mooney, MD, & Rachel McLean, MPH, Chief, Office of Viral Hepatitis
More informationHBV/HIV Co-infection in sub-saharan Africa CWN Spearman
HBV/HIV Co-infection in sub-saharan Africa CWN Spearman Division of Hepatology Department of Medicine Groote Schuur Hospital & University of Cape Town HIV/HBV Co-infection Outline of Talk Epidemiology
More informationHepatitis B infection
Hepatitis B infection Kenneth Kabagambe Executive Director The National Organization for People Living with Hepatitis B (NOPLHB Uganda General introduction: Viral hepatitis in Uganda Viruses that affect
More informationCases: Treatment of Hepatitis C in Patients with Cirrhosis and Advanced Liver Disease
Slide 1 of 20 Cases: Treatment of Hepatitis C in Patients with Cirrhosis and Advanced Liver Disease Kenneth E. Sherman, MD, PhD Gould Professor of Medicine Director, Division of Digestive Diseases University
More informationHepatitis B. What's the impact on the risk? Dr Himanshu Bhatia, Asia Chief Medical Officer ALUCA, Brisbane, Sept 2013
Hepatitis B What's the impact on the risk? Dr Himanshu Bhatia, Asia Chief Medical Officer ALUCA, Brisbane, Sept 2013 Some quick facts about Hepatitis B Worldwide: 350-400 Million are chronic infections
More informationCurrent Status of HBV and Liver Transplant
Current Status of HBV and Liver HBV as Indication for Liver ation in U.S. Significant decrease in rate of wait listing for decompensated cirrhosis since 2003 (since s) No change in rate of wait listing
More informationHepatitis Delta. Vicente Soriano Infectious Diseases Unit La Paz University Hospital & IdiPAZ Madrid, Spain
Hepatitis Delta Vicente Soriano Infectious Diseases Unit La Paz University Hospital & IdiPAZ Madrid, Spain Disclosures Member of speaker bureau and advisory board for: Roche, Boehringer, Gilead, Viiv,
More informationBHIVA Workshop: When to Start. Dr Chloe Orkin Dr Laura Waters
BHIVA Workshop: When to Start Dr Chloe Orkin Dr Laura Waters Aims To use cases to: Review new BHIVA guidance Explore current data around when to start To discuss: Medical decisions, pros and cons Luigi
More informationBible Class: Hepatitis B Virus Infection
Bible Class: Hepatitis B Virus Infection Nasser Semmo UVCM, Hepatology What is the HBV prevalence? 2 Hepatitis B Worldwide approx. 350 Mio. chronically infected with HBV Approx. 40% of the world population:
More informationReport Back from CROI 2010
Report Back from CROI 2010 Conference on Retroviruses and Opportunistic Infections Edwin Charlebois, MPH PhD Associate Professor of Medicine Department of Medicine University of California, San Francisco
More informationHepatitis B Virus therapy. Maria Buti Hospital Universitario Valle Hebron Barcelona Spain
Hepatitis B Virus therapy Maria Buti Hospital Universitario Valle Hebron Barcelona Spain Disclosures Advisor: AbbVie, Boehringer Ingelheim, Bristol-Myers Squibb, Gilead Sciences, Janssen, Merck Sharp &
More informationS401- Updates in the Treatments of Hepatitis B & C
S401- Updates in the Treatments of Hepatitis B & C Ruben Gonzalez-Vallina, MD Director of Gastroenterology Outpatient Initiatives Miami Children s Hospital Miami, Florida Disclosure of Relevant Relationship
More informationSpecial developments in the management of Hepatitis C. Disclosures
Special developments in the management of Hepatitis C Sandeep Mukherjee,MD Division of Gastroenterology CHI Health and Creighton University Medical Center Omaha, NE 68154 Sandeep.Mukherjee@alegent.org
More informationManagement of Acute HCV Infection
Management of Acute HCV Infection This section provides guidance on the diagnosis and medical management of acute HCV infection, which is defined as presenting within 6 months of the exposure. During this
More informationSupervivencia a 5 años de Pacientes Coinfectados por VHC-VIH Trasplantados Hepáticos: un Estudio de Casos y Controles
I Congreso de GESIDA Madrid, 21-24 de Octubre del 2009. Supervivencia a 5 años de Pacientes Coinfectados por VHC-VIH Trasplantados Hepáticos: un Estudio de Casos y Controles José M. Miró, 1 Miguel Montejo,
More informationHepatitis C in Disclosures
Hepatitis C in 2018 Sandeep Mukherjee, MD CHI Health and Creighton University Medical Center Division of Gastroenterology Grant support: Abbvie Disclosures Speaker: Abbvie, Gilead, Merck Section editor
More informationUpdate on Hepatitis B and Hepatitis C
Update on Hepatitis B and Hepatitis C Catherine Stedman Department of Gastroenterology, Christchurch Hospital and University of Otago, Christchurch Disclosures I have the following financial relationships
More informationJMSCR Volume 03 Issue 01 Page January 2015
www.jmscr.igmpublication.org Impact Factor 3.79 ISSN (e)-2347-176x Seroprevalence of HBV among HIV Patients and Blood Donors Author Dr. Vedavati B I 1, Dr. Amrutha Kumari B 2, Dr. Venkatesha D 3 Mysore
More informationIntron A Hepatitis B. Intron A (interferon alfa-2b) Description
Federal Employee Program 1310 G Street, N.W. Washington, D.C. 20005 202.942.1000 Fax 202.942.1125 5.01.01 Subject: Intron A Hepatitis B Page: 1 of 7 Last Review Date: November 30, 2018 Intron A Hepatitis
More informationEpidemiology of hepatitis B and D in Greece
Epidemiology of hepatitis B and D in Greece George V. Papatheodoridis Assistant Professor in Medicine & Gastroenterology 2nd Department of Internal Medicine, Athens University Medical School, Hippokration
More informationHIV and Hepatocellular Carcinoma. Dr Kosh Agarwal Institute of Liver Studies King s College Hospital Rome May 2013
HIV and Hepatocellular Carcinoma Dr Kosh Agarwal Institute of Liver Studies King s College Hospital Rome May 2013 1 In theory, there is no difference between theory and practice In practice there is Chuck
More informationHepatitis B Epidemiology and Prevention in the Elimination Era John W. Ward, MD
Hepatitis B Epidemiology and Prevention in the Elimination Era John W. Ward, MD Director, Program for Viral Hepatitis Elimination, Task Force for Global Health Senior Scientist, National Center for HIV/AIDS,
More informationDiscontinuation of Nucleotide or Nucleoside Analogue therapy for Chronic Hepatitis B infection
Discontinuation of Nucleotide or Nucleoside Analogue therapy for Chronic Hepatitis B infection Dr Abid Suddle Institute of Liver Studies King s College Hospital Why consider discontinuation of NA therapy?
More informationTreatment of Patients with HCV and HIV
Treatment of Patients with HCV and HIV BRUCE A. LUXON, MD, PHD, FACG ANTON AND MARGARET FUISZ CHAIR IN MEDICINE PROFESSOR AND CHAIRMAN DEPARTMENT OF MEDICINE GEORGETOWN UNIVERSITY Four Questions Is HIV/HCV
More informationChronic Hepatitis B: management update.
Chronic Hepatitis B: management update. E.O.Ogutu Department of clinical medicine & therapeutics, University of Nairobi. Physicians meeting,kisumu 2011. Background epidemiology Chronic hepatitis B (CHB)
More informationHCV in the Latino Community -Epidemiology, Natural History, Risk Factors, Screening and Diagnosis
HCV in the Latino Community -Epidemiology, Natural History, Risk Factors, Screening and Diagnosis Wari Allison MD, PhD Assistant Professor/Research Dept. of Medicine/Infectious Disease Medical Director
More informationProfessor Mark Nelson. Chelsea and Westminster Hospital, London, UK
Professor Mark Nelson Chelsea and Westminster Hospital, London, UK Treatment should be prioritized Treatment Indicated All naive and experienced pts with liver disease Prioritized Pts with fibrosis (F3)
More informationHEPATITIS C, ACUTE CRUDE DATA. Number of Cases 5 Annual Incidence a LA County 0.05 California b 0.10 United States b 0.68 Age at Diagnosis Mean 38
2016 Annual Morbidity Report HEPATITIS C, ACUTE a Rates calculated based on less than 19 cases or events are considered unreliable b Calculated from: CDC. Notice to Readers: Final 2016 Reports of Nationally
More informationJMSCR Vol 05 Issue 05 Page May 2017
www.jmscr.igmpublication.org Impact Factor 5.84 Index Copernicus Value: 83.27 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v5i5.09 A Correlative Study of Biochemical, Virological
More informationHepatitis C Update. Geri Brown, M.D. Associate Professor Department of Internal Medicine March 24, 2011
Hepatitis C Update Geri Brown, M.D. Associate Professor Department of Internal Medicine March 24, 2011 Outline n Educational Objectives Epidemiology and Natural History of Hepatitis C Current Treatment
More informationThe future of liver transplantation for viral hepatitis
The future of liver transplantation for viral hepatitis François Durand Hepatology & Liver Intensive Care Hospital Beaujon, Clichy University Paris Diderot France Liver transplantation in France 2013:
More informationHepatology for the Nonhepatologist
Hepatology for the Nonhepatologist Kenneth E. Sherman, MD, PhD Gould Professor of Medicine Director, Division of Digestive Diseases University of Cincinnati College of Medicine Cincinnati, Ohio Learning
More information26/09/2014. Types of Viral Hepatitis. Prevention of Viral Hepatitis as a Health Disparity for American Indians: Successes and Challenges
Rate per, Types of Viral Hepatitis A E B D C Prevention of Viral Hepatitis as a Health Disparity for American Indians: Successes and Challenges Source of virus Feces Feces Blood/bloodderived body fluids
More informationAcute Hepatitis C Are we finding it? Are we treating it? Dr Emma Page MBBS MRCP MD Chelsea and Westminster Hospital NHS Trust London
Acute Hepatitis C Are we finding it? Are we treating it? Dr Emma Page MBBS MRCP MD Chelsea and Westminster Hospital NHS Trust London Need sensitive & specific diagnostic tools Need a standardised case
More informationHCV Viremia Was Associated With Increased Mortality in a Prospective Taiwanese Cohort Study
Tram T. Tran, MD, FACG Approach to HCV Treatment in Patients with HCC Tram T. Tran, MD, FACG Professor of Medicine Medical Director, Liver Transplant Cedars Sinai Medical Center Natural History of HCV
More informationLong-term Clinical Outcomes and Risk of Hepatocellular Carcinoma in Chronic Hepatitis B Patients with HBsAg Seroclearance
Long-term Clinical Outcomes and Risk of Hepatocellular Carcinoma in Chronic Hepatitis B Patients with HBsAg Seroclearance Gi-Ae Kim, Han Chu Lee *, Danbi Lee, Ju Hyun Shim, Kang Mo Kim, Young-Suk Lim,
More informationInfluence of Baseline HCV Genotype upon Treatment Outcome of Acute HCV Infection in HIV Co-Infected Individuals
Influence of Baseline HCV Genotype upon Treatment Outcome of Acute HCV Infection in HIV Co-Infected Individuals Christoph Boesecke, Hans-Jürgen Stellbrink, Stefan Mauss, Emma Page, Mark Nelson, Sanjay
More informationHEPATITIS B: WHO AND WHEN TO TREAT?
HEPATITIS B: WHO AND WHEN TO TREAT? George V. Papatheodoridis Professor in Medicine & Gastroenterology Medical School of National & Kapodistrian University of Athens Director of Academic Department of
More informationPREVALENCE OF NAFLD & NASH
- - PREVALENCE OF & USA Prevalence in Middle Age Patients San Antonio, Texas (Williams et al., Gastroenterology 2011; 140:124-31) Dallas Heart Study Prevalence Numbers (Browning et al., Hepatology 2004;40:1387-95)
More informationUpdates in the Treatment of Hepatitis C
Disclosures Updates in the Treatment of Hepatitis C Arslan Kahloon M.D Assistant Professor of Medicine University of Tennessee, Chattanooga I have no conflicts of interest or financial sponsorship to disclose
More information