Middle Eastern Diet Linked To Improved Microbiome in Liver Patients

MedicalResearch.com Interview with:

“Turkish Food” by Garry Knight is licensed under CC BY 2.0Jasmohan S. Bajaj, M.D.
Associate Professor
Department of Internal Medicine
Division of Gastroenterology
Virginia Commonwealth University 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Altered gut microbiota composition can occur due to diseases and due to changes in the dietary practices. The interaction between these two and their linkage with clinical outcomes in liver diseases, such as cirrhosis is not clear from an international standpoint.

In this study we enrolled healthy subjects, and patients with cirrhosis who were either early or advanced in their process from USA and Turkey. We found that the Turkish subjects, who followed a Middle-eastern diet rich in vegetables and fermented milk products, had high microbial diversity, which was in turn associated with lower hospitalizations over 3 months. There was also an additional beneficial effect of coffee and tea intake. This protection persisted even when the clinical factors were accounted for. Continue reading

Most Baby Boomers Still Aren’t Screened For Hepatitis C

MedicalResearch.com Interview with:

In the United States, hepatitis A, hepatitis B and hepatitis C are the most common types, but also included are hepatitis D and E. CDC/ E.H. Cook, Jr.

Hepatitis Virions
CDC/ E.H. Cook, Jr.

Dr. Monica Kasting PhD first author
Dr. Anna Giuliano PhD
Susan. T. Vadaparampil, Ph.D., M.P.H.
Senior Member/Professor
Center for Infection Research in Cancer
H. Lee Moffitt Cancer Center, Tampa,
Florida.Department of Cancer Epidemiology,
H. Lee Moffitt Cancer Center,
Tampa, Florida 

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: In the U.S., approximately 1 in 30 baby boomers are chronically infected with hepatitis C virus. Half of all cases of liver cancer are caused by hepatitis C and liver cancer is one of only three cancer types that are actually increasing in incidence in the US. Because of this, in 2012 the CDC issued a recommendation for universal screening for hepatitis C virus for everyone born between 1945 and 1965 (baby boomers). We wanted to look at the time period after that to see if the rates of screening in that population increased. From 2013-2015 screening among baby boomers only increased by 0.9% (from 11.8% to 12.7%) which indicates we still have a long way to go before we meet our goal of universal screening.  Continue reading

Obesity Linked to Increased Risk of Liver Cancer in Hepatitis B Patients

MedicalResearch.com Interview with:
Sang Min Park MD, MPH, PhD

Chief, Department of Family Medicine, Seoul National University College of Medicine
Director, Health Promotion Center, Seoul National University Hospital
Professor, Department of Biomedical Science & Family Medicine
Seoul National University College of Medicine
Seoul, Korea

What is the background for this study? What are the main findings?

Response: Chronic hepatitis B patients have a higher risk of hepatocellular carcinoma than the general population, which has been well-established and known to be caused by progression of hepatitis B infection into severe liver diseases.

However, whether obesity-related carcinogenesis plays a central role in the development of hepatocellular carcinoma in chronic hepatitis B patients remained unclear. Therefore, we assessed the association between body mass index and risk of hepatocellular carcinoma in chronic hepatitis B patients, and stratified all analyses by sex using healthcare big data in the Republic of Korea.

We found positive association of trends between body mass index and risk of hepatocellular carcinoma in both men and women with hepatitis B infection. The magnitude of the association in women was stronger than that of men. In the severely obese category, the hazard ratio for hepatocellular carcinoma was significantly higher in women compared to men. Our findings highlight that high body mass index is associated with risk of hepatocellular carcinoma in chronic hepatitis B patients, especially in women, which may be partially explained by higher fat content for the same unit of body mass index in women compared to men.

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‘Liver-on-a-Chip’ Technology Can Accurately Mimic Hepatitis B Infection

MedicalResearch.com Interview with:

Primary hepatocytes grown in 3D microfluidic “liver-on-a-chip” platform following infection with hepatitis B virus. Credit: Marcus Dorner/Imperial College London

Primary hepatocytes grown in 3D microfluidic “liver-on-a-chip” platform following infection with hepatitis B virus. Credit: Marcus Dorner/Imperial College London

Marcus Dorner, PhD
Non-Clinical Senior Lecturer in Immunology
Wellcome Trust Investigator
Imperial College London
Department of Medicine, Section of Virology
School of Medicine
London United Kingdom 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response:  Hepatitis B virus (HBV) infection globally affects over 250 million people and is currently not curable. This infection can lead to liver cirrhosis and liver cancer and is among the leading causes for liver transplantation. Unfortunately, HBV is among the most difficult viruses to study in the laboratory, since model systems are not very good at recapitulating what happens in infected humans.

We have just described the first model to effectively change this. Using an artificial “Liver-on-a-Chip”, we have developed a tool, which can potentially revolutionise how we study viral infections by merging the study of viruses with tissue engineering. This model is over 10,000-fold more susceptible to HBV infection and accurately mimics, what happens in an infected patient. This can now be utilised to develop novel and potentially curative therapies, which would benefit millions of people currently living with chronic HBV infection.  Continue reading

Hepatitis: 8 Weeks of Once Daily, Combination Pill Found Effective in HCV 1 and 3

MedicalResearch.com Interview with:

In the United States, hepatitis A, hepatitis B and hepatitis C are the most common types, but also included are hepatitis D and E. CDC/ E.H. Cook, Jr.

In the United States, hepatitis A, hepatitis B and hepatitis C are the most common types, but also included are hepatitis D and E.
CDC/ E.H. Cook, Jr.

Stefan Zeuzem, M.D.
Professor of Medicine
Chief Internal Medicine
Goethe University Hospital
Frankfurt, Germany

MedicalResearch.com: What is the background for this study? What are the main findings? 

Response: Chronic hepatitis C virus (HCV) infection is a major global public health problem with more than 71 million people infected worldwide, and can result in significant morbidity and mortality, including liver cirrhosis, hepatocellular carcinoma, and death.1

This publication describes the efficacy and safety results from two Phase 3 clinical trials, ENDURANCE-1 and ENDURANCE-3, in patients with chronic HCV genotypes (GT) 1 or 3 infection who were treated with an all-oral, once-daily combination regimen of direct-acting antiviral agents (DAA) glecaprevir (GLE) at 300 mg and pibrentasvir (PIB) at 120 mg.

The findings from ENDURANCE-1 trial show that the GLE/PIB combination regimen (G/P) given for 8 weeks to HCV GT1 chronically infected non-cirrhotic treatment-naïve or treatment-experienced (with sofosbuvir and/or interferon with ribavirin) patients was safe and well-tolerated, achieved high efficacy with a sustained virologic response at post-treatment week 12 (SVR12) rate >99% and was non-inferior to 12-week treatment with G/P.

The trial also included subjects who were co-infected with human immunodeficiency virus (HIV), and all of these subjects achieved SVR12 while maintaining HIV suppression throughout the study. ENDURANCE-3 trial results show that the G/P regimen given for 8 weeks to HCV GT3 chronically infected non-cirrhotic treatment-naïve patients was safe and well-tolerated, achieved high efficacy in this historically difficult to cure GT with an SVR12 rate >94%, and was non-inferior to 12-week treatment with G/P, which in turn was non-inferior to the treatment with 12-week DAA regimen of sofosbivir and daclatasvir.  Continue reading

Benefits of Transplanting Hepatitis C Infected Livers May Outweigh Risks

MedicalResearch.com Interview with:

Jagpreet Chhatwal, PhD Assistant Professor, Harvard Medical School MGH Institute for Technology Assessment Boston, MA

Dr. Chhatwal

Jagpreet Chhatwal, PhD
Assistant Professor, Harvard Medical School
MGH Institute for Technology Assessment
Boston, MA and

Sumeyye Samur PhD Postdoctoral Fellow MGH-Harvard Medical School

Dr. Samur

Sumeyye Samur PhD
Postdoctoral Fellow
MGH-Harvard Medical School

MedicalResearch.com: What is the background for this study?

Response: The number of patients who are in need of liver transplant continues to rise whereas the availability of organs remains limited, therefore, it becomes is important to utilize all available livers.

Under the current practices, only Hep-C infected patients are eligible to receive infected livers. However, with the advent of high efficacy drugs, number of infected recipients has decreased over the last decade. On the other hand, with the rise of opioid use, number of Hep-C infected organs increased. With this contradiction, it becomes paramount of importance to utilize the infected livers which could help save more lives on the transplant waiting list.

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The Global Liver Institute Launches NASH Council To Fight Insidious Liver Disease

MedicalResearch.com Interview with:

Donna R. Cryer, JD CEO, Global Liver Institute

Donna Cryer JD

Donna R. Cryer, JD

CEO, Global Liver Institute

MedicalResearch.com: What is the background for this Council?

Response: The Global Liver Institute operates my constantly assessing the liver health landscape for what we call advocacy gaps to determine where we allocate our time and resources. We identified NASH 2 years ago as an imminent global public health crisis due to the tens of millions of diagnosed and estimated undiagnosed patients rising with rates of obesity and diabetes with no concomitant recognition and activity by public, patients, or physicians. We decided to launch the NASH Council with collaborative patient and physician leadership and involving Hepatology but deliberately reaching out to primary care, endocrine, cardiology, and obesity organizations.
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Drinking Coffee Reduced Mortality in Treated HIV-Hepatitis C Co-Infected Patients

MedicalResearch.com Interview with:

Coffee Wikipedia image

Coffee
Wikipedia image

Patrizia Carrieri PhD
INSERM U912 – ORS PACA
IHU – Faculté de Médecine
Marseille, France

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: This study is based on the longitudinal data of the French  ANRS HEPAVIH cohort of patients with HIV and Hepatitis C co-infection. This cohort was set up thanks to a collaboration between INSERM (National Institute of health and medical research) UMR912 in Marseille, the ISPED (public health and epidemiology institute) in Bordeaux and several hospital/university sites. Our INSERM team in Marseille is specialized in the study of the impact of behaviors on HIV and HCV outcomes, including mortality.

We could think that HCV cure was enough to reduce mortality in HIV-HCV patients as the mortality risk was 80% lower in those who were cured of (i.e. who “cleared”) Hepatitis C thanks to treatment.

However, our study showed that, even after HCV cure, sociobehavioral factors still matter: drinking at least 3 cups of coffee a day was associated with a 50% reduction in mortality risk as well as not smoking which was also associated with a reduced mortality risk. This association between elevated coffee intake and reduced mortality risk is probably due to the properties of polyphenols contained in coffee which can protect the liver and also reduce inflammation.

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Liver Key To Development of Diabetic Vascular Complications

MedicalResearch.com Interview with:

Dr. Mauricio Berriel Diaz Deputy Director & Head of Division Metabolic Dysfunction and Cancer Institute for Diabetes and Cancer IDC Helmholtz Center Munich and Joint Heidelberg-IDC Translational Diabetes Program Heidelberg University Hospital, Molecular Metabolic Control Medical Faculty, Technical University Munich Neuherberg, Germany

Dr. Berriel Diaz

Dr. Mauricio Berriel Diaz
Deputy Director & Head of Division Metabolic Dysfunction and Cancer
Institute for Diabetes and Cancer IDC
Helmholtz Center Munich and
Joint Heidelberg-IDC Translational Diabetes Program
Heidelberg University Hospital, Molecular Metabolic Control
Medical Faculty, Technical University Munich
Neuherberg, Germany 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Our institute takes part in a german collaborative research consortium (https://www.klinikum.uni-heidelberg.de/index.php?id=132204&L=1), in which the key objective is to understand why in diabetes mellitus late complications occur even when blood sugar is well controlled.

Our study focused the role of the liver and of inflammatory signaling, as the latter is known to be increased in metabolic diseases such as obesity and diabetes mellitus. We found that TNF-α-induced reactive oxygen species (ROS) formation in the liver abolished the function of the transcription factor GAbp. Impaired hepatic GAbp function resulted in transcriptional inactivation of the cellular energy sensor AMPK, which in turn induced hepatic cholesterol secretion, hypercholesterolemia and eventually atherosclerotic lesion formation.

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Hepatitis C Can Be Safely Treated By Primary Care Providers

MedicalResearch.com Interview with:

Sarah Kattakuzhy, MD Clinical and Administrative Director, DC PFAP Hepatitis Clinical Research Program Assistant Professor, Institute of Human Virology Division of Infectious Diseases University of Maryland 

Sarah Kattakuzhy, MD
Clinical and Administrative Director, DC PFAP Hepatitis Clinical Research Program
Assistant Professor, Institute of Human Virology
Division of Infectious Diseases
University of Maryland  

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: The recent introduction of highly effective, well-tolerated direct-acting antiviral (DAA) therapy for hepatitis C virus infection has raised the possibility of rapid treatment expansion and widespread cure. However, the current specialist workforce is insufficient to meet the treatment demands of the 2.7 million Americans living with HCV infection. Several studies of partial task shifting—shared treatment between specialists and primary care providers—have demonstrated success in improving access to HCV care. Yet, information on the success of nonspecialists practicing independent of specialist supervision is limited.

The primary objective of ASCEND was to evaluate the efficacy of Hepatitis C treatment managed independently by 3 community-based provider types—nurse practitioners (NPs), PCPs, and specialists—after a succinct, guideline-driven educational intervention, set within a real-world, urban population.

In this investigation, 516 out of 600 patients achieved SVR, a response rate of 86% (95% CI, 83.0% to 88.7%), with no major safety signals. Rates of SVR were consistent across the 3 provider types—NPs: 89.3% (CI, 83.3% to 93.8%); PCPs: 86.9% (CI, 80.6% to 91.7%); and specialists: 83.8% (CI, 79.0% to 87.8%). Patient loss to follow-up was the major cause of non-SVR.

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