Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0024591 (malignant hyperthermia)
 2,353 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Treatment of hepatitis C virus (HCV)-infected patients with cirrhosis remains challenging. Biopsy to stage liver fibrosis remains the standard for identifying cirrhosis, although the noninvasive technique of transient elastography is promising in this regard. Cirrhosis is categorized as compensated or decompensated, with the latter characterized by ascites, hepatic hydrothorax, bleeding varices, hepatic encephalopathy, and hepatorenal syndrome. In the interferon alfa treatment era, patients with compensated cirrhosis have been candidates for interferon alfa-based treatment, whereas those with decompensated cirrhosis have been treated with caution and only at a tertiary care or transplant center. New interferon alfa-free regimens offer safer treatment alternatives to patients with cirrhosis. Response to interferon alfa-based therapy alone and in combination with the first-generation HCV protease inhibitors boceprevir or telaprevir for the treatment of HCV genotype 1 infection has been poorer in patients with cirrhosis than in those without. With regimens that include newer direct-acting antivirals, response rates are tremendously improved for patients with cirrhosis but still slightly lower than those for patients without cirrhosis. As new regimens enter use outside of clinical trials, optimizing efficacy for patients with cirrhosis will be an important goal. Patients with cirrhosis must be taught to practice liver wellness following HCV cure, to lower the risk of progression of their liver disease. Risk of hepatocellular carcinoma also persists in patients with cirrhosis even if cure of HCV infection is achieved. The risk of these complications is dramatically reduced with cure of HCV infection through antiviral treatment. This article summarizes a presentation by Andrew J. Muir, MD, MHS, at the IAS-USA continuing education program held in Atlanta, Georgia, in September 2013.
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PMID:Cirrhosis in hepatitis C virus-infected patients: a review for practitioners new to hepatitis C care. 2539 70

There is evidence that hepatitis C virus (HCV) infection, like HIV infection, may be associated with chronic inflammation, immune activation, and immune senescence, which contribute to increased risks for cardiometabolic or other diseases outside the liver, as well as to ongoing damage in the liver. These effects may persist after a sustained virologic response (SVR) is achieved with HCV therapy. Such findings support initiation of treatment for HCV-infected individuals before damage to the liver is apparent and monitoring of individuals for complications even after an SVR is achieved. Fibrosis is not always reversible after SVR is achieved, and this should serve as an argument against waiting until fibrosis develops before initiating treatment for HCV-infected individuals. This article summarizes a presentation by Susanna Naggie, MD, MHS, at the IAS-USA continuing education program, Management of Hepatitis C Virus in the New Era: Small Molecules Bring Big Changes, in New York, New York, in September 2015.
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PMID:Hepatitis C Virus, Inflammation, and Cellular Aging: Turning Back Time. 2840 27

Direct-acting antiviral (DAA) regimens now allow treatment of previously untreated or treated (including prior DAA failures) patients with chronic hepatitis C virus (HCV) infection with 8 or 12 week regimens, largely without the use of ribavirin. Newer next-generation pan-genotypic regimens with activity against resistance-associated substitutions include glecaprevir/pibrentasvir (GLE/PIB), a combination of a nonstructural protein (NS)3 protease inhibitor and an NS5A inhibitor, and sofosbuvir/velpatasvir/voxilaprevir (SOF/VEL/VOX), a combination of an NS5B polymerase inhibitor, NS5A inhibitor, and NS3 protease inhibitor. Both regimens have indications in DAA-experienced patients. GLE/PIB is approved for treatment of patients with genotype 1, 2, 3, 4, 5, or 6 infection without cirrhosis or with compensated cirrhosis and for the treatment of patients with genotype 1 infection previously treated with a regimen containing an NS5A inhibitor or an NS3/4A protease inhibitor, but not the combination. SOF/VEL/VOX is approved for retreatment of patients without cirrhosis or with compensated cirrhosis with genotype 1, 2, 3, 4, 5, or 6 infection previously treated with an NS5A inhibitor-containing regimen, or with genotype 1a or 3 previously treated with a SOF-containing regimen without an NS5A inhibitor. This article summarizes an IAS-USA webinar given by Susanna Naggie, MD, MHS, on August 30, 2018.
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PMID:Treating HCV Infection: It Doesn't Get Much Better Than This. 3064 83