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
Part I: Investigating the Liver
1 Non-invasive markers of fibrosis: how reliable are they?
Laurent Castera
2 Liver biopsy in chronic liver disease: Is there still life left in it?
Michael Curry (Boston)
3 Screening for hepatocellular carcinoma in viral liver disease: Any new biomarkers on the horizon?
Amit Singal
4 Realistic estimates of HCV and HBV disease burden
Homi Razavi
Part II: Today's Therapies
Section 1: HCV
5 Acute hepatitis: treat immediately or give a chance to spontaneously clear?
David Kaplan
6 Is RBV alive or dead in current era of HCV therapy?
Paul Kwo
7 HCV genotype and viral testing, and on treatment monitoring: Necessary or an overkill?
Sirina Ekpanyapong and Reddy
8 Treatment of HCV in renal disease: can we use all the drugs without additional monitoring?
Stanilas Pol
9 Does directly acting antiviral therapy improve quality of life?
Dan Forton
10 Morbid obesity and hepatitis C: treat as normal or are there additional issues to consider?
Manuel Romero Gomez
11 Generic Directly Acting Antiviral Agents (DAAs): Do They Work Well?
Seng Gee Lim (Singapore)
12 Impact and management of patients with multiple HCV genotypes
Peter Ferenci
13 HCV and injecting drug users: What are the challenges
Olav Dalgard
14 HBV reactivation while on HCV DAA therapy: Is that a real concern and when is it a concern?
Marina Serper
15 Drug-drug interactions with DAAs – when do we need to care?
David Back
16 Treatment of hepatitis C in children
Maureen M. Jonas
17 While DAAs are effective, are there any unique safety considerations:
Marc Bourliere
18 Harm reduction strategies to prevent new infections and re-infections among people who inject drugs: How effective are they?
Jason Greberly (Australia)
19 HCV therapy in advanced liver disease: treat or transplant and treat
Bunchorntavakul and Reddy
20 Hepatocellular Carcinoma and Hepatitis C Virus: Which Should be Treated First?
Massimo Colombo
21 Should we incentivise patients to take HCV therapy
Ed Gane
22 Treating prisoners with hepatitis C – should we do it and how?
William Rosenberg
23 Use of HCV positive organ for uninfected recipients in the era of effective DAAs- PROS and CONS
Sirina Ekpanyapong and K. Rajender Reddy
24 Is real life HCV therapy as effective as in clinical trials?
Joseph Lim-Yale
Section 2: HBV, HDV, and HEV
25 Management of acute HBV infection – when should we offer antiviral therapy?
David John Mutimer
26 Rethinking the Inactive Carrier State: Management of Patients with Low-Replicative HBeAg Negative Chronic Hepatitis B and Normal Liver Enzymes
Maria Buti
27 HBeAg positive chronic hepatitis B infection with minimal changes on liver biopsy – what to do next
Patrick Kennedy
28 The Management of Hepatitis B Virus in Pregnancy
Henry Chan
29 Treatment of hepatitis B in children
Maureen M. Jonas
30 Hepatitis B Vaccine failures: How do we handle them?
Dani Shouval
31 The stopping rules in HBV therapy: Can we provide any guidance
T Berg
32 Hepatitis C and hepatitis B co-infection
JH Kao (Taiwan)
33 Chronic HEV infection: Is it reality or hype and where does it matter
N Kamar
34 HEV vaccines: Have they arrived -- when, where and for whom?
Rakesh Aggarwal
Part III: Clinical Set-up and the Future
35 Do we need expert HCV treaters or are amateur treaters good enough as we move forward
Shyam Kottilil (University of Maryland)
36 HCV vaccines: how close are we to the promised land?
Ellie Barnes (Oxford)
37 Elimination of HCV in high prevalence, low income countries - is it feasible?
Mahmoud Abdo, MD Dr.Hadeel Gamal Eldeen,
38 HBV diagnostics: Anything new
Robert Gish
Part V: On-going Controversies
39 Is HCC risk impacted favourably or unfavourably after successful HCV therapy by DAAs
Antonio Craxi
40 Global Elimination of HCV by 2030: The optimistic view
Greg Dore
41 Global Elimination of HCV by 2030: The pessimistic view
Michael Charlton
K. Rajender Reddy MD, FACP, FACG, FRCP is Ruimy Family President Distinguished Professor of Medicine, Professor of Medicine in Surgery, Director of Hepatology, Medical Director of Liver Transplantation, University of Pennsylvania, PA, USA.
Graham R Foster PhD, FRCP is Professor of Hepatology, Queen Mary University of London, Blizard Institute of Cell & Molecular Science, The Royal London Hospital, London, UK.
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