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Hepatitis C Virus Postexposure Prophylaxis in the Healthcare Worker: Why Direct-Acting Antivirals Don't Change a Thing

Currently, 380 000–400 000 occupational exposures to blood-borne pathogens occur annually in the United States. The management for occupational HIV or hepatitis B virus exposures includes postexposure prophylaxis (PEP) when necessary; however, PEP is not recommended for hepatitis C virus (HCV) exposures. Recent approval of HCV direct-acting antivirals (DAAs) has renewed discussions ...

A Systematic Review of Hepatitis E Virus Infection in Children

A systematic review was conducted, seeking all literature relevant to the epidemiology, clinical and laboratory features, and outcome of hepatitis E virus (HEV) infection in children. Transmission is thought to be primarily from fecal–oral transmission, with the role of transmission from animal reservoirs not being clear in children. Worldwide, seroprevalence is <10% up to 10 years ...

Evaluation of the Hepatitis C Virus–Infected Patient: The Initial Encounter

Deaths from hepatitis C virus (HCV)–related disease are increasing, now exceeding those from human immunodeficiency virus. Up to 7 million Americans (2.3%) may be infected with HCV, and more than half are undiagnosed. Proposed expansion of hepatitis C screening to include all persons born between 1945 and 1965 will lead to many new diagnoses, and infectious diseases physicians have ...

Advances in Therapy for HIV/Hepatitis C Virus–Coinfected Patients in the Liver Transplant Setting

Complications of cirrhosis due to hepatitis C virus (HCV) are increasing, and liver transplantation (LT) is the most effective treatment for those with liver decompensation or small hepatocellular carcinoma. However, for patients with human immunodeficiency virus (HIV) coinfection, barriers to LT exist. This is related to the poorer survival rates post-LT (55% at 5 years) and, up ...

Update on the Treatment of Patients With Non–Genotype 1 Hepatitis C Virus Infection

Current treatment for patients with non–genotype 1 hepatitis C virus infection consists of pegylated interferon plus ribavirin for 24 weeks, which leads to sustained virologic response (SVR) rates of 65%–80%. In the United States, the ribavirin dose for genotypes 2 and 3 is 800 mg/day. However, the use of weight-based ribavirin allows for the potential to shorten the duration of ...

HIV/Hepatitis C Virus–Coinfected Patients and Cirrhosis: How to Diagnose It and What to Do Next?

Liver disease, specifically cirrhosis, is a leading cause of morbidity and mortality in human immunodeficiency virus (HIV)–infected patients. The diagnosis of early cirrhosis in HIV/hepatitis C virus (HCV)–coinfected patients may be challenging. The development of noninvasive methods for fibrosis assessment empowers the infectious disease specialist to diagnose advanced fibrosis or ...

Elimination of Hepatitis C Virus Infection Among People Who Inject Drugs Through Treatment as Prevention: Feasibility and Future Requirements

The demonstration that antiretroviral treatment is effective for the prevention of human immunodeficiency virus (HIV) transmission has important implications for HCV prevention. HCV therapeutic development is advancing rapidly, with effective, simplified regimens available in the near future. In contrast to HIV, HCV treatment is both curative and circumscribed in duration—2 ...

Closing in on the Target: Sustained Virologic Response in Hepatitis C Virus Genotype 1 Infection Response-Guided Therapy

Retrospective analyses of the boceprevir and telaprevir phase 3 trial data demonstrate the clinical relevance of detected but not quantifiable hepatitis C virus (HCV) genotype 1 RNA during treatment. These analyses illustrate the importance of using precise and standard terminology in reporting low-level HCV RNA results for consistent data collection across clinical trials, and to ...

Hepatitis B Testing and Vaccination Among Adults With Sexually Transmitted Infections in a Large Managed Care Organization

Data on viral hepatitis B (HBV) testing and vaccination in primary care settings among persons at sexual risk for HBV infection have been sparse. We examined rates and factors associated with HBV serologic testing and vaccination rates in adults infected with sexually transmitted infections. We conducted a retrospective cohort study of adults diagnosed with chlamydia, gonorrhea, or ...

Hepatitis C Therapy: Highlights From the 2012 Annual Meeting of the European Association for the Study of the Liver

The results from clinical trials testing new direct-acting antivirals (DAAs) for chronic hepatitis C were the major focus of interest at the 2012 annual meeting of the European Association for the Study of the Liver. Besides triple combinations, in which any one of the new DAAs is given along with peginterferon-α/ribavirin, clinical trials exploring interferon-free oral regimens ...

Revisiting the Predictors of a Sustained Virologic Response in the Era of Direct-Acting Antiviral Therapy for Hepatitis C Virus

Several host (age, sex, race, fibrosis stage, interleukin 28B polymorphism) and viral factors (hepatitis C virus [HCV] genotype, viral load) allow estimating the response to interferon-based therapies (which includes first-generation protease inhibitors) before treatment. However, treatment should not be denied to any patient based on unfavorable factors alone. Metabolic conditions ...

First Things First: Balancing Hepatitis C and Human Immunodeficiency Virus

Camilla S. Graham () 0 Margaret James Koziel 0 0 Beth Israel Deaconess Medical Center and Harvard Medical School , Boston, Massachusetts Persons who are coinfected with HIV and hepatitis C virus

CD8+ Cell Responses to Hepatitis C Virus (HCV) in the Liver of Persons with HCV-HIV Coinfection versus HCV Monoinfection

ObjectiveCellular immune responses are difficult to detect in the peripheral blood of persons with chronic hepatitis C virus (HCV) infection. We sought to determine whether T cell responses were present in the liver of patients with human immunodeficiency virus (HIV) and HCV coinfection MethodsT cells were expanded from liver-biopsy samples from 10 patients coinfected with HIV and ...

Imported Fasciola hepatica Infection in the United States and Treatment with Triclabendazole

Infection with Fasciola hepatica, a liver trematode, is not frequently reported in the United States. We describe 2 patients, both originally from Cape Verde, who illustrate the spectrum of clinical presentations of F. hepatica as well as the means of treating infection with this parasite. Patient 1 had extensive disease and underwent multiple diagnostic procedures before the ...

Effect of Exposure to Injection Drugs or Alcohol on Antigen-Specific Immune Responses in HIV and Hepatitis C Virus Coinfection

Background. Ongoing substance use is a potential confounder for immunological studies on hepatitis C virus (HCV), but there is little in the literature regarding the effects of injection drug use (IDU) or alcohol on HCVspecific immune responses. We wanted to determine whether IDU or alcohol affected immune responses in HCVinfected and human immunodeficiency virus (HIV)/HCV ...

Kinetics of Intrahepatic Hepatitis C Virus (HCV)-Specific CD4+ T Cell Responses in HCV and Schistosoma mansoni Coinfection: Relation to Progression of Liver Fibrosis

The kinetics of intrahepatic hepatitis C virus (HCV)-specific CD4+ T cell responses and their role in progression of fibrosis have not previously been characterized. Subjects with HCV/Schistosoma mansoni coinfection have a more rapid progression of HCV liver fibrosis than do those with HCV infection alone. The present prospective longitudinal study compared the liver histology, ...