Quick Hits

The prevalence of hepatitis C (HCV) in dialysis patients is higher than that of the general population, ranging from 1.8 to 8 percent in developed countries, with much higher rates in the developing world. Its prevalence correlates with the number of patient-years on dialysis. HCVinfected patients on maintenance dialysis experience increased mortality compared to uninfected […]

Quick Hits

The connection between nutrition and gastroenterology should be intuitive given that gastroenterology involves the study of the organ system responsible for the digestion and absorption of nutrients. However, in my experience, nutrition is often an afterthought, being considered only after disease has negatively impacted an individual’s nutritional status. In the early years of gastroenterology, Dr. […]

Debates

Histologic assessment of liver disease has been a cornerstone of therapeutic decisions and predicting prognosis in chronic liver disease for much of modern hepatology. Although we still regard liver biopsy as the gold standard for assessment of injury, inflammation and fibrosis stage, its clinical application for chronic hepatitis C (HCV) has significantly decreased over the […]

Debates

Given the option of a diagnostic procedure that is invasive, even with a small risk of death, over a noninvasive equivalent, the choice seems obvious. As an analogy, why in 2016 would a patient with ulcerative colitis, a raised alkaline phosphatase level and suspected primary sclerosing cholangitis undergo ERCP first and not magnetic resonance cholangiopancreatography Now […]

Quick Hits

The hepatitis C virus is primed to develop resistance to direct acting antiviral drugs (DAAs). This stems from several aspects of HCV biology including an extraordinary rate of viral turnover in infected individuals and the error-prone nature of the viral RNA dependent RNA polymerase. Assumptions based on these characteristics led to modeling studies that predicted […]

Quick Hits

The patient was a 55-year-old, young grandmother who said, I’ve tried them all, as I reviewed her HCV treatment history, which included interferon (IFN), pegylated IFN, consensus IFN and now maintenance IFN. She pulled up her pant legs and said, My real problem is here. Her lower legs had hyperpigmentation on them but no obvious […]