Quick Hits

The advent of direct acting antivirals (DAAs) in the treatment of chronic hepatitis C infection has been revolutionary in that they have drastically mitigated the side effects of therapy while enhancing efficacy relative to interferon-based therapy. DAAs are broadly categorized into the NS3/4A protease inhibitors, NS5A inhibitors, and the non-nucleoside and nucleotide NS5B inhibitors. Ribavirin, […]

Quick Hits

Evidence from a few randomized trials and multiple observational studies supports performing a liver ultrasound every six months as part of hepatocellular carcinoma (HCC) surveillance in patients with hepatitis C virus-related cirrhosis (HCVc). Although the possibility of using other technical modalities is tempting, there are concerns regarding radiation exposure and cost. Use of multiphase computed […]

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 […]