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Highest Rated Articles

Torriani FJ, Rodriguez-Torres M, Rockstroh JK, et al. Peginterferon Alfa-2a plus Ribavirin for Chronic Hepatitis C Virus Infection in HIV-Infected Patients. NEJM. 2004:351:438-450.

Muir A, Bornstein J, Killenberg P. Peginterferon Alfa-2b and Ribavirin for the Treatment of Chronic Hepatitis C in Blacks and Non-Hispanic Whites. NEJM. 2004; 350:2265-2271.

Chung RT, Andersen J, Volberding P, et al. Peginterferon Alfa-2a plus Ribavirin versus Interferon Alfa-2a plus Ribavirin for Chronic Hepatitis C in HIV-Coinfected Persons. NEJM. 2004:351:451-459.

With the advent of HAART therapy recent years, treatment of human immunodeficiency virus (HIV) infection has undergone tremendous progress. Given the high prevalence of chronic hepatitis C in the HIV patient population, liver disease and cirrhosis has become a major cause of mortality and morbidity. Initial studies of antiviral therapy raised concerns regarding low efficacy and the potential for toxicity associated with combination therapy. The two studies reported here by Torriani et al and Chung et al suggest the reasonable efficacy and safety of pegylated interferon and ribavirin therapy. Similar to immunocompetent patients, the combination of pegylated interferon and ribavirin was superior to monotherapy or to the standard interferon and ribavirin combination. Although treatment-related cytopenias were commonly reported, these regimens were generally delivered in a safe fashion. These two studies make important contributions to the literature and provide clinicians additional support for treating patients with HIV/HCV co-infection.

Hasan F, Asker H, Al-Khaldi J, et al. Peginterferon Alfa-2b Plus Ribavirin for the Treatment of Chronic Hepatitis C Genotype 4. Am J Gastro. 2004:99:1733-37.

The prevalence of chronic hepatitis C is relatively high in the Middle East, especially in Egypt. Unlike the United States, the predominant type of HCV in Egypt is genotype 4. Large clinical trials of regimens used to treat chronic hepatitis have generally been conducted in Europe and North America, with only a small proportion of patients having HCV genotype 4. Recent data suggest that patients with chronic hepatitis C genotype 4 have lower rates of response to antiviral therapy as compared with HCV genotypes 2 and 3. On the other hand, their response seems to be better than those with HCV genotype 1. This study reports a relatively large number of patients with HCV genotype 4 from Egypt who were treated with a combination of pegylated interferon and ribavirin. As previously suspected, the study reports a viral eradication rate higher than that for HCV genotype 1 but lower than for genotypes 2 and 3. One of the obvious shortcomings of the study is its open-label design, which negatively impacts the strength of evidence provided by it. Nevertheless, this report is an excellent addition to the literature, providing valuable information regarding the efficacy of antiviral therapy in patients with chronic hepatitis C genotype 4.

Garcia-Retortillo M, Forns X, Llovet JM, et al. Hepatitis C recurrence is more severe after living donor compared to cadaveric liver transplantation. Hepatology. 2004; 40:699-707.

Chronic hepatitis C is the most common cause of cirrhosis and the most frequent indication for liver transplantation in the United States. With increasing numbers of patients waiting for liver transplantation, there is an increasing shortage of organs available. This shortage has led to alternative strategies to provide transplant options for these patients. Although commonly used in pediatric liver transplantation, living donor liver transplantation (LDLT) has also become an alternative for adults. This study by Garcia-Retortillo et al suggests that the outcome of patients with hepatitis C undergoing LDLT may not be very good. If confirmed, these important data could limit transplant options offered for HCV patients. Given that HCV is the most common indication for transplantation, the impact on these patients could be substantial.

Jeffers L, Cassidy W, Howell C, Hu S, Reddy K. Peginterferon alfa-2a (40 kd) and ribavirin for black American patients with chronic HCV genotype 1. Hepatology. 2004;39:1702-08.

In the United States, the prevalence of chronic hepatitis C is higher in minorities including Black Americans. Over the past decade, there has been increasing data suggesting a lower rate of disease progression in Black Americans. However, those who do develop cirrhosis seem to be at a higher risk for hepatocellular carcinoma. On the other hand, the efficacy of antiviral therapy has been reported to be lower in Black Americans. Although initially this lower rate was attributed to HCV genotype 1-the most common genotype in Black Americans-more recent data suggest a lower response rate regardless of HCV genotype. In this case, host factors may be playing an important role. In the two recently published studies by Muir et al and Jeffers et al, the efficacy of two combination regimens (pegylated interferon alfa-2b and ribavirin, and pegylated interferon alfa-2a and ribavirin) in Black American are reported. Both studies confirmed relatively lower rates of response (19% and 26%, respectively) in Black Americans. Despite these low viral eradication rates, some histologic improvement was reported. Additionally, the safety issues were similar to what has previously been reported. These important studies confirm relatively lower rates of response of antiviral therapy in Black Americans.

Wiegand J, Jackel E, Cornberg M, et al. Long-term follow-up after successful interferon therapy of acute hepatitis C. Hepatology. 2004;40:98-107.

Although clinically rare, acute hepatitis C has been shown to be highly responsive to interferon alfa therapy. Although previous short-term outcomes are available, long-term outcomes have not been available. This study is the first long-term follow-up on the efficacy of interferon alfa for acute HCV infection. The report confirms that long-term viral eradication is sustained in the vast majority of these patients. Additionally, the study suggests the marker of humoral and cellular immunity may attenuate over time. Both issues are very important in the long-term management of HCV patients who are successfully treated with antiviral therapy.

American Journal of Gastroenterology
Rating	Article Title
	Coppola AG, Karakousis PC, Metz DC, et al. Hepatitis C Knowledge among Primary Care Residents: Is Our Teaching Adequate for the Times? Am J Gastro. 2004;99:1720-25.
	Pockros PJ, Carithers R, Desmond P, et al. Efficacy and Safety of Two-Dose Regimens of Peginterferon Alpha-2a Compared with Interferon Alpha-2a in Chronic Hepatitis C: A Multicenter, Randomized Controlled Trial. Am J Gastro. 2004:99:1298-305.
	Soffredini R, Rumi MG, Parravicini ML, et al. Serum Levels of Hepatitis C Virus Core Antigen as a Marker of Infection and Response to Therapy. Am J of Gastro. 2004:99:1738-43.
	Sullivan SD, Jensen DM, Bernstein DE, et al. Cost-Effectiveness of Combination Peginterferon a-2a and Ribavirin Compared With Interferon a-2b and Ribavirin in Patients With Chronic Hepatitis C. Am J of Gastro. 2004:99:1490-96.
	Jacobson IM, Ahmed F, Russo MW, et al. Interferon Alpha-2b and Ribavirin for Patients with Chronic Hepatitis C and Normal ALT. Am J of Gastro. 2004;99:1700-05.
	Adams LA, Lindor KD, Angulo P. The Prevalence of Autoantibodies and Autoimmune Hepatitis in Patients with Nonalcoholic Fatty Liver Disease. Am J Gastro. 2004:99:1316-20.
	Verma S, Gunuwan B, Mendler M, Govindrajan S, Redeker A. Factors Predicting Relapse and Poor Outcome in Type I Autoimmune Hepatitis: Role of Cirrhosis Development, Patterns of Transaminases During Remission and Plasma Cell Activity in the Liver Biopsy. Am J Gastro. 2004:99:1510-6.
	Bruden DL, McMahon BJ, Hennessy TW, et al. Estimating the Date of Hepatitis C Virus Infection from Patient Interviews and Antibody Tests on Stored Sera. Am J Gastro. 2004:99:1517-22.
Gastroenterology
Rating	Article Title
	Lauer GM, Barnes E, Lucas M, et al. High resolution analysis of cellular immune responses in resolved and persistent hepatitis C virus infection. Gastro. 2004;127:924-36.
Hepatology
Rating	Article Title
	Mauss S, Berger F, Goelz J, Jacob B, Schmutz G. A prospective controlled study of interferon-based therapy of chronic hepatitis C in patients on methadone maintenance. Hepatology. 2004;40:120-24.
	Kamal SM, Ismail A, Graham CS, et al. Pegylated interferon therapy in acute hepatitis C: Relation to hepatitis C virus-specific T cell response kinetics. Hepatology. 2004;39:1721-31.
	Rahman F, Heller T, Sobao Y, et al. Effects of antiviral therapy on the cellular immune response in acute hepatitis C. Hepatology. 2004;40:87-97.
	McKiernan SM, Hagan R, Curry M, et al. Distinct MHC class I and II alleles are associated with hepatitis C viral clearance, originating from a single source. Hepatology. 2004;40:108-14.
	Butt AA, Fultz SL, Kwoh CK, Kelley D, Skanderson M, Justice AC. Risk of diabetes in HIV infected veterans pre- and post-HAART and the role of HCV coinfection. Hepatology. 2004;40:115-19.
	Czaja A, Carpenter H. Progressive fibrosis during corticosteroid therapy of autoimmune hepatitis Hepatology. 2004;39:1631-38.
	Major ME, Dahari H, Mihalik K, et al. Hepatitis C virus kinetics and host responses associated with disease and outcome of infection in chimpanzees. Hepatology. 2004;39:1709-20.
	Graham CS, Curry M, He Q, et al. Comparison of HCV-specific intrahepatic CD4+ T cells in HIV/HCV versus HCV. Hepatology. 2004;40:125-32.
	Girard S, Vossman E, Misek DE, et al. Hepatitis C virus NS5A-regulated gene expression and signaling revealed via microarray and comparative promoter analyses. Hepatology. 2004;40:708-18.
	Boni C, Amadei B, Urbani S, et al. Antiviral CD8-mediated responses in chronic HCV carriers with HBV superinfection. Hepatology. 2004;40:289-99.
	Wasmuth HE, Werth A, Mueller T, et al. Haplotype-tagging RANTES gene variants influence response to antiviral therapy in chronic hepatitis C. Hepatology. 2004;40:327-34.
	Dustin LB. Reexamining the role of the humoral immune response in control of hepatitis C virus infection. Hepatology. 2004;40:756-58.
Journal of Acquired Immune Deficiency Syndrome
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	Miller C, Wood E;@ et al. The Future Face of Coinfection: Prevalence and Incidence of HIV and Hepatitis C Virus Coinfection Among Young Injection Drug Users. JAIDS. 2004;36:743-49.
	Canchis PW, Yee HT, Fiel MI, et al. Intrahepatic CD4+ Cell Depletion in Hepatitis C Virus/HIV-Coinfected Patients. JAIDS. 2004;37:1125-31.
Liver Transplantation
Rating	Article Title
	Shiffman ML, Stravitz RT, Contos MJ, et al. Recurrence of chronic hepatitis C virus in patients after living donor and deceased donor liver transplantation. Liver Transpl. 2004;10:1248-55.
	Norris S, Taylor C, Muiesan P, et al. Outcomes of liver transplantation in HIV-infected individuals: The impact of HCV and HBV infection. Liver Transpl. 2004;10:1271-78.
	Regev A, Molina E, Moura R, et al. Reliability of histopathologic assessment for the differentiation of recurrent hepatitis C from acute rejection after liver transplantation. Liver Transpl. 2004;10:1233-39.
	Charlton M, Ruppert K, Belle SH, et al. Long-term results and modeling to predict outcomes in recipients with HCV infection: Results of the NIDDK liver transplantation database. Liver Transpl. 2004;10:1120-30.
	Firpi RJ, Abdelmalek MF, Soldevila-Pico C, et al.. One-year protocol liver biopsy can stratify fibrosis progression in liver transplant recipients with recurrent hepatitis C infection. Liver Transpl. 2004;10:1240-47.
	Martin P, Busuttil RW, Goldstein RM, et al. Impact of tacrolimus versus cyclosporine in hepatitis C virus-infected liver transplant recipients on recurrent hepatitis: A prospective, randomized trial. Liver Transpl. 2004;10:1258-62.
	Feliu A, Gay E, Garcia-Retortillo M, Saiz JC, Forns X. Evolution of hepatitis C virus quasispecies immediately following liver transplantation. Liver Transpl. 2004;10:1131-39.
New England Journal of Medicine
Rating	Article Title
	Stramer SL, Glynn SA, Kleinman SH, et al. Detection of HIV-1 and HCV Infections among Antibody-Negative Blood Donors by Nucleic Acid-Amplification Testing. NEJM. 2004; 351:760-68.
	Zou S, Dodd RY, Stramer SL, Strong DM; Tissue Safety Study Group. Probability of Viremia with HBV, HCV, HIV, and HTLV among Tissue Donors in the United States. NEJM. 2004; 351:751-59