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Highest Rated Articles

Hézode C, Roudot-Thoraval F, Nguyen S et al. Daily cannabis smoking as a risk factor for progression of fibrosis in chronic hepatitis C. Hepatology. 2005;42(1):63-71.

This is an important study and one that may have a direct impact on daily care of patients with hepatitis C. Tobacco use, excessive alcohol intake, and substance abuse are common in the HCV-infected population in Western societies. Identifying a potentially harmful effect of using marijuana in HCV patients may explain in part the heterogeneity in the rate of fibrosis progression seen in HCV patients (fast progression and slow progression of fibrosis). In the absence of a universally effective HCV therapy, measures that may delay or prevent the development of cirrhosis such as avoidance of marijuana use are essential in the management of these patients.

Everson GT, Trotter J, Forman L et al. Treatment of advanced hepatitis C with a low accelerating dosage regimen of antiviral therapy. Hepatology. 2005;42(2):255-262.

This non-randomized clinical trial provides a potentially winning strategy for some chronic HCV patients with advanced cirrhosis who are awaiting liver transplantation. The results from earlier pilot studies were disappointing for both tolerability of interferon alpha and for efficacy. In this relatively large pilot trial, patients received a low dose of interferon initially, which was gradually increased to a full dose if tolerated. Although SVR in those with HCV genotype 1 infection was suboptimal, those infected with non-1 genotype had 50% SVR suggesting that treatment should be considered in this population. Even for those with HCV genotype 1 infection, therapy using this low accelerated dose regimen could be considered especially if they had CTP class A.

A word of caution: combining data from this study with that of previously published pilots, one should keep in mind that serious complications including death have been reported in this group of patients. Treatment should be done in highly experienced centers and remains experimental until more data on safety and efficacy become available.

Lok AS, Ghany MG, Goodman ZD et al. Predicting cirrhosis in patients with hepatitis C based on standard laboratory tests: Results of the HALT-C cohort. Hepatology. 2005;42(2):282-292.

The identification of noninvasive markers of hepatic fibrosis has been a major focus of recent research and remains of great interest given the occasional serious complications and cost associated with liver biopsy procedures. This study is one of several that examined the predictive value of routine simple laboratory tests for the presence of advanced hepatic fibrosis. A model comprising platelet count, AST/ALT ratio, and INR was established and shown to potentially obviate the need to biopsy liver in 50% of patients. Although these findings are of interest and may have some applicability in patients with a contraindication for liver biopsy, its use in clinical medicine will likely be limited. A more applicable model may need to have a higher accuracy in identifying those with cirrhosis or advanced fibrosis and may need to be validated in patients with liver disorders besides chronic hepatitis C.

Shim M, Khaykis I, Park J, Bini EJ. Susceptibility to hepatitis A in patients with chronic liver disease due to hepatitis C virus infection: Missed opportunities for vaccination. Hepatology. 2005;42(3):688-695.

Vaccination against HAV has proven efficacy and is recommended for all patients with chronic liver diseases, given the endemic nature of HAV and the relatively high rate of new infections each year. HAV infection in those with chronic liver diseases including HCV has been associated with a severe course, leading in some cases to fulminant liver failure. The poor compliance and adherence with these recommendations is likely a reflection of lack of awareness among primary care physicians and may call for improved educational efforts for both physicians and patients given the simplicity and effectiveness of vaccination in preventing a potentially deadly condition (HAV infection) in this special group of patients.

von Wagner M, Huber M, Berg T et al. Peginterferon-alpha-2a (40KD) and ribavirin for 16 or 24 weeks in patients with genotype 2 or 3 chronic hepatitis C. Hepatology. 2005;129(2):522-527.

This is clearly an important and a potentially practice changing study. Investigators demonstrated that a shorter length of treatment (16 weeks) for chronic HCV patients infected with HCV genotypes 2 or 3 with low viral load who had rapid virologic response is equally as effective as the standard 24 weeks of therapy. Rapid virologic response was defined in this study as a decline in HCV RNA to less than 600 IU/mL at the end of week 4 of therapy. Although HCV genotypes 2 and 3 are substantially less prevalent than HCV genotype 1, these findings may have cost-saving implications and may make treatment better tolerated and more accepted by patients.

American Journal of Gastroenterology
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	Tamori A, Nishiguchi S, Shiomi S et al. Hepatitis B virus DNA integration in hepatocellular carcinoma after interferon-Induced disappearance of hepatitis C virus. AM J Gastroenterol. 2005;100(8):1748-1753.
	Bini EJ, Bräu N, Currie S et al. Prospective multicenter study of eligibility for antiviral therapy among 4,084 U.S. veterans with chronic hepatitis C virus infection . Am J Gastroenterol. 2005;100(8):1772-1779.
	Hu KQ, Lee SM, Hu SX, Xia VW, Hillebrand D, Kyulo NL. Clinical presentation of chronic hepatitis C in patients with end-stage renal disease and on hemodialysis versus those with normal renal function. Am J of Gastroenterol. 2005;100(9):2010-2018.
Clinical Infectious Disease
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	Miller MF, Haley C,  Koziel MJ, Rowley CF. Impact of hepatitis C virus on immune restoration in HIV-Infected patients who start highly active antiretroviral therapy: a meta-analysis. Clin Infect Dis. 2005;41:713-720.
	Netski DM, Mosbruger T,  Depla E et al. Humoral immune response in acute hepatitis C virus infection. Clin Infect Dis. 2005;41:667-675.
	Hilsabeck RC, Castellon SA, Hinkin CH. Neuropsychological aspects of coinfection with HIV and hepatitis C virus. Clin Infect Dis. 2005;41:S38-S44.
	McGovern B, Fiore J, Wurcel A et al. Delivering therapy for hepatitis C virus infection to incarcerated HIV-seropositive patients. Clin Infect Dis. 2005;41:S56-S62.
	Shire NJ, Sherman KE. Clinical trials of treatment for hepatitis C virus infection in HIV-infected patients: past, present, and future. Clin Infect Dis. 2005;41:S63-S68.
	Cooper CL, Cameron DW. Effect of alcohol use and highly active antiretroviral therapy on plasma levels of hepatitis C virus (HCV) in patients coinfected with HIV and HCV. Clin Infect Dis. 2005;41:S105-S109.
Gastroenterology
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	Schulze-Krebs A, Preimel D, Popov Y et al. Hepatitis C virus-replicating hepatocytes induce fibrogenic activation of hepatic stellate cells. Gastroenterology. 2005;129(1):246-258.
	Nakagawa M, Sakamoto N, Tanabe Y et al. Suppression of hepatitis C virus replication by cyclosporin a is mediated by blockade of cyclophilins. Gastroenterology. 2005;129(3)1031-1041.
Hepatology
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	Cox AL, Mosbruger T, Lauer GM, Pardoll D, Thomas DL, Ray SC. Comprehensive analyses of CD8+ T cell responses during longitudinal study of acute human hepatitis C. Hepatology. 2005;42:104-112.
	Seidel N, Volkmann X, Länger F et al. The extent of liver steatosis in chronic hepatitis C virus infection is mirrored by caspase activity in serum. Hepatology. 2005; 42(1):113-120.
	Monto A, Dove LM, Bostrom A, Kakar S, Tien PC, Wright TL. Hepatic steatosis in HIV/hepatitis C coinfection: Prevalence and significance compared with hepatitis C monoinfection. Hepatology. 2005;42:310-316
	Mohamed MK, Abdel-Hamid M, Mikhail N et al. Intrafamilial transmission of hepatitis C in Egypt. Hepatology. 2005;42(3):683-7.
	Mosley JW, Operskalski EA, Tobler LH et al. Viral and host factors in early hepatitis C virus infection. Hepatology. 2005;42(1):86-92.
	Lau DT, Luxon BA, Xiao SY, Beard MR, Lemon SM. Intrahepatic gene expression profiles and alpha-smooth muscle actin patterns in hepatitis C virus induced fibrosis. Hepatology. 2005;42(2):273-281.
	Marceau G, Lapierre P, Béland K, Soudeyns H, Alvarez F. LKM1 autoantibodies in chronic hepatitis C infection: A case of molecular mimicry? Hepatology. 2005;42(3):675-82.
	Salcedo X, Medina J, Sanz-Cameno P et al. The potential of angiogenesis soluble markers in chronic hepatitis C. Hepatology. 2005;42(3):696-701.
	Helbig KJ, Lau DT, Semendric L, Harley HA, Beard MR. Analysis of ISG expression in chronic hepatitis C identifies viperin as a potential antiviral effector. Hepatology. 2005; 42(3):702-710.
	Hutchinson SJ, Bird SM, Goldberg DJ. Modeling the current and future disease burden of hepatitis C among injection drug users in Scotland. Hepatology. 2005;42:711-723.
	Moradpour D, Brass V, Penin F. Function follows form: The structure of the N-terminal domain of HCV NS5A. Hepatology. 2005;42(3):732-735.
Liver Transplantation
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	Wiesner RH, Shorr JS, Steffen BJ, Chu AH, Gordon RD. Mycophenolate mofetil combination therapy improves long-term outcomes after liver transplantation in patients with and without hepatitis C. Liver Transpl. 2005;11(7):750–759.
	Davis GL, Nelson DR, Terrault N et al. A randomized, open-label study to evaluate the safety and pharmacokinetics of human hepatitis C immune globulin (Civacir) in liver transplant recipients. Liver Transpl. 2005; 11(8):941-949.