Treating patients with both hepatitis C and severe kidney disease has always been one of our greatest challenges. Last month at the AASLD Liver Meeting in Boston, I witnessed what could be a game-changing moment: the presentation of the EXPEDITION-4 trial results for glecaprevir/pibrentasvir. Understanding the Patient Population Let me paint a picture of the challenges these patients face. Every…
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Global Hepatitis C Elimination: A Tale of Progress and Stagnation
The recent AASLD Liver Meeting in Washington DC revealed a stark reality in global hepatitis C elimination efforts. Having worked in viral hepatitis for years, the Center for Disease Analysis Foundation’s findings both encourage and concern me deeply. The Success Stories Only eleven countries are on track for 2030 elimination, each offering valuable lessons. I’ve closely followed Egypt’s remarkable transformation…
Read MoreMeal Timing and Fatty Liver Disease: A Circadian Revolution
After years of telling patients to watch what they eat, new research suggests when they eat matters just as much. The findings from the 2016 AASLD Liver Meeting in Boston fundamentally change how I approach NAFLD prevention and treatment, revealing meal timing as a crucial yet modifiable risk factor. The NHANES Study: Scale and Scope The analysis of 9,015 adults…
Read MoreTAF vs TDF in Hepatitis B: A Clinical Revolution in Safety
The data presented at the International Liver Congress in Amsterdam marks a significant shift in hepatitis B treatment. As someone who’s prescribed both TDF and TAF, seeing the concrete evidence of TAF’s safety improvements reinforces what many of us observed clinically. Let me walk you through the remarkable findings from these pivotal studies. Study Design and Demographics The research combined…
Read MoreBreaking Ground: Treating Hepatitis C in Young Children
Last week at the International Liver Congress in Amsterdam, I witnessed a breakthrough in pediatric HCV treatment. The data presented showed a 99% cure rate using half-strength sofosbuvir/ledipasvir tablets in children aged 6-11, finally offering an alternative to the grueling interferon treatments I’ve had to prescribe for years. The Study Population The trial enrolled 90 children across 30 sites in…
Read MoreThe Hidden Face of Fatty Liver Disease: A Study of Lean NAFLD
Through my years treating fatty liver disease, I’ve noticed an intriguing pattern: some of my leanest patients develop NAFLD despite having none of the typical risk factors. Recent data from the NHANES study finally helps explain this phenomenon, analyzing 3,242 lean and 2,952 obese individuals over a 19-year period. Last week, I diagnosed NAFLD in a marathon runner with perfect…
Read MoreLiver Cancer Risk After HCV Treatment: A Tale of Two Studies
Watching patients develop liver cancer after successful HCV treatment has been one of the most frustrating experiences in my clinical practice. Two recent studies presented at The Liver Meeting finally shed light on who remains at risk, and the findings challenge some of our previous assumptions about post-cure cancer surveillance. The research spans thousands of patients across multiple countries, giving…
Read MoreA Mental Health Revolution in HCV Treatment
Having watched dramatic improvements in patients’ mental states after HCV cure, but seeing the data from this Indian study finally quantifies what many of us suspected. Depression, anxiety, and cognitive function all showed marked improvement post-treatment. The Punjab Study Design The research followed 385 patients through Punjab’s decentralized treatment program, using sofosbuvir combinations. Most participants were male (76%), around 39…
Read MoreSafety vs Efficacy: A Year with TAF
After tracking the tenofovir alafenamide (TAF) data since its introduction, and the one-year follow-up results from San Francisco’s AASLD Liver Meeting reveal exactly what many of us hoped to see. The kidney and bone safety improvements are striking, though the efficacy remains comparable to TDF. Trial Demographics and Design The pooled analysis combined two phase III trials – 425 HBeAg-negative…
Read MoreHepatitis C: Transmission and prevention
Having seen blood-to-blood transmission prove deceptively simple yet persistently misunderstood. I remember a nurse who contracted it from a needlestick in ’89, before we even had reliable screening tests – the sort of case that’s thankfully rare now, but still keeps me vigilant in the emergency department. The Blood Product Revolution The screening revolution of 1991 transformed our approach to…
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