Clinical Liver Disease
© 2014 The American Association for the Study of Liver Diseases
Recently Published Issues
Current Issue:September 2014
Volume 4, Issue 3
Special Issue: Liver Disease in Pregnancy
Volume 4, Issue 2
Special Issue: Liver-Lung Syndromes
Volume 4, Issue 1
Special Issue: Drug-Induced Liver Injury (DILI)
Volume 3, Issue 6
Special Issue: Vascular Disorders
Volume 3, Issue 5
Special Issue: Heavy Metals and the Liver
New Issue: Pregnancy and the Liver
Guest Edited by: Grace L. Su, M.D.
Test your knowledge with CLD's
Pregnancy and the Liver
Jennifer M. Ryan, M.B.B.S., B.Sc., M.R.C.P. and Michael A. Heneghan, M.D., M.Med.Sc., F.R.C.P.I.
Changes in liver biochemical profile are normal during pregnancy, but severe liver disease can occur and must be recognized at an early stage to reduce morbidity and mortality for mother and infant. Read on for an overview of the liver conditions that are primarily associated with pregnancy and the effect of preexisting liver disease in pregnancy.
Viral Hepatitis and Pregnancy
Hellan Kwon, M.D. and Anna S. Lok, M.D.
Pregnancy is generally considered to be an immunosuppressed state, however the impact of pregnancy on mothers with viral hepatitis and the impact of viral hepatitis on fetuses or infants are not the same for all types of hepatitis. Learn to recognize the differences with Drs. Kwon and Lok.
Intrahepatic Cholestasis of Pregnancy:
Diagnosis and Management
Yannick Bacq M.D., and Loic Sentilhes M.D., PhD
Intrahepatic cholestasis of pregnancy (ICP) is a liver disease unique to pregnancy. Learn about the pathophysiology, presentation, management, and maternal and fetal outcomes; and get tips for recognizing and treating patients affected by ICP.
Pregnancy in Patients with Advanced Chronic Liver Disease
Silvia Degli Esposti, M.D.
Historically, pregnancy in the setting of advanced liver disease was thought to be rare, based on the assumptions that liver disease is more prevalent in a population older than reproductive age, and that liver disease is associated with infertility. Today, we know better.
Preeclampsia-induced Liver Dysfunction, HELLP Syndrome, and Acute Fatty Liver of Pregnancy
Ghassan M. Hammoud M.D., M.P.H., and Jamal A. Ibdah M.D., Ph.D., AGAF
HELLP syndrome and AFLP are both rare and serious disorders unique to pregnancy, most often seen in the third trimester, and preeclampsia is associated with both. The disorders carry significant perinatal and maternal morbidity and mortality - learn to distinguish the signs, and how to take appropriate action.
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Series on New Treatments for Hepatitis C
Guest Edited by Donald M. Jensen, M.D., F.A.C.P.
HCV Testing and Linkage to Care:
Nancy Reau, M.D.
The limitation to HCV therapy is not treatment efficacy; it's identification of patients and linking them to providers interested in delivering antiviral therapy. Where does the system break down? Dr. Nancy Reau investigates.
Read Dr. Reau's recent editorial in Hepatology:Reau NS, Jensen DM. Sticker shock and the price of new therapies for hepatitis C: Is it worth it? Hepatology. 59:4 1246–1249, April, 2014.
New All-Oral HCV Therapies for Genotype 1: A Final Good-bye to Interferon
Anna S.F. Lok, M.D.
With more than 30 direct-acting antiviral agents (DAAs) in clinical trials, the hepatitis C community anticipates that the right combinations of DAAs will emerge, permitting treatment of hepatitis C virus (HCV) genotype 1 with interferon (IFN)-free regimens.
For more information related to HCV genotypes, read:
Goossens N, Negro F. Is genotype 3 of hepatitis C virus the new villian? Hepatology. 59:6, 2403–2412, June 2014.
New AASLD/IDSA HCV Practice Guidelines: An Online Resource
Gary L. Davis, M.D.
As treatment for Hepatitis C rapidly evolves, how are recommendations being developed, and how they will be updated over time? Read or listen to Dr. Gary Davis' review to learn more about how organiziations like the AASLD are working to keep clinicians informed with the best and most up-to-date guidelines.
Recent FDA Approval of Sofosbuvir and Simeprevir. Implications for Current HCV Treatment
M. Valerie Lin, M.D., and Raymond Chung, M.D.
Drs. Lin and Chung break down what clinicians need to know about Sofosbuvir and Simeprevir: from mechanisms of action, to approved indications, use outside approved indications, and treatment challenges.
Guest Edited by: Michael B. Fallon, M.D.NEW in Liver-Lung Syndromes:
Liver Transplantation for Portopulmonary Hypertension
James R. Runo, M.D.
Pulmonary arterial hypertension (PAH), arising in the setting of portal hypertension, with or without liver cirrhosis, is called portopulmonary hypertension (PoPH). Can you name its three essential elements?
More from the Liver-Lung issue:
Hepatic Hydrothorax: Current Concepts
Karen L. Krok, M.D.
Hepatic hydrothorax is an uncommon complication of portal hypertension, but when it does occur, portends a poor outcome and presents challenging treatment problems for clinicians.
Liver Transplantation for Hepatopulmonary Syndrome
Vivek N. Iyer M.D., M.P.H.
Hepatopulmonary syndrome (HPS) and portopulmonary hypertension (POPH) are often considered together as pulmonary vascular complications of end-stage liver disease(ESLD), however the clinical presentation, pathophysiology and management of HPS and POPH are quite distinct from each other - learn how to recognize the differences.
Portopulmonary Hypertension: Diagnosis, Clinical Features, and Medical Therapy
Sonja D. Bartolome, M.D.
Dr. Bartolome reviews the pathophysiology, epidemiology, prognosis, clinical features, diagnosis, and management of PH.
HPS: Diagnosis, Clinical Features, and Medical Therapy
Valentin Fuhrmann Ph.D., Andreas Drolz M.D., Karoline Rutter M.D., and Thomas Horvatits M.D.
HPS is the most frequent complication of the pulmonary vascular bed in patients with liver cirrhosis, and is found in up to 30% of patients undergoing evaluation for LTX (liver transplantation). HPS is also reported in other forms of acute and chronic noncirrhotic liver diseases such as acute liver failure, hypoxic hepatitis, and chronic viral hepatitis, making early detection initiation of appropriate therapy key for patient outcomes.
For a more comprehensive review of the liver-lung syndromes, read a recent review by Drs . Machiacao, Balakrishnan and Fallon: