Monthly Archives: January 2011

Journal Club: Statin therapy improves SVR among diabetic patients with chronic HCV

 (Gastroenterology 2011;140:144-152) Most statins are thought to have modest antiviral activity.  This may be from a statin’s ability to inhibit viral replication (mostly in vitro evidence).  This retrospective study used a VA database of 8,293 HCV patients and aimed to identify predictors … Continue reading

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The Sunday Chronicles

Changing of the Guard (AP) – For the first time since 1936, no. 2 is ranked ahead of no. 1, the latest polls show.  A spokesman for no. 2 mused “It’s been a winding road, that’s for sure.  But we’ve remained cohesive as a … Continue reading

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Hepatorenal syndrome

Question: A 61 year old male with cryptogenic cirrhosis is in the ICU following a variceal bleed.  You are asked about starting treatment for HRS because his creatinine rose from a baseline of 1.2 on admission to 1.9 in 72 hours.  A urine … Continue reading

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Pathology: Acute cellular rejection

Acute cellular rejection (ACR) occurs  in 30-60% of orthotopic liver transplants.  It can be noted late in the first week following transplant, or up to many years later; the pattern of LFT abnormalities is unpredictable but is usually hepatocellular in nature.  … Continue reading

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Quotation

If the license to practice meant the completion of his education how sad it would be for the practitioner, how distressing to his patients! More clearly than any other the physician should illustrate the truth of Plato’s saying that education … Continue reading

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Journal Club: Early steroid-free immunosuppression with FK506 after liver transplantation

(Transplantation 2010;90:1562-1566) Following liver transplantation, it is common to use two or three immunosuppressive medications, including a steroid.  Steroids have many side effects including components of the metabolic syndrome, osteoporosis, and in the setting of HCV infection there is always … Continue reading

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Definition: rapid virologic response (RVR)

Rapid virologic response (RVR) occurs when a HCV viral load is undetectable four weeks after beginning antiviral therapy.  This is considered an excellent kinetic response and leads to a sustained virologic response (SVR; “cure”) in 90% of cases.

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