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Hepatitis B virus treatment beyond the guidelines: special populations and consideration of treatment withdrawal
The goal of chronic hepatitis B (CHB) treatment is to improve survival by preventing disease progression to decompensated cirrhosis and hepatocellular carcinoma which is the cause of over 1 million deaths annually. The risk of disease progression is reduced when a sustained reduction of hepatitis B virus (HBV) DNA to undetectable levels and suppression of HBV replication are obtained which can result in regression of liver fibrosis and may even reverse cirrhosis. However, even if HBsAg loss occurs, HBV is not completely eradicated by treatment, and long-term therapy is required in patients who are HBeAg– and HBeAg+ w...
Source: Therapeutic Advances in Gastroenterology - May 27, 2014 Category: Gastroenterology Authors: Vallet-Pichard, A., Pol, S. Tags: Reviews Source Type: research

Sofosbuvir, a NS5B polymerase inhibitor in the treatment of hepatitis C: a review of its clinical potential
Treatment of chronic hepatitis C (HCV) is currently undergoing a significant change. Traditional interferon-based therapy has been limited by both efficacy and tolerability, and many direct acting antiviral (DAA) drugs are emerging. Sofosbuvir (GS-7977) is a HCV NS5B nucleotide polymerase inhibitor that has now been evaluated extensively in phase II and III interferon-free clinical trials. The focus of this review is on the clinical potential of sofosbuvir in the treatment of HCV. Sofosbuvir has a pan-genotypic effect on HCV, although viral genotype-specific differences in sustained virological response (SVR) have emerged ...
Source: Therapeutic Advances in Gastroenterology - March 28, 2014 Category: Gastroenterology Authors: Stedman, C. Tags: Reviews Source Type: research

Endoscopic approach to subepithelial lesions
Endoscopy and endoscopic ultrasound (EUS) play a critical role in the detection and management of subepithelial lesions of the gastrointestinal tract. The most common subepithelial lesions detected by endoscopists are gastrointestinal stromal tumors (GISTs), leiomyomas, lipomas, granular cell tumors (GCTs), pancreatic rests and carcinoid tumors. These lesions can be classified based on unique histochemical staining and the gastrointestinal layer of origin. While the majority of the lesions are considered benign, some tumors such as GISTs and carcinoids have a strong propensity for malignant transformation. Therefore, appro...
Source: Therapeutic Advances in Gastroenterology - March 28, 2014 Category: Gastroenterology Authors: Menon, L., Buscaglia, J. M. Tags: Reviews Source Type: research

Bowel preparation regimens for colon capsule endoscopy: a review
Colon capsule endoscopy (CCE) is being actively evaluated as an emerging complementary or alternative procedure for evaluation of the colon. The yield of CCE is significantly dependent on the quality of bowel preparation. In addition to achieving a stool-free colon the bowel preparation protocols need to decrease bubble effect and aid propulsion of the capsule. An extensive English literature search was done using PubMed with search terms of colon capsule endoscopy, PillCam and bowel preparation. Full-length articles which met the criteria were included for review. A total of 12 studies including 1149 patients were reviewe...
Source: Therapeutic Advances in Gastroenterology - March 28, 2014 Category: Gastroenterology Authors: Singhal, S., Nigar, S., Paleti, V., Lane, D., Duddempudi, S. Tags: Reviews Source Type: research

Small bowel stricture characterization and outcomes of dilatation by double-balloon enteroscopy: a single-centre experience
Conclusion: DBE is a useful method in determining the need for dilatation by assessing for active ulceration. Dilatation is effective in the 10–18 mm range, however perforation does occur. (Source: Therapeutic Advances in Gastroenterology)
Source: Therapeutic Advances in Gastroenterology - March 28, 2014 Category: Gastroenterology Authors: Gill, R. S., Kaffes, A. J. Tags: Original Research Source Type: research