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Table Of Contents

1. Hepatitis A
Sven Pischke and Heiner Wedemeyer
The virus
Epidemiology
Transmission
Clinical course
Extrahepatic manifestations
Diagnosis
Treatment and prognosis
References
2. Hepatitis B
Christoph Boesecke and Jan-Christian Wasmuth
Introduction
Sexual transmission
Percutaneous inoculation
Perinatal transmission
Horizontal transmission
Blood transfusion
Nosocomial infection
Organ transplantation
Postexposure prophylaxis
Natural history and clinical manifestations
Acute hepatitis
Chronic hepatitis
Prognosis and survival
3. Hepatitis C
Injection drug use
Sexual or household contact
Hemodialysis
Other rare transmission routes
Needlestick injury
Clinical manifestations
Chronic hepatitis C
Natural history
Cirrhosis and hepatic decompensation
Disease progression
4. Hepatitis E: an underestimated problem?
HEV: genetic characteristics of the virus
Diagnosis of hepatitis E
Worldwide distribution of HEV infections
Transmission of HEV
Acute hepatitis E in immunocompetent individuals
Hepatitis E in patients with HIV infection
Extrahepatic manifestations of hepatitis E
Treatment of chronic hepatitis E
Vaccination
Conclusions/Recommendations
5. HBV Virology
Maura Dandri, Jörg Petersen
Taxonomic classification and genotypes
HBV structure and genomic organization
HBV structural and non-structural proteins
The HBV replication cycle
Animal models of HBV infection
6. HCV Virology
History
Taxonomy and genotypes
Viral structure
Genome organization
Genes and proteins
Model systems for HCV research
7. Prophylaxis and Vaccination
Prophylaxis of hepatitis viruses
Hepatitis A and E
Hepatitis B and D
Hepatitis C
Vaccination against hepatitis A
Vaccination against hepatitis B
Efficacy of vaccination against hepatitis B
Post-exposure prophylaxis
Safety of HBV vaccines
Long-term immunogenicity of hepatitis B vaccination
Prevention of vertical HBV transmission
Vaccination against hepatitis C
Vaccination against hepatitis E
8. Hepatitis B: Diagnostic Tests
Serological tests for HBV
Collection and transport
Hepatitis B surface antigen and antibody
Hepatitis B core antigen and antibody
Hepatitis B e antigen and antibody
Serum HBV DNA assays
Chronic hepatitis B
Summary of treatment indications in the German Guidelines of 2011
Endpoints of antiviral treatment
How to treat
Treatment options
Interferons
Nucleoside and nucleotide analogs
Choosing the right treatment option
Prognostic factors for treatment response
Monitoring before and during antiviral therapy
Treatment duration and stopping rules
10. Management of Resistance in HBV Therapy
Stefan Mauss and Heiner Wedemeyer
Antiviral HBV therapy – how to avoid resistance
Treatment endpoints
Resistance patterns of HBV polymerase inhibitors
Management of drug resistance
Special considerations in HIV/HBV coinfection
Conclusion
11. Hepatitis D – Diagnosis and Treatment
Virology of hepatitis delta
Epidemiology of hepatitis delta
Pathogenesis of HDV infection
Clinical course of delta hepatitis
Acute HBV/HDV coinfection
Chronic delta hepatitis
Diagnosis of delta hepatitis
Treatment of delta hepatitis
Recombinant interferon α
Pegylated interferon α
Liver transplantation for hepatitis delta
12. Hepatitis C: Diagnostic Tests
Christian Lange and Christoph Sarrazin
Serologic assays
HCV core antigen assays
Nucleic acid testing for HCV
Qualitative HCV RNA detection assays
Qualitative assays for HCV RNA detection
Qualitative RT-PCR
Transcription-mediated amplification (TMA) of HCV RNA
Quantitative HCV RNA detection
quantitative assay)
Real-time PCR-based HCV RNA detection assays
HCV genotyping
Real-time PCR technology (RealTime™ HCV Genotype II assay)
Implications for diagnosing and managing acute and chronic hepatitis C
Diagnosing acute hepatitis C
Diagnosing chronic hepatitis C
Diagnostic tests in the management of hepatitis C therapy
13. Standard Therapy of Chronic Hepatitis C Virus Infection
Goal of antiviral therapy
Basic therapeutic concepts and medication
Predictors of treatment response
Antiviral resistance
Treatment of HCV genotype 1
Treatment of naïve patients
Treatment of patients with prior antiviral treatment failure
PEG-IFN maintenance therapy
Treatment of HCV genotypes 2 and 3
Naïve patients
Treatment of HCV G2/3 patients with prior antiviral treatment failure
Treatment of HCV genotypes 4, 5, and 6
Optimisation of HCV treatment
Adherence to therapy
Management of side effects and complications
Drug interactions
Treatment of hepatitis C in special populations
Patients with acute hepatitis C
Patients with normal aminotransferase levels
Patients with compensated liver cirrhosis
Patients after liver transplantation
Hemodialysis patients
Drug abuse and patients on stable maintenance substitution
Patients with coinfections
Patients with hemophilia
Patients with extrahepatic manifestations
14. Hepatitis C: New Drugs
Christian Lange, Christoph Sarrazin
HCV life cycle and treatment targets
NS3-4A protease inhibitors
Molecular biology
Ciluprevir (BILN 2061)
Other NS3 protease inhibitors
Resistance to NS3-4A inhibitors
NS5B polymerase inhibitors
Nucleoside analogs
Non-nucleoside analogs
NS5A inhibitors
Compounds targeting viral attachment and entry
Host factors as targets for treatment
Cyclophilin B inhibitors
Nitazoxanide
Silibinin
Miravirsen
Newer combination therapies
Quadruple therapy
All-oral therapy without ribavirin
All-oral therapy with ribavirin
Novel interferons
Conclusions
Adherence
16. Extrahepatic Manifestations of Chronic HCV
Karl-Philipp Puchner, Albrecht Böhlig and Thomas Berg
Mixed cryoglobulinemia
Malignant lymphoproliferative disorders/NHL
Etiology and pathogenesis of LPDs in patients with HCV infection
Treatment of lymphoproliferative disorders
Systemic vasculitis
Peripheral neuropathy
Further hematological manifestations
HCV-associated thrombocytopenia
HCV-related autoimmune hemolytic anemia
HCV-related glomerulonephritis
Endocrine manifestations
Dermatologic and miscellaneous manifestations
Management of resistance to HBV polymerase inhibitors
18. Management of HCV/HIV Coinfection
Christoph Boesecke, Stefan Mauss, Jürgen Kurt Rockstroh
Epidemiology of HIV and HCV coinfection
Diagnosis of HCV in HIV coinfection
Natural course of hepatitis C in HIV coinfection
Effect of hepatitis C on HIV infection
Effect of HAART on hepatitis C
Treatment of hepatitis C in HIV coinfection
The choice of antiretrovirals while on HCV therapy
Treatment of HCV for relapsers or non-responders
Treatment of acute HCV in HIV
Liver transplantation in HIV/HCV-coinfected patients
19. HBV/HCV Coinfection
Carolynne Schwarze-Zander and Jürgen Kurt Rockstroh
Epidemiology of HBV/HCV coinfection
Screening for HBV/HCV coinfection
Viral interactions between HBV and HCV
Clinical scenarios of HBV and HCV infection
Acute hepatitis by simultaneous infection of HBV and HCV
HCV superinfection
HBV superinfection
Occult HBV infection in patients with HCV infection
Chronic hepatitis in HBV/HCV coinfection
Cirrhosis
Hepatocellular carcinoma
Treatment of HBV and HCV coinfection
20. Assessment of Hepatic Fibrosis in Chronic Viral Hepatitis
Frank Grünhage and Frank Lammert
Mechanisms of liver fibrosis in chronic viral hepatitis
Liver biopsy – the gold standard for staging of liver fibrosis
Surrogate markers of liver fibrosis in chronic viral hepatitis
Transient elastography
Clinical decision algorithms
Summary
21. Diagnosis, Prognosis & Therapy of Hepatocellular Carcinoma
Classification of HCC
Surveillance of patients at high risk and early HCC diagnosis
Stage-adapted therapy for liver cancer
Potentially curative therapy in BCLC stages 0-A
Palliative therapy in BCLC stages B and C
Prophylaxis of liver cancer
22. Update in Transplant Hepatology
S. Beckebaum, G. Gerken, V. R. Cicinnati
Timing and indications for liver transplantation
Patient evaluation
Pretransplant management issues
Waiting list monitoring of hepatitis B liver transplant candidates
Adjunctive treatment and staging of HCC transplant candidates
Perioperative complications
Long-term complications after liver transplantation
Opportunistic infections
Chronic ductopenic rejection
Other side effects of CNI
Corticosteroid minimization/avoidance protocols
De novo malignancies
Biliary complications
Metabolic bone disease
Recurrent diseases after liver transplantation
Recurrence of hepatitis B in the allograft
Recurrence of hepatitis C in the allograft
Recurrence of cholestatic liver diseases and autoimmune hepatitis
Outcome in patients transplanted for hepatic malignancies
Outcome after liver transplantation for acute hepatic failure
23. End-stage Liver Disease, HIV Infection and Liver Transplantation
Clinical features of coinfected patients with ESLD
Prognosis after decompensation
Management of cirrhosis complications
Substance abuse
HCV/HBV management
Combination antiretroviral therapy (HAART)
Orthotopic liver transplant (OLT)
Liver disease criteria
HIV infection criteria
Clinical criteria
Immunological criteria
Virologic criteria
Other criteria
Outcome of OLT in HIV-positive patients
HIV/HCV coinfection
HIV/HVB coinfection
Liver retransplantation
24. Metabolic Liver Diseases: Hemochromatosis
Definition and classification of iron overload diseases
Type 1 HFE hemochromatosis
Etiology and pathogenesis
Early diagnosis and screening
Complications of iron overload
Therapy
Juvenile hereditary hemochromatosis
Transferrin receptor 2 (TFR2)-related type 3 hemochromatosis
Type 4 hemochromatosis – Ferroportin Disease
Secondary hemochromatosis
Pathophysiology
25. NAFLD and NASH
Prevalence
Demographics and risk factors
Pathogenesis
Diet and lifestyle recommendations
Pharmacological treatment
Surgery for obesity
Liver transplantation (LTX) for NASH
26. Wilson’s Disease
Clinical presentation
Serum ceruloplasmin
Serum copper
Urinary copper excretion
Hepatic copper concentration
Radiolabelled copper
Liver biopsy findings
Neurology and MRI of the CNS
Genetic Studies
Treatment
Monitoring of treatment
27. Autoimmune Liver Diseases: AIH, PBC and PSC
Autoimmune hepatitis (AIH)
Definition and diagnosis of autoimmune hepatitis
Epidemiology and clinical presentation
Natural history and prognosis
Who requires treatment?
Who does not require treatment?
Standard treatment strategy
Treatment of elderly patients
Alternative Treatments
Budesonide
Deflazacort
Cyclosporine A
Tacrolimus
Mycophenolic acid
Cyclophosphamide
Anti-TNF α antibodies
Ursodeoxycholic acid
Liver transplantation
Recurrence and de novo AIH after liver transplantation
Primary biliary cirrhosis
Definition and prevalence of PBC
Diagnostic principles of PBC
Therapeutic principles in PBC
Primary sclerosing cholangitis
Diagnosis of primary sclerosing cholangitis (PSC)
Differential diagnosis: sclerosing cholangitis
Association of PSC with inflammatory bowel disease
PSC as a risk factor for cancer
Medical therapy of PSC
Therapy of IBD in PSC
28. Alcoholic Hepatitis
Classification and natural history of alcoholic liver disease
Clinical features and diagnosis of alcoholic hepatitis
Course and severity
Mechanisms of alcohol-related liver injury
Abstinence from alcohol
Supportive therapy
Corticosteroids
Pentoxifylline
N-acetyl cysteine
Anti-TNF-α therapy
Nutritional support
Other pharmacologic treatments
29. Vascular Liver Disease
Disorders of the hepatic sinusoid
Sinusoidal obstruction syndrome
Peliosis hepatis
Disorders of the hepatic artery
Hereditary hemorrhagic teleangiectasia (Osler-Weber-Rendu syndrome)
Disorders of the portal vein
Portal vein thrombosis
Nodular regenerative hyperplasia
Hepatoportal sclerosis
Disorders of the hepatic veins
Budd-Chiari syndrome
30. Acute Liver Failure
Introduction and definition
Epidemiology and etiologies
Intoxication
Amanita intoxication
Viral hepatitis
Immunologic etiologies
Wilson’s Disease
Vascular disorders
Pregnancy-induced liver injury
Undetermined
Molecular mechanisms and clinical presentation
Prognosis
General management
Hepatic encephalopathy
Coagulopathy
Liver Transplantation
Extracorporal liver support systems
Specific treatment options
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Published by: larapale on Jul 15, 2013
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01/27/2014

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