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Hepatitis B and human immunodeficiency virus co-infection

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World Journal of Gastroenterology 2014年第46期20卷 17360-17367页

作者： Bao-Chau Phung Philippe Sogni Odile Launay Université Paris Descartes Sorbonne Paris Cité75006 ParisFrance Assistance Publique-H?pitaux de Paris H?pital CochinCIC Cochin Pasteur75014 ParisFrance inserm CIC141775014 ParisFrance APHP H?pital CochinService d’hépatologie75014 ParisFrance

Hepatitis B and human immunodeficiency virus(HBV and HIV)infection share transmission patterns and risk factors,which explains high prevalence of chronic HBV infection in HIV infected *** natural course of HBV disease is altered by the HIV infection with less chance to clear acute HBV infection,faster progression to cirrhosis and higher risk of liver-related death in HIVHBV co-infected patients than in HBV mono-infected *** infected patients with chronic hepatitis B should be counseled for liver damage and surveillance of chronic hepatitis B should be performed to screen early hepatocellular *** tools are now available to evaluate liver *** hepatitis B core antibodies(anti-HBc)are a good predictive marker of occult HBV *** the prevalence and significance of occult HBV infection is controversial,but its screening may be important in the management of antiretroviral *** against HBV infection is recommended in non-immune HIV *** optimal treatment for almost all HIV-HBV co-infectedpatients should contain tenofovir plus lamivudine or emtricitabine and treatment should not be stopped to avoid HBV *** term tenofovir therapy may lead to significant decline in hepatitis B surface *** emergence of resistant HBV strains may compromise the HBV therapy and vaccine therapy.

关键词： Chronic hepatitis B Human immunodeficiency virus Management Occult hepatitis Treatment

Comparison of alternative arterial anastomosis site during liver transplantation when the recipient’s hepatic artery is unusable

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Hepatobiliary Surgery and Nutrition 2022年第1期11卷 1-12页

作者： Jean Marie Beaurepaire Francesco Orlando Giovanni Battista Levi Sandri Caroline Jezequel Edouard Bardou-Jacquet Christophe Camus Mohamed Lakehal Veronique Desfourneaux Aude Merdrignac Elodie Gaignard Alexandre Thobie Damien Bergeat Bernard Meunier Michel Rayar CHU Rennes Service de Chirurgie Hépatobiliaire et DigestiveRennesFrance UniversitéRennes 1 Facultéde MédecineRennesFrance CHU Rennes Service des Maladies du FoieRennesFrance inserm CIC 1414RennesFrance CHU Rennes Service de Maladies Infectieuses et Réanimation MédicaleRennesFrance

Background:Few studies have analyzed outcomes of liver transplantation(LT)when the recipient hepatic artery(HA)was not ***:We retrospectively evaluated the outcomes of LT performed using the different alternative sites to ***:Between 2002 and 2017,1,677 LT were performed in our institution among which 141(8.4%)with unusable recipient HA were *** groups were defined according to the site of anastomosis:the splenic artery(SA group,n=26),coeliac trunk(CT group,n=12),aorta using or not the donor’s vessel(Ao group,n=91)and aorta using a vascular prosthesis(Ao-P group,n=12)as *** median number of intraoperative red blood cell transfusions was significantly increased in the Ao and Ao-P groups(5,5,8.5 and 16 for SA,CT,Ao and Ao-P group respectively,P=0.002),as well as fresh frozen plasma(4.5,2.5,10,17 for the SA,CT,Ao and Ao-P groups respectively,P=0.001).Hospitalization duration was also significantly increased in the Ao and Ao-P groups(15,16,24,26.5 days for the SA,CT,Ao and Ao-P groups respectively,P<0.001).The occurrence of early allograft dysfunction(EAD)(P=0.07)or arterial complications(P=0.26)was not statistically *** of factor V,INR,bilirubin and creatinine during the 7th postoperative days(POD)was significantly improved in the SA *** difference was observed regarding graft(P=0.18)and patient(P=0.16)***:In case of unusable HA,intraoperative and postoperative outcomes are improved when using the SA or CT compared to aorta.

关键词： liver transplantation(LT) hepatic artery(HA) arterial anastomosis splenic artery(SA)

Acoustic radiation force impulse imaging for assessing liver fibrosis in alcoholic liver disease

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World Journal of Gastroenterology 2016年第20期22卷 4926-4935页

作者： Anita Kiani Vanessa Brun Fabrice Lainé Bruno Turlin Jeff Morcet Sophie Michalak Antonia Le Gruyer Ludivine Legros Edouard Bardou-Jacquet Yves Gandon Romain Moirand Department of Abdominal Imaging Rennes University Hospital Clinical Inverstigation Center CIC INSERM 1414 Rennes University Hospital Department of Hepatology Rennes University Hospital Department of Pathology Rennes University Hospital Rennes Department of Pathology Angers University Hospital Department of Addictology Rennes University Hospital Department of Research inserm UMR 991 Rennes 1 Medicine University

AIM: To evaluate the performance of elastography by ultrasound with acoustic radiation force impulse(ARFI) in determining fibrosis stage in patients with alcoholic liver disease(ALD) undergoing alcoholic detoxification in relation to ***: Eighty-three patients with ALD undergoing detoxification were prospectively enrolled. Each patient underwent ARFI imaging and a liver biopsy onthe same day. Fibrosis was staged according to the METAVIR scoring system. The median of 10 valid ARFI measurements was calculated for each ***: Sixty-nine males and thirteen females(one patient excluded due to insufficient biopsy size) were assessed with a mean alcohol consumption of 132.4 ± 128.8 standard drinks per week and mean cumulative year duration of 17.6 ± 9.5 years. Sensitivity and specificity were respectively 82.4%(0.70-0.95) and 83.3%(0.73-0.94)(AUROC = 0.87) for F ≥ 2 with a cut-off value of 1.63m/s; 82.4%(0.64-1.00) and 78.5%(0.69-0.89)(AUROC = 0.86) for F ≥ 3 with a cut-off value of 1.84m/s; and 92.3%(0.78-1.00] and 81.6%(0.72-0.90)(AUROC = 0.89) for F = 4 with a cut-off value of 1.94 m/***: ARFI is an accurate, non-invasive and easy method for assessing liver fibrosis in patients with ALD undergoing alcoholic detoxification.

关键词： Alcoholic liver disease Elastography Noninvasive Acoustic radiation force impulse Fibrosis

Evaluation of Doppler-ultrasonography in the diagnosis of transjugular intrahepatic portosystemic shunt dysfunction: A prospective study

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World Journal of Hepatology 2017年第27期9卷 1125-1132页

作者： Charlotte Nicolas Amelie Le Gouge Louis d’Alteroche Jean Ayoub Monica Georgescu Vincent Vidal Denis Castaing Jean-Pierre Cercueil Patrick Chevallier Jerome Roumy Herve Trillaud Louis Boyer Vincent Le Pennec Christophe Perret Bruno Giraudeau Jean-Marc Perarnau STIC-TIPS group Service d’Hepato-Gastroenterologie Hopital TrousseauCHRU Tours cic CHRU de Tours inserm united’echographie-doppler Hopital TrousseauCHRU Tours Service de Radiologie Hopital de la Timone Centre Hepato-Biliaire Hopital Paul Brousse Service de Radiologie CHRU Dijon Service d’Imagerie Medicale Diagnostique et interventionnelle Hopital de l’ArchetⅡNice Service de Radiologie et Echographie CHRU Poitiers Service d’Imagerie Medicale Hopital Saint Andre CHRU Bordeaux Service d’Imagerie viscerale et vasculaire CHRU Clermont Ferrand Service de Radiologie CHRU Caen Service de Radiologie CHRU Nantes 不详

AIM To prospectively evaluate the performance of Dopplerultrasonography(US) for the detection of transjugular intrahepatic portosystemic shunt(TIPS) dysfunction within a multicenter cohort of cirrhotic *** This study was conducted in 10 french teaching hospitals. After TIPS insertion, angiography and liver Doppler-US were carried out every six months to detect dysfunction(defined by a portosystemic gradient ≥ 12 mm Hg and/or a stent stenosis ≥ 50%). The association between ultrasonographic signs and dysfunction was studied by logistic random-effects models, and the diagnostic performance of each Doppler criterion was estimated by the bootstrap method. This study was approved by the ethics committee of *** Two hundred and eighteen pairs of examinations performed on 87 cirrhotic patients were analyzed. Variables significantly associated with dysfunction were: The speed of flow in the portal vein(P = 0.008), the reversal of flow in the right(P = 0.038) and left(P = 0.049) portal branch, the loss of modulation of portal flow by the right atrium(P = 0.0005), ascites(P = 0.001) and the overall impression of the operator(P = 0.0001). The diagnostic performances of these variables were low; sensitivity was < 58% and negative predictive value was < 73%. Therefore, dysfunction cannot be ruled out from Doppler-US. CONCLUSION The performance of Doppler-US for the detection of TIPS dysfunction is poor compared to angiography. New tools are needed to improve diagnosis of TIPS dysfunction.

关键词： Transjugular intrahepatic portosystemic shunt Dysfunction Doppler-ultrasonography