Preventing Perinatal Transmission of Hepatitis B Virus (HBV): Hepatology 2014; 60: 468-76. This nonrandomized study, conducted between 2009-2011 with approximately 700 patients, showed that the rate of perinatal transmission of can be brought down almost to zero by instituting therapy with either telbivudine or lamivudine in the third trimester of pregnancy. The accompanying editorial (pgs 448-51) indicates that either telbivudine or tenofovir (both pregnancy class B agents with regard to teratogenicity) are preferred agents due to higher barrier to resistance. And, the article suggests starting as early as week 28 (especially if high viral HBV DNA load) and no later than 32 weeks gestation. Other recommendations from editorial include stopping antiviral after delivery in women who intend to breastfeed.
More on coffee: Hepatology 2014; 60: 661-69. Coffee but not tea conferred protection from cirrhosis mortality. “Compared to non-daily coffee drinkers, those who drank two or more cups per day had a 66% reduction in mortality risk.” This study also had an accompanying editorial (pg 464-67) which reviews the biologic plausibility and potential mechanisms.
NASH pathology: Hepatology 2014; 60: 565-75. The study describes a more precise way to categorize the diagnosis of nonalcoholic steatohepatitis (NASH) using the European Fatty Liver Inhibition of Progression (FLIP) pathology consortium proposal. The diagnosis of NASH requires the presence of ballooning and lobular inflammation in addition to steatosis. Using the FLIP approach, diagnosis concordance increased significantly.
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