Hepatitis D surgery: Difference between revisions
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==Overview== | ==Overview== | ||
Treatment of hepatitis D does not involve [[surgery]]. Some procedures may be indicated | Treatment of hepatitis D does not involve [[surgery]]. Some procedures may be indicated for certain [[complications]], such as [[ascites]], in which [[peritoneal]] drainage may be performed. [[Liver transplantation]] may be indicated for: end-stage [[liver disease]]; [[liver failure]] secondary to [[HDV infection]], for patients in which treatment with [[interferon]] is not indicated; and [[hepatocellular carcinoma]].<ref name="pmid23242761">{{cite journal| author=Heidrich B, Manns MP, Wedemeyer H| title=Treatment options for hepatitis delta virus infection. | journal=Curr Infect Dis Rep | year= 2013 | volume= 15 | issue= 1 | pages= 31-8 | pmid=23242761 | doi=10.1007/s11908-012-0307-z | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23242761 }} </ref><ref name="pmid20051970">{{cite journal| author=Wedemeyer H, Manns MP| title=Epidemiology, pathogenesis and management of hepatitis D: update and challenges ahead. | journal=Nat Rev Gastroenterol Hepatol | year= 2010 | volume= 7 | issue= 1 | pages= 31-40 | pmid=20051970 | doi=10.1038/nrgastro.2009.205 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20051970 }} </ref> | ||
==Surgery== | ==Surgery== | ||
Revision as of 00:27, 19 August 2014
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Hepatitis D |
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Diagnosis |
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Treatment |
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Hepatitis D surgery On the Web |
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American Roentgen Ray Society Images of Hepatitis D surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2] Jolanta Marszalek, M.D. [3]
Overview
Treatment of hepatitis D does not involve surgery. Some procedures may be indicated for certain complications, such as ascites, in which peritoneal drainage may be performed. Liver transplantation may be indicated for: end-stage liver disease; liver failure secondary to HDV infection, for patients in which treatment with interferon is not indicated; and hepatocellular carcinoma.[1][2]
Surgery
The treatment of hepatitis D does not involve surgical procedures. However, some complications, such as ascites, may require interventional procedures such as peritoneal drainage.
Liver Transplantation
Liver transplant is indicated in patients with end-stage liver disease, or liver failure secondary to HDV infection, in whom treatment with interferon is not indicated.[1][2][3] These patients usually have a good outcome, with inhibition of HBV and HDV reinfection, when simultaneously treated with nucleoside and nucleotide analogues, and hepatitis B antibodies.[4] However, HDV remains latent and can be detected in the new liver for several months after the transplant. Therefore prevention of HBV reinfection should be maintained, in order to simultaneously avoid resurgence of HDV.[1]
After liver transplantation chances of reinfection of the the new liver, may be reduced with administration of HBsAg immunoglobulins. These reduce the levels of HBsAg in the patient to a point where HDV is eliminated, at the same time reducing HDV RNA levels. Long term administration of these immunoglobulins help to prevent re-infection of the graft.[5][3][6]
Liver transplantation has a good outcome, with more than 80% 5-year survival rate.[3]
References
- ↑ 1.0 1.1 1.2 Heidrich B, Manns MP, Wedemeyer H (2013). "Treatment options for hepatitis delta virus infection". Curr Infect Dis Rep. 15 (1): 31–8. doi:10.1007/s11908-012-0307-z. PMID 23242761.
- ↑ 2.0 2.1 Wedemeyer H, Manns MP (2010). "Epidemiology, pathogenesis and management of hepatitis D: update and challenges ahead". Nat Rev Gastroenterol Hepatol. 7 (1): 31–40. doi:10.1038/nrgastro.2009.205. PMID 20051970.
- ↑ 3.0 3.1 3.2 Hughes SA, Wedemeyer H, Harrison PM (2011). "Hepatitis delta virus". Lancet. 378 (9785): 73–85. doi:10.1016/S0140-6736(10)61931-9. PMID 21511329.
- ↑ Samuel D, Zignego AL, Reynes M, Feray C, Arulnaden JL, David MF; et al. (1995). "Long-term clinical and virological outcome after liver transplantation for cirrhosis caused by chronic delta hepatitis". Hepatology. 21 (2): 333–9. PMID 7843702.
- ↑ Smedile A, Casey JL, Cote PJ, Durazzo M, Lavezzo B, Purcell RH; et al. (1998). "Hepatitis D viremia following orthotopic liver transplantation involves a typical HDV virion with a hepatitis B surface antigen envelope". Hepatology. 27 (6): 1723–9. doi:10.1002/hep.510270636. PMID 9620349.
- ↑ Mederacke I, Filmann N, Yurdaydin C, Bremer B, Puls F, Zacher BJ; et al. (2012). "Rapid early HDV RNA decline in the peripheral blood but prolonged intrahepatic hepatitis delta antigen persistence after liver transplantation". J Hepatol. 56 (1): 115–22. doi:10.1016/j.jhep.2011.06.016. PMID 21762665.