Just released to the public domain:
Results from study of HepQuant technology and Ledipasvir/Sofosbuvir HCV antivirals.
PDF Page# 1149, Publication Page# 1134A
“Early Improvement in the HepQuant®(HQ)-SHUNT Function Test during Treatment with Ledipasvir/Sofosbuvir in Liver Transplant Recipients with Allograft Fibrosis or Cirrhosis and Patients with Decompensated Cirrhosis who have not undergone Transplantation. O’Leary JG, Burton JR, Helmke SM, Herman A, Cookson MW, Lauriski S, Trotter JF, Denning JM, Pang PS, McHutchison JG, Everson GT. Hepatology 2014;60:1134A.”
This study investigated hypocalcemia in patients with acute gastroenteritis at Liaquat University Hospital in Hyderabad, Pakistan. The study included 66 patients with acute gastroenteritis and 66 healthy control subjects. The mean serum calcium level was significantly lower in patients with acute gastroenteritis (6.8455 ± 1.8266 mg/dL) compared to the control group (9.2167 ± 0.4534 mg/dL). Hypocalcemia was observed in 62 (94%) of gastroenteritis patients but only 13 (20%) of controls. The results demonstrated that low serum calcium or hypocalcemia is common in patients with acute gastroenteritis.
This document provides consensus statements from guidelines on the management of hepatitis B virus (HBV) infection in India. It covers epidemiology, vaccination, diagnosis, treatment goals and monitoring, antiviral treatment strategies, special populations including children and healthcare workers, and pregnancy considerations. The guidelines were developed through an expert panel discussion and aim to standardize management of HBV in India based on available evidence.
Arv active-toxcity-monitoring-gaberone-training-workshop-on-managmentprempanigrahi
This document outlines key aspects of monitoring and managing adverse drug reactions related to antiretroviral therapies. It discusses WHO recommendations for antiretroviral drugs, defines important terms like adverse drug reactions and treatment limiting toxicities, and describes the major toxicities associated with different antiretroviral regimens as well as approaches for clinical management. It also covers recommendations for routine and active toxicity monitoring.
Estudios que evaluaron el tratamiento actual de la hepatitis C, los cuales fueron presentados en el consenso de viena en abril de 2015.
Forman parte de EASL guidelines HCV 2015.
1. The Diabetes Prevention Program (DPP) found that an intensive lifestyle intervention aimed at 7% weight loss was more effective than metformin or placebo at preventing diabetes in patients with prediabetes over 3 years, with a 58% reduction in relative risk.
2. For Mrs. K, an intensive lifestyle intervention targeting at least 7% weight loss would be the recommended first-line evidence-based approach based on the DPP findings.
3. After 1 year of lifestyle changes, Mrs. K had achieved 6% weight loss and normal fasting glucose and A1C levels, indicating response to treatment. However, 12 months later with 10 pounds regained, her glucose levels have
Nejm Effects of Aspirin for Primary Prevention in Persons with Diabetes MellitusBhargav Kiran
This document summarizes the results of the ASCEND trial, which investigated the effects of low-dose aspirin (100 mg daily) for primary prevention of cardiovascular events in 15,480 adults with diabetes but no history of cardiovascular disease. Over a mean follow-up of 7.4 years:
- Serious vascular events were lower in the aspirin group (8.5%) compared to placebo (9.6%), but major bleeding events were higher with aspirin (4.1% vs 3.2%).
- There was no significant difference in gastrointestinal cancer rates between groups.
- Aspirin prevented some vascular events but increased bleeding, largely offsetting the benefits. The absolute risks and benefits were closely balanced
Antihyperglycemic effects of short term resveratrol supplementation in type 2...zanet1
1) The study examined the effects of short term resveratrol supplementation in patients with type 2 diabetes who were receiving standard antidiabetic treatment. 66 patients were randomly assigned to receive either 1 g per day of resveratrol or a placebo for 45 days.
2) Resveratrol treatment significantly decreased systolic blood pressure, fasting blood glucose, HbA1c, insulin, and insulin resistance compared to baseline. HDL was also significantly increased.
3) In contrast, the placebo group had slightly increased fasting glucose and LDL compared to baseline. Liver and kidney function markers were unchanged with resveratrol treatment.
This study investigated hypocalcemia in patients with acute gastroenteritis at Liaquat University Hospital in Hyderabad, Pakistan. The study included 66 patients with acute gastroenteritis and 66 healthy control subjects. The mean serum calcium level was significantly lower in patients with acute gastroenteritis (6.8455 ± 1.8266 mg/dL) compared to the control group (9.2167 ± 0.4534 mg/dL). Hypocalcemia was observed in 62 (94%) of gastroenteritis patients but only 13 (20%) of controls. The results demonstrated that low serum calcium or hypocalcemia is common in patients with acute gastroenteritis.
This document provides consensus statements from guidelines on the management of hepatitis B virus (HBV) infection in India. It covers epidemiology, vaccination, diagnosis, treatment goals and monitoring, antiviral treatment strategies, special populations including children and healthcare workers, and pregnancy considerations. The guidelines were developed through an expert panel discussion and aim to standardize management of HBV in India based on available evidence.
Arv active-toxcity-monitoring-gaberone-training-workshop-on-managmentprempanigrahi
This document outlines key aspects of monitoring and managing adverse drug reactions related to antiretroviral therapies. It discusses WHO recommendations for antiretroviral drugs, defines important terms like adverse drug reactions and treatment limiting toxicities, and describes the major toxicities associated with different antiretroviral regimens as well as approaches for clinical management. It also covers recommendations for routine and active toxicity monitoring.
Estudios que evaluaron el tratamiento actual de la hepatitis C, los cuales fueron presentados en el consenso de viena en abril de 2015.
Forman parte de EASL guidelines HCV 2015.
1. The Diabetes Prevention Program (DPP) found that an intensive lifestyle intervention aimed at 7% weight loss was more effective than metformin or placebo at preventing diabetes in patients with prediabetes over 3 years, with a 58% reduction in relative risk.
2. For Mrs. K, an intensive lifestyle intervention targeting at least 7% weight loss would be the recommended first-line evidence-based approach based on the DPP findings.
3. After 1 year of lifestyle changes, Mrs. K had achieved 6% weight loss and normal fasting glucose and A1C levels, indicating response to treatment. However, 12 months later with 10 pounds regained, her glucose levels have
Nejm Effects of Aspirin for Primary Prevention in Persons with Diabetes MellitusBhargav Kiran
This document summarizes the results of the ASCEND trial, which investigated the effects of low-dose aspirin (100 mg daily) for primary prevention of cardiovascular events in 15,480 adults with diabetes but no history of cardiovascular disease. Over a mean follow-up of 7.4 years:
- Serious vascular events were lower in the aspirin group (8.5%) compared to placebo (9.6%), but major bleeding events were higher with aspirin (4.1% vs 3.2%).
- There was no significant difference in gastrointestinal cancer rates between groups.
- Aspirin prevented some vascular events but increased bleeding, largely offsetting the benefits. The absolute risks and benefits were closely balanced
Antihyperglycemic effects of short term resveratrol supplementation in type 2...zanet1
1) The study examined the effects of short term resveratrol supplementation in patients with type 2 diabetes who were receiving standard antidiabetic treatment. 66 patients were randomly assigned to receive either 1 g per day of resveratrol or a placebo for 45 days.
2) Resveratrol treatment significantly decreased systolic blood pressure, fasting blood glucose, HbA1c, insulin, and insulin resistance compared to baseline. HDL was also significantly increased.
3) In contrast, the placebo group had slightly increased fasting glucose and LDL compared to baseline. Liver and kidney function markers were unchanged with resveratrol treatment.
This document provides standards of care for diabetes management as established by the American Diabetes Association (ADA). It discusses the classification and diagnosis of diabetes, including the criteria for diagnosing diabetes based on A1C, fasting plasma glucose, and oral glucose tolerance tests. It also defines categories of increased risk for diabetes, also known as prediabetes. The standards are intended to provide guidance to clinicians and others on the components of diabetes care and treatment goals.
Sydney Sexual Health Centre Journal Club presentation by Gwamaka E.M. on The Journal of Infectious Diseases Volume 214 Issue 10, published in November 2016.
The Journal of Infectious Diseases has been published continuously since 1904 and describes itself as "the premier global journal for original research on infectious diseases". Research published in the JID includes studies in microbiology, immunology, epidemiology, and related disciplines, on the pathogenesis, diagnosis, and treatment of infectious diseases; on the microbes that cause them; and on disorders of host immune responses. JID is an official publication of the Infectious Diseases Society of America.
The Sydney Sexual Health Centre Journal Club allows our team to stay up-to-date with what is being published in the field of sexual health. Staff members take turns to read, review and share the contents of an allocated journal. Journal Club encourages knowledge sharing and discussion about topics raised.
This document provides guidelines from the American Diabetes Association for the standards of medical care in diabetes. It discusses the classification and diagnosis of diabetes, including the criteria for diagnosing diabetes based on A1C, fasting plasma glucose, and oral glucose tolerance tests. It also defines categories of increased risk for diabetes, also known as prediabetes. The guidelines are intended to provide clinicians, patients, and others with the components of diabetes care and treatment goals.
This study investigated calcium and vitamin D intake in healthy children. 184 children with intake below recommendations were randomly assigned to receive dietary counseling plus calcium/vitamin D supplements (Group 1) or counseling alone (Group 2). After 4 months, Group 1 showed improved intake of both nutrients and optimal vitamin D levels, while Group 2 only improved calcium intake and had lower vitamin D levels. The study concludes that counseling alone is not sufficient to achieve adequate vitamin D intake.
This document discusses the management of Hepatitis C in 2019 and beyond. It provides guidance on assessing liver disease, treatment aims and options, and available drugs in Pakistan. Key points include:
- Assessing liver disease involves tests of the blood, liver function, imaging and virological testing.
- Treatment aims to prevent liver complications and improve quality of life. The endpoint is an undetectable viral load 12 weeks post treatment (SVR12).
- Available drugs for genotype 3 infection include Sofosbuvir/Velpatasvir for 12 weeks in non-cirrhotic patients or Glecaprevir/Pibrentasvir for 8-12 weeks depending on fibrosis stage.
-
1) Hepatitis C virus genotype 4 is predominant in Egypt, with a prevalence of around 9%.
2) New direct-acting antiviral agents have improved treatment outcomes, but the virus's ability to mutate rapidly can lead to resistance.
3) The document provides treatment recommendations and regimens using direct-acting antivirals like sofosbuvir and daclatasvir to treat hepatitis C genotype 4, including for different patient populations and treatment experiences. It establishes guidelines for Egyptian treatment protocols.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
The document discusses various metabolic complications associated with HIV infection and antiretroviral therapy (HAART), including lactic acidemia, lipodystrophy, dyslipidemia, and insulin resistance. Lactic acidemia is proposed to result from mitochondrial toxicity of nucleoside reverse transcriptase inhibitors (NRTIs) and can range from asymptomatic to potentially fatal lactic acidosis. Lipodystrophy involves abnormal fat redistribution including central lipohypertrophy and peripheral lipoatrophy, which are associated with prolonged HAART use and protease inhibitor therapy. Management of these conditions involves treatment interruption or switching antiretrovirals to limit toxicity.
This lecture is about Treatment of HCV Genotype 4 presented by Dr. Tamer Elbaz, Assistant professor of Hepatology & Gastroenterology, Cairo University.
The lecture was presented in the scientific meeting of Internal and Tropical Medicine departments, Ahmed Maher Teaching Hospital titled (Towards Eradication of HCV in Egypt) in celebration of World Hepatitis Day on July 28, 2016.
https://www.facebook.com/AMTH.IM
https://www.facebook.com/events/1072758396145209/
http://www.no4c.com
This document reports on 6 cases of new onset diabetes that appeared after kidney transplantation. It finds that 30% of kidney transplant patients in the studied population developed diabetes, with an average onset of 5 months post-transplant. Risk factors for developing diabetes included older age, family history, overweight status, and immunosuppressive medications. Treatment included insulin therapy, oral medications, and adjusting immunosuppression. Good glycemic control is important for transplant outcomes, but treatment must be carefully managed to avoid rejection.
Nivolumab, a programmed death 1 (PD-1) checkpoint inhibitor, was associated with encouraging overall survival in uncontrolled studies involving previously treated patients with advanced renal-cell carcinoma. This randomized, open-label, phase 3 study compared nivolumab with everolimus in patients with renal-cell carcinoma who had received previous treatment.
This document discusses new-onset diabetes after transplantation (NODAT), which occurs in some patients after receiving a solid organ transplant. It defines NODAT and reviews its epidemiology and risk factors. The document outlines the pathogenesis and risk of NODAT associated with different immunosuppressive drugs. It also discusses the diagnosis, screening, and management of NODAT, including monitoring patients, treating hyperglycemia, and controlling cardiovascular risk factors. The document notes ongoing areas of uncertainty around preventing NODAT and determining the long-term impacts of improved glycemic control.
Journal club solid organ transplant (New Onset Diabetes)Daniel Le
This study compared the risk of new onset diabetes after transplantation (NODAT) in kidney transplant recipients receiving either early corticosteroid withdrawal (CSWD) or chronic corticosteroid (CCS) therapy. Over 5 years of follow up:
- There was no difference in patient survival or graft loss between the CSWD and CCS groups.
- Rates of death and graft loss were also not different for those with or without NODAT.
- However, insulin use was significantly higher at 5 years in the CCS group (11.1%) compared to the CSWD group (6.3%).
- For the other 8 definitions of NODAT, there were no significant differences
The document outlines standards of medical care for diabetes in 2011 as published by the American Diabetes Association (ADA). It includes recommendations for classifying and diagnosing diabetes, testing asymptomatic patients, detecting gestational diabetes, preventing type 2 diabetes, initial diabetes care evaluations, and monitoring and treating diabetes and its complications. The recommendations are evidence-based, graded according to level of evidence from A to E. Components of an initial comprehensive diabetes evaluation are also outlined.
Work-up and management of chronic hepatitis B in non-pregnant adults, especially in a setting with limited resources such as Pakistan's healthcare system.
Direct Oral Anticoagulants in Patients With Atrial Fibrillation and Liver Dis...Shadab Ahmad
Guidelines for the treatment of nonvalvular atrial fibrillation (AF) recommend oral anticoagulation (OAC) for stroke prevention with either warfarin or direct oral anticoagulants (DOACs), with a stronger recommendation for DOACs in the general population.
Advanced liver disease is known to increase the risk for bleeding and affects the hepatic clearance and metabolism of drugs.
Even so, OAC is associated with a lower risk for ischemic stroke and no difference in bleeding, including intracranial hemorrhage (ICH), in patients with AF and liver cirrhosis, and thus OAC should still be considered in this population.
This document provides standards of care for diabetes management as established by the American Diabetes Association (ADA). It discusses the classification and diagnosis of diabetes, including the criteria for diagnosing diabetes based on A1C, fasting plasma glucose, and oral glucose tolerance tests. It also defines categories of increased risk for diabetes, also known as prediabetes. The standards are intended to provide guidance to clinicians and others on the components of diabetes care and treatment goals.
Sydney Sexual Health Centre Journal Club presentation by Gwamaka E.M. on The Journal of Infectious Diseases Volume 214 Issue 10, published in November 2016.
The Journal of Infectious Diseases has been published continuously since 1904 and describes itself as "the premier global journal for original research on infectious diseases". Research published in the JID includes studies in microbiology, immunology, epidemiology, and related disciplines, on the pathogenesis, diagnosis, and treatment of infectious diseases; on the microbes that cause them; and on disorders of host immune responses. JID is an official publication of the Infectious Diseases Society of America.
The Sydney Sexual Health Centre Journal Club allows our team to stay up-to-date with what is being published in the field of sexual health. Staff members take turns to read, review and share the contents of an allocated journal. Journal Club encourages knowledge sharing and discussion about topics raised.
This document provides guidelines from the American Diabetes Association for the standards of medical care in diabetes. It discusses the classification and diagnosis of diabetes, including the criteria for diagnosing diabetes based on A1C, fasting plasma glucose, and oral glucose tolerance tests. It also defines categories of increased risk for diabetes, also known as prediabetes. The guidelines are intended to provide clinicians, patients, and others with the components of diabetes care and treatment goals.
This study investigated calcium and vitamin D intake in healthy children. 184 children with intake below recommendations were randomly assigned to receive dietary counseling plus calcium/vitamin D supplements (Group 1) or counseling alone (Group 2). After 4 months, Group 1 showed improved intake of both nutrients and optimal vitamin D levels, while Group 2 only improved calcium intake and had lower vitamin D levels. The study concludes that counseling alone is not sufficient to achieve adequate vitamin D intake.
This document discusses the management of Hepatitis C in 2019 and beyond. It provides guidance on assessing liver disease, treatment aims and options, and available drugs in Pakistan. Key points include:
- Assessing liver disease involves tests of the blood, liver function, imaging and virological testing.
- Treatment aims to prevent liver complications and improve quality of life. The endpoint is an undetectable viral load 12 weeks post treatment (SVR12).
- Available drugs for genotype 3 infection include Sofosbuvir/Velpatasvir for 12 weeks in non-cirrhotic patients or Glecaprevir/Pibrentasvir for 8-12 weeks depending on fibrosis stage.
-
1) Hepatitis C virus genotype 4 is predominant in Egypt, with a prevalence of around 9%.
2) New direct-acting antiviral agents have improved treatment outcomes, but the virus's ability to mutate rapidly can lead to resistance.
3) The document provides treatment recommendations and regimens using direct-acting antivirals like sofosbuvir and daclatasvir to treat hepatitis C genotype 4, including for different patient populations and treatment experiences. It establishes guidelines for Egyptian treatment protocols.
The IOSR Journal of Pharmacy (IOSRPHR) is an open access online & offline peer reviewed international journal, which publishes innovative research papers, reviews, mini-reviews, short communications and notes dealing with Pharmaceutical Sciences( Pharmaceutical Technology, Pharmaceutics, Biopharmaceutics, Pharmacokinetics, Pharmaceutical/Medicinal Chemistry, Computational Chemistry and Molecular Drug Design, Pharmacognosy & Phytochemistry, Pharmacology, Pharmaceutical Analysis, Pharmacy Practice, Clinical and Hospital Pharmacy, Cell Biology, Genomics and Proteomics, Pharmacogenomics, Bioinformatics and Biotechnology of Pharmaceutical Interest........more details on Aim & Scope).
All manuscripts are subject to rapid peer review. Those of high quality (not previously published and not under consideration for publication in another journal) will be published without delay.
The document discusses various metabolic complications associated with HIV infection and antiretroviral therapy (HAART), including lactic acidemia, lipodystrophy, dyslipidemia, and insulin resistance. Lactic acidemia is proposed to result from mitochondrial toxicity of nucleoside reverse transcriptase inhibitors (NRTIs) and can range from asymptomatic to potentially fatal lactic acidosis. Lipodystrophy involves abnormal fat redistribution including central lipohypertrophy and peripheral lipoatrophy, which are associated with prolonged HAART use and protease inhibitor therapy. Management of these conditions involves treatment interruption or switching antiretrovirals to limit toxicity.
This lecture is about Treatment of HCV Genotype 4 presented by Dr. Tamer Elbaz, Assistant professor of Hepatology & Gastroenterology, Cairo University.
The lecture was presented in the scientific meeting of Internal and Tropical Medicine departments, Ahmed Maher Teaching Hospital titled (Towards Eradication of HCV in Egypt) in celebration of World Hepatitis Day on July 28, 2016.
https://www.facebook.com/AMTH.IM
https://www.facebook.com/events/1072758396145209/
http://www.no4c.com
This document reports on 6 cases of new onset diabetes that appeared after kidney transplantation. It finds that 30% of kidney transplant patients in the studied population developed diabetes, with an average onset of 5 months post-transplant. Risk factors for developing diabetes included older age, family history, overweight status, and immunosuppressive medications. Treatment included insulin therapy, oral medications, and adjusting immunosuppression. Good glycemic control is important for transplant outcomes, but treatment must be carefully managed to avoid rejection.
Nivolumab, a programmed death 1 (PD-1) checkpoint inhibitor, was associated with encouraging overall survival in uncontrolled studies involving previously treated patients with advanced renal-cell carcinoma. This randomized, open-label, phase 3 study compared nivolumab with everolimus in patients with renal-cell carcinoma who had received previous treatment.
This document discusses new-onset diabetes after transplantation (NODAT), which occurs in some patients after receiving a solid organ transplant. It defines NODAT and reviews its epidemiology and risk factors. The document outlines the pathogenesis and risk of NODAT associated with different immunosuppressive drugs. It also discusses the diagnosis, screening, and management of NODAT, including monitoring patients, treating hyperglycemia, and controlling cardiovascular risk factors. The document notes ongoing areas of uncertainty around preventing NODAT and determining the long-term impacts of improved glycemic control.
Journal club solid organ transplant (New Onset Diabetes)Daniel Le
This study compared the risk of new onset diabetes after transplantation (NODAT) in kidney transplant recipients receiving either early corticosteroid withdrawal (CSWD) or chronic corticosteroid (CCS) therapy. Over 5 years of follow up:
- There was no difference in patient survival or graft loss between the CSWD and CCS groups.
- Rates of death and graft loss were also not different for those with or without NODAT.
- However, insulin use was significantly higher at 5 years in the CCS group (11.1%) compared to the CSWD group (6.3%).
- For the other 8 definitions of NODAT, there were no significant differences
The document outlines standards of medical care for diabetes in 2011 as published by the American Diabetes Association (ADA). It includes recommendations for classifying and diagnosing diabetes, testing asymptomatic patients, detecting gestational diabetes, preventing type 2 diabetes, initial diabetes care evaluations, and monitoring and treating diabetes and its complications. The recommendations are evidence-based, graded according to level of evidence from A to E. Components of an initial comprehensive diabetes evaluation are also outlined.
Work-up and management of chronic hepatitis B in non-pregnant adults, especially in a setting with limited resources such as Pakistan's healthcare system.
Direct Oral Anticoagulants in Patients With Atrial Fibrillation and Liver Dis...Shadab Ahmad
Guidelines for the treatment of nonvalvular atrial fibrillation (AF) recommend oral anticoagulation (OAC) for stroke prevention with either warfarin or direct oral anticoagulants (DOACs), with a stronger recommendation for DOACs in the general population.
Advanced liver disease is known to increase the risk for bleeding and affects the hepatic clearance and metabolism of drugs.
Even so, OAC is associated with a lower risk for ischemic stroke and no difference in bleeding, including intracranial hemorrhage (ICH), in patients with AF and liver cirrhosis, and thus OAC should still be considered in this population.
Cutting-Edge Advances in Gastroenterology and Hepatology_ Latest Breakthrough...DoctorsFoundationMed
Cutting-Edge Advances in Gastroenterology and Hepatology_ Latest Breakthroughs in Diagnostics, Therapies, and Patient Care
"Explore the latest innovations in gastroenterology and hepatology, from groundbreaking diagnostic techniques to revolutionary therapies and enhanced patient care strategies. This article delves into cutting-edge advancements that are shaping the future of gastrointestinal health and liver disease management, offering insights into state-of-the-art diagnostic tools, novel treatment approaches, and patient-centered care models. Discover how these breakthroughs are revolutionizing healthcare in the fields of gastroenterology and hepatology."
Valproic acid is an anticonvulsant used to treat epilepsy, bipolar disorder, and migraines. It exists in multiple preparations and salt forms. Dosing is initially 10-15 mg/kg/day divided every 8-12 hours, up to a maximum of 60 mg/kg/day. Therapeutic drug monitoring aims for serum concentrations of 50-100 mcg/mL. Valproic acid has nearly complete bioavailability and is highly protein bound. It undergoes hepatic metabolism and renal excretion. Dose adjustments may be necessary in renal or hepatic impairment due to altered protein binding and clearance.
Современное лечение ВИЧ: лечение ВИЧ у пациентов с вирусными гепатитами.Conte...hivlifeinfo
Современное лечение ВИЧ: лечение ВИЧ у пациентов с вирусными гепатитами.Contemporary Management of HIV. Managing HIV in Viral Hepatitis Coinfection.2016
In this downloadable slideset, David L. Wyles, MD, and Program Director Eric S. Daar, MD, review key data and optimal approaches for ART management in patients with HIV and viral hepatitis coinfection.
Format: Microsoft PowerPoint (.ppt)
File size: 1.85 MB
Buying time in situations of extreme hemodynamic instability by partially reversing acidemia with a controlled strategy involving bicarbonate, calcium and hyperventilation.
Minimizing CO2 buildup as well as resulting hypocalcemia after alkalinization improves hemodynamics in a rat-derived french study.
1) The article summarizes the guidelines for treatment of chronic hepatitis B and C in Japan. For hepatitis B, long-term interferon and sequential entecavir treatment are recommended for younger patients, while entecavir is the first choice for older patients. For hepatitis C, peginterferon and ribavirin are recommended for high viral loads, while interferon monotherapy is used for low viral loads.
2) Treatment is also recommended for hepatitis C patients with normal liver enzyme levels if fibrotic liver is shown on biopsy or low platelet count.
3) The guidelines are revised annually in Japan and provide treatment protocols separately for different patient groups.
This document summarizes the effects of alcohol on the liver, including fatty liver, alcoholic hepatitis, and cirrhosis. It discusses how alcohol is metabolized and causes a buildup of fatty acids in the liver over time with heavy drinking. Inflammation occurs which can progress to fibrosis and scarring of the liver. Symptoms range from jaundice to liver failure. Diagnosis involves physical examination. Treatment focuses on supportive care, with controversies around corticosteroids and trials of other medications to reduce inflammation. Severe cases may require liver transplantation.
This document provides guidelines for the management of acute pancreatitis (AP). It summarizes key recommendations regarding the diagnosis, etiology, risk stratification, and management of AP. The diagnosis of AP is usually established by abdominal pain and elevated serum amylase and/or lipase levels. Contrast-enhanced CT or MRI is only recommended if the diagnosis is unclear or the patient fails to improve. Patients should be stratified based on the presence of organ failure or systemic inflammatory response syndrome and those with organ failure admitted to intensive care. Aggressive intravenous hydration within the first 24 hours and assessment of fluid status is important. Guidelines are also provided for managing gallstone pancreatitis, infectious complications, and interventions.
Effects of Virechana In Non-alcoholic Fatty liver Diseases-A Case StudySushant Sahu
This document presents a case study on the effects of virechana (therapeutic purgation) in treating non-alcoholic fatty liver disease. It summarizes that NAFLD is a growing cause of chronic liver disease in India, with no approved modern medical treatment. The case study administered virechana according to Ayurvedic guidelines to a patient diagnosed with NAFLD via blood tests and ultrasound. Follow-up tests after treatment showed decreased liver enzymes, weight, BMI, and hepatomegaly, indicating virechana improved the condition and liver function. The study concludes that virechana is an effective Ayurvedic approach for managing NAFLD and its symptoms.
giornate nefrologiche pisane: Quintaliani Presente e futuro della terapia nut...Giuseppe Quintaliani
This document summarizes a presentation on present and future nutrition therapy for chronic kidney disease (CKD), discussing the cost-benefit rationale. It notes that while dietary counseling is used irregularly for reasons like initial findings that low-protein diets did not significantly slow CKD progression in non-diabetic patients, randomized controlled trials have since found that protein restriction does delay end-stage renal disease in adults with chronic renal failure. The document concludes that protein restriction effectively slows the progression of both diabetic and nondiabetic renal diseases.
Venous Thromboembolism (VTE) and Anticoagulation in Cancerflasco_org
This document discusses venous thromboembolism (VTE) and anticoagulation in cancer patients. It notes that cancer patients have a higher risk of VTE than non-cancer patients, and that VTE is a common cause of death in cancer patients. For initial treatment of VTE, low molecular weight heparin (LMWH) is the standard of care based on clinical trial evidence showing it reduces VTE recurrence compared to warfarin without increasing bleeding risk. For long-term treatment, LMWH is also preferred over warfarin due to warfarin's interactions with cancer and its treatments. Direct oral anticoagulants are an emerging option but more research is needed before recommending
Cadth 2015 e5 noac ad symposium_panel_14apr2015CADTH Symposium
This document summarizes a symposium on promoting evidence-based use of anticoagulants across Canada. It discusses the prevalence of atrial fibrillation, options for anticoagulation including warfarin and newer oral anticoagulants, and initiatives for collaboration between provinces to educate health professionals and patients on appropriate anticoagulant therapy. Speakers from various provinces outlined academic detailing programs and a CADTH systematic review comparing benefits and harms of anticoagulants.
This document provides guidance on indications and limitations of bariatric interventions in severely obese children and adolescents with and without nonalcoholic steatohepatitis (NASH). It finds that bariatric surgery can decrease steatosis, inflammation, and fibrosis in NASH, but uncomplicated NAFLD is not an indication. Roux-en-Y gastric bypass is considered safe and effective for adolescents with extreme obesity if long-term follow-up is provided, while laparoscopic adjustable gastric banding is still investigational. More research is needed on other procedures and temporary devices in pediatrics. NASH with significant fibrosis, type 2 diabetes, moderate-to-severe sleep apnea, and pseudot
Rivaroxaban versus Warfarina en el tratamiento de la Fibrilación AuricularHospital Guadix
This randomized controlled trial compared the anticoagulant rivaroxaban to warfarin for preventing stroke in patients with nonvalvular atrial fibrillation. Over 14,000 patients were assigned to either rivaroxaban or warfarin. In the primary analysis, rivaroxaban was found to be noninferior to warfarin in preventing strokes and systemic embolisms. Rivaroxaban was also associated with less intracranial hemorrhaging and fatal bleeding than warfarin. Major bleeding events occurred at a similar rate between the two groups. The study provides evidence that rivaroxaban is a noninferior alternative to warfarin for preventing strokes in patients with atrial fib
This document provides guidelines for evaluating abnormal liver chemistries. It defines key liver enzymes and what they indicate, such as ALT and AST indicating hepatocellular injury and alkaline phosphatase indicating cholestatic injury or obstruction. The guidelines recommend testing patients for various liver diseases based on the degree of elevation of their liver enzymes. For mild elevations under 5 times the upper limit of normal, the guidelines recommend testing for viral hepatitis, NAFLD, hemochromatosis, and other conditions. For moderate elevations from 5-15 times the upper limit, they recommend additional testing for acute hepatitis. For severe elevations over 15 times the upper limit or over 10,000 IU/L, testing for acetaminophen toxicity
This document discusses guidelines for monitoring HIV patients on antiretroviral treatment. It recommends monitoring baseline labs at treatment initiation, including CD4 count. Patients should be closely monitored in the first 6 months, including for treatment toxicity and failure. Labs and clinical assessments are recommended every 2-4 weeks initially, then every 6 months once stable. Toxicities may require switching antiretroviral drugs, like substituting TDF for kidney issues. The goal of monitoring is to ensure viral suppression through adherence and detecting problems promptly.
International Journal of Engineering Research and Applications (IJERA) is an open access online peer reviewed international journal that publishes research and review articles in the fields of Computer Science, Neural Networks, Electrical Engineering, Software Engineering, Information Technology, Mechanical Engineering, Chemical Engineering, Plastic Engineering, Food Technology, Textile Engineering, Nano Technology & science, Power Electronics, Electronics & Communication Engineering, Computational mathematics, Image processing, Civil Engineering, Structural Engineering, Environmental Engineering, VLSI Testing & Low Power VLSI Design etc.
Similar to study and results of HepQuant tests with HCV antivirals PDF pg 1149 (20)
Describing and Interpreting an Immersive Learning Case with the Immersion Cub...Leonel Morgado
Current descriptions of immersive learning cases are often difficult or impossible to compare. This is due to a myriad of different options on what details to include, which aspects are relevant, and on the descriptive approaches employed. Also, these aspects often combine very specific details with more general guidelines or indicate intents and rationales without clarifying their implementation. In this paper we provide a method to describe immersive learning cases that is structured to enable comparisons, yet flexible enough to allow researchers and practitioners to decide which aspects to include. This method leverages a taxonomy that classifies educational aspects at three levels (uses, practices, and strategies) and then utilizes two frameworks, the Immersive Learning Brain and the Immersion Cube, to enable a structured description and interpretation of immersive learning cases. The method is then demonstrated on a published immersive learning case on training for wind turbine maintenance using virtual reality. Applying the method results in a structured artifact, the Immersive Learning Case Sheet, that tags the case with its proximal uses, practices, and strategies, and refines the free text case description to ensure that matching details are included. This contribution is thus a case description method in support of future comparative research of immersive learning cases. We then discuss how the resulting description and interpretation can be leveraged to change immersion learning cases, by enriching them (considering low-effort changes or additions) or innovating (exploring more challenging avenues of transformation). The method holds significant promise to support better-grounded research in immersive learning.
Anti-Universe And Emergent Gravity and the Dark UniverseSérgio Sacani
Recent theoretical progress indicates that spacetime and gravity emerge together from the entanglement structure of an underlying microscopic theory. These ideas are best understood in Anti-de Sitter space, where they rely on the area law for entanglement entropy. The extension to de Sitter space requires taking into account the entropy and temperature associated with the cosmological horizon. Using insights from string theory, black hole physics and quantum information theory we argue that the positive dark energy leads to a thermal volume law contribution to the entropy that overtakes the area law precisely at the cosmological horizon. Due to the competition between area and volume law entanglement the microscopic de Sitter states do not thermalise at sub-Hubble scales: they exhibit memory effects in the form of an entropy displacement caused by matter. The emergent laws of gravity contain an additional ‘dark’ gravitational force describing the ‘elastic’ response due to the entropy displacement. We derive an estimate of the strength of this extra force in terms of the baryonic mass, Newton’s constant and the Hubble acceleration scale a0 = cH0, and provide evidence for the fact that this additional ‘dark gravity force’ explains the observed phenomena in galaxies and clusters currently attributed to dark matter.
Discovery of An Apparent Red, High-Velocity Type Ia Supernova at 𝐳 = 2.9 wi...Sérgio Sacani
We present the JWST discovery of SN 2023adsy, a transient object located in a host galaxy JADES-GS
+
53.13485
−
27.82088
with a host spectroscopic redshift of
2.903
±
0.007
. The transient was identified in deep James Webb Space Telescope (JWST)/NIRCam imaging from the JWST Advanced Deep Extragalactic Survey (JADES) program. Photometric and spectroscopic followup with NIRCam and NIRSpec, respectively, confirm the redshift and yield UV-NIR light-curve, NIR color, and spectroscopic information all consistent with a Type Ia classification. Despite its classification as a likely SN Ia, SN 2023adsy is both fairly red (
�
(
�
−
�
)
∼
0.9
) despite a host galaxy with low-extinction and has a high Ca II velocity (
19
,
000
±
2
,
000
km/s) compared to the general population of SNe Ia. While these characteristics are consistent with some Ca-rich SNe Ia, particularly SN 2016hnk, SN 2023adsy is intrinsically brighter than the low-
�
Ca-rich population. Although such an object is too red for any low-
�
cosmological sample, we apply a fiducial standardization approach to SN 2023adsy and find that the SN 2023adsy luminosity distance measurement is in excellent agreement (
≲
1
�
) with
Λ
CDM. Therefore unlike low-
�
Ca-rich SNe Ia, SN 2023adsy is standardizable and gives no indication that SN Ia standardized luminosities change significantly with redshift. A larger sample of distant SNe Ia is required to determine if SN Ia population characteristics at high-
�
truly diverge from their low-
�
counterparts, and to confirm that standardized luminosities nevertheless remain constant with redshift.
CLASS 12th CHEMISTRY SOLID STATE ppt (Animated)eitps1506
Description:
Dive into the fascinating realm of solid-state physics with our meticulously crafted online PowerPoint presentation. This immersive educational resource offers a comprehensive exploration of the fundamental concepts, theories, and applications within the realm of solid-state physics.
From crystalline structures to semiconductor devices, this presentation delves into the intricate principles governing the behavior of solids, providing clear explanations and illustrative examples to enhance understanding. Whether you're a student delving into the subject for the first time or a seasoned researcher seeking to deepen your knowledge, our presentation offers valuable insights and in-depth analyses to cater to various levels of expertise.
Key topics covered include:
Crystal Structures: Unravel the mysteries of crystalline arrangements and their significance in determining material properties.
Band Theory: Explore the electronic band structure of solids and understand how it influences their conductive properties.
Semiconductor Physics: Delve into the behavior of semiconductors, including doping, carrier transport, and device applications.
Magnetic Properties: Investigate the magnetic behavior of solids, including ferromagnetism, antiferromagnetism, and ferrimagnetism.
Optical Properties: Examine the interaction of light with solids, including absorption, reflection, and transmission phenomena.
With visually engaging slides, informative content, and interactive elements, our online PowerPoint presentation serves as a valuable resource for students, educators, and enthusiasts alike, facilitating a deeper understanding of the captivating world of solid-state physics. Explore the intricacies of solid-state materials and unlock the secrets behind their remarkable properties with our comprehensive presentation.
Immersive Learning That Works: Research Grounding and Paths ForwardLeonel Morgado
We will metaverse into the essence of immersive learning, into its three dimensions and conceptual models. This approach encompasses elements from teaching methodologies to social involvement, through organizational concerns and technologies. Challenging the perception of learning as knowledge transfer, we introduce a 'Uses, Practices & Strategies' model operationalized by the 'Immersive Learning Brain' and ‘Immersion Cube’ frameworks. This approach offers a comprehensive guide through the intricacies of immersive educational experiences and spotlighting research frontiers, along the immersion dimensions of system, narrative, and agency. Our discourse extends to stakeholders beyond the academic sphere, addressing the interests of technologists, instructional designers, and policymakers. We span various contexts, from formal education to organizational transformation to the new horizon of an AI-pervasive society. This keynote aims to unite the iLRN community in a collaborative journey towards a future where immersive learning research and practice coalesce, paving the way for innovative educational research and practice landscapes.
Authoring a personal GPT for your research and practice: How we created the Q...Leonel Morgado
Thematic analysis in qualitative research is a time-consuming and systematic task, typically done using teams. Team members must ground their activities on common understandings of the major concepts underlying the thematic analysis, and define criteria for its development. However, conceptual misunderstandings, equivocations, and lack of adherence to criteria are challenges to the quality and speed of this process. Given the distributed and uncertain nature of this process, we wondered if the tasks in thematic analysis could be supported by readily available artificial intelligence chatbots. Our early efforts point to potential benefits: not just saving time in the coding process but better adherence to criteria and grounding, by increasing triangulation between humans and artificial intelligence. This tutorial will provide a description and demonstration of the process we followed, as two academic researchers, to develop a custom ChatGPT to assist with qualitative coding in the thematic data analysis process of immersive learning accounts in a survey of the academic literature: QUAL-E Immersive Learning Thematic Analysis Helper. In the hands-on time, participants will try out QUAL-E and develop their ideas for their own qualitative coding ChatGPT. Participants that have the paid ChatGPT Plus subscription can create a draft of their assistants. The organizers will provide course materials and slide deck that participants will be able to utilize to continue development of their custom GPT. The paid subscription to ChatGPT Plus is not required to participate in this workshop, just for trying out personal GPTs during it.
The debris of the ‘last major merger’ is dynamically youngSérgio Sacani
The Milky Way’s (MW) inner stellar halo contains an [Fe/H]-rich component with highly eccentric orbits, often referred to as the
‘last major merger.’ Hypotheses for the origin of this component include Gaia-Sausage/Enceladus (GSE), where the progenitor
collided with the MW proto-disc 8–11 Gyr ago, and the Virgo Radial Merger (VRM), where the progenitor collided with the
MW disc within the last 3 Gyr. These two scenarios make different predictions about observable structure in local phase space,
because the morphology of debris depends on how long it has had to phase mix. The recently identified phase-space folds in Gaia
DR3 have positive caustic velocities, making them fundamentally different than the phase-mixed chevrons found in simulations
at late times. Roughly 20 per cent of the stars in the prograde local stellar halo are associated with the observed caustics. Based
on a simple phase-mixing model, the observed number of caustics are consistent with a merger that occurred 1–2 Gyr ago.
We also compare the observed phase-space distribution to FIRE-2 Latte simulations of GSE-like mergers, using a quantitative
measurement of phase mixing (2D causticality). The observed local phase-space distribution best matches the simulated data
1–2 Gyr after collision, and certainly not later than 3 Gyr. This is further evidence that the progenitor of the ‘last major merger’
did not collide with the MW proto-disc at early times, as is thought for the GSE, but instead collided with the MW disc within
the last few Gyr, consistent with the body of work surrounding the VRM.
Microbial interaction
Microorganisms interacts with each other and can be physically associated with another organisms in a variety of ways.
One organism can be located on the surface of another organism as an ectobiont or located within another organism as endobiont.
Microbial interaction may be positive such as mutualism, proto-cooperation, commensalism or may be negative such as parasitism, predation or competition
Types of microbial interaction
Positive interaction: mutualism, proto-cooperation, commensalism
Negative interaction: Ammensalism (antagonism), parasitism, predation, competition
I. Mutualism:
It is defined as the relationship in which each organism in interaction gets benefits from association. It is an obligatory relationship in which mutualist and host are metabolically dependent on each other.
Mutualistic relationship is very specific where one member of association cannot be replaced by another species.
Mutualism require close physical contact between interacting organisms.
Relationship of mutualism allows organisms to exist in habitat that could not occupied by either species alone.
Mutualistic relationship between organisms allows them to act as a single organism.
Examples of mutualism:
i. Lichens:
Lichens are excellent example of mutualism.
They are the association of specific fungi and certain genus of algae. In lichen, fungal partner is called mycobiont and algal partner is called
II. Syntrophism:
It is an association in which the growth of one organism either depends on or improved by the substrate provided by another organism.
In syntrophism both organism in association gets benefits.
Compound A
Utilized by population 1
Compound B
Utilized by population 2
Compound C
utilized by both Population 1+2
Products
In this theoretical example of syntrophism, population 1 is able to utilize and metabolize compound A, forming compound B but cannot metabolize beyond compound B without co-operation of population 2. Population 2is unable to utilize compound A but it can metabolize compound B forming compound C. Then both population 1 and 2 are able to carry out metabolic reaction which leads to formation of end product that neither population could produce alone.
Examples of syntrophism:
i. Methanogenic ecosystem in sludge digester
Methane produced by methanogenic bacteria depends upon interspecies hydrogen transfer by other fermentative bacteria.
Anaerobic fermentative bacteria generate CO2 and H2 utilizing carbohydrates which is then utilized by methanogenic bacteria (Methanobacter) to produce methane.
ii. Lactobacillus arobinosus and Enterococcus faecalis:
In the minimal media, Lactobacillus arobinosus and Enterococcus faecalis are able to grow together but not alone.
The synergistic relationship between E. faecalis and L. arobinosus occurs in which E. faecalis require folic acid
EWOCS-I: The catalog of X-ray sources in Westerlund 1 from the Extended Weste...Sérgio Sacani
Context. With a mass exceeding several 104 M⊙ and a rich and dense population of massive stars, supermassive young star clusters
represent the most massive star-forming environment that is dominated by the feedback from massive stars and gravitational interactions
among stars.
Aims. In this paper we present the Extended Westerlund 1 and 2 Open Clusters Survey (EWOCS) project, which aims to investigate
the influence of the starburst environment on the formation of stars and planets, and on the evolution of both low and high mass stars.
The primary targets of this project are Westerlund 1 and 2, the closest supermassive star clusters to the Sun.
Methods. The project is based primarily on recent observations conducted with the Chandra and JWST observatories. Specifically,
the Chandra survey of Westerlund 1 consists of 36 new ACIS-I observations, nearly co-pointed, for a total exposure time of 1 Msec.
Additionally, we included 8 archival Chandra/ACIS-S observations. This paper presents the resulting catalog of X-ray sources within
and around Westerlund 1. Sources were detected by combining various existing methods, and photon extraction and source validation
were carried out using the ACIS-Extract software.
Results. The EWOCS X-ray catalog comprises 5963 validated sources out of the 9420 initially provided to ACIS-Extract, reaching a
photon flux threshold of approximately 2 × 10−8 photons cm−2
s
−1
. The X-ray sources exhibit a highly concentrated spatial distribution,
with 1075 sources located within the central 1 arcmin. We have successfully detected X-ray emissions from 126 out of the 166 known
massive stars of the cluster, and we have collected over 71 000 photons from the magnetar CXO J164710.20-455217.
PPT on Alternate Wetting and Drying presented at the three-day 'Training and Validation Workshop on Modules of Climate Smart Agriculture (CSA) Technologies in South Asia' workshop on April 22, 2024.
Alternate Wetting and Drying - Climate Smart Agriculture
study and results of HepQuant tests with HCV antivirals PDF pg 1149
1. Official Journal of the American Association for the Study of Liver Diseases
HEPATOLOGY
VOLUME 60, NUMBER 1 (SUPPL) — OCTOBER 2014
HEPATOLOGYOctober2014—Pages1–1266VOLUME60,NUMBER1(SUPPL)
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3. Over 9 years of prescribing
experience in the US
More than 9 million
prescriptions filled
worldwide1
All individuals depicted are
models and not actual patients.
Over 99 years of prescribing
experience in the US
Important Safety Information
WARNINGS: SEVERE ACUTE EXACERBATIONS OF HEPATITIS B, PATIENTS
CO-INFECTED WITH HIV AND HBV, and LACTIC ACIDOSIS AND HEPATOMEGALY
• Severe acute exacerbations of hepatitis B have been reported in patients
who have discontinued anti-hepatitis B therapy, including entecavir.
Hepatic function should be monitored closely with both clinical and
laboratory follow-up for at least several months in patients who
discontinue anti-hepatitis B therapy. If appropriate, initiation of
anti-hepatitis B therapy may be warranted.
• Limited clinical experience suggests there is a potential for the
development of resistance to HIV (human immunodeficiency virus)
nucleoside reverse transcriptase inhibitors if BARACLUDE (entecavir) is
used to treat chronic HBV infection in patients with HIV infection that is
not being treated. Therapy with BARACLUDE is not recommended for
HIV/HBV co-infected patients who are not also receiving highly active
antiretroviral therapy (HAART).
• Lactic acidosis and severe hepatomegaly with steatosis, including
fatal cases, have been reported with the use of nucleoside analogues,
alone or in combination with antiretrovirals.
Please see Brief Summary of
Full Prescribing Information,
Including Boxed WARNINGS,
following the next pages.
Indication
BARACLUDE (entecavir) is indicated for the treatment of chronic hepatitis B
virus (HBV) infection in adults with evidence of active viral replication
and either evidence of persistent elevations in serum aminotransferases
(ALT or AST) or histologically active disease. The following points should be
considered when initiating BARACLUDE:
• This indication is based on histologic, virologic, biochemical, and serologic
responses in nucleoside-treatment-naïve and lamivudine-resistant adult
subjects with HBeAg-positive or HBeAg-negative chronic HBV infection
and compensated liver disease.
• Virologic, biochemical, serologic, and safety data are available from
a controlled study in adult subjects with chronic HBV infection
and decompensated liver disease.
• Virologic, biochemical, serologic, and safety data are available for a
limited number of adult subjects with HIV/HBV co-infection who have
received prior lamivudine therapy.
(continued on the following pages)
4. BARACLUDE®
(entecavir) is a
recommended first-line option
in CHB guidelines in the
US and around the world2-8
BAR
reco
in C
US a
American Association
for the Study of Liver
Diseases (AASLD)
US Algorithm European
Association for
the Study of the
Liver (EASL)
Japanese Ministry
of Health, Labour
and Welfare Study
Group Guideline
for CHB
The Korean
Association
for the Study
of the Liver
Chinese
Medical
Association
Asian Pacific
Association
for the Study
of the Liver
For nucleoside-naïve chronic hepatitis B (CHB) adults with evidence of active virus and
either evidence of persistent elevations in ALT or AST or histologically active disease
Warnings and Precautions
• Before initiating BARACLUDE (entecavir)
therapy, HIV antibody testing should be
offered to all patients. BARACLUDE has not
been studied as a treatment for HIV infection
and is not recommended for this use.
• Lactic acidosis with BARACLUDE use has been
reported, often in association with hepatic
decompensation, other serious medical
conditions, or drug exposures. Patients with
decompensated liver disease may be at higher
risk for lactic acidosis. BARACLUDE should
be suspended in any patient who develops
clinical or laboratory findings suggestive of
lactic acidosis or pronounced hepatotoxicity.
Adverse Reactions
• In clinical trials in patients with compensated
liver disease, the most common (≥3%) adverse
reactions of any severitywithatleast a possible
relation to study drug for BARACLUDE-
treated subjects were headache, fatigue,
dizziness, and nausea. In these trials, the most
common adverse reactions of moderate to
severe intensity (grades 2-4) were diarrhea,
dyspepsia, nausea, vomiting, fatigue,
headache, dizziness, somnolence, and
insomnia.
• In the decompensated liver disease trial,
the most common adverse reactions of
any severity among patients treated with
BARACLUDE, regardless of causality,
included: peripheral edema (16%),
ascites (15%), pyrexia (14%), hepatic
encephalopathy (10%), and upper respiratory
infection (10%). In this trial, 18% (18/102) of
BARACLUDE patients and 20% (18/89) of
adefovir patients died during the first 48
weeks of therapy. The majority of those
deaths were due to liver related causes.
Drug Interactions
BARACLUDE is primarily eliminated by
the kidneys, therefore coadministration of
BARACLUDE with drugs that reduce renal
function or compete for active tubular secretion
may increase serum concentrations of either
entecavir or the coadministered drug. Patients
should be monitored closely when receiving
BARACLUDE with other renally-eliminated
drugs.
Pregnancy and Nursing Mothers
• There are no adequate and well-controlled
studies of BARACLUDE in pregnant women.
BARACLUDE should be used during
pregnancy only if clearly needed and after
careful consideration of the risks and benefits.
• There are no studies on the effect of
BARACLUDE on transmission of HBV from
mother to infant. Therefore, appropriate
interventions should be used to prevent
neonatal acquisition of HBV.
• It is not known whether BARACLUDE is
excreted into human milk; however, many
drugs are excreted into breast milk. Due to
the potential for serious adverse reactions
in nursing infants from BARACLUDE, risks
and benefits should be considered when
deciding whether to discontinue breast-
feeding or discontinue BARACLUDE in
nursing women.
Pediatric Use
• Safety and effectiveness of BARACLUDE in
pediatric patients below the age of 16 years
have not been established.
Renal Impairment
• Dosage adjustment of BARACLUDE is
recommended for patients with a creatinine
clearance <50 mL/min, including those on
Please see Brief Summary of Full Prescribing Information,
including Boxed WARNINGS, following the next pages.
Important Safety Information about BARACLUDE®
(entecavir) TABLETS:
(continued from previous page)
(continued on the following page)
APASL
6. BARACLUDE®
(entecavir)BARACLUDE®
(entecavir) tablets, for oral use
BARACLUDE®
(entecavir) oral solution
Brief Summary of Prescribing Information. For complete prescribing information consult official
package insert.
WARNING: SEVERE ACUTE EXACERBATIONS OF HEPATITIS B, PATIENTS CO-INFECTED
WITH HIV AND HBV, and LACTIC ACIDOSIS AND HEPATOMEGALY
Severe acute exacerbations of hepatitis B have been reported in patients who have
discontinued anti-hepatitis B therapy, including entecavir. Hepatic function should
be monitored closely with both clinical and laboratory follow-up for at least several
months in patients who discontinue anti-hepatitis B therapy. If appropriate, initiation of
anti-hepatitis B therapy may be warranted [see Warnings and Precautions].
Limited clinical experience suggests there is a potential for the development of
resistance to HIV (human immunodeficiency virus) nucleoside reverse transcriptase
inhibitors if BARACLUDE (entecavir) is used to treat chronic hepatitis B virus (HBV)
infection in patients with HIV infection that is not being treated. Therapy with
BARACLUDE is not recommended for HIV/HBV co-infected patients who are not also
receiving highly active antiretroviral therapy (HAART) [see Warnings and Precautions].
Lactic acidosis and severe hepatomegaly with steatosis, including fatal cases, have been
reported with the use of nucleoside analogue inhibitors alone or in combination with
antiretrovirals [see Warnings and Precautions].
CONTRAINDICATIONS: None.
WARNINGS AND PRECAUTIONS: Severe Acute Exacerbations of Hepatitis B - Severe acute
exacerbations of hepatitis B have been reported in patients who have discontinued anti-hepatitis B
therapy, including entecavir [see Adverse Reactions]. Hepatic function should be monitored closely
with both clinical and laboratory follow-up for at least several months in patients who discontinue
anti-hepatitis B therapy. If appropriate, initiation of anti-hepatitis B therapy may be warranted.
Patients Co-infected with HIV and HBV - BARACLUDE has not been evaluated in HIV/HBV co-infected
patients who were not simultaneously receiving effective HIV treatment. Limited clinical experience
suggests there is a potential for the development of resistance to HIV nucleoside reverse transcriptase
inhibitors if BARACLUDE is used to treat chronic hepatitis B virus infection in patients with HIV infection
that is not being treated [see Microbiology (12.4) in full Prescribing Information]. Therefore, therapy
with BARACLUDE is not recommended for HIV/HBV co-infected patients who are not also receiving
HAART. Before initiating BARACLUDE therapy, HIV antibody testing should be offered to all patients.
BARACLUDE has not been studied as a treatment for HIV infection and is not recommended for this use.
Lactic Acidosis and Severe Hepatomegaly with Steatosis - Lactic acidosis and severe hepatomegaly
with steatosis, including fatal cases, have been reported with the use of nucleoside analogue inhibitors,
including BARACLUDE, alone or in combination with antiretrovirals. A majority of these cases have been
in women. Obesity and prolonged nucleoside inhibitor exposure may be risk factors. Particular caution
should be exercised when administering nucleoside analogue inhibitors to any patient with known risk
factors for liver disease; however, cases have also been reported in patients with no known risk factors.
Lactic acidosis with BARACLUDE use has been reported, often in association with hepatic
decompensation, other serious medical conditions, or drug exposures. Patients with decompensated
liver disease may be at higher risk for lactic acidosis. Treatment with BARACLUDE should be suspended
in any patient who develops clinical or laboratory findings suggestive of lactic acidosis or pronounced
hepatotoxicity (which may include hepatomegaly and steatosis even in the absence of marked
transaminase elevations).
ADVERSE REACTIONS: The following adverse reactions are discussed in other sections of the labeling:
• Exacerbations of hepatitis after discontinuation of treatment [see Boxed Warning, Warnings and
Precautions].
• Lactic acidosis and severe hepatomegaly with steatosis [see Boxed Warning, Warnings and
Precautions].
Clinical Trial Experience in Adults - Because clinical trials are conducted under widely varying
conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared
to rates in the clinical trials of another drug and may not reflect the rates observed in practice.
Compensated Liver Disease - Assessment of adverse reactions is based on four studies (AI463014,
AI463022, AI463026, and AI463027) in which 1720 subjects with chronic hepatitis B virus infection
and compensated liver disease received double-blind treatment with BARACLUDE 0.5 mg/day (n=679),
BARACLUDE 1 mg/day (n=183), or lamivudine (n=858) for up to 2 years. Median duration of therapy
was 69 weeks for BARACLUDE-treated subjects and 63 weeks for lamivudine-treated subjects in
Studies AI463022 and AI463027 and 73 weeks for BARACLUDE-treated subjects and 51 weeks for
lamivudine-treated subjects in Studies AI463026 and AI463014. The safety profiles of BARACLUDE and
lamivudine were comparable in these studies.
The most common adverse reactions of any severity (≥3%) with at least a possible relation to
study drug for BARACLUDE-treated subjects were headache, fatigue, dizziness, and nausea. The
most common adverse reactions among lamivudine-treated subjects were headache, fatigue, and
dizziness. One percent of BARACLUDE-treated subjects in these four studies compared with 4% of
lamivudine-treated subjects discontinued for adverse events or abnormal laboratory test results.
Clinical adverse reactions of moderate-severe intensity and considered at least possibly related to
treatment occurring during therapy in four clinical studies in which BARACLUDE was compared with
lamivudine are presented in Table 1.
Table 1: Clinical Adverse Reactionsa
of Moderate-Severe Intensity (Grades 2-4) Reported in
Four Entecavir Clinical Trials Through 2 Years
Nucleoside-Inhibitor-Naïveb
Lamivudine-Refractoryc
Body System/
Adverse Reaction
BARACLUDE
0.5 mg
n=679
LVD
100 mg
n=668
BARACLUDE
1 mg
n=183
LVD
100 mg
n=190
Any Grade 2-4
adverse reactiona
Gastrointestinal
Diarrhea
Dyspepsia
Nausea
Vomiting
General
Fatigue
Nervous System
Headache
Dizziness
Somnolence
Psychiatric
Insomnia
15%
<1%
<1%
<1%
<1%
1%
2%
<1%
<1%
<1%
18%
0
<1%
<1%
<1%
1%
2%
<1%
<1%
<1%
22%
1%
1%
<1%
<1%
3%
4%
0
0
0
23%
0
0
2%
0
3%
1%
1%
0
<1%
a
Includes events of possible, probable, certain, or unknown relationship to treatment regimen. b
Studies
AI463022 and AI463027. c
Includes Study AI463026 and the BARACLUDE 1 mg and lamivudine treatment
arms of Study AI463014, a Phase 2 multinational, randomized, double-blind study of three doses of
BARACLUDE (0.1, 0.5, and 1 mg) once daily versus continued lamivudine 100 mg once daily for up to 52
weeks in subjects who experienced recurrent viremia on lamivudine therapy. LVD = Lamivudine.
Laboratory Abnormalities - Frequencies of selected treatment-emergent laboratory abnormalities
reportedduringtherapyinfourclinicaltrialsofBARACLUDEcomparedwithlamivudinearelistedinTable2.
Table 2: Selected Treatment-Emergenta
Laboratory Abnormalities Reported in Four Entecavir
Clinical Trials Through 2 Years
Nucleoside-Inhibitor-Naïveb
Lamivudine-Refractoryc
Test
BARACLUDE
0.5 mg
n=679
LVD
100 mg
n=668
BARACLUDE
1 mg
n=183
LVD
100 mg
n=190
Any Grade 3-4
laboratory
abnormalityd
ALT >10 x ULN and
>2 x baseline
ALT >5 x ULN
Albumin <2.5 g/dL
Total bilirubin
>2.5 x ULN
Lipase ≥2.1 x ULN
Creatinine >3 x ULN
Confirmed creatinine
increase ≥0.5 mg/dL
Hyperglycemia, fasting
>250 mg/dL
Glycosuriae
Hematuriaf
Platelets <50,000/mm3
35%
2%
11%
<1%
2%
7%
0
1%
2%
4%
9%
<1%
36%
4%
16%
<1%
2%
6%
0
1%
1%
3%
10%
<1%
37%
2%
12%
0
3%
7%
0
2%
3%
4%
9%
<1%
45%
11%
24%
2%
2%
7%
0
1%
1%
6%
6%
<1%
a
On-treatment value worsened from baseline to Grade 3 or Grade 4 for all parameters except albumin
(any on-treatment value <2.5 g/dL), confirmed creatinine increase ≥0.5 mg/dL, and ALT >10 x ULN
and >2 x baseline. b
Studies AI463022 and AI463027. c
Includes Study AI463026 and the BARACLUDE
1 mg and lamivudine treatment arms of Study AI463014, a Phase 2 multinational,
randomized, double-blind study of three doses of BARACLUDE (0.1, 0.5, and 1 mg)
once daily versus continued lamivudine 100 mg once daily for up to 52 weeks in subjects who experienced
recurrent viremia on lamivudine therapy. d
Includes hematology, routine chemistries, renal and liver
function tests, pancreatic enzymes, and urinalysis. e
Grade 3 = 3+, large, ≥500 mg/dL; Grade 4 = 4+,
marked, severe. f
Grade 3 = 3+, large; Grade 4 = ≥4+, marked, severe, many. LVD = Lamivudine, ULN
= upper limit of normal.
Among BARACLUDE-treated subjects in these studies, on-treatment ALT elevations greater than
10 times the upper limit of normal (ULN) and greater than 2 times baseline generally resolved with
continued treatment. A majority of these exacerbations were associated with a ≥2 log10
/mL reduction
in viral load that preceded or coincided with the ALT elevation. Periodic monitoring of hepatic function
is recommended during treatment.
Exacerbations of Hepatitis after Discontinuation of Treatment - An exacerbation of hepatitis
or ALT flare was defined as ALT >10 x ULN and >2 x the subject’s reference level (minimum
of the baseline or last measurement at end of dosing). For all subjects who discontinued
treatment (regardless of reason), the proportion of subjects who experienced post-treatment
ALT flares was as follows: 2% (4/174) in the BARACLUDE-treated group and 9% (13/147)
in the lamivudine-treated group in nucleoside-inhibitor-naïve, HBeAg-positive subjects
in study AI463022; 8% (24/302) in the BARACLUDE-treated group and 11% (30/270) in the
lamivudine-treated group in nucleoside-inhibitor-naïve HBeAg-negative subjects in study AI463027;
12% (6/52) in the BARACLUDE-treated group and 0% (0/16) in the lamivudine-treated group among
lamivudine-refractory subjects in study AI463026. The median time to off-treatment exacerbation
was 23 weeks for BARACLUDE-treated subjects and 10 weeks for lamivudine-treated subjects.
In these studies, a subset of subjects was allowed to discontinue treatment at or after 52 weeks if
they achieved a protocol-defined response to therapy. If BARACLUDE is discontinued without regard to
treatment response, the rate of post-treatment flares could be higher. [See Warnings and Precautions.]
Decompensated Liver Disease - Study AI463048 was a randomized, open-label study of
BARACLUDE 1 mg once daily versus adefovir dipivoxil 10 mg once daily given for up to 48 weeks
in adult subjects with chronic HBV infection and evidence of hepatic decompensation, defined as
a Child-Turcotte-Pugh (CTP) score of 7 or higher [see Clinical Studies (14.1) in full Prescribing
Information]. Among the 102 subjects receiving BARACLUDE, the most common treatment-emergent
adverse events of any severity, regardless of causality, occurring through Week 48 were peripheral
7. edema (16%), ascites (15%), pyrexia (14%), hepatic encephalopathy (10%), and upper respiratory infection
(10%). Clinical adverse reactions not listed in Table 1 that were observed through Week 48 include blood
bicarbonate decreased (2%) and renal failure (<1%).
Eighteen of 102 (18%) subjects treated with BARACLUDE and 18/89 (20%) subjects treated with adefovir
dipivoxil died during the first 48 weeks of therapy. The majority of deaths (11 in the BARACLUDE group
and 16 in the adefovir dipivoxil group) were due to liver-related causes such as hepatic failure, hepatic
encephalopathy, hepatorenal syndrome, and upper gastrointestinal hemorrhage. The rate of hepatocellular
carcinoma (HCC) through Week 48 was 6% (6/102) for subjects treated with BARACLUDE and 8% (7/89)
for subjects treated with adefovir dipivoxil. Five percent of subjects in either treatment arm discontinued
therapy due to an adverse event through Week 48.
No subject in either treatment arm experienced an on-treatment hepatic flare (ALT >2 x baseline and >10
x ULN) through Week 48. Eleven of 102 (11%) subjects treated with BARACLUDE and 11/89 (13%) subjects
treated with adefovir dipivoxil had a confirmed increase in serum creatinine of 0.5 mg/dL through Week 48.
HIV/HBV Co-infected - The safety profile of BARACLUDE 1 mg (n=51) in HIV/HBV co-infected subjects
enrolled in Study AI463038 was similar to that of placebo (n=17) through 24 weeks of blinded treatment
and similar to that seen in non-HIV infected subjects [see Warnings and Precautions].
Liver Transplant Recipients - Among 65 subjects receiving BARACLUDE in an open-label, post-liver
transplant trial [see Use in Specific Populations], the frequency and nature of adverse events were
consistent with those expected in patients who have received a liver transplant and the known safety
profile of BARACLUDE.
Clinical Trial Experience in Pediatric Subjects - Because clinical trials are conducted under widely
varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly
compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice.
The safety of BARACLUDE in pediatric subjects 2 to less than 18 years of age is based on two ongoing
clinical trials in subjects with chronic HBV infection (one Phase 2 pharmacokinetic trial [AI463028] and
one Phase 3 trial [AI463189]). These trials provide experience in 168 HBeAg-positive subjects treated with
BARACLUDE for a median duration of 72 weeks. The adverse reactions observed in pediatric subjects who
received treatment with BARACLUDE were consistent with those observed in clinical trials of BARACLUDE in
adults. Adverse drug reactions reported in greater than 1% of pediatric subjects included abdominal pain,
rash events, poor palatability (“product taste abnormal”), nausea, diarrhea, and vomiting.
Postmarketing Experience - The following adverse reactions have been reported during postmarketing
use of BARACLUDE. Because these reactions were reported voluntarily from a population of unknown
size, it is not possible to reliably estimate their frequency or establish a causal relationship to
BARACLUDE exposure. Immune system disorders: Anaphylactoid reaction. Metabolism and nutrition
disorders: Lactic acidosis. Hepatobiliary disorders: Increased transaminases. Skin and subcutaneous
tissue disorders: Alopecia, rash.
DRUG INTERACTIONS: Since entecavir is primarily eliminated by the kidneys [see Clinical Pharmacology
(12.3) in full Prescribing Information], coadministration of BARACLUDE with drugs that reduce renal
function or compete for active tubular secretion may increase serum concentrations of either entecavir
or the coadministered drug. Coadministration of entecavir with lamivudine, adefovir dipivoxil, or tenofovir
disoproxil fumarate did not result in significant drug interactions. The effects of coadministration of
BARACLUDE with other drugs that are renally eliminated or are known to affect renal function have
not been evaluated, and patients should be monitored closely for adverse events when BARACLUDE is
coadministered with such drugs.
USE IN SPECIFIC POPULATIONS: Pregnancy - Pregnancy Category C. There are no adequate and well-
controlled studies of BARACLUDE in pregnant women. Because animal reproduction studies are not always
predictive of human response, BARACLUDE should be used during pregnancy only if the potential benefit
justifies the potential risk to the fetus.
Antiretroviral Pregnancy Registry: To monitor fetal outcomes of pregnant women exposed to
BARACLUDE, an Antiretroviral Pregnancy Registry has been established. Healthcare providers are
encouraged to register patients by calling 1-800-258-4263.
Animal Data - Animal reproduction studies with entecavir in rats and rabbits revealed no evidence of
teratogenicity. Developmental toxicity studies were performed in rats and rabbits. There were no signs
of embryofetal or maternal toxicity when pregnant animals received oral entecavir at approximately
28 (rat) and 212 (rabbit) times the human exposure achieved at the highest recommended human dose
of 1 mg/day. In rats, maternal toxicity, embryofetal toxicity (resorptions), lower fetal body weights, tail and
vertebral malformations, reduced ossification (vertebrae, sternebrae, and phalanges), and extra lumbar
vertebrae and ribs were observed at exposures 3100 times those in humans. In rabbits, embryofetal
toxicity (resorptions), reduced ossification (hyoid), and an increased incidence of 13th rib were observed at
exposures 883 times those in humans. In a peri-postnatal study, no adverse effects on offspring occurred
when rats received oral entecavir at exposures greater than 94 times those in humans.
Labor and Delivery - There are no studies in pregnant women and no data on the effect of BARACLUDE on
transmission of HBV from mother to infant. Therefore, appropriate interventions should be used to prevent
neonatal acquisition of HBV.
Nursing Mothers - It is not known whether BARACLUDE is excreted into human milk; however, entecavir
is excreted into the milk of rats. Because many drugs are excreted into human milk and because of the
potential for serious adverse reactions in nursing infants from BARACLUDE, a decision should be made to
discontinue nursing or to discontinue BARACLUDE taking into consideration the importance of continued
hepatitis B therapy to the mother and the known benefits of breastfeeding.
Pediatric Use - BARACLUDE was evaluated in two clinical trials of pediatric subjects 2 years of age
and older with HBeAg-positive chronic HBV infection and compensated liver disease. The exposure of
BARACLUDE in nucleoside-inhibitor-treatment-naïve and lamivudine-experienced pediatric subjects
2 years of age and older with HBeAg-positive chronic HBV infection and compensated liver disease
receiving 0.015 mg/kg (up to 0.5 mg once daily) or 0.03 mg/kg (up to 1 mg once daily), respectively,
was evaluated in Study AI463028. Safety and efficacy of the selected dose in treatment-naïve pediatric
subjects were confirmed in Study AI463189, a randomized, placebo-controlled treatment trial [see Adverse
Reactions and Indications and Usage (1), Dosage and Administration (2.3), Clinical Pharmacology (12.3),
and Clinical Studies (14.2) in full Prescribing Information].
There are limited data available on the use of BARACLUDE in lamivudine-experienced pediatric patients;
BARACLUDE should be used in these patients only if the potential benefit justifies the potential risk to
the child. Since some pediatric patients may require long-term or even lifetime management of chronic
active hepatitis B, consideration should be given to the impact of BARACLUDE on future treatment options
[see Microbiology (12.4) in full Prescribing Information].
The efficacy and safety of BARACLUDE have not been established in patients less than 2 years of age.
Use of BARACLUDE in this age group has not been evaluated because treatment of HBV in this age group
is rarely required.
BARACLUDE®
(entecavir) BARACLUDE®
(entecavir)
Geriatric Use - Clinical studies of BARACLUDE did not include sufficient numbers of subjects aged
65 years and over to determine whether they respond differently from younger subjects. Entecavir
is substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater
in patients with impaired renal function. Because elderly patients are more likely to have decreased
renal function, care should be taken in dose selection, and it may be useful to monitor renal function
[see Dosage and Administration (2.4) in full Prescribing Information].
Racial/Ethnic Groups - There are no significant racial differences in entecavir pharmacokinetics.
The safety and efficacy of BARACLUDE 0.5 mg once daily were assessed in a single-arm, open-label
trial of HBeAg-positive or -negative, nucleoside-inhibitor-naïve, Black/African American (n=40) and
Hispanic (n=6) subjects with chronic HBV infection. In this trial, 76% of subjects were male, the mean
age was 42 years, 57% were HBeAg-positive, the mean baseline HBV DNA was 7.0 log10
IU/mL,
and the mean baseline ALT was 162 U/L. At Week 48 of treatment, 32 of 46 (70%) subjects had
HBV DNA <50 IU/mL (approximately 300 copies/mL), 31 of 46 (67%) subjects had ALT normalization
(≤1 × ULN), and 12 of 26 (46%) HBeAg-positive subjects had HBe seroconversion. Safety data were
similar to those observed in the larger controlled clinical trials.
Because of low enrollment, safety and efficacy have not been established in the US Hispanic population.
Renal Impairment - Dosage adjustment of BARACLUDE is recommended for patients with creatinine
clearance less than 50 mL/min, including patients on hemodialysis or CAPD [see Dosage and
Administration (2.4) and Clinical Pharmacology (12.3) in full Prescribing Information].
Liver Transplant Recipients - The safety and efficacy of BARACLUDE were assessed in a single-arm,
open-label trial in 65 subjects who received a liver transplant for complications of chronic HBV infection.
Eligible subjects who had HBV DNA less than 172 IU/mL (approximately 1000 copies/mL) at the time
of transplant were treated with BARACLUDE 1 mg once daily in addition to usual post-transplantation
management, including hepatitis B immune globulin. The trial population was 82% male, 39% Caucasian,
and 37% Asian, with a mean age of 49 years; 89% of subjects had HBeAg-negative disease at the time
of transplant.
Four of the 65 subjects received 4 weeks or less of BARACLUDE (2 deaths, 1 retransplantation, and
1 protocol violation) and were not considered evaluable. Of the 61 subjects who received more
than 4 weeks of BARACLUDE, 60 received hepatitis B immune globulin post-transplant. Fifty-three
subjects (82% of all 65 subjects treated) completed the trial and had HBV DNA measurements at or
after 72 weeks treatment post-transplant. All 53 subjects had HBV DNA <50 IU/mL (approximately
300 copies/mL). Eight evaluable subjects did not have HBV DNA data available at 72 weeks, including 3
subjects who died prior to study completion. No subjects had HBV DNA values ≥50 IU/mL while receiving
BARACLUDE (plus hepatitis B immune globulin). All 61 evaluable subjects lost HBsAg post-transplant;
2 of these subjects experienced recurrence of measurable HBsAg without recurrence of HBV viremia.
This trial was not designed to determine whether addition of BARACLUDE to hepatitis B immune
globulin decreased the proportion of subjects with measurable HBV DNA post-transplant compared to
hepatitis B immune globulin alone.
If BARACLUDE treatment is determined to be necessary for a liver transplant recipient who has received
or is receiving an immunosuppressant that may affect renal function, such as cyclosporine or tacrolimus,
renal function must be carefully monitored both before and during treatment with BARACLUDE [see
Dosage and Administration (2.4) and Clinical Pharmacology (12.3) in full Prescribing Information].
OVERDOSAGE: There is limited experience of entecavir overdosage reported in patients. Healthy subjects
who received single entecavir doses up to 40 mg or multiple doses up to 20 mg/day for up to 14 days
had no increase in or unexpected adverse events. If overdose occurs, the patient must be monitored for
evidence of toxicity, and standard supportive treatment applied as necessary.
Following a single 1 mg dose of entecavir, a 4-hour hemodialysis session removed approximately 13%
of the entecavir dose.
NONCLINICAL TOXICOLOGY: Carcinogenesis, Mutagenesis, Impairment of Fertility.
Carcinogenesis - Long-term oral carcinogenicity studies of entecavir in mice and rats were carried
out at exposures up to approximately 42 times (mice) and 35 times (rats) those observed in humans
at the highest recommended dose of 1 mg/day. In mouse and rat studies, entecavir was positive for
carcinogenic findings.
In mice, lung adenomas were increased in males and females at exposures 3 and 40 times those in
humans. Lung carcinomas in both male and female mice were increased at exposures 40 times those
in humans. Combined lung adenomas and carcinomas were increased in male mice at exposures 3
times and in female mice at exposures 40 times those in humans. Tumor development was preceded
by pneumocyte proliferation in the lung, which was not observed in rats, dogs, or monkeys administered
entecavir, supporting the conclusion that lung tumors in mice may be a species-specific event.
Hepatocellular carcinomas were increased in males and combined liver adenomas and carcinomas were
also increased at exposures 42 times those in humans. Vascular tumors in female mice (hemangiomas
of ovaries and uterus and hemangiosarcomas of spleen) were increased at exposures 40 times those
in humans. In rats, hepatocellular adenomas were increased in females at exposures 24 times those in
humans; combined adenomas and carcinomas were also increased in females at exposures 24 times
those in humans. Brain gliomas were induced in both males and females at exposures 35 and 24 times
those in humans. Skin fibromas were induced in females at exposures 4 times those in humans.
It is not known how predictive the results of rodent carcinogenicity studies may be for humans.
Mutagenesis - Entecavir was clastogenic to human lymphocyte cultures. Entecavir was not mutagenic
in the Ames bacterial reverse mutation assay using S. typhimurium and E. coli strains in the presence
or absence of metabolic activation, a mammalian-cell gene mutation assay, and a transformation assay
with Syrian hamster embryo cells. Entecavir was also negative in an oral micronucleus study and an oral
DNA repair study in rats.
Impairment of Fertility - In reproductive toxicology studies, in which animals were administered
entecavir at up to 30 mg/kg for up to 4 weeks, no evidence of impaired fertility was seen in male or
female rats at systemic exposures greater than 90 times those achieved in humans at the highest
recommended dose of 1 mg/day. In rodent and dog toxicology studies, seminiferous tubular degeneration
was observed at exposures 35 times or greater than those achieved in humans. No testicular changes
were evident in monkeys.
1323583 Rev May 2014
686US14BR01514-02-01
8. OFFIC IAL JOURNAL OF THE AMERI CAN A SSOCIATION F OR THE STUDY OF LI VER DISEASES
Editor
Michael H. Nathanson, New Haven, CT
SENIOR ASSOCIATE EDITORS
James L. Boyer, New Haven, CT
Roberto J. Groszmann, New Haven, CT
ASSOCIATE EDITORS
Frank A. Anania, Atlanta, GA
Jorge A. Bezerra, Cincinnati, OH
Guadalupe Garcia-Tsao, New Haven, CT
Stephen A. Harrison, Fort Sam Houston, TX
Donald M. Jensen, Chicago, IL
Brett Lindenbach, New Haven, CT
Jacquelyn Maher, San Francisco, CA
Wajahat Mehal, New Haven, CT
Lola M. Reid, Chapel Hill, NC
Mario Strazzabosco, New Haven, CT
Norah Terrault, San Francisco, CA
Snorri S. Thorgeirsson, Bethesda, MD
Michael Trauner, Vienna, Austria
CONSULTING BIOSTATISTICIAN
James Dziura, New Haven, CT
HEPATOLOGY ELSEWHERE
Yasuko Iwakiri, New Haven, CT
Tamar H. Taddei, New Haven, CT
EDITORS EMERITUS
Irwin M. Arias, Boston, MA, Founding Editor
Steven Schenker, San Antonio, TX
Paul D. Berk, New York, NY
D. Montgomery Bissell, San Francisco, CA
Andres T. Blei, Chicago, IL
Keith D. Lindor, Rochester, MN
CLINICAL OBSERVATIONS IN HEPATOLOGY
Victor J. Navarro, Philadelphia, PA
Simona Jakab, New Haven, CT
HEPATOLOGY HIGHLIGHTS
Jean-Franc¸ois Dufour, Bern, Switzerland
PRODUCTION STAFF
Ann Haran, Managing Editor
Kareytis Martinez, Editorial Assistant
Tazeen Shirazi, Editorial Assistant
Dana Lombardi, Editorial Assistant
Kara Cheatham, Editorial Assistant
EDITORIAL BOARD
Manal Abdelmalek, Durham, NC
Juan Abraldes, Alberta, Canada
Gianfranco Alpini, Temple, TX
Raul Andrade, Ma´laga, Spain
Mario Angelico, Rome, Italy
Paul Angulo, Lexington, KY
Meena Bansal, New York, NY
Ulrich Beuers, Amsterdam, Netherlands
Jordi Bruix, Barcelona, Spain
Elizabeth Brunt, St. Louis, MO
John Bucuvalas, Cincinatti, OH
Michael Charlton, Rochester, MN
John Chiang, Rootstown, OH
David Cohen, Boston, MA
Kenneth Cusi, San Antonio, TX
Mark Czaja, New York, NY
Gennaro D’Amico, Palermo, Italy
Gary Davis, Dallas, TX
Anna Mae Diehl, Durham, NC
Alvaro Domenico, Rome, Italy
Jean Dubuisson, Lille, France
Ronald Oude Elferink, Amsterdam, Netherlands
Jeff Esko, Manchester, United Kingdom
Michael Fallon, Houston, TX
Jordan Feld, Toronto, Canada
Ariel Feldstein, Cleveland, OH
Andrew Feranchak, Dallas, TX
Peter Ferenci, Vienna, Austria
Jose Fernandez-Checa, Barcelona, Spain
Peter Fickert, Graz, Austria
Stuart Forbes, Edinburgh, United Kingdom
Michael Fried, Chapel Hill, NC
Mark Furth, Winston-Salem, NC
Bin Gao, Bethesda, MD
Juan Carlos Garcia-Paga´n, Barcelona, Spain
Eugenio Gaudio, Rome, Italy
Eric Gershwin, Sacramento, CA
Jim D Gorham, Lebanon, NH
Arash Grakoui, Atlanta, GA
Ivo Graziadei, Innsbruck, Austria
Kenichi Ikejima, Tokyo, Japan
Ira Jacobson, New York, NY
Dhanpat Jain, New Haven, CT
Harmut Jaeschke, Kansas City, KS
Peter Jansen, Netherlands
Harry Janssen, Rotterdam, Netherlands
Cynthia Ju, Denver, CO
Patrick Kamath, Rochester, MN
Neil Kaplowitz, Los Angeles, CA
Tom Karlsen, Oslo, Norway
Saul Karpen, Atlanta, GA
W. Ray Kim, Rochester, MN
Curtis Klaassen, Kansas City, KS
Percy Knolle, Bonn, Germany
Sanjay Kulkarni, New Haven, CT
William Lee, Dallas, TX
Stanley Lemon, Chapel Hill, NC
Massimo Levrero, Rome, Italy
Joseph Lim, New Haven, CT
Maribel Lucena, Ma´laga, Spain
Derek Mann, Newcastle Upon Tyne, United Kingdom
M. Michele Manos, Oakland, CA
Fabio Marra, Florence, Italy
Jane McKeating, Birmingham, United Kingdom
Brian McMahon, Anchorage, Alaska
Philip Meuleman, Ghent, Belgium
Pram Mistry, New Haven, CT
Atsushi Miyajima, Tokyo, Japan
Satdarshan Monga (Paul) Singh, Pittsburgh, PA
Richard Moreau, Beaujon, France
Masaki Mori, Osaka, Japan
Antonio Moschetta, Bari, Italy
Andrew Muir, Durham, NC
Kevin Mullen, Cleveland, OH
Laura Nagy, Cleveland, OH
David Nelson, Bethesda, MD
James Neuberger, Birmingham, United Kingdom
Young-Nyun Park, Yonsei, Korea
Markus Peck-Radosavljevic, Vienna, Austria
Robert Perrillo, Dallas, TX
Massimo Pinzani, Florence, Italy
Jeffrey Pollak, New Haven, CT
Fred Poordad, Los Angeles, CA
Elizabeth Powell, Brisbane, Australia
Nancy Reau, Chicago, IL
K. Rajender Reddy, Philadelphia, PA
Mary Rinella, Chicago, IL
Cristina Ripoll, Halle an der Saale, Germany
Lewis R. Roberts, Rochester, MN
Sammy Saab, Los Angeles, CA
Francesco Salerno, Milan, Italy
Peter Schirmacher, Heidelberg, Germany
Robert Schwabe, New York, NY
Gamel Shiha, Almansoura, Egypt
Ben Shneider, Pittsburgh, PA
Ron Sokol, Aurora, CO
Bruno Stieger, Zurich, Switzerland
Fred Suchy, Denver, CO
Mark Sulkowski, Baltimore, MD
Gyongyi Szabo, Worchester, MA
Puneeta Tandon, Edmonton, Canada
Neil Theise, New York, NY
Zhigang Tian, Hefei, China
Dawn Torres, Baltimore, MD
Augusto Villanueva, Barcelona, Spain
Miriam Vos, Atlanta, GA
Fu-Sheng Wang, Beijing, China
Yunfang Wang, Beijing, China
Xin Wei Wang, Bethesda, MD
Rebecca Wells, Philadelphia, PA
Brian West, New Haven, CT
Reiner Wiest, Regensberg, Germany
Florence Wong, Toronto, Canada
Hushan Yang, Philadelphia, PA
Min You, San Francisco, CA
Nizar Zein, Cleveland, OH
Jessica Zucman-Rossi, Paris, France
American Association for the Study of Liver Diseases—Governing Board 2014
President
Adrian M. Di Bisceglie, St. Louis, MO
President-Elect
Gyongi Szabo, Worcester, MA
Secretary
Gary L. Davis, Simpsonville, SC
Past President
J. Gregory Fitz, Dallas, TX
Councilors
Keith D. Lindor, Tempe, AZ
Anna S.F. Lok, Ann Arbor, MI
Ronald J. Sokol, Aurora, CO
Councilors-at-Large
Raymond T. Chung, Boston, MA
Susan Orloff, Portland, OR
K. Rajender Reddy, Philadelphia, PA
Publications Committee Chair
Theo Heller, Bethesda, MD
Treasurer
W. Ray Kim, Stanford, CA
AASLD National Headquarters: 1001 North Fairfax Street, Suite 400, Alexandria, VA 22314. Phone: 703-299-9766; Fax: 703-299-9622; E-mail: AASLD@AASLD.org.
Chief Executive Officer, Steven Echard
Editorial Office: 1001 North Fairfax Street, Suite 400, Alexandria, VA 22314. Phone: 703-299-9766; Fax: 703-299-9676; E-mail: hepatology@aasld.org
HEPATOLOGY (Print ISSN 0270-9139; Online ISSN 1527-3350 at Wiley Online Library (wileyonlinelibrary.com)) is published monthly in two indexed volumes through Wiley Subscription
Services, a Wiley Company, 111 River St., Hoboken, NJ 07030. Subscription rates for Volumes 59-60, 2014. Institution (includes Liver Transplantation, Volume 20, 2014) Print only: in U.S.,
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9. 2015 Research and Career Development Awards
We understand the phenomenal return on investment that research can provide. Several
young investigators began their careers in biomedical research thanks to funding from
our program, demonstrating the importance of these awards not only to investigators and
practitioners, but to the very endeavor of medical and hepatobiliary research itself.
Application Deadline:
DECEMBER 4, 2014
*NP/PA Clinical Hepatology
Fellowship Application Deadline:
FEBRUARY 5, 2015
Recipient Notification:
MAY 2015
Award Start Date:
JULY 1, 2015
Research Awards
Pinnacle Research Award in Liver Disease
$300,000—3 year award
NEW IN 2015
Clinical and Translational Research Awards in Liver Diseases
$150,000—2 year award
Career Development Award in Liver Transplantation
$90,000—2 year award
Career Development Awards
NP/PA Clinical Hepatology Fellowship*
$78,000—1 year award
AASLD/LIFER Clinical and Translational Research Fellowship
$75,000—1 year award
Advanced/Transplant Hepatology Fellowship
$60,000—1 year award
Awards applications
are available at
WWW.AASLD.ORG/AWARDS
10. iiA
The overall goal of The Liver Meeting® is to provide a forum
for the exchange of ground breaking research and clinical
information in diseases of the liver and biliary tract and in liver
transplantation.
Target Audience
Groups include clinical hepatologists, gastroenterologists,
other health care providers (midlevel providers, internists,
pediatricians, family practitioners), and trainees (students,
residents, and specialty fellows). The target audience also
encompasses scientists studying the development, physiology,
pathology, translational medicine, and clinical trials related to
the liver and biliary tract and liver transplantation.
AASLD takes responsibility for the content, quality, and scientific
integrity of this live activity.
Learning Objectives
Upon participation in this live educational activity, learners will
be able to:
• Incorporate new scientific evidence into clinical care
protocols and improve the outcome of adults and children
with acute and chronic diseases of the liver and biliary tract.
• Establish new collaborations, implement new clinical trials,
develop comparative effectiveness projects, and complete
investigative efforts that will improve the outcome of adults
and children with acute and chronic diseases of the liver and
biliary tract.
• Implement effective care plans to improve the long-term
outcome of the transplanted patient.
Continuing Medical Education (CME)
Accreditation Statement
The American Association for the Study of Liver Diseases
(AASLD) is accredited by the Accreditation Council for
Continuing Medical Education (ACCME) to provide continuing
medical education for physicians.
Credit Designation Statement
AASLD designates these live activities for AMA PRA Category 1
Credits™. Physicians should claim only the credit commensurate
with the extent of their participation in the activity.
Maximum Credits Available
Annual Meeting (State-of-the-Art Lectures; President’s Choice;
General Hepatology Update; Advances for Practitioners;
Plenaries and Parallel Sessions; Global Forum; MOC Session;
Value-Based Medicine in Hepatology; and
Emerging Trends) . . . . . . . . . . . . . . . . . . 20.5 CME Credits
Postgraduate Course. . . . . . . . . . . . . . . . 12.0 CME Credits
Basic Research Workshop . . . . . . . . . . . . . 4.0 CME Credits
Hepatology Associates Course . . . . . . . . . . 5.5 CME Credits
AASLD/ILTS Transplant Course* . . . . . . . . . 6.5 CME Credits
AASLD/NASPGHAN
Pediatric Symposium**. . . . . . . . . . . . . . 3.0 CME Credits
AASLD/ASGE Endoscopy Course** . . . . . . . 7.0 CME Credits
Transplant Surgery Workshop . . . . . . . . . . 3.5 CME Credits
*This activity has been planned and implemented in accordance
with the Essential Areas and Policies of the Accreditation Council for
Continuing Medical Education through the joint providership of the
American Association for the Study of Liver Diseases (AASLD), and the
International Liver Transplantation Society (ILTS). AASLD is accredited
by the ACCME to provide continuing medical education for physicians.
**Co-sponsored activity: The American Association for the Study of
Liver Diseases (AASLD) is accredited by the Accreditation Council for
Continuing Medical Education to provide continuing medical education
for physicians.
Please note: As an accredited provider, AASLD ensures the content of
all CME activities and related materials will promote improvements or
quality in health care, and not a specific proprietary business interest
of a commercial interest. As such, some sessions or ticketed activities
may not offer CME credits.
Continuing Education (CE)
The Institute for Advancement of Human Behavior (IAHB) is accredited
as a provider of continuing nursing education by the American Nurses
Credentialing Center’s Commission on Accreditation. These activities
are co-provided by IAHB and AASLD. Maximum 20 contact hours.
The following ticketed activities will award nurse continuing education
contact hours:
• AASLD/ILTS Transplant Course – 5 contact hours
• Postgraduate Course – 10 contact hours
• Hepatology Associates Course – 5 contact hours
Faculty Disclosure
It is the policy of AASLD to ensure balance, independence,
objectivity, and scientific rigor in all its individually or jointly
sponsored educational programs.
All faculty/authors participating in any AASLD sponsored
programs, as well as planners and committee members are
expected to disclose any real or apparent conflict(s) of interest
that may have a direct bearing on the subject matter of the
continuing medical education program.
When an unlabeled use of a commercial product, or an
investigational use not yet approved for any purpose is
discussed during an educational activity, the speaker shall
disclose to the audience that the product is not labeled for the
use under discussion or that the product is still investigational.
All disclosure information is provided to the activity participant
prior to the start of the educational activity. In addition,
disclosure slides will be the first slide in each oral presentation
viewed by participants. AASLD will identify and resolve all
conflicts of interest prior to program implementation.
Accreditation and Continuing Education Information
11. iiiA
Accreditation and Continuing Education Information
Disclaimer Statement
Statements, opinions, and results of studies presented at The
Liver Meeting® are solely those of the authors and do not reflect
the policy or position of AASLD. AASLD does not provide any
warranty to the accuracy or reliability of information presented
either verbally or in writing by presenters. No responsibility is
assumed by AASLD for any injury and/or damage to persons
or property resulting from any use of such information.
Use of AASLD Scientific Program Content
Information presented during the 65th Annual Meeting is the
property of AASLD and the presenter. Information may not
be recorded, photographed, copied, photocopied, transferred
to electronic format, reproduced, or distributed without the
written permission of AASLD and the presenter. Any use of
the program content, which includes, but is not limited to oral
presentations, audiovisual materials used by speakers, and
program handouts, without the written consent of AASLD is
prohibited.
Claiming CME/CE Credit and
Certificates of Attendance
The CME/CE evaluations are electronic and can be completed
using the following options:
• Upon download, use the meeting app to evaluate the
sessions in real-time
• Using your personal device, link to the CME and/or CE
evaluation on The Liver Meeting® website
• Visit Tech Connect to access the evaluation from any
available kiosk
CME and CE credit will be awarded upon completion of the
electronic evaluation. You will have the ability to download
and/or print a certificate for your records once you have
completed the CME and/or CE evaluations.
Certificates of Attendance are also available. Certificates may
be downloaded and/or printed upon completion of The Liver
Meeting® evaluation.
Outcomes Follow-up Survey
A follow-up survey will be sent to all attendees within three
months of the conclusion of the meeting to assess the new skills
and competencies learned as a result of participating in this
live activity.
12. ivA
Future Meetings 2015
Digestive Disease Week® (DDW)
May 16 – 19
Walter E. Washington Convention Center
Washington, DC
Clinical Hepatology: State-of-the-Art Management
June 27 – 28
The Westin Chicago River North
Chicago, Illinois
Emerging Trends Conference
AASLD Industry Colloquium: Novel Targets and Therapies in Liver Disease
Spring 2015
Location TBD
The Liver Meeting®
November 13 – 17
Moscone West Convention Center
San Francisco, California
Postgraduate Course
Managing Liver Disease - From the Clinic to the Community
November 14
Moscone West Convention Center
San Francisco, California
13. vA
THE AMERICAN ASSOCIATION FOR THE STUDY OF LIVER DISEASES
65th ANNUAL MEETING AND POSTGRADUATE COURSE
N O V E M B E R 7 – N O V E M B E R 1 1 • B O S T O N , M A
The Liver Meeting®
2O14
Table of Contents
Meeting-at-a-Glance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2A
General Meeting Information . . . . . . . . . . . . . . . . . . . . . . . 5A
Limited License . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7A
Disclosure Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8A
Oral Sessions
Friday, November 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 32A
Saturday, November 8 . . . . . . . . . . . . . . . . . . . . . . . . . . 39A
Sunday, November 9 . . . . . . . . . . . . . . . . . . . . . . . . . . . 43A
Monday, November 10 . . . . . . . . . . . . . . . . . . . . . . . . . . 65A
Tuesday, November 11 . . . . . . . . . . . . . . . . . . . . . . . . . . 85A
Poster Sessions
Saturday, November 8 . . . . . . . . . . . . . . . . . . . . . . . . . . 92A
Sunday, November 9 . . . . . . . . . . . . . . . . . . . . . . . . . . 119A
Monday, November 10 . . . . . . . . . . . . . . . . . . . . . . . . . 146A
Tuesday, November 11 . . . . . . . . . . . . . . . . . . . . . . . . . 169A
Abstracts . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 197A
Author Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1206A
Category Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1256A
The Scientific Program Committee has created an exciting
and diverse scientific program that highlights new technology,
current clinical issues and hot topics facing the hepatology
community. Members include:
Adrian M. Di Bisceglie, MD, FACP, Co-Chair
Gary L. Davis, MD, Co-Chair
Carla W. Brady, MD
Kenneth D. Chavin, MD, PhD
Mark J. Czaja, MD
Marc G. Ghany, MD
Saul J. Karpen, MD, PhD
Keith D. Lindor, MD
Gyongyi Szabo, MD, PhD
Rebecca T. Wells, MD
14. NP/PA Clinical Hepatology Fellowship Program
$
78,000, One Year*
Pursue a full year of training in clinical hepatology—apply for the NP/PA Clinical
Hepatology Fellowship. If you are new to the field or interested in a shift in focus to
clinical hepatology—the NP/PA Clinical Hepatology Fellowship provides $78,000* for
one year of clinical training for those committed to the field of hepatology and better
treatment for patients with liver disease.
The application is available at www.aasld.org/awards
Application Deadline:
FEBRUARY 5, 2015
Award Start Date:
JULY 1, 2015
*Salary and benefit support only—AASLD provides equal opportunity for all
research and fellowship award applicants without regard to race, color, creed,
religion, gender, sexual orientation, national origin, age, marital status, mental
or physical disability, pregnancy, military or veteran status, or any other basis
prohibited by state or federal law.
15. Earn CME and prepare for your internal medicine,
gastroenterology, or transplant hepatology exam
with board-style practice questions from Clinical
Liver Disease (CLD). Each question set helps
you identify areas for further review and links to
free online resources—articles, videos, webinars,
and podcasts—that can help you update your
knowledge on a variety of hepatology topics.
Nurses and physician assistants will also
benefit from the review questions and from the
full spectrum of clinical education available
through CLD.
Visit cldlearning.com/questions to start today.
CLD is an online learning resource of the American
Association for the Study of Liver Diseases.
Free Board Review
Questions
16. YOU CAN ALSO DOWNLOAD THESE
PRACTICE GUIDELINE TOPICS FOR LIVER DISEASE
■■ Acute Liver Failure
■■ Alcoholic Liver
Disease
■■ Ascites due
to Cirrhosis
■■ Autoimmune
Hepatitis
■■ Gastroesophageal
Varices and Variceal
Hemorrhage
in Cirrhosis
■■ Hemochromatosis
■■ Hepatitis B, Chronic
■■ Hepatocellular
Carcinoma
■■ Liver Biopsy
■■ Long-Term
Management of
Adult Patients
After Liver
Transplantation
■■ Long-Term
Management
of Pediatric
Patients After Liver
Transplantation
■■ Non-alcoholic Fatty
Liver Disease
■■ Primary Biliary
Cirrhosis
■■ Primary Sclerosing
Cholangitis
■■ TIPS in
Management of
Portal Hypertension
■■ Vascular Disorders
of the Liver
■■ Wilson Disease
NEW Practice
Guidelines in 2014
Available at www.aasld.org
■■ Hepatic Encephalopathy in Chronic Liver Disease
■■ Evaluation for Liver Transplantation in Adults
■■ Evaluation of the Pediatric Patient for Liver Transplantation
These evidence-based guidelines are developed and
updated regularly by a committee of experts and include
recommendations of preferred approaches to the diagnostic,
therapeutic, and preventative aspects of care.
FIND OUT MORE
AT
THE PAVILION
Visit the AASLD Pavilion
Just outside registration
17. 2A
Meeting-at-a-Glance
The majority of events during The Liver Meeting® will take place in the Hynes Convention Center. Those events not taking
place at the convention center will be noted. Sessions marked with an asterisk * require a ticket for entrance.
Day/Time Activity Location Page
Friday, November 7
7:55 am – 3:00 pm AASLD/ASGE Endoscopy Course * Room 302 32A
8:00 am – 2:45 pm AASLD/ ILTS Transplant Course * Ballroom B/C 33A
10:00 am – Noon Career Development Workshop * Room 311 34A
Noon – 3:00 pm AASLD/NASPGHAN Pediatric Symposium * Room 312 35A
12:30 – 2:45 pm Competency Training Workshop Room 309 36A
12:30 – 3:30 pm Clinical Research Workshop * Room 304/306 37A
3:30 – 7:30 pm Postgraduate Course * Auditorium 38A
Saturday, November 8
8:00 am – 5:00 pm Postgraduate Course * Auditorium 39A
9:00 am – Noon SIG Program: Outreach in Liver Transplant Room 302 40A
12:20 – 1:40 pm Meet-the-Professor Luncheons * Check your Ticket 41A
2:00 – 7:30 pm Poster Session I Hall C
• Ascites, Renal Dysfunction and Hepatorenal Syndrome 92A
• Behavioral, Quality of Life, and Practice Issues 93A
• Cholangiocyte Biology 93A
• Cholestasis and Autoimmune Liver Disease 94A
• Donor Factors and Allocation 97A
• Encephalopathy and Other Complications 98A
• Experimental Cholestasis 101A
• Fibrosis: Clinical and Translational 101A
• Hemochromatosis, Wilson Disease, a-1 Antitrypsin Deficiency 104A
• Imaging in Cancer 104A
• Imaging in Fibrosis 105A
• Immunosuppression 106A
• Infections and Acute on Chronic Liver Failure 110A
• Inflammation and Immunobiology: Animal Models 112A
• Innate Immunity and Adaptive 113A
• Living Donor and Split Transplant 114A
• Mechanisms of Injury 115A
• Metabolic and Genetic Diseases 115A
• Viral and Autoimmune Hepatitis 116A
• Viral Hepatitis and Liver Transplant 116A
3:30 – 7:00 pm Transplant Surgery Workshop * Room 302 42A
5:15 – 6:15 pm AASLD Business Meeting (Members Only) Auditorium 42A
5:00 – 7:30 pm Exhibits Open Hall D 41A
5:00 – 7:30 pm Opening Reception Hall C/D 41A
Sunday, November 9
6:45 – 7:45 am Early Morning Workshops * Check your ticket 43A
8:00 – 9:30 am Transplant Plenary I Auditorium 44A
8:00 am – Noon Basic Research Workshop * Ballroom A 45A
8:00 am – 1:30 pm Hepatology Associates Course * Room 304/306 46A
8:00 am – 5:30 pm Poster Session II Hall C
• Acute Liver Failure 119A
• Basic Fibrosis 121A
• Clinical Steatohepatitis 123A
• Experimental Hepatocarcinogenesis 129A
• Hepatitis C: Approved Therapeutic Agents 132A
• Hepatotoxicity: Drug Metabolism 138A
• Hepatotoxicity: Mechanisms 139A
• Imaging of Steatohepatitis 140A
• Steatohepatitis 140A
• Transport, Bilirubin, Cholesterol, Lipids and Bile Salts 145A
18. 3A
Sunday, November 9
9:30 – 10:00 am Thomas E. Starzl Transplant Surgery State-of-the-Art Lecture Auditorium 47A
9:30 am – 3:00 pm Exhibits Open Hall D 44A
10:00 – 10:30 am Coffee Break Hall D 47A
10:00 – 11:30 am Emerging Trends Symposium Room 312 48A
10:30 am – Noon Transplant Plenary II Auditorium 49A
Noon – 12:30 pm Hans Popper Basic Science State-of-the-Art Lecture Auditorium 50A
1:00 – 3:00 pm Value-based Medicine in Hepatology Room 302 50A
1:15 – 2:45 pm Maintenance of Certification (MOC) Update Room 210 51A
1:30 – 2:00 pm Snack Break Hall D 51A
2:00 – 2:30 pm Ethics and Humanities State-of-the-Art Lecture Auditorium 52A
2:45 – 3:00 pm Distinguished Clinician Educator / Mentor Award Auditorium 52A
3:00 – 4:30 pm General Hepatology Update Ballroom A/B/C 52A
3:00 – 4:30 pm Parallel Sessions
1. Advances in Fibrosis Imaging Room 309 53A
2. Antivirals, Acute Liver Failure in Liver Transplantation Room 312 53A
3. Basic Mechanisms of Liver Fibrosis Sheraton, Republic Ballroom 54A
4. Cholestatic and Autoimmune Liver Disease Room 302 54A
5. Experimental Hepatocarcinogenesis Sheraton, Back Bay Ballroom C 55A
6. Hepatitis C: Currently Approved Drugs Auditorium 55A
7. Mechanisms of Hepatotoxicity Room 210 56A
8. Novel Approaches in Diagnosis and Treatment
in NAFLD and NASH Room 304/306 56A
9. Tissue Damage in Liver Disease and Inflammatory and Viral Room 311 57A
4:45 – 6:15 pm Parallel Sessions
10. HBV Diagnosis, Epidemiology, Prevention and Natural History Room 312 57A
11. Hepatitis C: Health Economics and Cost-effectiveness Room 304/306 58A
12. Hepatitis C: New Agents – Part 1 Auditorium 58A
13. Machine Perfusion and Cellular Therapy Room 309 59A
14. Outcomes in Cirrhosis Ballroom A/B/C 59A
15. Steatohepatitis: Experimental Room 311 60A
4:45 – 6:45 pm SIG Program: Pharmacogenomic Approaches in DILI Research Room 210 61A
4:45 – 7:00 pm SIG Program: Primary Liver Carcinomas with Intermediate/Stem Cell
Features: Microscopic to Genomic Evidence and Back Sheraton, Back Bay Ballroom C 62A
4:45 – 7:00 pm SIG Program: Controversies in the Management
of PSC in Children and Adults Room 302 63A
4:45 – 7:45 pm SIG Program: The Cell Biology of Hepatic Disease Sheraton, Republic Ballroom 64A
Monday, November 10
6:45 – 7:45 am Early Morning Workshops * Check your ticket 65A
8:00 – 9:30 am Basic Plenary Auditorium 66A
8:00 am – 5:30 pm Poster Session III Hall C
• Alcohol: Clinical and Basic Mechanisms 146A
• Basic Hepatobiliary Neoplasia 148A
• Biliary Atresia and Cholestasis 150A
• Cellular and Molecular Biology 150A
• Cellular Immunobiology 152A
• Clinical Hepatobiliary Neoplasia 153A
• Cost-effectiveness 160A
• HCV: Diagnostics, Epidemiology, and Natural History 160A
• Health Care Delivery 166A
• Pediatric Liver Disease – Basic Science 168A
• Pediatric Liver Transplantation 168A
9:30 – 10:00 am Distinguished Service and Achievement Awards Auditorium 66A
9:30 am – 3:00 pm Exhibits Open Hall D 66A
10:00 – 10:30 am Hyman J. Zimmerman Hepatotoxicity State-of-the-Art Lecture Auditorium 67A
10:30 – 11:00 am Coffee Break Hall D 67A
11:00 am – 12:30 pm Clinical Plenary Auditorium 68A
11:00 am – 12:30 pm Advances for Practitioners Ballroom A/B/C 69A
11:45 am – 1:15 pm Professional Development Workshop * Sheraton, Republic Ballroom 70A
Meeting-at-a-Glance (continued)
Day/Time Activity Location Page
19. 4A
Meeting-at-a-Glance (continued)
Day/Time Activity Location Page
Monday, November 10
1:30 – 2:00 pm Snack Break Hall D 70A
2:00 – 4:00 pm Global Forum Room 304/306 71A
2:15 – 2:45 pm President’s Choice Auditorium 72A
2:45 – 4:30 pm Late-breaking Abstract Session Auditorium 72A
3:00 – 4:30 pm Parallel Sessions
16. Access, Delivery, and Cost of Care Room 210 73A
17. Allocation, MELD, and Liver Transplantation Room 312 73A
18. Basic Hepatobiliary Neoplasia Room 310 74A
19. Cholestatic Liver Disease Room 302 74A
20. Mechanisms and Mortality in Alcoholic Liver Disease Room 313 75A
21. Molecular and Cellular Biology Room 309 75A
22. Pediatric Liver Diseases: Models, Modifiers, Mechanisms,
and Markers Room 311 76A
23. Pharmacologic Therapies for Cirrhosis Complications Ballroom A/B/C 76A
4:45 – 6:15 pm HCV Symposium: #What’s Trending in Hepatitis C? Auditorium 77A
4:45 – 6:15 pm Parallel Sessions
24. Clinical Hepatobiliary Neoplasia Room 302 78A
25. Hepatitis C: Diagnosis, Epidemiology and Natural History Room 312 78A
26. Living Donor and Split Liver Transplantation, Hepatobiliary Surgery Room 210 79A
27. Pediatric Liver Diseases: Clinical and Translational Studies Room 311 79A
28. The Good and Bad of Innate Immunity in Liver Disease Room 309 80A
4:45 – 6:50 pm SIG Program: Non-invasive Methods to Stratify Risk in Patients
with Compensated Cirrhosis Ballroom A/B/C 81A
4:45 – 6:55 pm SIG Program: Immunity and Lipids as New Drivers in Inflammation
and Fibrosis of Non-Alcoholic Steatohepatitis Sheraton, Back Bay Ballroom C 82A
4:45 – 7:25 pm SIG Program: Renal Dysfunction in Cirrhosis: Should We Change
the Way we Manage These Patients? Sheraton, Republic Ballroom 83A
4:45 – 7:50 pm SIG Program: The Next Generation of HBV Therapy:
From Discovery to Cure Room 304/306 84A
Tuesday, November 11
6:45 – 7:45 am Early Morning Workshops * Check your ticket 85A
8:00 – 9:30 am Hepatitis Plenary Auditorium 86A
8:00 am – Noon Poster Session IV Hall C
• HBV: Diagnostics, Epidemiology, and Natural History 169A
• HBV: Virology and Pathogenesis 174A
• HCV: Health Economics and Cost-effectiveness 177A
• HCV: Virology, Pathogenesis and Immunology 178A
• Hepatitis B Therapy 182A
• Hepatitis C: New Agents (Not Approved) 187A
• Hepatitis C: Preclinical Development 191A
• Portal Hypertension: Experimental 192A
• Stem Cell Biology 194A
• Varices and Bleeding 194A
9:45 – 10:30 am Hepatitis Debrief Auditorium 86A
10:30 – 11:00 am Leon Schiff State-of-the-Art Lecture Auditorium 87A
11:15 am – 12:45 pm Parallel Sessions
29. Biliary Biology and Pathobiology: Mechanisms and Treatments Room 210 88A
30. Correlates of Complications in Cirrhosis Room 302 88A
31. Emerging Trends in NASH Room 304/306 89A
32. HBV Basic Virology Room 311 89A
33. HCV Pathogenesis: Is the Battle Over? Room 312 90A
34. Hepatitis B: Outcomes of Approved Therapy Ballroom A/B/C 90A
35. Hepatitis C: New Agents – Part 2 Auditorium 91A
*Indicates a ticket is required for entrance.
20. 5A
Abstracts
Abstract information and text selected for presentation at The
Liver Meeting® are available in many formats:
• USB drive distributed at registration*
• Online Itinerary Planner*
• LiverLearning®
• ePosters*
• October supplement to Hepatology (members and sub-
scribers) – in order to minimize waste, additional copies
of this supplement will not be available at the meeting.
• Meeting app*
*The Abstracts on USB Flash-drive is supported by AbbVie
*The online Itinerary Planner is supported by Bristol-Myers
Squibb
*ePosters are supported by Merck
* Meeting app supported by Bayer HealthCare and
Onyx Pharmaceuticals
Abstract Embargo
Accepted abstracts are made available to the public on the
AASLD website and are published in the October supplement of
Hepatology. Information contained in those abstracts may not
be released until the abstracts appear on the AASLD website.
Academic institutions, private organizations, and companies
with products whose values may be influenced by information
contained in an abstract may issue a press release to coincide
with the availability of an abstract on the AASLD website. How-
ever, information beyond that contained in the abstract, e.g.,
discussion of the abstract done as part of a scientific presenta-
tion or presentation of additional or new information that will be
available at the time of the meeting is embargoed from release
to the general public until the first day of The Liver Meeting®.
Information released prior to this day is a violation of the AASLD
Abstract Embargo Policy and the abstract is subject to with-
drawal from The Liver Meeting® program. Authors are responsi-
ble for notifying financial and other sponsors about this policy.
AASLD may allow for exceptions, on a case-by-case basis, to
the Abstract Embargo Policy for compelled disclosures man-
dated by federal securities laws. However, AASLD requires the
company President, General Counsel, or other appropriate offi-
cial of a company seeking such an exception to attest in writing
to the specific facts in support of the request, including exactly
how the securities laws are implicated, with statutory citation(s).
General statements of the need to comply with the law will not
be considered sufficient. Requests for an exception must be
sent to the AASLD CEO. AASLD requires a minimum of five
(5) days from receipt of the request to evaluate the request. In
granting an exception, AASLD requires the company to state in
their public disclosure that the complete and final results will be
presented at The Liver Meeting®. AASLD will also require the
inclusion of unreleased and unique data in such a presentation
at The Liver Meeting®.
Public release of a journal article relevant to the abstract will be
considered an exception to the Embargo Policy if at the time of
the abstract submission deadline, the decision concerning the
manuscript had not been revealed to the authors.
ADA Compliance
The Hynes Convention Center and all participating hotels at
The Liver Meeting® are fully accessible to the physically chal-
lenged. Anyone who has a need for special assistance should
notify the appropriate hotel or the Hynes Convention Center
and indicate the type of assistance needed. AASLD cannot
ensure the availability of appropriate assistance without prior
notice.
Exhibit Hall • Hall D
The Exhibit Hall, an informative and important component of
The Liver Meeting®, provides you with a valuable opportunity
to meet with representatives from various organizations that
are committed to the field of hepatology. A complete listing of
exhibitors and their product descriptions can be found on our
website at www.thelivermeeting.org/exhibitors
Exhibit Hours
Saturday, November 8 5:00 – 7:30 pm
Sunday, November 9 9:30 am – 3:00 pm
Monday, November 10 9:30 am – 3:00 pm
Posters • Hall C
The Poster Sessions are an important event during The Liver
Meeting®. Approximately 470 posters will be displayed daily.
The top 10% of posters accepted are designated in the pro-
gram as a “Presidential Poster of Distinction”.
Posters should be set-up and viewed during the following times:
Poster Session I
Saturday, November 8
Set-up: 8:00 am – 2:00 pm
Viewing Time: 2:00 – 7:30 pm
Presentation Time: 5:30 – 7:00 pm*
*Posters must be displayed until 7:30 pm
Dismantle Time: 7:30 – 8:00 pm
General Information
21. 6A
Poster Session II
Sunday, November 9
Set-up: 6:30 – 8:00 am
Viewing Time: 8:00 am – 5:30 pm
Presentation Time: 12:30 – 2:00 pm*
*Posters must be displayed until 5:30 pm
Dismantle Time: 5:30 – 6:00 pm
Poster Session III
Monday, November 10
Set-up: 6:30 – 8:00 am
Viewing Time: 8:00 am – 5:30 pm
Presentation Time: 12:30 – 2:00 pm*
*Posters must be displayed until 5:30 pm
Dismantle Time: 5:30 – 6:00 pm
Poster Session IV
Tuesday, November 11
Set-up: 6:30 – 8:00 am
Viewing Time: 8:00 am – Noon
Presentation Time: 10:30 am – Noon*
*Posters must be displayed until Noon
Dismantle Time: Noon – 12:30 pm
Posters must be dismantled immediately following the viewing
time. Posters left on the boards will be removed and discarded.
Note: No CME will be provided for Poster Sessions.
ePosters • AASLD Pavilion
ePosters are an interactive technologically advanced viewing
system that brings posters to virtual life for all of The Liver Meet-
ing® attendees and archived in LiverLearning®. ePosters will
be available from the first day of the meeting in the AASLD
Pavilion.
ePosters are supported by Merck
Press Room • Room 208
Friday, November 7 1:00 pm – 5:00 pm
Saturday, November 8 8:00 am – 6:00 pm
Sunday, November 9 8:00 am – 5:00 pm
Monday, November 10 8:00 am – 5:00 pm
Tuesday, November 11 8:00 am – Noon
The official press contact for The Liver Meeting® is:
Ann Haran
AASLD
1001 N. Fairfax Street, Suite 400
Alexandria, VA 22314-2720
Telephone: 703-299-9766
Fax: 703-299-9676
Email: aharan@aasld.org
Website: www.thelivermeeting.org/press
Registration Hours • Hall A
Thursday, November 6 2:00 – 8:00 pm
Friday, November 7 6:30 am – 7:30 pm
Saturday, November 8 6:30 am – 7:30 pm
Sunday, November 9 6:30 am – 6:00 pm
Monday, November 10 6:30 am – 6:00 pm
Tuesday, November 11 6:30 am – 12:30 pm
Speaker Ready Room • Room 207
Presenters should check-in 24 hours in advance, or no later than
2 hours prior to your session. If you are a speaker/presenter,
review the presenter tab at www.thelivermeeting.org prior to
the meeting for presentation tips, instructions, and guidelines.
Friday, November 7 6:30 am – 7:30 pm
Saturday, November 8 6:30 am – 7:30 pm
Sunday, November 9 6:30 am – 6:00 pm
Monday, November 10 6:30 am – 6:00 pm
Tuesday, November 11 6:30 am – 12:30 pm
General Information (continued)
When citing an abstract, please use the following format:
Desai RJ, Schnitzler MA, Di Bisceglie AM. Estimated impact of screening and anitviral treatment on
prevention of HBV reactivation associated with cancer chemotherapy [Abstract]. Hepatology 2014,
60(4Suppl.1):[Page]A.
22. 7A
Limited License for Use
The Liver Meeting® is protected by copyright, trademark, and/
or other applicable laws. Any use of The Liver Meeting®,
including recordings and the development of derivative works,
is prohibited. The name, logo and acronym of the American
Association for the Study of Liver Diseases and The Liver Meet-
ing® are the exclusive property of and are trademarked by
AASLD. They may not be used in any way, for any purpose,
or at any time (including but not limited to announcements,
invitations, emails, Web publications, etc.) without the express
written permission of AASLD.
Without limiting the foregoing, Information presented during
The Liver Meeting® is the property of AASLD and the presenter.
Information may not be recorded, photographed, copied,
photocopied, transferred to electronic format, reproduced, or
distributed without the written permission of AASLD and the
presenter. Any use of the program content which includes,
but is not limited to, oral presentations, audiovisual materials
used by speakers, and program handouts, without the written
consent of AASLD is prohibited.
Notwithstanding the above, AASLD grants a non-exclusive,
non-transferable, royalty-free license to nonprofit, §501(c) (3),
AAMC-accredited educational institutions to conduct a “Best of
AASLD” conference or similar event (“Event”) of up to eight (8)
hours in length that features highlights from AASLD sessions at
the most recent occurrence of The Liver Meeting® and to utilize
the name of AASLD in connection with the same. No Event
may be held, nor may the name of AASLD be utilized, except
pursuant to this Limited License or as otherwise authorized by
AASLD in writing.
When using the term “AASLD” or “The Liver Meeting®”, you
must attribute AASLD’s trademark as follows: The Liver Meet-
ing® and AASLD are registered trademarks of the American
Association for the Study of Liver Diseases. You may not use
the AASLD trademark(s):
• In, as, or as part of your own trademarks
• To identify products or services that do not belong to AASLD
• In a manner likely to cause confusion, including colors and
fonts
• In a manner that implies inaccurately that AASLD sponsors or
endorses, or is otherwise connected with your own activities,
products and services
The content of an Event shall be of the highest quality and
shall accurately reflect material and information presented at
the AASLD sessions. No Event shall include any statements or
other communication that maligns or disparages AASLD or any
AASLD session, presenter, or representative.
All Event announcements, brochures, descriptions, and mate-
rials, whether in print or electronic form, shall clearly identify
the content as being derived from AASLD sessions by including
the following statement: “All content is derived from presenta-
tions and similar offerings made at The Liver Meeting® 2014
and is presented with permission of the American Association
for the Study of Liver Diseases.” As between AASLD and any
institution, AASLD is the owner of all AASLD programming and
AASLD does not relinquish any such ownership rights by virtue
of this Limited License.
AASLD disclaims all warranties, express and implied, as to
any information or materials presented in connection with any
AASLD session or meeting, including as to intellectual property
ownership. AASLD shall not be liable for any direct, indirect,
punitive, consequential, or other damages in any way arising
or resulting from the Event or the use of information or materi-
als from AASLD sessions by any institution. Should any claim
or suit be brought against AASLD arising from an Event, the
institution shall indemnify and hold AASLD harmless for any
damages, liability, and costs, including attorney fees, suffered
or incurred by AASLD in defense and satisfaction thereof.
This Limited License does not create a partnership, joint ven-
ture, or similar relationship between AASLD and any institution.
This Limited License is non-transferable, including by sale or
sublicense.
This Limited License shall terminate automatically upon violation
of any of its terms. In addition, AASLD may terminate, or mod-
ify the terms of, this Limited License in its discretion, generally
or with respect to any particular institution.
This Limited License shall be construed in accordance with
the laws of the Commonwealth of Virginia, without regard
to conflicts principles, and, as applicable, federal copyright
and trademark laws. A court of competent jurisdiction in or
for Alexandria, Virginia shall be the exclusive forum for the
resolution of any dispute between AASLD and any institution,
and institutions irrevocably consent to the personal and subject
matter jurisdiction, and venue, of such court.
23. Continuing Medical Education and Disclosures
8A
Statement on Disclosure
AASLD is committed to ensuring balance, independence objectivity and scientific rigor in its sponsored and jointly sponsored
educational activities. Individuals in a position to control the content of an AASLD-sponsored activity (program planners, course
directors, speakers, etc.) are expected to disclose all relevant financial relationships during the past 12 months.
When an unlabeled use of a commercial product or an investigational use not yet approved for any purpose is discussed during
an educational activity, the speaker shall disclose to the audience that the product is not labeled for the use under discussion or
that the product is still investigational.
All disclosure information is provided to the activity participant prior to the start of the educational activity. In addition, disclosure
slides will be the first side in each oral presentation viewed by participants. AASLD will identify and resolve all conflicts of interest
prior to program implementation.
Invited speakers, course directors, moderators, program planners, abstract reviewers and staff have provided the following
disclosures:
2014 Committee, Abstract Reviewer and Staff Disclosures
Afdhal, Nezam H., MD
(Abstract Reviewer)
Consulting: Abbott, Pharmasett, Gilead, Springbank,
GlaxoSmithKline, Idenix, Merck, Vertex
Grants/Research Support: Merck, Vertex, Idenix, GlaxoSmithKline,
Springbank, Gilead, Pharmasett, Abbott
Adhami, Talal, MD
(Program Evaluation Committee)
Speaking and Teaching: Gilead
Ahmad, Jawad, MD
(Abstract Reviewer)
Nothing to disclose
Alberti, Alfredo, MD
(Abstract Reviewer)
Grants/Research Support: Merck, Gilead
Advisory Board: Merck, Roche, Gilead
Speaking and Teaching: Novartis, Bristol-Myers Squibb
Al-Osaimi, Abdullah, MD
(Abstract Reviewer)
Nothing to disclose
Alvarez, Fernando, MD
(Abstract Reviewer)
Nothing to disclose
Angeli, Paolo, MD, PhD
(Abstract Reviewer)
Advisory Board: Sequana Medical
Aranda-Michel, Jaime, MD
(Abstract Reviewer)
Nothing to disclose
Arteel, Gavin E., PhD
(Basic Research Committee, Abstract Reviewer)
Grants/Research Support: NIH
Asrani, Sumeet, MD
(Abstract Reviewer)
Nothing to disclose
Aytaman, Ayse, MD
(Abstract Reviewer)
Nothing to disclose
Bajaj, Jasmohan S., MD
(Clinical Research Committee, Abstract Reviewer)
Grants/Research Support: Salix, Otsuka, Grifols
Advisory Board: American College of Gastroenterology, Grifols,
Salix, Merz, Otsuka, Ocera
Bambha, Kiran, MD
(Abstract Reviewer)
Nothing to disclose
Bass, Nathan M., MD, PhD
(Abstract Reviewer)
Nothing to disclose
Beaven, Simon, MD
(Abstract Reviewer)
Nothing to disclose
Beavers, Kimberly, MD
(Program Evaluation Committee)
Nothing to disclose
Befeler, Alex, MD
(Program Evaluation Committee, Abstract Reviewer)
Advisory Board: Gilead
Stock: Amgen, Gilead
Bergasa, Nora V., MD
(Abstract Reviewer)
Nothing to disclose
Beier, Juliane Ingeborg, PhD
(Education Committee)
Nothing to disclose
Berzigotti, Annalisa, MD, PhD
(Education Committee)
Nothing to disclose
8A
24. Continuing Medical Education and Disclosures (continued)
9A
Bhamba, Kiran, MD
(Clinical Research Committee)
Nothing to disclose
Biggins, Scott W., MD
(Abstract Reviewer)
Nothing to disclose
Boelsterli, Urs A., PhD
(Abstract Reviewer)
Nothing to disclose
Bologna, Gregory
(Staff)
Nothing to disclose
Bosch, Jaime, MD
(Abstract Reviewer)
Consulting: Falk, Gilead Science, Norgine, ONO-USA, Intercept
Pharma, Exalenz, Almirall, Conatus
Grants/Research Support: Gore
Bowlus, Christopher L., MD
(Education Committee)
Advisory Board: Lumena
Grants/Research Support: Gilead, Lumena, Intercept
Brady, Carla W., MD
(Program Evaluation Committee, Scientific Program Committee)
Nothing to disclose
Brenner, David A., MD
(Abstract Reviewer)
Nothing to disclose
Brigstock, David R., PhD
(Basic Research Committee)
Intellectual Property Rights: FibroGen, Inc.
Brosgart, Carol, MD
(Abstract Reviewer)
Nothing to disclose
Brown, Kimberly Ann, MD
(Abstract Reviewer)
Advisory Board: CLDF, Merck, Salix, Gilead, Vertex, Novartis,
Genentech, Janssen, Salix
Grants/Research Support: CLDF, Gilead, Exalenz, CDC, Bristol-
Myers Squibb, Bayer-Onyx, Ikaria, Hyperion, Merck
Speaking and Teaching: Salix, Merck, Genentech, Gilead, CLDF,
Vertex
Consulting: Salix, Blue Cross Transplant Centers
Browning, Jeffrey D., MD
(Basic Research Committee)
Nothing to disclose
Bruce, Heidi
(Staff)
Nothing to disclose
Brunt, Elizabeth M., MD
(Abstract Reviewer)
Consulting: Synageva
Speaking and Teaching: Geneva Foundation, Independent
Contractor: Kadmon, Rottapharm
Buck, Martina, PhD
(Basic Research Committee)
Grants/Research Support: NIH
Speaking and Teaching: Conatus, Gilead
Caravan, Peter, PhD
(Abstract Reviewer)
Stock: Factor IA, LLC, Collagen Medical
Consulting: Biogen Idec
Carithers, Robert L., MD
(Abstract Reviewer)
Nothing to disclose
Carr, Rotonya M., MD
(Basic Research Committee)
Nothing to disclose
Chalasani, Naga P., MD
(Abstract Reviewer)
Grants/Research Support: Galectin, Cumberland, Gilead,
Intercept, Lilly
Consulting: Salix, AbbVie, Lilly, Boehringer Ingelheim, Aegerion
Chavin, Kenneth D., MD, PhD
(Scientific Program Committee, Surgery and Liver Transplantation
Committee)
Grants/Research Support: Novartis
Scientific Consultant: Bridge to Life
Chojkier, Mario, MD
(Abstract Reviewer)
Nothing to disclose
Chung, Raymond T., MD
(Governing Board, Basic Research Committee, Abstract Reviewer)
Scientific Consultant: AbbVie
Grants/Research Support: Gilead, Mass Biologics, Transzyme,
Vertex
Cohen, Stanley M., MD
(Training and Workforce Committee)
Nothing to disclose
Colquhoun, Steven D., MD
(Abstract Reviewer)
Nothing to disclose
Corbett, Ruth J., MSN, APRN
(Training and Workforce Committee, Abstract Reviewer)
Nothing to disclose
Corey, Kathleen E., MD
(Clinical Research Committee)
Nothing to disclose
Cotler, Scott, MD
(Clinical Research Committee, Abstract Reviewer)
Nothing to disclose
Crawford, James, MD, PhD
(Abstract Reviewer)
Nothing to disclose
25. Continuing Medical Education and Disclosures (continued)
10A
Currie, Sue, EdD, MA
(Hepatology Associates Committee)
Employee, Officer, Director: Health Interactions
Cusi, Kenneth, MD, PhD
(Abstract Reviewer)
Nothing to disclose
Czaja, Mark J., MD
(Scientific Program Committee, Basic Research Committee,
Abstract Reviewer)
Consulting: Oncozyme Pharma, Inc.
Grants/Research Support: Oncozyme Pharma, Inc.
Daniel, James F., MD
(Program Evaluation Committee)
Nothing to disclose
Davis, Gary L., MD
(Governing Board, Program Evaluation Committee, Scientific
Program Committee, Abstract Reviewer)
Nothing to disclose
Dawson, Paul, MD
(Abstract Reviewer)
Consulting: GlaxoSmithKline, Isis Pharmaceuticals, Lumena
Pharmaceuticals
Stock: XenoPort, Inc.
Deal, Julie
(Staff)
Stock: Bristol-Myers Squibb
Delgado-Borrego, Aymin, MD
(Program Evaluation Committee)
Nothing to disclose
DeLeve, Laurie D., MD, PhD
(Abstract Reviewer)
Advisory Board: Pfizer, Takeda, Bristol-Myers Squibb
Di Bisceglie, Adrian M., MD, FACP
(Governing Board, Scientific Program Committee)
Advisory Board: Gilead, Data Safety Monitoring Board, Bayer,
Novartis
Grants/Research Support: AbbVie, Bristol-Myers Squibb, Gilead,
Janssen, Transgene, Vertex, Alpha-1 Foundation
Royalties: Section Editor on Hepatitis C, UpToDate
Diaz, Susan M., PA-C, MPAS
(Surgery and Liver Transplantation Committee)
Nothing to disclose
Dickson, Rolland C., MD
(Education Committee, Abstract Reviewer)
Advisory Board: Bristol-Myers Squibb, Cowen and Associates
Grants/Research Support: Gilead, Roche, Tibotec, Vertex
Scientific Consultant: Biotest
Speaking and Teaching: Gilead
Diehl, Anna Mae, MD
(Abstract Reviewer)
Consulting: Roche
Grants/Research Support: Gilead, Genfit
Dieterich, Douglas, MD
(Abstract Reviewer)
Consulting: Gilead, Bristol-Myers Squibb
Advisory Board: Merck, Idenix, Janssen
Dolganiuc, Angela, MD
(Abstract Reviewer)
Nothing to disclose
Doo, Edward, MD
(Abstract Reviewer)
Nothing to disclose
Echard, Steven
(Staff)
Nothing to disclose
Eggers, Carol A., MSN, FNP
(Program Evaluation Committee)
Nothing to disclose
Eghtesad, Bijan, MD
(Surgery and Liver Transplantation Committee)
Nothing to disclose
Ekong, Udeme D., MD
(Abstract Reviewer)
Nothing to disclose
El-Serag, Hashem B., MD
(Abstract Reviewer)
Nothing to disclose
Emerick, Karan M., MD
(Abstract Reviewer)
Nothing to disclose
Emond, Jean C., MD
(Abstract Reviewer)
Nothing to disclose
Fallon, Michael B., MD
(Abstract Reviewer)
Grants/Research Support: Bayer-Onyx, Eaisi, Gilead, Grifolis
Feld, Jordan J., MD
(Abstract Reviewer)
Advisory Board: Idenix, Merck, Janssen, Gilead, AbbVie, Merck,
Theravance, Bristol-Myers Squibb
Grants/Research Support: AbbVie, Boehringer Ingelheim, Janssen,
Gilead, Merck
Feldstein, Ariel E., MD
(Abstract Reviewer)
Nothing to disclose
Feng, Sandy, MD, PhD
(Abstract Reviewer)
Nothing to disclose
Fenkel, Jonathan M., MD
(Abstract Reviewer)
Consulting: Gilead, Janssen
26. Continuing Medical Education and Disclosures (continued)
11A
Fiel, Maria Isabel, MD
(Education Committee)
Leadership: HEPATOLOGY
Speaking and Teaching: Richmond University Hospital
Grants/Research Support: P20 Mini Center, RO1 Detection of liver
fibrosis, HCC in non-cirrhotic liver
Expert Testimony: Fowler White Burnett, Kopff, Nardelli & Dopf,
Bailly and McMillan McCormick Fitzpatrick
Firpi, Roberto J., MD
(Education Committee, Abstract Reviewer)
Advisory Board: Gilead, Vertex
Grants/Research Support: Bayer, Boehringer, Bristol-Myers Squibb,
Gilead, Idenix, Novartis, Salix
Fitz, J. Gregory, MD
(Governing Board)
Nothing to disclose
Fix, Oren K., MD
(Training and Workforce Committee, Abstract Reviewer)
Nothing to disclose
Forde, Kimberly A., MD
(Clinical Research Committee)
Nothing to disclose
Foster, Temitope Y., MD
(Program Evaluation Committee)
Nothing to disclose
Friedman, Joshua, MD, PhD
(Abstract Reviewer)
Employment: Janssen Research & Development
Fuchs, Michael, MD, PhD
(Training and Workforce Committee)
Nothing to disclose
Fung, John J., MD
(Abstract Reviewer)
Advisory Board: Astellas, Novartis
Consulting: Vital Therapies
Grants/Research Support: Sanofi
Gao, Bin, MD, PhD
(Abstract Reviewer)
Nothing to disclose
Gardenier, Donald, DNP, FNP-BC
(Hepatology Associates Committee)
Scientific Consultant: BV, Elsevier
Leadership in Related Society: American Association of Nurse
Practitioners
Gaspard, Gabrielle M., MPH
(Basic Research Committee)
Nothing to disclose
Gautam, Manjushree, MD
(Abstract Reviewer)
Nothing to disclose
George, Jacob, MD, PhD
(Clinical Research Committee, Abstract Reviewer)
Advisory Board: Roche, Bristol-Myers Squibb, MSD, Gilead,
Janssen
Gerbes, Alexander L., MD
(Abstract Reviewer)
Nothing to disclose
Gershwin, M. Eric, MD
(Abstract Reviewer)
Nothing to disclose
Ghany, Marc G., MD
(Scientific Program Committee, Clinical Research Committee)
Expert Testimony: Clinical Care Options
Gilles, HoChong, FNP
(Education Committee, Hepatology Associates Committee)
Speaking and Teaching: Bayer
Gish, Robert, MD
(Abstract Reviewer)
Consulting: Arrowhead
Advisory Board: Gilead, Bristol-Myers Squibb, Genentech,
Arrowhead
Stock: Arrowhead
Goacher, Elizabeth K., PA-C, MHS
(Clinical Research Committee)
Speaking and Teaching: Merck, Vertex
Gonzalez, Stevan, MD
(Abstract Reviewer)
Speaking and Teaching: Gilead, Salix
Gonzalez-Peralta, Regino P., MD
(Abstract Reviewer)
Consulting: Roche, Boehringer Ingelheim, Vertex
Grants/Research Support: Bristol-Myers Squibb, Roche, Merck
Gordon, Fredric D., MD
(Abstract Reviewer)
Nothing to disclose
Gordon, Stuart C., MD
(Abstract Reviewer)
Consulting: Bristol-Myers Squibb, Gilead, CVS Caremark, Merck
Grants/Research Support: Exalenz, Roche/Genentech, Vertex,
Gilead, Bristol-Myers Squibb, Abbott, Intercept
Advisory Board: Tibotec
Grace, Norman D., MD
(Abstract Reviewer)
Nothing to disclose
Green, Richard, MD
(Abstract Reviewer)
Nothing to disclose
Guo, Grace, MD
(Abstract Reviewer)
Nothing to disclose
27. Continuing Medical Education and Disclosures (continued)
12A
Gupta, Sanjeev, MD
(Abstract Reviewer)
Nothing to disclose
Hagedorn, Curt H., MD
(Abstract Reviewer)
Nothing to disclose
Harrison, Stephen, MD
(Education Committee, Abstract Reviewer)
Advisory Board: Galectin, Genfit
Speaking and Teaching: Gilead
Hassanein, Tarek, MD
(Abstract Reviewer)
Grants/Research Support: AbbVie, Boehringer Ingelheim, Bristol-
Myers Squibb, Eiasi, Gilead, Janssen, Idenix, Ikaria, Merck, Roche,
Ocera, Salix, Sundise, TaiGen, Takeda, Vital Therapies
Speaking and Teaching: Baxter, Bristol-Myers Squibb, Gilead,
Salix
Advisory Board: AbbVie, Bristol-Myers Squibb
Heimbach, Julie, MD
(Abstract Reviewer)
Nothing to disclose
Henderson, Neil C., MBChB, PhD
(Abstract Reviewer)
Nothing to disclose
Horne, Patrick, MSN, ARNP
(Education Committee, Hepatology Associates Committee)
Advisory Board: Gilead
Grants/Research Support: Bayer
Horslen, Simon, MD
(Abstract Reviewer)
Nothing to disclose
Howell, Charles D., MD
(Education Committee)
Grants/Research Support: Boehringer Ingelheim, Bristol-Myers
Squibb, Gilead
Leadership in a Related Society: National Medical Association
Hepatitis C Task Force
Ioannou, George, MD
(Clinical Research Committee)
Nothing to disclose
Jalan, Rajiv, MD, PhD
(Abstract Reviewer)
Consulting: Ocera, Conatus
Grants/Research Support: Grifols, Gambro
Janssen, Harry L.A., MD, PhD
(Program Evaluation Committee, Abstract Reviewer)
Consulting: Santaris, Roche, Novartis, Medtronic, Merck, Gilead,
Debio, Abbott, Bristol-Myers Squibb
Grants/Research Support: Anadys, Bristol-Myers Squibb, Gilead,
Innogenetics, Kirin, Merck, Medtronic, Novartis, Roche, Santaris
Jeong, Won-ll, DVM, PhD
(Abstract Reviewer)
Nothing to disclose
Jonas, Maureen M., MD
(Abstract Reviewer)
Consulting: Eisai
Grants/Research Support: Bristol-Myers Squibb, Roche, Merck
Advisory Board: Gilead
Kaestner, Klaus H., PhD
(Abstract Reviewer)
Nothing to disclose
Kamath, Patrick S., MD
(Abstract Reviewer)
Advisory Board: Sequana Medical
Kaplowitz, Neil, MD
(Abstract Reviewer)
Consulting: GlaxoSmithKline, JNJ, Merck, Novartis, Hepregen,
Takeda, Otsuka, Pfizer, Geron, Daiichi-Sanyo
Independent Contractor: Acetaminophen Litigation
Karpen, Saul J., MD, PhD
(Scientific Program Committee, Abstract Reviewer)
Nothing to disclose
Keaveny, Andrew, MD
(Education Committee)
Expert Testimony: UpToDate, Inc.
Kim, Arthur Y., MD
(Abstract Reviewer)
Grants/Research Support: Gilead, Bristol-Myers Squibb
Consulting: AbbVie, Gilead
Kisseleva, Tatiana, MD, PhD
(Abstract Reviewer)
Nothing to disclose
Klett, Janeil
(Staff)
Stock: Merck, Pfizer
Klintmalm, Goran, MD, PhD
(Abstract Reviewer)
Grants/Research Support: Astellas, Novartis, Opson, Quark
Advisory Board: Novartis
Kneteman, Norman M., MD
(Abstract Reviewer)
Nothing to disclose
Knisely, Alexander S., MD
(Abstract Reviewer)
Nothing to disclose
Kohli, Rohit, MD
(Clinical Research Committee, Abstract Reviewer)
Grants/Research Support: Synageva Biopharma, Johnson and
Johnson
Independent Contractor: Lumena Pharmaceuticals, Galectin
Therapeutics
Korenblat, Kevin M., MD
(Abstract Reviewer)
Grants/Research Support: Merck
Advisory Board: Vertex
28. Continuing Medical Education and Disclosures (continued)
13A
Koteish, Ayman A., MD
(Program Evaluation Committee)
Nothing to disclose
Kowdley, Kris V., MD
(Abstract Reviewer)
Advisory Board: Janssen, Ikaria, Boehringer Ingelheim, Vertex,
AbbVie, Gilead, Merck, Novartis, Trio Health
Grants/Research Support: AbbVie, Beckman, Boehringer
Ingelheim, Bristol-Myers Squibb, Gilead, Ikaria, Janssen, Merck,
Mochida
Kulkarni, Sanjay, MD
(Surgery and Liver Transplantation Committee)
Grants/Research Support: Alexion
Lai, Ching Lung, MD
(Abstract Reviewer)
Nothing to disclose
Larson, Anne M., MD
(Abstract Reviewer)
Speaking and Teaching: Gilead, Genentech, Salix
Lau, George, MD
(Abstract Reviewer)
Consulting: Novartis, Roche
Lauer, Georg M., MD
(Basic Research Committee, Abstract Reviewer)
Nothing to disclose
Laurin, Jacqueline, MD
(Education Committee)
Nothing to disclose
Leise, Michael, MD
(Abstract Reviewer)
Nothing to disclose
Leonis, Mike A., MD, PhD
(Training and Workforce Committee)
Grants/Research Support: NIH
Leadership in Related Society: NASPGHAN Research Committee
member
Levitsky, Josh, MD
(Training and Workforce Committee, Abstract Reviewer)
Consulting: Transplant Genomics, Inc.
Grants/Research Support: Novartis
Speaking and Teaching: Gilead, Salix
Levy, Cynthia, MD
(Clinical Research Committee, Abstract Reviewer)
Consulting: Lumena, Gilead, Evidera
Liangpunsakul, Suthat, MD
(Abstract Reviewer)
Nothing to disclose
Liddle, Christopher, MD, PhD
(Abstract Reviewer)
Nothing to disclose
Lidofsky, Steven D., MD
(Abstract Reviewer)
Nothing to disclose
Lim, Joseph K., MD
(Abstract Reviewer)
Grants/Research Support: Achillion, Abbott, Boehringer Ingelheim,
Bristol-Myers Squibb, Genentech, Gilead, Janssen/Tibotec, Vertex
Consulting: Merck, Vertex, Gilead, Bristol-Myers Squibb,
Boehringer Ingelheim
Lindor, Keith, MD
(Governing Board, Hepatology Associates Committee, Scientific
Program Committee)
Advisory Board: Intercept, Lumena
Ling, Simon C., MBChB, MRCP
(Abstract Reviewer)
Grants/Research Support: Bristol-Myers Squibb
Lippello, Anita, CRNP, NP-C, DNP
(Hepatology Associates Committee)
Nothing to disclose
Little, Ester C., MD
(Education Committee)
Nothing to disclose
Liu, Chen, MD, PhD
(Abstract Reviewer)
Nothing to disclose
Llovet, Josep M., MD
(Abstract Reviewer)
Grants/Research Support: Beohringer Ingelheim, Bayer, Bristol-
Myers Squibb
Consulting: GlaxoSmithKline, Bayer, Bristol-Myers Squibb, Imclone,
Biocompatibles, Novartis
Advisory Board: Nanostring, Blueprint Medicines
Lok, Anna S. F., MD
(Governing Board, Education Committee, Abstract Reviewer)
Advisory Board: Gilead, Immune Targeting System, MedImmune,
Arrowhead, Bayer, GlaxoSmithKline, Janssen, Novartis, ISIS,
Tekmira
Grants/Research Support: Abbott, Bristol-Myers Squibb, Gilead,
Merck, Roche, Boehringer Ingelheim
Loomba, Rohit, MD
(Program Evaluation Committee, Abstract Reviewer)
Advisory Board: American Liver Foundation
Grants/Research Support: Daiichi Sankyo, Inc., Merck
Scientific Consultant: Gilead, J and J Inc., Merck
Loomes, Kathleen M., MD
(Training and Workforce Committee)
Grants/Research Support: NIH
Lu, Shelly, MD
(Abstract Reviewer)
Nothing to disclose
Magee, John, MD
(Surgery and Liver Transplantation Committee, Abstract Reviewer)
Grants/Research Support: Novartis