Intensive enteral nutrition is ineffective for individuals with severe alcoholic hepatitis treated with corticosteroids.
; ; et al
in Gastroenterology (2016), 150
BACKGROUND & AIMS: Severe alcoholic hepatitis (AH) is a lifethreatening disease for which adequate oral nutritional support is recommended. We performed a randomized controlled trial to determine whether ... [more ▼]
BACKGROUND & AIMS: Severe alcoholic hepatitis (AH) is a lifethreatening disease for which adequate oral nutritional support is recommended. We performed a randomized controlled trial to determine whether the combination of corticosteroid and intensive enteral nutrition therapy is more effective than corticosteroid therapy alone in patients with severe AH. METHODS: We enrolled 136 heavy consumers of alcohol (age, 18–75 y) with recent onset of jaundice and biopsy-proven severe AH in our study, performed at 18 hospitals in Belgium and 2 in France, from February 2010 through February 2013. Subjects were assigned randomly (1:1) to groups that received either intensive enteral nutrition plus methylprednisolone or conventional nutrition plus methylprednisolone (controls). In the intensive enteral nutrition group, enteral nutrition was given via feeding tube for 14 days. The primary end point was patient survival for 6 months. RESULTS: In an intention-to-treat analysis, we found no significant difference between groups in 6-month cumulative mortality: 44.4% of patients died in the intensive enteral nutrition group (95% confidence interval [CI], 32.2%–55.9%) and 52.1% of controls died (95% CI, 39.4%– 63.4%) (P ¼ .406). The enteral feeding tube was withdrawn prematurely from 48.5% of patients, and serious adverse events considered to be related to enteral nutrition occurred in 5 patients. Regardless of group, a greater proportion of patients with a daily calorie intake less than 21.5 kcal/kg/day died (65.8%; 95% CI, 48.8–78.4) than patients with a higher intake of calories (33.1%; 95% CI, 23.1%–43.4%) (P < .001). CONCLUSIONS: In a randomized trial of patients with severe AH treated with corticosteroids, we found that intensive enteral nutrition was difficult to implement and did not increase survival. However, low daily energy intake was associated with greater mortality, so adequate nutritional intake should be a main goal for treatment. [less ▲]Detailed reference viewed: 32 (9 ULg)
Discovery of novel accessible proteins for therapeutic targeting of hepatocellular carcinoma.
Turtoi, Andrei ; ; et al
in Acta Gastro-Enterologica Belgica (2016, March), 79(1), 13Detailed reference viewed: 15 (2 ULg)
Multicenter Belgian experience of sofosbuvir medical need program in pre-and post-liver transplantation patients: safety and efficacy results.
; ; et al
in Acta Gastro-Enterologica Belgica (2016, March), 79(1), 15Detailed reference viewed: 16 (3 ULg)
Sofosbuvir in combination with simeprevir +/- ribavirin in genotype 4 hepatitis C patients with advanced fibrosis or cirrhosis: real-life experience from Belgium
; ; DELWAIDE, Jean et al
in Acta Gastro-Enterologica Belgica (2016, March), 79(1), 08Detailed reference viewed: 23 (1 ULg)
Light-to-moderate alcohol intake increases the risk of hepatocellular carcinoma in patients with HCV-related compensated cirrhosis: a prospective study.
; ; et al
in Acta Gastro-Enterologica Belgica (2016, March), 79(1), 01Detailed reference viewed: 25 (1 ULg)
La maladie de Rendu-Osler: une cause rare d'encéphalopathie ammoniacale.
; LOLY, Jean-Philippe ; DELWAIDE, Jean et al
in Revue Médicale de Liège (2016), 71(2), 83-89Detailed reference viewed: 15 (3 ULg)
Sofosbuvir + simeprevir +/-ribavirin treatment is efficient in genotype 4 chronic hepatitis C patients: results of a large international cohort.
; ; et al
in Hepatology (Baltimore, Md.) (2016), 64(1), 1990Detailed reference viewed: 16 (1 ULg)
Alcohol intake increases the risk of HCC in hepatitis C virus-related cirrhosis: a prospective study.
; ; et al
in Journal of Hepatology (2016), 65
Background & Aims:Whether alcohol intake increases the risk of complications in patients with HCV-related cirrhosis remains unclear. The aim of this study was to determine the impact of alcohol intake and ... [more ▼]
Background & Aims:Whether alcohol intake increases the risk of complications in patients with HCV-related cirrhosis remains unclear. The aim of this study was to determine the impact of alcohol intake and viral eradication on the risk of hepatocellular carcinoma (HCC), decompensation of cirrhosis and death. Methods: Data on alcohol intake and viral eradication were prospectively collected in 192 patients with compensated HCVrelated cirrhosis. Results: 74 patients consumed alcohol (median alcohol intake: 15 g/day); 68 reached viral eradication. During a median followup of 58 months, 33 patients developed HCC, 53 experienced at least one decompensation event, and 39 died. The 5-year cumulative incidence rate of HCC was 10.6% (95% CI: 4.6–16.6) in abstainers vs. 23.8% (95% CI: 13.5–34.1) in consumers (p = 0.087), and 2.0% (95% CI: 0–5.8) vs. 21.7% (95% CI: 14.2–29.2) in patients with and without viral eradication (p = 0.002), respectively. The lowest risk of HCC was observed for patients without alcohol intake and with viral eradication (0%) followed by patients with alcohol intake and viral eradication (6.2% [95% CI: 0–18.4]), patients without alcohol intake and no viral eradication (15.9% [95% CI: 7.1– 24.7]), and patients with alcohol intake and no viral eradication (29.2% [95% CI: 16.5–41.9]) (p = 0.009). In multivariate analysis, lack of viral eradication and alcohol consumption were associated with the risk of HCC (hazard ratio for alcohol consumption: 3.43, 95% CI: 1.49–7.92, p = 0.004). Alcohol intake did not influence the risk of decompensation or death. Conclusions: Light-to-moderate alcohol intake increases the risk of HCC in patients with HCV-related cirrhosis. Patient care should include measures to ensure abstinence. Lay summary:Whether alcohol intake increases the risk of complications in patients with HCV-related cirrhosis remains unclear. In this prospective study, light-to-moderate alcohol intake was associated with the risk of hepatocellular carcinoma in multivariate analysis. No patients who did not use alcohol and who reached viral eradication developed hepatocellular carcinoma during follow-up. The risk of hepatocellular carcinoma increased with alcohol intake or in patients without viral eradication and was highest when alcohol intake was present in the absence of viral eradication. Patients with HCV-related cirrhosis should be strongly advised against any alcohol intake. Patient care should include measures to ensure abstinence. [less ▲]Detailed reference viewed: 30 (4 ULg)
Sofosbuvir in combination with simeprevir +/- ribavirin in genotype 4 hepatitis C patients with advanced fibrosis or cirrhosis: a real-life experience from Belgium
; ; DELWAIDE, Jean et al
in Hepatology (Baltimore, Md.) (2015, October), 62(1), 746
Background: All-oral, interferon-free regimens that combine direct-acting antiviral drugs have significantly advanced the treatment of hepatitis C (HCV), especially for genotype 1(G1) patients. However ... [more ▼]
Background: All-oral, interferon-free regimens that combine direct-acting antiviral drugs have significantly advanced the treatment of hepatitis C (HCV), especially for genotype 1(G1) patients. However, efficacy and safety data of interferon-free regimens in HCV genotype 4 (G4) patients are scarce. In Belgium, Sofosbuvir (SOF) and Simeprevir (SMV) treatment is available since January 2015 for G4 patients with advanced fibrosis (F3-F4 METAVIR) for 12 weeks. Methods: analysis of HCV G4 patients receiving SOF and SMV treatment in Belgium. The aim of the study was to evaluate the safety and efficacy of the treatment. Results: 73 G4 patients were enrolled in this data collection including 32 (43.8%) patients with severe fibrosis F3 and 41(56.2%) cirrhotic patients. The study population comprised 58.9% male, 77.8% treatment experienced patients. Median age was 59 [51-66] years and 5 patients were HCV/HIV co-infected. 24 patients received the treatment associated with ribavirin, 11/32 (34.37%) of patients with advanced fibrosis and 13/41 (31.71%) of cirrhotic patients. In cirrhotic patients, median MELD and Child-Pugh score were 9 [7-12.5] and 5 [5-6], 46.2% had platelet below 100.000/mm and 28.6% had albumin below 35 g/L. W4 HCV RNA was undetectable in 31.25% (15/48). 9 of the 15 patients with undetectable W4 HCV RNA received RBV. At W12, 100% (23/23) had HCV RNA below the limit of quantification, with 6/23 still detectable. All SVR12 data will be available at the time of presentation. No patient experienced serious adverse event. Conclusions: these preliminary results in difficult-to-treat G4 HCV patients show that SOF/SIM +/- RBV treatment is safe and seems promising, in line with that was observed in G1 HCV patients. [less ▲]Detailed reference viewed: 73 (9 ULg)
Syndrome thyrogastrique autoimmun (STGA) : la gastrite auto-immune isolée (GAI) et celle associée à Helicobacter (Hp) ont des caractéristiques anatomocliniques différentes
VALDES SOCIN, Hernan Gonzalo ; MESUREUR, Thierry ; POLUS, Marc et al
in Abstract book - Annales d'Endocrinologie - 32ème Congrès de la Société Française d'Endocrinologie (2015, October)Detailed reference viewed: 54 (7 ULg)
Prognostic value of (18)F-FDG PET/CT in liver transplantation for hepatocarcinoma.
Detry, Olivier ; ; De Roover, Arnaud et al
in World journal of gastroenterology : WJG (2015), 21(10), 3049-54
AIM: To evaluate the prognostic value of pretreatment FDG positron emission tomography computed tomography (PET-CT) in patients with hepatocarcinoma treated by liver transplantation (LT). METHODS: The ... [more ▼]
AIM: To evaluate the prognostic value of pretreatment FDG positron emission tomography computed tomography (PET-CT) in patients with hepatocarcinoma treated by liver transplantation (LT). METHODS: The authors retrospectively analyzed the data of 27 patients (mean age 58 +/- 9 years) who underwent FDG PET-CT before LT for hepatocarcinoma. Mean follow-up was 26 +/- 18 mo. The FDG PET/CT was performed according to a standard clinical protocol: 4 MBqFDG/kg body weight, uptake 60 min, low-dose non-enhanced CT. The authors measured the SUVmax and SUVmean of the tumor and the normal liver. The tumor/liver activity ratios (RSUVmax and RSUVmean) were tested as prognostic factors and compared to the following conventional prognostic factors: MILAN, CLIP, OKUDA, TNM stage, alphafoetoprotein level, portal thrombosis, size of the largest nodule, tumor differentiation, microvascular invasion, underlying cirrhosis and liver function. RESULTS: Overall and recurrence free survivals were 80.7% and 67.4% at 3 years, and 70.6% and 67.4% at 5 years, respectively. According to a multivariate Cox model, only FDG PET/CT RSUVmax predicted recurrence free survival. Even though the MILAN criteria alone were not predictive, it is worth noting that none of the patients outside the MILAN criteria and with RSUVmax < 1.15 relapsed. CONCLUSION: FDG PET/CT with an RSUVmax cut-off value of 1.15 is a strong prognostic factor for recurrence and death in patients with HCC treated by LT in this retrospective series. Further prospective studies should test whether this metabolic index should be systematically included in the preoperative assessment. [less ▲]Detailed reference viewed: 76 (13 ULg)
Multicenter Belgian experience of sofosbuvir (medical need program) in very difficult-to-treat HCV patients: safety and efficacy results.
; ; et al
in Acta Gastro-Enterologica Belgica (2015, March), 78(1), 03Detailed reference viewed: 28 (3 ULg)
Impact of intensive enteral nutrition in association with corticosteroïds in the treatment of severe alcoholic hepatitis: a multicenter randomized controlled trial
; ; et al
in Acta Gastro-Enterologica Belgica (2015, March), 78(1), 01Detailed reference viewed: 32 (2 ULg)
La cardiomyopathie du cirrhotique : un bref aperçu
MARCHETTA, Stella ; DELWAIDE, Jean ; LANCELLOTTI, Patrizio
in Revue Médicale de Liège (2015), 2Detailed reference viewed: 72 (4 ULg)
Hyperthyroïdie induite par interféron alpha : rapport d'un cas et revue de la littérature
Maiga, Ibrahima ; VALDES SOCIN, Hernan Gonzalo ; Delwaide, Jean et al
in Revue Médicale de Liège (2015), 70(7-8), 390-394Detailed reference viewed: 90 (40 ULg)
Ethnic epidemiological profiles and antiviral therapy among patients infected with hepatitis C virus genotype 4: a multicenter study from Belgium.
; ; et al
in Acta Gastro-Enterologica Belgica (2015), 78(4), 365-372
Background: Hepatitis C virus genotype 4 (HCV-4) is the most prevalent genotype in Central Africa. A large population of Black African individuals, among whom HCV-4 infection is widespread, resides in ... [more ▼]
Background: Hepatitis C virus genotype 4 (HCV-4) is the most prevalent genotype in Central Africa. A large population of Black African individuals, among whom HCV-4 infection is widespread, resides in Belgium. Aim: To compare epidemiology, clinical characteristics and any differences in receipt of HCV therapy in two populations of HCV-4 patients residing in Belgium. Methods: This retrospective multicenter study selected 473 patients from seven hospital databases and compared them according to ethnic origin, i.e., Black African (n=331) or not (n=142), for epidemiological, clinical, biological and histological characteristics. Interleukin 28B polymorphism (CC-genotype) was evaluated in a second cohort of 69 Black African and 30 non-Black African patients. Results: Compared to other patients, the Black African patients were more likely to be female and were older, more commonly overweight, more frequently had abnormal glucose metabolism and arterial hypertension; they were less likely to have dyslipidemia, a history of alcohol consumption or ALT elevation. The route of infection was more frequently unknown in Black African than in other patients. Black African patients had more HCV-4 subtypes, were less frequently of IL28B CC-genotype and had less severe liver fibrosis. The proportion of patients who received antiviral treatment was similar in the two groups. Conclusion: In this Belgian cohort, patients with HCV-4 infection were more frequently of Black African origin than of other origin. Infected Black African patients were more commonly female, older at diagnosis, and had more co-morbidities than other patients; they also had less advanced liver fibrosis than infected non-Black African patients and fewer had a CC genotype. The number of patients treated with antiviral therapy was similar in the two groups. [less ▲]Detailed reference viewed: 24 (3 ULg)
Budd-Chiari syndrome: a case report and review of the literature.
OUHADI, Lorraine ; CREEMERS, Etienne ; HONORE, Pierre et al
in Revue Médicale de Liège (2015), 70(7-8), 378-383Detailed reference viewed: 31 (1 ULg)
Cost-effectiveness model for sofosbuvir in chronic hepatitis C
; ; DELWAIDE, Jean
in Value in Health (2014, November)
Pan-genotypic cost-effectiveness has been demonstrated for sofosbuvir in comparison for the current standard of care in HCV in Belgium. Overall, the wheghted pan-genotypic ICER is 15.575 Euros.Detailed reference viewed: 65 (4 ULg)
A non-interventional phase IV Belgian survey to assess the antiviral effectiveness of pegylated interferon alpha 2b and ribavirin treatment according to the stage of liver fibrosis in previously untreated patients with genotype 1/4/5/6 chronic hepatitis C (Practice)
; ; DELWAIDE, Jean et al
in Acta Gastro-Enterologica Belgica (2014), 77Detailed reference viewed: 49 (4 ULg)