References of "Moreno, C"
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See detailIntensive enteral nutrition is ineffective for individuals with severe alcoholic hepatitis treated with corticosteroids.
Moreno, C; Deltenre, P; Senterre, C 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 The enteral feeding tube was withdrawn prematurely from 48.5% of patients, and serious adverse events considered to be related to enteral nutrition occurred in 5 patients.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 ▲]

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See detailSofosbuvir in combination with simeprevir +/- ribavirin in genotype 4 hepatitis C patients with advanced fibrosis or cirrhosis: a real-life experience from Belgium
Moreno, C; Lasser, L; DELWAIDE, Jean ULg 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 ▲]

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See detailMulticenter Belgian experience of sofosbuvir (medical need program) in very difficult-to-treat HCV patients: safety and efficacy results.
Degre, D; Laleman, W; Verhelst, X et al

in Acta Gastro-Enterologica Belgica (2015, March), 78(1), 03

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See detailImpact of intensive enteral nutrition in association with corticosteroïds in the treatment of severe alcoholic hepatitis: a multicenter randomized controlled trial
Moreno, C; Trepo, E; Louvet, A et al

in Acta Gastro-Enterologica Belgica (2015, March), 78(1), 01

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See detailEthnic epidemiological profiles and antiviral therapy among patients infected with hepatitis C virus genotype 4: a multicenter study from Belgium.
Nkuize, M; Mulkay, JP; Moreno, C 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 ▲]

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See detailImpact of intensive enteral nutrition in association with corticosteroïds in the treatment of severe alcoholic hepatitis: a multicenter randomized controlled trial
Moreno, C; Trepo, E; Louvet, A et al

in Hepatology (Baltimore, Md.) (2014, October), 60(S1),

Intensive enteral nutrition by feeding tube does not improve 6-month survival in patients with severe alcoholic hepatitis. However, adequate nutritional support is associated with a better short-term ... [more ▼]

Intensive enteral nutrition by feeding tube does not improve 6-month survival in patients with severe alcoholic hepatitis. However, adequate nutritional support is associated with a better short-term prognosis. Adequate nutritional intake should be targeted in alcoholic hepatitis patients treated with corticosteroids. [less ▲]

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See detailOrthotopic liver transplantation for hepatocellular car- cinoma after successful downstaging: results from the Belgian multicentre cohort
Schreiber, J.; Lerut, J; Verslype, C et al

in Hepatology (Baltimore, Md.) (2014, October), 60(S1), 468550

Purpose: Successful downstaging of hepatocellular carcinoma (HCC) into the Milan criteria (MC) remains a controversial indication for orthotopic liver transplantation (OLT). In Belgium, successful ... [more ▼]

Purpose: Successful downstaging of hepatocellular carcinoma (HCC) into the Milan criteria (MC) remains a controversial indication for orthotopic liver transplantation (OLT). In Belgium, successful downstaging of HCC is an accepted non-standard- ized exception (NSE) for liver allocation. This NSE group rep- resents a unique cohort to analyse if OLT can be safely offered to patients with those extended allocation criteria. The aim of this study is to compare the overall and recurrence free survival after cadaveric OLT between patients with successful downstaging (MILDOWN) and patients always inside the MC (MILIN) from all Belgian transplant centres. Methods: We ret- rospectively analysed all patients listed for OLT with HCC and underlying cirrhosis between 12/2006 and 12/2011 from all Belgian liver transplant centres. Successful downstaging was defined as bringing a patient who was outside the MC into the MC after locoregional therapy (LRT). Results: Overall 381 patients were listed in Belgium during the study period. Of these, 320 received OLT. 248 were MILIN, 62 were MIL- DOWN and 10 were transplanted outside MC. Downstaging treatment included transarterial chemoembolization (TACE; n=26), radiofrequency (RF; n=9), transarterial radioembolisa- tion (TARE; n=4), resection (n=3), percutaneous ethanol injec- tion (n=2) and a combination of the above-mentioned therapies in 18 cases. In the MILIN group 67.3% received locoregional therapy before transplantation, with no significant differences in the distribution of treatment type compared to the MIL- DOWN group. At listing there were no significant differences between the MILIN and MILDOWN group for age, gender and underlying liver disease. Median time on waiting list between the two groups was similar (120 days vs. 115.5 days). Overall survival at 1 year was not significantly different between MILIN and MILDOWN (87.1% vs. 79%; p=0.120). 1.6% of patients were lost to follow-up in both groups. Although not significant, recurrence free survival at 1 year tended to be higher in the MILIN group than in the MILDOWN group (83.9% vs. 74.2%; p=0.073). Conclusion: In this large Belgian multicentre cohort, overall and recurrence free survival at 1 year are not signifi- cantly different between patients who have been downstaged successfully and patients who were always inside the Milan criteria. However, a longer follow up period will define, if the trend of lower survival in the successfully downstaged group becomes significant. Factors associated with HCC recurrence have to be identified. [less ▲]

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See detailHepatitis B virus and hepatitis C virus infection in Belgium: similarities and differences in epidemic and initial management
De Vroey, B; Moreno, C; Laleman, W et al

in European Journal of Gastroenterology & Hepatology (2013), 25(5), 613-619

Introduction Nationwide studies comparing patients with hepatitis B and C virus (HBV and HCV) infections are mandatory for assessing changes in epidemiology. Aim The aim of this study was to compare ... [more ▼]

Introduction Nationwide studies comparing patients with hepatitis B and C virus (HBV and HCV) infections are mandatory for assessing changes in epidemiology. Aim The aim of this study was to compare epidemiological data and initial management of newly diagnosed patients with persistent HBV (HBsAg positive) or HCV (detectable HCV RNA) infection in Belgium. Patients and methods Data were extracted from two Belgian observational databases. Results A total of 655 patients (387 HBV and 268 HCV) were included. Compared with HCV patients, HBV patients were younger, more frequently men, more often of Asian or African origin (43 vs. 10%, P < 0.0001), and less frequently contaminated by transfusion or intravenous drug use (9 and 6% vs. 34 and 44%, P< 0.0001). Viral replication was assessed in 89% of HBV patients. Compared with HCV patients, HBV patients more frequently had normal alanine aminotransferase (ALT) levels (65 vs. 29%, P < 0.0001), less frequently underwent liver biopsy (29 vs. 67%, P < 0.0001), and were less often considered for antiviral therapy (25 vs. 54%, P < 0.0001). When taking only HBV patients with detectable viral replication into consideration, results remained unchanged. During the multivariate analysis, ALT was a major factor for performing liver biopsy or considering antiviral therapy in both groups. Conclusion HBV and HCV screening policies should be targeted toward immigrants and intravenous drug users, respectively. Guidelines recommending systematic search for viral replication should be reinforced in HBV patients. HBV patients less frequently underwent liver biopsy and were less often considered for antiviral therapy compared with HCV patients. Despite the lack of sensitivity and specificity, ALT remains a pivotal decision-making tool for liver biopsy and antiviral therapy in both infections. [less ▲]

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See detailUpdate of the Belgian Association for the Study of the Liver Guidelines for the treatment of chronic hepatitis C genotype 1 with protease inhibitors.
Orlent, H; Deltenre, P; Francque, S et al

in Acta Gastro-Enterologica Belgica (2012), 75(2), 245-259

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See detailOutcome of patients with hepatocellular carcinoma listed for liver transplantation before and after the MELD-based allocation system within Eurotransplant. A BElgian multicentre retrospective study.
Vos, B.; Rogge, S.; Nevens, F. et al

in Acta Gastro-Enterologica Belgica (2011, March), 74(1), 13

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See detailAre patients with HBV and HCV infection different? Comparison between 2 cohorts of newly diagnosed cases included in prospective registries of the Belgian Association for the Study of the Liver
De Vroey, B.; Moreno, C.; Laleman, W. et al

in Acta Gastro-Enterologica Belgica (2011, March), 74(1), 21

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