Abstract:
:In conclusion, the natural history of chronic HCV infection has not yet been fully defined. Current data suggest that the process runs an indolent course during the first two decades after initial infection, accounting for modest morbidity and mortality. Serious sequelae are more likely to emerge as the disease process enters the third and fourth decades after infection. These sequelae will presumably be concentrated among those whose liver biopsies display features of cirrhosis, but seem less likely to effect those with liver biopsy evidence of chronic hepatitis alone unless their disease advances to cirrhosis. The frequency of progression from chronic hepatitis to cirrhosis as the disease process enters the third decade remains to be determined. Associated chronic alcoholism appears to be an important additive factor, but other factors that might promote disease progression need to be defined. It seems probable that end-stage liver disease will result in only a proportion of infected individuals. If so, the challenge is to learn how to determine for each individual during the course of their chronic illness what outcome can be expected.
journal_name
Clin Liver Disjournal_title
Clinics in liver diseaseauthors
Seeff LBdoi
10.1016/s1089-3261(05)70323-8subject
Has Abstractpub_date
1997-11-01 00:00:00pages
587-602issue
3eissn
1089-3261issn
1557-8224pii
S1089-3261(05)70323-8journal_volume
1pub_type
杂志文章,评审abstract::Nonalcoholic fatty liver (NAFL) is increasingly recognized as an important and common public health problem that can lead to cirrhosis and hepatic failure. Because it is often asymptomatic,many people may not know that they have it. NAFL is closely linked to obesity, which in the United States and other developed coun...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2004.04.008
更新日期:2004-08-01 00:00:00
abstract::Autoimmune liver diseases have much in common with each other, and there are clear associations with genetic haplotypes. Elegant studies have shown autoimmune liver disease induced by viruses and drugs. Although there is evidence for nonimmunological events precipitating immune disease, especially in primary sclerosin...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/s1089-3261(05)70005-2
更新日期:1998-05-01 00:00:00
abstract::Hepatitis C virus (HCV) infection is a systemic disease with hepatic and extrahepatic manifestations, including neuropsychiatric conditions. Depression is a frequent disorder, which has been reported in one-third of patients with HCV infection and has an estimated prevalence of 1.5 to 4.0 times higher than that observ...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2017.03.007
更新日期:2017-08-01 00:00:00
abstract::The diagnosis of hepatic encephalopathy is predominantly clinical, and the tests available assist in the diagnosis only by excluding other causes. Covert hepatic encephalopathy, which is defined as abnormal performance on psychometric tests when standard neurologic examination is completely normal, has gained widespre...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2015.04.001
更新日期:2015-08-01 00:00:00
abstract::Since the introduction of small bowel capsule endoscopy, and more recently of esophageal capsule endoscopy, these diagnostic tools have become available for the evaluation of the consequences of portal hypertension in the esophagus, stomach, and small intestine. The main advantage of the esophageal and the small bowel...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2010.03.004
更新日期:2010-05-01 00:00:00
abstract::The greatest challenge facing liver transplantation today is the shortage of donor livers. Demand far exceeds supply, and this deficit has driven expansion of what is considered an acceptable organ. The evolving standard has not come without costs, however, as each new frontier of expanded donor quality (i.e., advanci...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2014.05.005
更新日期:2014-08-01 00:00:00
abstract::Autoimmune hepatitis (AIH) is an immune-mediated, autodestructive liver disease with hepatocytes as target cells, mostly affecting young women. Primary biliary cirrhosis (PBC) is also regarded as an autoimmune liver disease with bile duct epithelia as the target cells, resulting in a continuous loss of bile ducts. Bot...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/s1089-3261(02)00007-7
更新日期:2002-05-01 00:00:00
abstract::Cirrhosis is a complex process in which the architecture of the liver is replaced by structurally abnormal nodules due to cirrhosis. Cirrhosis frequently leads to the development of portal hypertension. In children, portal hypertension may be caused by a wide range of etiologies, including extrahepatic portal vein obs...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2018.06.007
更新日期:2018-11-01 00:00:00
abstract::Patients with hepatocellular carcinoma (HCC) have many treatment options. For patients with surgical indication, consideration of future liver remnant and the surgical complexity of the procedure is essential. A new 3-level complexity classification categorizing 11 liver resection procedures predicts surgical complexi...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2020.07.004
更新日期:2020-11-01 00:00:00
abstract::Hepatic encephalopathy (HE) represents a continuum of transient and reversible neurologic and psychiatric dysfunction. It is a reversible state of impaired cognitive function or altered consciousness in patients with liver disease or portosystemic shunting. Over the last several years, high-quality studies have been c...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2012.03.009
更新日期:2012-05-01 00:00:00
abstract::The Model for End-stage Liver Disease (MELD) has been demonstrated to be an excellent predictor of survival in patients who have end-stage liver disease. It is derived from the international normalized ratio (INR) of prothrombin time, serum creatinine, and serum total bilirubin. The major use of the MELD score is to p...
journal_title:Clinics in liver disease
pub_type: 杂志文章
doi:10.1016/j.cld.2008.09.001
更新日期:2009-02-01 00:00:00
abstract::Non-alcoholic fatty liver disease (NAFLD) is common and may progress to end-stage liver disease. Liver-related morbidity and mortality occur almost exclusively in patients whose disease progresses to advanced fibrosis and cirrhosis. Presence and severity of liver fibrosis seem the most important indicators of long-ter...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2007.02.004
更新日期:2007-02-01 00:00:00
abstract::The causes of hepatic granulomas are numerous and their identification can be difficult. Sarcoidosis is a main cause of hepatic granulomas. The mechanisms that initiate the formation of sarcoid granulomas are unknown. This article discusses the pathology of hepatic sarcoidosis and hepatic granulomas. ...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/s1089-3261(05)70108-2
更新日期:2000-02-01 00:00:00
abstract::Hepatobiliary dysfunction associated with the use of total parenteral nutrition is a commonly recognized phenomenon occurring in up to 90% of patients on long-term therapy. Reasons for these abnormalities, both supported by research as well as theoretical possibilities are explored. Practical guidelines considered use...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/s1089-3261(05)70368-8
更新日期:1998-02-01 00:00:00
abstract::This article discusses direct-acting antiviral agents that target hepatitis C virus replication, their mechanism of action, strengths, and weaknesses. In addition, varying strategies using combinations of these agents are discussed. ...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2015.06.002
更新日期:2015-11-01 00:00:00
abstract::The answers to these questions are key to understanding the pathogenesis of PBC. Although the study of PBC is significantly retarded by the lack of an adequate animal model, the molecular technology to address these issues is advancing rapidly. In addition, the ability to isolate and culture human biliary epithelial c...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/s1089-3261(03)00093-x
更新日期:2003-11-01 00:00:00
abstract::Despite significant advances in nonsurgical treatments of hepatocellular carcinoma, these approaches rarely result in cure. Surgery remains the mainstay of curative therapy for hepatocellular carcinoma. Liver transplantation, in particular, has emerged as one of the most beneficial therapeutic modalities. Questions re...
journal_title:Clinics in liver disease
pub_type: 杂志文章
doi:10.1016/j.cld.2011.03.005
更新日期:2011-05-01 00:00:00
abstract::Primary biliary cirrhosis (PBC) is characterized by the presence of high-titer disease specific autoantibodies directed against mitochondrial antigens (AMA) of the inner mitochondrial membrane, that are members of the 2-oxo acid complex. Among numerous other autoantibodies found in PBC the focus of ongoing studies is ...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/s1089-3261(03)00104-1
更新日期:2003-11-01 00:00:00
abstract::Hepatocellular carcinoma can be treated using minimally invasive, image-guided, catheter-based or percutaneous techniques. Such procedures offer compelling clinical outcomes with a favorable side-effect profile in a population of patients who are poor candidates for surgical or systemic treatment. This article discuss...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2015.01.008
更新日期:2015-05-01 00:00:00
abstract::Scientists and clinicians have made tremendous advances in understanding the pathogenesis of hepatitis C virus (HCV) infection and have developed impressive strategies for treating this hepatotropic virus in the short time since its discovery in 1989. This article goes beyond the current guidelines for the treatment o...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2006.08.024
更新日期:2006-11-01 00:00:00
abstract::The past decade has brought tremendous growth in the under-standing of the pathophysiologic mechanisms involved in cholestasis, both at the genetic and acquired levels. The discovery and characterization of an array of hepatobiliary transport proteins, the nuclear receptors that regulate them, and the potential clinic...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/S1089-3261(03)00125-9
更新日期:2004-02-01 00:00:00
abstract::The incidence of nonalcoholic fatty liver disease is increasing at an astonishing rate in the US population. Although only a small proportion of these patients develop steatohepatitis (NASH), those who do have a greater likelihood of developing end-stage liver disease and complications. Research on liver fibrosis and ...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2012.05.002
更新日期:2012-08-01 00:00:00
abstract::Noncirrhotic portal hypertension represents a heterogeneous group of conditions that have distinct clinical and hemodynamic features that often help distinguish them from cirrhosis. [figure: see text] The sites of portal flow resistance may not be precisely localized to one area of the hepatic lobule and may extend be...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/s1089-3261(05)70191-4
更新日期:2001-08-01 00:00:00
abstract::There have been major advances in the field of hepatitis B (HBV) over the last few decades. These advances have resulted in the understanding of the natural history of chronic HBV infection, effective vaccines against the virus, sensitive assays for screening and monitoring of treatment, and effective treatments for v...
journal_title:Clinics in liver disease
pub_type: 历史文章,杂志文章,评审
doi:10.1016/j.cld.2010.05.003
更新日期:2010-08-01 00:00:00
abstract::Primary biliary cirrhosis is an insidious disease that progresses through the clinical phases: preclinical, asymptomatic, symptomatic, and liver insufficiency. The outlook of patients diagnosed with PBC has improved significantly over the past 2 decades because more patients are being diagnosed earlier in the disease ...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2008.02.012
更新日期:2008-05-01 00:00:00
abstract::The global risk of hepatocellular carcinoma (HCC) has been largely driven by hepatitis B virus (HBV) infection for the past century, along with hepatitis C virus (HCV), aflatoxin, excessive alcohol consumption, and obesity/diabetes. The dominant effect of HBV on global HCC risk should decline as the population vaccina...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2011.03.006
更新日期:2011-05-01 00:00:00
abstract::Serologic assays for HBV are the mainstay diagnostic tools for HBV infection. However, the advent of molecular biology-based techniques has added a new dimension to the diagnosis and treatment of patients with chronic HBV infection. Over the past decade, improvements in molecular technology, permitting detection of as...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2004.02.001
更新日期:2004-05-01 00:00:00
abstract::Combination therapy with beta-blockers and endoscopic band ligation (EBL) is the standard prophylaxis of esophageal variceal rebleeding in cirrhosis. Beta-blockers are the backbone of combination therapy, since their benefit extend to other complications of portal hypertension. EBL carries the risk of post-banding ulc...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2014.01.007
更新日期:2014-05-01 00:00:00
abstract::The pathogenesis of HCC is poorly understood at present. There is insufficient understanding to propose a robust general model of hepatic carcinogenesis, partly because pathogenic host and environmental factors show significant regional variation, making such generalization difficult. Figure 4 is a model based on data...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/s1089-3261(05)70154-9
更新日期:2001-02-01 00:00:00
abstract::Epidemiologic studies suggest that 10% to 15% of patients infected with hepatitis C virus (HCV) are coinfected with hepatitis B virus (HBV) in the United States as a result of the shared modality of transmission, but the true prevalence is not known. The progression of liver disease to cirrhosis and hepatocellular car...
journal_title:Clinics in liver disease
pub_type: 杂志文章,评审
doi:10.1016/j.cld.2019.04.003
更新日期:2019-08-01 00:00:00