Treatment of HG involves supportive treatment with IV hydration, anti-emetics and vitamin supplementation especially thiamine to prevent Wernicke’s encephalopathy. HG resolves by 18 weeks of gestation and ICP after delivery. However, ICP can lead to fetal prematurity and anoxia and therefore delivery should be considered after fetal maturity has

been achieved in refractory cases. “
“Hepatitis delta remains a therapeutic challenge. Interferon-alpha (IFN-α) is the sole therapeutic option for patients with chronic hepatitis delta, but results are suboptimal. Less than 30% of patients treated for 48 weeks with pegylated IFN-α (Peg-IFN-α) have a negative viremia 24 weeks after the end of treatment. Heidrich et al. report on the long-term outcome of patients treated in the HIDIT-1 trial. Their assessment is humbling. More than 50% of the patients Selleckchem BI 2536 NVP-LDE225 ic50 with a negative viremia 24 weeks

after treatment have late relapse, and Peg-IFN-α therapy was not associated with a reduction of hepatic events until year 5 of follow-up. On a positive note, none of the patients with a negative viremia at 24 weeks post-treatment experienced a clinical event. This article delivers two messages: (1) A negative viremia 24 weeks post-treatment should not be considered a sustained virological response (SVR) in hepatitis delta and (2) better treatments are required. (Hepatology 2014;60:87-97.) There is no doubt that the best way to avoid problems with hepatitis B virus (HBV) is to vaccinate at birth. Since the implementation of programs Clomifene aiming at vaccinating every newborn, the effect of HBV decreased substantially, especially in countries with high prevalence. But, how important is it to have the multiple shots that a complete vaccination against HBV implies? To answer this question, Chien et al. stratified 3.8 million Taiwanese subjects, according to their complete or incomplete vaccination status, and investigated whether an incomplete vaccination could be associated

with liver-related outcomes (i.e., chronic liver disease, hepatocellular carcinoma [HCC], or fulminant liver failure). All of these outcomes were significantly more frequent in individuals who did not receive a complete vaccination, in comparison with those who had a complete vaccination. To implement general vaccination against hepatitis B is excellent, but to be sure that the complete vaccination is performed is even better. (Hepatology 2014;60:125-132.) Patients with cirrhosis are prone to develop infections, and infections in these patients can lead to severe, potentially lethal complications, such as acute-on-chronic liver failure (ACLF). It is essential to identify patients at high risk as early as possible. Bajaj et al., for the North American Consortium for the Study of End-stage Liver Disease, studied 507 patients with cirrhosis hospitalized with an infection.