Hepatologie - úvod do problematiky

Radan Brůha

Vnitr Lek 2019, 65(9):535-537 | DOI: 10.36290/vnl.2019.093  

Noninvasive diagnostics of liver diseases - imaging methods

Karel Dvořák

Vnitr Lek 2019, 65(9):539-545 | DOI: 10.36290/vnl.2019.094  

Introduction and spread of elastographical methods have changed clinical practice in hepatology substantially. Elastography is becoming more available and the field of non-invasive diagnostics of liver diseases keeps growing dynamically. New technologies and applications are being developed allowing non-invasive staging of liver diseases to much broader extent. Ultrasound based methods like transient elastography (TE) and shear wave elastography (SWE) are dominating the field of liver elastography. Both methods are able to distinguish advanced liver fibrosis/cirrhosis with high accuracy and in patients with all most common chronic liver diseases. A...

Current view on hepatitis B diagnosis and therapy

Petr Husa

Vnitr Lek 2019, 65(9):546-551 | DOI: 10.36290/vnl.2019.095  

Hepatitis B virus (HBV) infection remains a global public health problem with changing epidemiology due to several factors predominantly vaccination policy and migration. Chronic hepatitis B means the duration of HBV infection for more than 6 months. It is a dynamic process reflecting the interaction between HBV replication and the host immune response and not all patients with chronic HBV infection have chronic hepatitis B. All patients with chronic HBV infection are in increased risk of progression to liver cirrhosis and hepatocellular carcinoma. The long-term administration of potent nucleos(t)ide analogue with high barrier of resistance (tenofovir,...

Pangenotypic treatment regimens for chronic hepatitis C

Petr Urbánek

Vnitr Lek 2019, 65(9):553-563 | DOI: 10.36290/vnl.2019.096  

The treatment of chronic hepatitis C is currently based exclusively on the use of drugs from the direct-acting antiviral class. They are substances that inhibit one of the 3 most important enzymes of the virus replication cycle. Antiviral drugs are divided according to the target structure into 3 basic classes, further division is mainly based on the chemical structure of individual antivirals. A common feature of all the regimens is high efficiency and safety. Pangenotypic efficacy regimens are those that utilize a combination of 2 or 3 antiviral agents of different classes, and are effective for all HCV genotypes. Currently there are 3 such regimens...

Current knowledge of hepatitis E virus related disease

Matúš Mihalčin, Petr Husa

Vnitr Lek 2019, 65(9):564-569 | DOI: 10.36290/vnl.2019.097  

Hepatitis E virus (HEV) infection is one of the most common causes of acute hepatitis worldwide. The Czech Republic is also a region with a natural occurrence of HEV genotype 3. Diseases caused by different genotypes have distinct clinical and epidemiological characteristics. In industrialized countries, numerous local animal reservoirs have been described and infection is considered to be zoonotic disease in these areas. The most significant route of transmission is through ingestion of insufficiently cooked meat of reservoir animals. In addition, numerous extrahepatic manifestations, even without dominant liver disease, and the possibility of chronic...

Non-Alcoholic Fatty Liver Disease

Radan Brůha

Vnitr Lek 2019, 65(9):571-575 | DOI: 10.36290/vnl.2019.098  

Non-alcoholic fatty liver disease (NAFLD), the hepatic manifestation of a metabolic syndrome, is a leading cause of chronic liver disease worldwide with prevalence 17-46 % in adult population. NAFLD is associated with type 2 diabetes, obesity and genetic factors and includes a spectrum of potentially progressive liver disease that comprises of simple steatosis, non-alcoholic steatohepatitis (NASH), variable degree of fibrosis and, ultimately, cirrhosis. Simple steatosis has been considered a benign condition, while the progression to fibrosis and advanced liver disease is related to NASH development. While steatosis is diagnosed by routine imaging...

Serum markers in diagnostics of steatohepatitis

Barbora Nováková, Radan Brůha

Vnitr Lek 2019, 65(9):577-582 | DOI: 10.36290/vnl.2019.099  

Along with the increasing incidence and prevalence of obesity and the metabolic syndrome, the number of patients with its hepatic manifestation - NAFL, characterized by triglyceride storage in liver, is rising. NAFL (non-alcoholic fatty liver) is now, with the prevalence of 40 %, the most common liver disease in Western countries. Despite that NAFL has usually no symptoms and in most patients, it is diagnosed as an incidental finding by abdominal ultra-sound, every third of these patients develops NASH (non-alcoholic steatohepatitis), resulting in an individual progression of the sequence of fibrosis - cirrhosis - hepatocellular carcinoma. Due to the...

Rizikové faktory a surveillance hepatocelulárního karcinomu

Soňa Fraňková, Jan Šperl

Vnitr Lek 2019, 65(9):583-587 | DOI: 10.36290/vnl.2019.100  

Hepatocellular carcinoma (HCC) is the second most frequent cause of cancer-related death globally. Approximately 90 % of HCCs are associated with a known underlying etiology, most frequently liver cirrhosis owing to chronic hepatitis B and C. HCC surveillance is based on regular examination of patients in higher risk of HCC occurrence in order to decrease HCC-related mortality. The target population for HCC surveillance is represented by patients with liver cirrhosis, independently of its origin. Tests that can be used in HCC surveillance include serological tests and imaging examinations. The imaging test most widely used for surveillance is ultrasound...

Liver transplantation - changes in indications over last decade

Pavel Trunečka

Vnitr Lek 2019, 65(9):588-594 | DOI: 10.36290/vnl.2019.101  

To achieve satisfactory results of liver transplantation, proper selection of transplant candidates is essential. Moreover, indication process is crucial regulator to solve disparity between need for transplantation and capacity of transplant services. Any patient entering the transplant waiting list must have a chance to achieve at least average transplant benefit, currently described as 50% chance to survive 5 years after liver replacement. Until now, liver transplantation is procedure designed to treat life threatening liver disorders with aim to offer long-term survival. Nevertheless, an increase in incidence of hepatocellular carcinoma, and nonalcoholic...

Z odborné literatury

Vnitr Lek 2019, 65(9):595-597  

errata et corrigenda

redakce

Vnitr Lek 2019, 65(9):597