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Hepatitis: HELP
Articles by Philipp de Leuw
Based on 3 articles published since 2008
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Between 2008 and 2019, P. de Leuw wrote the following 3 articles about Hepatitis.
 
+ Citations + Abstracts
1 Review Protease inhibitor therapy for hepatitis C virus-infection. 2018

de Leuw, P / Stephan, C. ·a Medical Clinic II, Infectious Diseases Unit , Goethe-University Hospital Frankfurt , Frankfurt am Main , Germany. ·Expert Opin Pharmacother · Pubmed #29595065.

ABSTRACT: INTRODUCTION: The hepatitis C virus (HCV) has affected an estimated of 80 million individuals worldwide and is a strain on public health. Around 25-30% of patients in Europe and the US who are infected with HIV are coinfected with HCV. Prior to 2013, treatment modalities containing an NS3/4A protease inhibitor in combination with pegylated interferon and ribavirin improved sustained virological response (SVR) rates. However, rates of severe side effects were high. Nowadays, oral direct-acting antiviral (DAA) combination therapy offers excellent treatment efficacy, safety and tolerability. AREAS COVERED: This review focuses on the current literature and clinical evidence and their impact regarding NS3/4A protease inhibitors. The pitfalls encountered in treating HIV- and HBV-coinfected patients are also discussed. EXPERT OPINION: In the era of DAA treatment, third-generation pan-genotypic NS3/4A protease inhibitors (mainly glecaprevir and voxilaprevir) show high antiviral activity and a genetic resistance barrier with cure rates of over 95% when combined with an NS5A inhibitor, irrespective of baseline resistance associated variants (RASs) being present. These new key components of DAA combination therapy are impressive options to eradicate HCV in the so-called difficult-to-treat population (e.g. compensated cirrhosis, end-stage renal disease and patients who failed previous DAA treatment).

2 Article Criteria Used in Clinical Practice to Guide Immunosuppressive Treatment in Patients with Primary Sclerosing Cholangitis. 2015

Schulze, Kornelius / Weismüller, Tobias J / Bubenheim, Michael / Huebener, Peter / Zenouzi, Roman / Lenzen, Henrike / Rupp, Christian / Gotthardt, Daniel / de Leuw, Philipp / Teufel, Andreas / Zimmer, Vincent / Reiter, Florian P / Rust, Christian / Tharun, Lars / Quaas, Alexander / Weidemann, Sören A / Lammert, Frank / Sarrazin, Christoph / Manns, Michael P / Lohse, Ansgar W / Schramm, Christoph / Anonymous4020846. ·I. Department of Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. · Department of Internal Medicine I, University of Bonn, Bonn, Germany; Clinic of Gastroenterology, Hepatology, and Endocrinology, Hannover Medical School, Hannover, Germany. · Department of Biostatistics, Rouen University Hospital-Charles Nicolle, Rouen, France. · Clinic of Gastroenterology, Hepatology, and Endocrinology, Hannover Medical School, Hannover, Germany. · IV. Department of Medicine, University Medical Center Heidelberg, Heidelberg, Germany. · I. Department of Medicine, University Medical Center Frankfurt, Frankfurt am Main, Germany. · I. Department of Medicine, University Medical Center Mainz, Mainz, Germany; Department of Medicine, University Hospital Regensburg, Regensburg, Germany. · II. Department of Medicine, Saarland University Medical Center Homburg, Homburg, Germany. · Department of Medicine II, Liver Center Munich, University of Munich, Grosshadern Campus, Munich, Germany. · Department of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. · Department of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Pathology, University Medical Center Cologne, Cologne, Germany. · Department of Pathology, University Medical Center Cologne, Cologne, Germany. ·PLoS One · Pubmed #26489083.

ABSTRACT: BACKGROUND & AIMS: Current guidelines recommend immunosuppressive treatment (IT) in patients with primary sclerosing cholangitis (PSC) and elevated aminotransferase levels more than five times the upper limit of normal and elevated serum IgG-levels above twice the upper limit of normal. Since there is no evidence to support this recommendation, we aimed to assess the criteria that guided clinicians in clinical practice to initiate IT in patients with previously diagnosed PSC. METHODS: This is a retrospective analysis of 196 PSC patients from seven German hepatology centers, of whom 36 patients had received IT solely for their liver disease during the course of PSC. Analyses were carried out using methods for competing risks. RESULTS: A simplified autoimmune hepatitis (AIH) score >5 (HR of 36, p<0.0001) and a modified histological activity index (mHAI) greater than 3/18 points (HR 3.6, p = 0.0274) were associated with the initiation of IT during the course of PSC. Of note, PSC patients who subsequently received IT differed already at the time of PSC diagnosis from those patients, who did not receive IT during follow-up: they presented with increased levels of IgG (p = 0.004) and more frequently had clinical signs of cirrhosis (p = 0.0002). CONCLUSIONS: This is the first study which investigates the parameters associated with IT in patients with PSC in clinical practice. A simplified AIH score >5 and a mHAI score >3, suggesting concomitant features of AIH, influenced the decision to introduce IT during the course of PSC. In German clinical practice, the cutoffs used to guide IT may be lower than recommended by current guidelines.

3 Article How to use virological tools for the optimal management of chronic hepatitis C. 2011

de Leuw, Philipp / Sarrazin, Christoph / Zeuzem, Stefan. ·Medizinische Klinik I, Klinikum der Johann-Wolfgang Goethe-Universität, Frankfurt am Main, Germany. ·Liver Int · Pubmed #21205131.

ABSTRACT: Approximately 180 million individuals are chronically infected with hepatitis C, which is strongly associated with the development of cirrhosis, end-stage liver disease and hepatocellular carcinoma. Several virological tools (anti-HCV antibody assays, measurement of HCV-RNA, HCV-genotyping) are useful in management of hepatitis C infected patients. The primary goal of antiviral therapy in chronic hepatitis C is a sustained virological response (SVR). The HCV genotype should be determined in every patient considered for antiviral therapy because the currently recommended treatment duration and ribavirin doses differ among HCV genotypes. Exact subtyping might gain increased importance for future therapies with direct-acting antiviral agents (DAA) because of differences of antiviral activities and barriers to resistance among HCV subtypes. Monitoring HCV RNA by a highly sensitive assay (LOD ≤ 15 IU/ml) is the basis for management of response guided therapy of chronic hepatitis C with pegylated IFN plus ribavirin. Rules for early discontinuation of antiviral therapy in non-responders and determination of optimal treatment durations in virologic responders have been developed for application of individualized treatment strategies.