Curbside Consultation of the Liver : 49 Clinical Questions

Contents Dedication Acknowledgmentsx About the Editor Contributing Authors Preface SECTION I: VIRAL HEPATITIS C Question 1: What Is the Likelihood That My Patient With Chronic Hepatitis C Will Develop Cirrhosis, Heaptocellular Carcinoma, and/or Hepatic Decompensation? Seela Ramesh, MD and Mitchell L. Shiffman, MD Question 2: How Should a Patient Who Tests Positive for Chronic Hepatitis C but Has Persistently Normal Serum Liver Amino-Transaminases Be Evaluated? Ramesh Ashwath, MD and Mitchell L. Shiffman, MD Question 3: Do All Patients With Chronic Hepatitis C Virus Require a Liver Biopsy? Ramesh Ashwath, MD and Mitchell L. Shiffman, MD Question 4. How Often Should I Measure HCV RNA While Treating a Patient With Peginterferon and Ribavirin? Mitchell L. Shiffman, MD Question 5: When A Patient Receiving Peginterferon and Ribavirin Therapy Develops Anemia Should I Prescribe Epoetin Alfa or Reduce the Dose of the Ribavirin? Mitchell L. Shiffman, MD Question 6: Is There Anything I Can Do to Improve the Chance That an African American With Chronic Hepatitis C Will Respond to Peginterferon and Ribavirin? Mitchell L. Shiffman, MD Question 7: Is It Safe to Treat Patients With Chronic Hepatitis C and Cirrhosis With Peginterferon and Ribavirin? Mitchell L. Shiffman, MD Question 8: How Often Should I Follow a Patient Who Had Chronic Hepatitis C After He Achieved a Sustained Virologic Response? Mitchell L. Shiffman, MD SECTION II: Viral Hepatitis B Question 9: Which Patients With Chronic Hepatitis B Require a Liver Biopsy? Wei Hou, MD and Mitchell L. Shiffman, MD Question 10: How Do I Decide Which Medication to Utilize in a Patient With Hepatitis B Virus? Mitchell L. Shiffman, MD Question 11: Can I Ever Stop Treatment in a Patient With Chronic Hepatitis B Receiving an Oral Antiviral Agent? Wei Hou, MD and Mitchell L. Shiffman, MD Question 12: How Do I Know When a Patient Receiving an Oral Antiviral Agent Has Developed Resistence and What Do I When This Happens? Mitchell L. Shiffman, MD Question 13: How Do I Treat a Patient Who Is Coinfected With Chronic Hepatitis B and C Viruses? Mitchell L. Shiffman, MD SECTION III: LIVER DISEASE IN PATIENTS WITH HIV INFECTION Question 14: How Does Having HIV Affect the Likelihood That My Patient With Chronic HCV Will Develop Cirrhosis? Kevin M. Comar, MD and Richard K. Sterling, MD, FACP, FACG Question 15: Which Patients With Chronic HCV and HIV Coinfection Should Be Treated With Peginterferon and Ribavirin? Kevin M. Comar, MD and Richard K. Sterling, MD, FACP, FACG Question 16: Is There a Simple Way to Treat a Patient Who Is Coinfected With Hepatitis B Virus and HIV? Richard K. Sterling, MD, FACP, FACG Question 17: What Things Could Cause My Patient With HIV to Develop Jaundice? Richard K. Sterling, MD, FACP, FACG Question: 18 Should I Stop HIV Medications in a Patient Who Has Developed an Elevation In Serum Liver Transaminases? Richard K. Sterling, MD, FACP, FACG SECTION IV: GENETIC DISORDERS THAT CAUSE CHRONIC LIVER DISEASE Question 19: What Is the Best Screening Test for Genetic Hemochromatosis? Peter Dienhart, MD; Jayanta Choudhury, MD; and Anastasios A. Mihas, MD, DMSc, FACT, FACG Question 20: How Frequently Should I Have a Patient With Genetic Hemochromatosis Undergo Phlebotomy? Peter Dienhart, MD; Jayanta Choudhury, MD; and Anastasios A. Mihas, MD, FACT, FACG Question 21: What Is the Best Screening Test for Wilsonrsquo;s Disease? Opang Cheung, MD and Anastasios A. Mihas, MD, DMSc, FACS, FACG Question 22: What Should I Tell My Patient Who Is a Carrier for Alpha-1- Antitrypsin Deficiency? Anastasios A. Mihas, MD, DMSc, FACS, FACG Question 23: Do All Patients With Autoimmune Hepatitis Require Immune Suppressive Medications? R. Todd Stravitz, MD Question 24: My Patient With and Autoimmune Hepatitis Cannot Take Corticosteroids. Are There Any Other Medications I Could Use? R. Todd Stravitz, MD Question 25: Do I Need to Perform a Live