[Liver diseases]

In Digestive Disease Week 2008, interesting advances in the treatment of hepatitis C were presented, especially related to the promising increase in the therapeutic efficacy of the combination of conventional treatment with the protease inhibitor, telaprevir. Also revealed was the influence of viral replication of hepatitis B virus in the development of complications, including hepatocarcinoma. In this sense, drugs such as entecavir and tenofovir seem to provide sustained inhibition of viral replication without the development of resistance. Among the complications of cirrhosis, the growing prognostic implications of bacterial infections, associated with an increased risk of death, have been demonstrated. Likewise, diverse studies have provided greater understanding of the role of elastography in the evaluation of liver fibrosis, including the role of this technique in the evaluation of treatment response and in liver transplantation. The importance of fatty acid liver disease was clearly shown in several studies confirming the influence of diabetes in the presence of inflammation and fibrosis and the increase in the indication of liver transplantation for this disease, which may recur in the graft, especially in patients with a high body mass index. A meta-analysis of hepatocarcinoma and a decision model were unable to detect differences in survival in small tumors treated with radiofrequency or surgery.