JAUNDICE & EVALUATION OF ABNORMAL LIVER BIOCHEMICAL TESTS
Elevated AST levels have been reported to be associated with shorter life expectancy.
ACUTE HEPATITIS C & OTHER CAUSES OF ACUTE VIRAL HEPATITIS
The USPSTF recommends that asymptomatic adults ages 18-79 be screened for hepatitis C virus infection.
In 2019, the American Association for the Study of Liver Diseases and the Infectious Diseases Society of America recommended two preferred regimens for hepatitis C: glecaprevir and pibrentasvir for 8 weeks for genotypes 1-6, and sofosbuvir and velpatasvir for 12 weeks for genotypes 1, 2, 4, 5, or 6.
ALCOHOL-ASSOCIATED LIVER DISEASE
Baclofen appears to be safe in persons with end-stage alcoholassociated liver disease but can worsen hepatic encephalopathy.
DRUG- & TOXIN-INDUCED LIVER INJURY
Some newly identified HLA and other genetic associations with drug hepatotoxicity include HLA-B57:01 with flucloxacillin in Asians and HLA-DRB1*15:01 with amoxicillin-clavulanic acid.
NONALCOHOLIC FATTY LIVER DISEASE
Risk factors for fibrosis in patients with fatty liver without nonalcoholic steatohepatitis are severe steatosis and the I148M variant of the PNPLA3 gene.
CHOLEDOCHOLITHIASIS & CHOLANGITIS
In acute calculous cholecystitis, predictors of concomitant choledocholithiasis are serum aminotransferase levels over three times the upper limit of normal, an alkaline phosphatase level above normal, a serum lipase over three times the upper limit of normal, a bilirubin of 1.8 mg/dL or more, and a bile duct diameter above 6 mm.
For bile duct stones 1 cm or more in diameter, endoscopic sphincterotomy followed by large balloon dilation has been recommended.
PRIMARY SCLEROSING CHOLANGITIS
Statin use is associated with improved outcomes in patients with primary sclerosing cholangitis.