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Browsing by Author "Ridruejo, Ezequiel"

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An update on the management of hepatitis C : guidelines for protease inhibitor-based triple therapy from the Latin American Association for the Study of the Liver
(2013) Chávez Tapia, Norberto C.; Ridruejo, Ezequiel; Alves De Mattos, Angelo; Bessone, Fernando; Druich, Jorge; Sánchez Avila, Juan F.; Cheinquer, Hugo; Zapata, Rodrigo; Uribe, Misael; Soza, Alejandro; Bosques Padilla, Francisco; Gadano Espinoza, Adrián; Dávalos Moscol, Milagro; Marroni, Claudio; Muñoz Espinoza, Linda; Castro Narro, Graciela; Paraná, Raimundo; Méndez Sánchez, Nahum
Decompensated cirrhosis and liver transplantation negatively impact in DAA treatment response: Real-world experience from HCV-LALREAN cohort
(2020) Ridruejo, Ezequiel; Piñero, Federico; Mendizabal, Manuel; Cheinquer, Hugo; Soza, Alejandro; Herz Wolff, Fernando; Anders, Margarita; Reggiardo, Virginia; Ameigeiras, Beatriz; Palazzo, Ana; Alonso, Cristina; Schinoni, María Isabel; Videla Zuain, María Grazia; Tanno, Federico; Figueroa, Sebastián; Santos, Luisa; Peralta, Mirta; Vistarini, Cecilia; Adrover, Raúl; Fernández, Nora
Drug-induced liver injury: A management position paper from the Latin American Association for Study of the liver
(2021) Bessone, Fernando; Hernandez, Nelia; Tagle, Martin; Arrese, Marco; Parana, Raymundo; Mendez-Sanchez, Nahum; Ridruejo, Ezequiel; Mendizabal, Manuel; Dagher, Lucy; Contreras, Fernando; Fassio, Eduardo; Pessoa, Mario; Brahm, Javier; Silva, Marcelo
Idiosyncratic drug-induced liver injury (DILI) caused by xenobiotics (drugs, herbals and dietary supplements) is an uncommon cause of liver disease presenting with a wide range of phenotypes and disease severity, acute hepatitis mimicking viral hepatitis to autoimmune hepatitis, steatosis, fibrosis or rare chronic vascular syndromes. Disease severity ranges from asymptomatic liver test abnormalities to acute liver failure. DILI has been traditionally classified in predictable or intrinsic (dose-related) or unpredictable (not dose-related) mechanisms. Few prospective studies are assessing the real prevalence and incidence of hepatotoxicity in the general population. DILI registries represent useful networks used for the study of liver toxicity, aimed at improving the understanding of causes, phenotypes, natural history, and standardized definitions of hepatotoxicity. Although most of the registries do not carry out population-based studies, they may provide important data related to the prevalence of DILI, and also may be useful to compare features from different countries. With the support of the Spanish Registry of Hepatotoxicity, our Latin American Registry (LATINDILI) was created in 2011, and more than 350 DILI patients have been recruited to date. This position paper describes the more frequent drugs and herbsinduced DILI in Latin America, mainly focusing on several features of responsible medicaments. Also, we highlighted the most critical points on the management of hepatotoxicity in general and those based on findings from our Latin American experience in particular. (C) 2021 Fundacion Clinica Medica Sur, A.C. Published by Elsevier Espana, S.L.U.
Effectiveness of the implementation of a re-linkage to care strategy in patients with Hepatitis C who were lost of follow-up
(2021) Mendizabal, Manuel; Thompson, Marcos Andres; Ridruejo, Ezequiel; Gonzalez Ballerga, Esteban; Ruiz Velasco, Jose Antonio Velarde; Palazzo, Ana; Mezzano, Gabriel; Muñoz Espinosa, Linda Elsa; Pessoa, Mario; Cerda Reyes, Eira; Soza, Alejandro; Ruiz, Sandro; Gomez-Aldana, Andres Jose; Gerona, Solange; Fuster, Francisco; Anders, Margarita; Beltran Valdivia, Flor De Maria; Poniachik, Jaime; Schinoni, Maria Isabel; Hernandez, Nelia; Montes, Pedro; Girala, Marcos; Castillo, Lida; Castillo-Barradas, Mauricio; Chavez, Rocio; Cabrera, Cecilia; Tenorio, Laura; Zevallos, Katherine; Garavito, Jorge; Brutti, Julia; Tagle, Martin; Castro Narro, Graciela; Vera Pozo, Emilia; Perazzo, Rosalia; Guillermo Toro, Luis; Varon, Adriana; Ferreiro, Melina; Lazcano, Monserrat; Dolores Murga, Maria; Gomez, Fernando; Hernandez, Larissa; Damasio Moutinho, Bruna; Gandara-Calderon, Julian; Vargas Domínguez, José Ignacio; Simian, Daniela; Silva, Marcelo
Background: In order to achieve the World Health Organization’s ambitious goal of eliminating hepatitis C (HCV), we must implement innovative strategies to diagnose and treat more patients. Therefore, our study aimed to identify patients with chronic HCV infection who lost follow-up and offer them re-linkage to care and treatment with direct-acting antivirals (DAAs). Methods: We conducted an implementation study of a strategy to contact patients with chronic HCV who were not under regular follow-up in 10 countries from Latin America. Patients with HCV were identified by the international classification of diseases (ICD-9/10) or similar. Medical records were then reviewed to confirm the diagnosis of chronic HCV infection defined as anti-HCV + and detectable HCVRNA. Identified patients who were not under follow-up by a liver specialist were contacted to offer them a medical reevaluation and, eventually, treatment with DAA. Results: A total of 3,709 patients were classified as HCV, of which 367 (9.9%) presented undetectable HCVRNA, and 148 (4.0%) were wrongly coded. Overall, 3,194 (86.1%) individuals were identified with chronic HCV infection, 49,9% were male, median age was 61 years (IQR 51-69); 166 (5.2%) developed hepatocellular carcinoma, and 117 (3.7%) underwent liver transplantation. Advanced liver fibrosis (F3-F4) was present in 1,361 (42.6%) patients. A total of 1,764 (55.2%) patients were under close care. Of these, 1,371 (74.7%) received antiviral treatment, 70 (5.3%) did not achieve sustained virologic response, 314 (17.8%) were not treated for different reasons and 133 (7.5%) died. We identified 1,430 (44.8%) patients who were lost of follow-up, 564 (39.4%) of whom were finally located. Of those contacted, 402 (71.3%) were candidates to receive DAAs, 108 (19.2%) were treated in other institutions, 12 (2.1%) did not wish to be treated, and 42 (7.4%) died (Figure). Globally, in our study 786/3,194 (24.6%) patients were candidates to receive antiviral therapies. Conclusion: In our cohort, 1 out of 4 patients with chronic HCV could be re-linked to care and treated. This strategy impresses to be effective, accessible and, significantly impact on the HCV cascade to cure.
Herbal and Dietary Supplements-Induced Liver Injury in Latin America: Experience From the LATINDILI Network
(2022) Bessone, Fernando; Garcia-Cortes, Miren; Medina-Caliz, Inmaculada; Hernandez, Nelia; Parana, Raymundo; Mendizabal, Manuel; Schinoni, Maria, I; Ridruejo, Ezequiel; Nunes, Vinicius; Peralta, Mirta; Santos, Genario; Anders, Margarita; Chiodi, Daniela; Tagle, Martin; Montes, Pedro; Carrera, Enrique; Arrese, Marco; Isabel Lizarzabal, M.; Alvarez-Alvarez, Ismael; Caballano-Infantes, Estefania; Niu, Hao; Pinazo, Jose; Cabello, Maria R.; Isabel Lucena, M.; Andrade, Raul J.
BACKGROUND: Herbal and dietary supplements (HDS) consumption, a growing cause of hepatotoxicity, is a common practice among Latin-American populations. Objectives: To evaluate clinical, laboratory features and outcome in HDS-hepatotoxicity included in the Latin America-Drug Induced Liver Injury (LATINDILI) Network.
Implementation of a re-linkage to care strategy in patients with chronic hepatitis C who were lost to follow-up in Latin America
(2023) Mendizabal, Manuel; Thompson, Marcos; Gonzalez-Ballerga, Esteban; Anders, Margarita; Castro-Narro, Graciela E.; Pessoa, Mario G.; Cheinquer, Hugo; Mezzano, Gabriel; Palazzo, Ana; Ridruejo, Ezequiel; Descalzi, Valeria; Velarde-Ruiz Velasco, Jose A.; Marciano, Sebastian; Munoz, Linda; Schinoni, Maria, I; Poniachik, Jaime; Perazzo, Rosalia; Cerda, Eira; Fuster, Francisco; Varon, Adriana; Ruiz Garcia, Sandro; Soza, Alejandro; Cabrera, Cecilia; Gomez-Aldana, Andres J.; de Maria Beltran, Flor; Gerona, Solange; Cocozzella, Daniel; Bessone, Fernando; Hernandez, Nelia; Alonso, Cristina; Ferreiro, Melina; Antinucci, Florencia; Torre, Aldo; Moutinho, Bruna D.; Coelho Borges, Silvia; Gomez, Fernando; Dolores Murga, Maria; Pinero, Federico; Sotera, Gisela F.; Ocampo, Jhonier A.; Cortes Mollinedo, Valeria A.; Simian, Daniela; Silva, Marcelo O.
To achieve WHO's goal of eliminating hepatitis C virus (HCV), innovative strategies must be designed to diagnose and treat more patients. Therefore, we aimed to describe an implementation strategy to identify patients with HCV who were lost to follow-up (LTFU) and offer them re-linkage to HCV care. We conducted an implementation study utilizing a strategy to contact patients with HCV who were not under regular follow-up in 13 countries from Latin America. Patients with HCV were identified by the international classification of diseases (ICD-9/10) or equivalent. Medical records were then reviewed to confirm the diagnosis of chronic HCV infection defined by anti-HCV+ and detectable HCV-RNA. Identified patients who were not under follow-up by a liver specialist were contacted by telephone or email, and offered a medical reevaluation. A total of 10,364 patients were classified to have HCV. After reviewing their medical charts, 1349 (13%) had undetectable HCV-RNA or were wrongly coded. Overall, 9015 (86.9%) individuals were identified with chronic HCV infection. A total of 5096 (56.5%) patients were under routine HCV care and 3919 (43.5%) had been LTFU. We were able to contact 1617 (41.3%) of the 3919 patients who were LTFU at the primary medical institution, of which 427 (26.4%) were cured at a different institutions or were dead. Of the remaining patients, 906 (76.1%) were candidates for retrieval. In our cohort, about one out of four patients with chronic HCV who were LTFU were candidates to receive treatment. This strategy has the potential to be effective, accessible and significantly impacts on the HCV care cascade.
Nitrofurantoin-induced liver injury: long-term follow-up in two prospective DILI registries
(2023) Bessone, Fernando; Ferrari, Antonella; Hernandez, Nelia; Mendizabal, Manuel; Ridruejo, Ezequiel; Zerega, Alina; Tanno, Federico; Reggiardo, Maria Virginia; Vorobioff, Julio; Tanno, Hugo; Arrese, Marco; Nunes, Vinicius; Tagle, Martin; Medina-Caliz, Inmaculada; Robles-Diaz, Mercedes; Niu, Hao; Alvarez-Alvarez, Ismael; Stephens, Camilla; Lucena, M. Isabel; Andrade, Raul J.
Nitrofurantoin is a synthetic antibiotic that is recommended as first-choice treatment for uncomplicated urinary tract infections. The prescription of this drug has increased dramatically, especially in Latin American countries. We described the demographics, clinical characteristics, biochemical features, and outcome of nitrofurantoin-induced liver injury. We analyzed 23 cases from the Latin American DILI Network (LATINDILI) and the Spanish DILI Registry. Causality was assessed with the RUCAM and RECAM scale. Of the 23 DILI cases included in our series, 96% patients were women, and the mean age of the whole cohort was 61 years. The median time of drug exposure was 175 days (interquartile range [IQR] 96-760), with 11 patients who were prescribed nitrofurantoin for more than six months. Hepatocellular damage was the most frequent pattern of liver injury (83%), and nearly half of the patients had an asymptomatic presentation (52%). Neither death nor liver transplantation was documented in this series. Overall, 65% of the patients (n = 15) presented with positive autoantibody titres. The median time to resolution was 81 days (IQR 57-141), and 15 patients (83%) recovered within six months. Five patients (22%) developed nitrofurantoin-induced autoimmune-like hepatitis (NI-AILH), of whom two were characterized by a persistent increase in transaminases that required immunosuppressive treatment to achieve normalization of liver enzymes. Clinicians who prescribe nitrofurantoin should be aware that patients who had taken nitrofurantoin for a long term may be at risk of developing nitrofurantoin-induced autoimmune-like hepatitis.
Ombitasvir/paritaprevir/ritonavir/dasabuvir +/- ribavirin is safe and effective in HCV-infected patients in a real-life cohort from Latin America
(2017) Mendizabal, Manuel; Haddad, Leila; Gallardo, Patricia E.; Ferrada, Alejandro; Soza, Alejandro; Adrover, Raúl; Aravena, Edmundo; Roblero, Juan P.; Prieto, Jhon; Vujacich, Claudia; Romero, Gustavo; Muñoz, Alberto; Anders, Margarita; Hernández, Nelia; Coccozella, Daniel; Gruz, Fernando; Reggiardo, María Virginia; Ruf, Andrés E.; Varón, Adriana; Cartier, Mariano; Pérez Ravier, Roberto; Ridruejo, Ezequiel; Peralta, Mirta; Poncino, Daniel; Vorobioff, Julio; Aballay Soteras, Gabriel; Silva, Marcelo
Serious liver injury induced by Nimesulide: an international collaborative study
(2021) Bessone, Fernando; Hernandez, Nelia; Mendizabal, Manuel; Ridruejo, Ezequiel; Gualano, Gisela; Fassio, Eduardo; Peralta, Mirta; Fainboim, Hugo; Anders, Margarita; Tanno, Hugo; Tanno, Federico; Parana, Raymundo; Medina-Caliz, Inmaculada; Robles-Diaz, Mercedes; Alvarez-Alvarez, Ismael; Niu, Hao; Stephens, Camilla; Colombato, Luis; Arrese, Marco; Reggiardo, M. Virginia; Ono, Suzane Kioko; Carrilho, Flair; Lucena, M. Isabel; Andrade, Raul J.
Nimesulide is a non-steroidal anti-inflammatory drug still marketed in many countries. We aim to analyze the clinical phenotype, outcome, and histological features of nimesulide-induced liver injury (nimesulide-DILI). We analyzed 57 cases recruited from the Spanish and Latin American DILI registries. Causality was assessed by the RUCAM scale. Mean age of the whole case series was 59 years (86% women) with a median time to onset of 40 days. A total of 46 patients (81%) were jaundiced. Nimesulide-DILI pattern was hepatocellular in 38 (67%), mixed in 12 (21%), and cholestatic in 7 (12%) cases. Transaminases were elevated with a mean of nearly 20-fold the upper limit of normality (ULN), while alkaline phosphatase showed a twofold mean elevation above ULN. Total bilirubin showed a mean elevation of 13-fold the ULN. Liver histology was obtained in 14 cases (25%), most of them with a hepatocellular pattern. Median time to recovery was 60 days. Overall, 12 patients (21%) developed acute liver failure (ALF), five (8.8%) died, three underwent liver transplantation (5.3%), and the remaining four resolved. Latency was <= 15 days in 12 patients (21%) and one patient developed ALF within 7 days from treatment initiation. Increased total bilirubin and aspartate transaminase levels were independently associated with the development of ALF. In summary, nimesulide-DILI affects mainly women and presents typically with a hepatocellular pattern. It is associated with ALF and death in a high proportion of patients. Shorter (<= 15 days) duration of therapy does not prevent serious nimesulide hepatotoxicity, making its risk/benefit ratio clearly unfavorable.
The case for simplifying and using absolute targets for viral hepatitis elimination goals
(2021) Razavi, Homie; Blach, Sarah; Razavi-Shearers, Devin; Abaalkhail, Faisal; Abbas, Zaigham; Abdallah, Ayat; Ferreira, Paulo Abrao; Abu Raddad, Laith Jamal; Adda, Danjuma; Agarwal, Kosh; Aghemo, Alessio; Ahmed, Aijaz; Al-Busafi, Said A.; Al-hamoudi, Waleed; Al-Kaabi, Saad; Al-Romaihi, Hamad; Aljarallah, Badr; AlNaamani, Khalid; Alqahtani, Saleh; Alswat, Khalid; Altraif, Ibrahim; Asselah, Tarik; Bacon, Bruce; Bessone, Fernando; Bizri, Abdul Rahman; Block, Tim; Bonino, Ferruccio; BranclaoMello, Carlos Eduardo; Browny, Kimberly; Bruggmann, Philip; Brunetto, Maurizia Rossana; Buti, Maria; Cabezas, Joaquin; Calleja, Jose Luis; Batanjer, Erika Castro; Chan, Henry Lik-Yuen; Chang, Henry; Chen, Chien-Jen; Christensen, Peer Brehm; Chuang, Wan-Long; Cisneros, Laura; Cohen, Chari; Colombo, Massimo; Conway, Brian; Cooper, Curtis; Craxi, Antonio; Crespo, Javier; Croes, Esther; Cryer, Donna; de Barros, Fernando Passos Cupertino; Derbala, Moutaz; Dillon, John; Doss, Wahid; Dou, Xiaoguang; Doyle, Joseph; Duberg, Ann-Sofi; Dugan, Ellen; Dunn, Rick; Dusheiko, Geoffrey; El Khayat, Hisham; EI-Sayed, Manal H.; Eshraghian, Ahad; Esmat, Gamal; Mur, Rafael Esteban; Ezzat, Sameera; Falconer, Karolin; Fassio, Eduardo; Ferrinho, Paulo; Flamm, Steven; Flisiak, Robert; Foster, Graham; Fung, James; Garcia-Samaniego, Javier; Gish, Robert G.; Goncales, Fernando; Halota, Waldemar; Hamoudi, Waseem; Hassany, Mohamed; Hatzakis, Angelos; Hay, Susan; Himatt, Sayed; Hoepelman, I. M.; Hsu, Yao-Chun; Hui, Yee Tak; Hunyady, Bela; Jacobson, Ira; Janjua, Naveed; Janssen, Harry; Jarcuska, Peter; Kabagambe, Kenneth; Kanto, Tatsuya; Kao, Jia-Horng; Kaymakoglu, Sabahattin; Kershenobich, David; Khamis, Faryal; Kim, Dong Joon; Kim, Young; Kondili, Loreta A.; KottiliI, Shyamasundaran; Kramvis, Anna; Kugelmas, Marcelo; Kurosaki, Masayuki; Lacombe, Karine; Lagging, Martin; Lao, WaiCheung; Lavanchy, Daniel; Lazarus, Jeffrey, V; Lee, Alice; Lee, Samual S.; Levyl, Miriam; Liakina, Valentina; Lim, YoungSuk; Liu, Shuang; Maddrey, Willis; Malekzade, Reza; Marinho, Rui Tato; Mathur, Poonam; Maticic, Mojca; Mendes Correa, Maria Cassia; Mera, Jorge; Merat, Shahin; Mogawer, Sherif; Mohamed, Rosmawati; Muellhaupti, Beat; Muljono, David; Mostafa, Ibrahim; Nahum, Mendez Sanchez; Nawaz, Arif; Negro, Francesco; Ninburg, Michael; Ning, Qing; Ntiri-Reid, Boatemaa; Nymadawa, Pagbajabyn; Oevrehus, Anne; Ormeci, Necati; Orrego, Mauricio; Osman, Alaa; Oyunsuren, Tsendsuren; Pant, Calvin; Papaevangelou, Vassiliki; Papatheodoridis, George; Popping, Stephanie; Prasad, Papu; Prithiviputh, Rittoo; Qureshi, Huma; Ramji, Alnoor; Razavi-Shearer, Kathryn; Reddy, Rajender; Remak, William; Richter, Clemens; Ridruejo, Ezequiel; Robaeys, Geert; Robert, Stuart; Roberts, Lewis; Roudot-Thoraval, Francoise; Saab, Sammy; Said, Sanaa; Salamat, Amjad; Sanai, Faisal; Sanchez-Avila, Juan Francisco; Schiff, Eugene; Schinazi, Raymond; Sebastiani, Giada; Seguin-Devaux, Carole; Shanmugam, R. P.; Sharara, Ala; Shilton, Sonjelle; Shouval, Daniel; Sievert, William; Simonova, Marieta; Sohrabpour, Amir Ali; Sonderup, Mark; Soza, Alejandro; Spearman, C. Wendy; Steinfurth, Nancy; Sulkowski, Mark; Tan, Soek-Siam; Tanaka, Junko; Tashi, Dhondup; Thein, Hla-Hla; Thompson, Peyton; Tolmane, Ieva; Toy, Mehlika; Valantinas, Jonas; Van de Vijver, David; Velez-Moller, Patricia; Vince, Adriana; Waked, Imam; Wang, Su; Wedemeyer, Heiner; Wong, Vincent; Xie, Qing; Yamada, Seiji; Yang, Hwai-, I; Yesmembetov, Kakharman; Yilmaz, Yusuf; Younossi, Zobair; Yu, Ming-Lung; Yuen, Man-Fung; Yurdaydin, Cihan; Yusuf, Aasim; Zekry, Amany; Zeuzem, Stefan
The 69th World Health Assembly endorsed the Global Health Sector Strategy for Viral Hepatitis, embracing a goal to eliminate hepatitis infection as a public health threat by 2030. This was followed by the World Health Organization's (WHO) global targets for the care and management of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. These announcements and targets were important in raising awareness and calling for action; however, tracking countries' progress towards these elimination goals has provided insights to the limitations of these targets. The existing targets compare a country's progress relative to its 2015 values, penalizing countries who started their programmes prior to 2015, countries with a young population, or countries with a low prevalence. We recommend that (1) WHO simplify the hepatitis elimination targets, (2) change to absolute targets and (3) allow countries to achieve these disease targets with their own service coverage initiatives that will have the maximum impact. The recommended targets are as follows: reduce HCV new chronic cases to <= 5 per 100 000, reduce HBV prevalence among 1-year-olds to <= 0.1%, reduce HBV and HCV mortality to <= 5 per 100 000, and demonstrate HBV and HCV year-to-year decrease in new HCV- and HBV-related HCC cases. The objective of our recommendations is not to lower expectations or diminish the hepatitis elimination standards, but to provide clearer targets that recognize the past and current elimination efforts by countries, help measure progress towards true elimination, and motivate other countries to follow suit.
Treatment with direct‐acting antivirals for HCV decreases but does not eliminate the risk of hepatocellular carcinoma
(2019) Piñero, Federico; Mendizabal, Manuel; Ridruejo, Ezequiel; Herz Wolff, Fernando; Ameigeiras, Beatriz; Anders, Margarita; Schinoni, María Isabel; Reggiardo, María Virginia; Palazzo, Ana; Soza, Alejandro; Videla, María; Alonso, Cristina; Santos, Luisa; Varón, Adriana; Figueroa, Sebastián; Vistarini, Cecilia; Adrover, Raúl; Fernández, Nora; Perez, Daniela; Tanno, Federico; Hernández, Nelia; Sixto, Marcela; Borzi, Silvia; Bruno, Andres; Cocozzella, Daniel; Descalzi, Valeria; Estepo, Claudio; Zerega, Alina; Araujo, Alexandre de; Cheinquer, Hugo; Silva, Marcelo; LALREAN
Which strategies should be implemented in Latin America to eradicate hepatitis C virus by 2030?
(2019) Ridruejo, Ezequiel; Soza, Alejandro

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