International Conference on Hepatitis October 19-20, 2020 Helsinki, Finland

Track 1: Hepatitis and its Types

Hepatitis is the inflammatory condition of the liver. The most common cause is viral infection and is known as viral hepatitis. The other possible causes of hepatitis include auto immune hepatitis and hepatitis that occurs as a secondary result of drugs, alcohol, toxins and other medications. Autoimmune hepatitis occurs when our body's immune system that typically attacks bacteria, viruses, and other pathogens, rather targets your liver tissue. Viral infections of liver include hepatitis A, B, C, D and E. Each different virus is accountable for each type of virally transmitted hepatitis. These 5 viruses are of greatest concern because of the burden of illness, weakness and death they cause and potential for epidemic spread. Hepatitis A virus is always an acute, a short term disease, while hepatitis B, hepatitis C, hepatitis D virus are most likely to become chronic. Hepatitis E virus is usually acute but can be particularly dangerous in pregnant women. All these viruses primarily multiply in the liver cells which make the liver unable to perform its functions.

• Hepatitis B
• Hepatitis C
• Autoimmune hepatitis
• Viral hepatitis
• Chronic liver disease
• Non-alcoholic fatty liver disease

Track 2: Liver Cancer

Liver cancer, otherwise called hepatic cancer, is the condition which occurs when the different types of cells in the liver forms into several types of malignant tumors. Liver cancer is generally of primary or secondary. Primary liver cancer begins in the liver whereas Secondary liver cancer also known as liver metastasis starts in another part of the body spreads to the liver. The main reason for liver cancer is cirrhosis because of hepatitis viruses B and C or alcohol. The other different causes include non-alcoholic fatty liver disease, aflatoxin, and liver flukes. Some of the most common symptoms of liver cancer are weight loss, easy bruising, yellowish skin, pain in the right side beneath the rib cage, loss of appetite and weakness. The generally recognized sorts are hepatocellular carcinoma (HCC), which makes up 80% of cases, and cholangiocarcinoma. Primary liver cancer is all around the 6th most frequent cancer (6%) and the second leading reason for death from cancer (9%).

Primary Liver cancer includes

• Hepatocellular carcinoma
• Intrahepatic cholangiocarcinoma
• Angiosarcoma and hemangiosarcoma
• Hepatoblastoma

Track 3: Gastroenterology

Gastroenterology is the branch of medicine which deals with the digestive system and its disorders by investigating the typical capacity and infections. It contains complete comprehension of typical activity (physiology) of the gastrointestinal organs containing the program of material through the stomach and digestive system (mobility), the digestion and absorption of supplements into the body, expulsion of waste from the system, and the occupation of the liver as a stomach related organ. It contains common and significant disorders such as colon polyps and cancer, hepatitis, Gastroesophageal reflux (heartburn), peptic ulcer disease, colitis, gallbladder and biliary tract disease, nutritional problems, Irritable Bowel Syndrome (IBS), and pancreatitis.

• Esophagus
• Stomach
• Small intestine
• Colon and rectum
• Pancreas
• Gallbladder
• Bile ducts
• Liver

Track 4: Pancreatic Diseases

Pancreas is a gland which plays a key role in digestion and harmone production. This organ secrets and activates digestive juices, or enzymes before they are released into the small intestine. These enzymes will help to break down food and harmones and also helps to control blood sugar levels. Acute pancreatitis and chronic pancreatitis are two forms of pancreatic disorders which differ in their causes and symptoms and require different treatment. Acute pancreatitis is a sudden inflammation of pancreas, most commonly caused by gallstones or alcoholism. Chronic pancreatitis is a long term progressive inflammatory disease of pancreas. This occurs when the digestive enzymes are released into the small intestine and starts attacking the pancreas.

• Pancreatitis
• Pancreatic cancer
• Cystic fibrosis
• Diabetes mellitus
• Intraductal Papillary Mucinous Neoplasm (IPMN) pancreas
• Pancreas divisum

Track 5: Liver Diseases Diagnosis

Liver disease diagnosis involves a group of blood tests called liver function tests has been advocated with the intention to look after specific liver problems or genetic conditions. These tests are performed in order to correctly diagnose the underlying cause and to halt its progression. Your doctor may recommend blood tests, imaging tests, or checking a tissue sample. Abnormal liver tests assess the synthesis of proteins made by the liver which involves albumin, clotting factors and also to measure the liver's capacity to metabolize drugs.

• Test for diagnosis
• Fibroscan
• Liver imaging
• Liver biopsy
• Radiological studies

Track 6: Pregnancy and Liver Diseases

Liver diseases that occurs during pregnancy is a present challenge for healthcare providers. Some certain liver diseases are uniquely associated with pregnancy, while some are unrelated. Liver diseases that have an impact during pregnancy may include acute fatty liver of pregnancy (AFLP), Intrahepatic cholestasis of pregnancy (ICP), Hyperemesis gravidarum and Hemolysis and Elevated Liver enzymes and Low Platelets (HELLP) syndrome. Both acute viral hepatitis and chronic viral hepatitis have an impact on pregnancy. Acute viral hepatitis can occur in pregnancy, and pregnancy may occur in patient suffering with chronic liver disease. It also includes patients with liver cirrhosis, portal hypertension, and the patients who have undergone liver transplantation.

• Acute fatty liver of pregnancy (AFLP)
• Intrahepatic cholestasis of pregnancy (ICP)
• Hemolysis and Elevated Liver enzymes and Low Platelets (HELLP) syndrome
• Hyperemesis gravidarum

Track 7: Liver Transplantation and Surgery

Liver transplantation surgery is an operation or a technique that replaces a diseased or injured liver with a healthy liver from a donor. Liver plays an key role in all metabolic processes which includes metabolism of drugs and toxins, discharging degradation products of normal body metabolism (like clearing of ammonia and bilurubin from the blood), synthesis of many essential proteins and enzymes (like elements required for blood to clot). A very rare condition in new-born infants extrahepatic ductopenia commonly called as Biliary atresia in which the bile ducts that carry bile out of liver and exists in between liver and small intestine is blocked. Bariatic surgery is performed on the people in a variety of different procedures, who have obesity. Discharging a sample tissue (biopsy) from the liver helps to diagnose liver disorders. Liver biopsy is performed by inserting a long needle into the skin to extract a tissue sample and then analyzed in a laboratory.

• Hepatitis infection after liver transplantation
• Long term complications following liver transplant
• Complications of liver transplantation
• Post-transplantation Care
• Postorthotopic liver transplantation
• Living-donor liver transplant

Track 8: HCV/HIV CO-infection

HCV and HIV co-infection is correlated with accelerated hepatic fibrosis advancement and high rates of liver deterioration and death when compared to HCV monoinfection. Liver disease is also a prominent cause of non-AIDS associated mortality among HIV-infected patients. About one-third of people with HIV may also have Hepatitis C virus. Hepatitis C virus can spread in the way as HIV and Hepatitis B. HIV not only advances the defy of liver injury, but also speeds up the onset of liver damage and infection. Patients who are coinfected with HCV and HIV must work firmly with health care providers in order to closely monitor and also to treat both the conditions.

• Management of HCV in HIV-coinfected individuals
• Assessment of HCV/HIV coinfection
• Antiretroviral therapy in HCV/HIV coinfection
• Treatment of HIV in persons with HCV coinfection

Track 9: Liver Fibrosis

Liver fibrosis occurs when the healthy tissue of your liver becomes scarred by excessive accumulation of extracellular matrix proteins including collagen which makes the liver cannot work as well. Liver repairs damage through the deposition of new collagen, as the way the skin and different organs heal wounds through deposition of collagen and other grid constituents. Advanced liver fibrosis results in cirrhosis of the liver, in which the architectural organization of the functional units of the liver becomes disrupted. Over time this process can result in liver failure, liver cancer and portal hypertension and often requires liver transplantation. While some studies have shown that the potential for the liver to regenerate or heal itself, once liver damage is done in humans, the liver doesn’t usually heal. However, medications and lifestyle changes can help to keep fibrosis from getting worse.

• Basis Fibrosis research
• Invasive and Non-invasive assessment of fibrosis
• Clinical and translational fibrosis research
• Syphilis
• Gonorrhea
• Blastomycosis

Track 10: Intestinal Rehabilitation

Intestinal rehabilitation is the process of gradually restoring the intestine's ability to digest food and absorb nutrients. Generally, people with all types of gastrointestinal disorders may qualify for intestinal rehab without the need for transplant. This is done through recent advanced diet, medicines and surgery which greatly reduced the need for intestine organ transplants. Total Parenteral Nutrition (TPN) is a lifesaver for patients who are unable to absorb enough nutrition through their small intestine. TPN is the process where the nutrition is given into the blood through a vein (intravenously) by a central line placed in the child’s chest, neck or groin. Intestinal rehabilitation involves strategies and therapies designed to make the bowel to work better by giving nutritional support, nutritional rehabilitation, medical management and restorative surgery.

• Adverse effects of intestinal surgery
• Intestinal rehabilitation centers
• Benefits of intestinal rehabilitation

Track 11: Hepatitis: Care and Cure

Before any vaccine or medicine intake, the patient should undergo blood test to check whether antibody to the virus is present already, in which case vaccination or medication is unnecessary. Treatment usually involves supportive care, with specific complications treated as appropriate. Liver transplantation, in some selected cases, is an option if the patient has Fulminant Hepatic Failure (FHF). Patients at risk of acute hepatitis A virus (HAV) infection should undergo immunization for the virus. About 25% of the patients with chronic hepatitis B can be cured with a drug called pegylated interferon-alpha. The most effective therapy for hepatitis C virus is a drug combination consisting of pegylated interferon and ribavirin. Lifestyle changes can make your medications work better and help you look and feel good.

• Entecavir (Baraclude)
• Tenofovir (Viread)
• lamivudine (Epivir)
• Telbivudine (Tyzeka)
• Pegylated interferon and ribavirin

Track 12: Assessment of Liver Diseases

Assessment of liver diseases thus encircles history, clinical findings, biochemical tests and most usually liver histology which may include patients who have a sign of jaundice and with abnormal liver biochemistry and no significant symptoms. The objective of assessment is to determine the cause of liver damage and also to define its severity and the requirement for therapy. This assessment must be made in two common settings which include the patients who have a clear sign of significant liver disease, usually jaundice and also with the patients who present with abnormal liver biochemistry and no significant symptoms. Then two settings vary in the route and rapidity of the investigations needed. The assessing of liver cells and liver diseases can be done using blood tests, biopsy, fibroscan.

Track 13: Liver Cancer and Hepatocellular Carcinoma

Liver is a football-sized organ that is located in the upper right area of your abdomen, beneath your diaphragm and just above your stomach. Liver cancer also called hepatic cancer is a type that starts in the cells of the liver. Cancer that spreads to the liver is more often than cancer that stats in the liver cells. Cancer that begins in another area of the body and then spreads to the liver is called metastatic cancer. Hepatocellular carcinoma is the most common type, which begins in the main type of liver cell called hepatocyte. Hepatocellular carcinoma often referred to as malignant hepatoma. The most common cases of this cancer are the result of viral hepatitis infection (hepatitis B or C), metabolic toxins such as alcohol or aflatoxin, conditions like hemochromatosis. Treatment options for HCC and diagnosis dependents on many factors but especially on tumor size, staging, and extent of hepatic injury. High-grade tumors will have a poor prognosis, while low-grade tumors may unnoticed for many years.

• Hepatocellular carcinoma
• Intrahepatic cholangiocarcinoma
• Hepatoblastoma
• Fibrolamellar hepatocellular carcinoma
• Metastatic hepatocellular carcinoma
• Multifocal hepatocellular carcinoma

Track 14: Effect of Industrial Toxic Pollutants on Liver

Industrial Toxic pollutants contaminates many sources of drinking water and releases unwanted toxins into air which strongly associates with the increased incidence of several liver diseases.   Inhalation exposure to high-concentration airborne particulate matter and other air pollutants such as carbon black has direct effects on the liver, triggering to liver fibrosis and many other chronic liver diseases. Physicians or health care workers monitors liver pathology and undergoes many preventive therapeutic strategies for liver diseases for populations and patients in urban air pollution environments.

Track 15: Herbal Medicines for Liver Diseases

Herbal products are used as medications for the treatment of liver diseases for a long time. Several herbal products are available in the market. The main four commonly used herbal medicine are Phyllanthus, Silybum marianum (milk thistle), glycyrrhizin (licorice root extract), Liv 52 (mixture of herbs). Silybum marianum have clinical applications in treating of toxic hepatitis, fatty liver, cirrhosis, ischemic injury, radiation toxicity, and viral hepatitis through its antioxidative, anti-lipid peroxidative, antifibrotic, anti-inflammatory, immunomodulating, and liver regenerating. Phyllanthus is large genus of shrubs, trees, that is found in almost warmer parts of the world. This helps in clearing HBV markers, hepatotoxicity, viral and bacterial diseases.

• Phyllanthus
• Silybum marianum (milk thistle)
• glycyrrhizin (licorice root extract)
• Liv 52 (mixture of herbs)

Track 16: Advancement in New Drug Discovery for Treatment of Hepatitis

The current existing treatments eliminates the virus in only a little more than half of all patients. Those drugs may also have unwanted side effects which makes it difficult for patients to take them. In recent years, tremendous research advances are transforming on treatment of Hepatitis. This progress has occurred in just last three years with new and effective therapies transforming the trajectory of the disease for many patients. The scientific advances that are made by biopharmaceutical researchers have already begun to have a tangible impact on thousands of patients. In all these areas, rapid progress is being made and more new medicines are on the way. The Food and Drug Administration has approved a new drug named Harvoni, which combines sofosbuvir and ledipasvir which cures Hepatitis C virus in just eight weeks.

• Synthetic RNAi's in hepatitis B therapy
• RNaseH inhibitors in hepatitis B therapy
• Bacteriophages in hepatitis B virus therapy

Track 17: Current Research in Hepatology

Hepatology is a medical specialty that focuses on the structure, function, pathology and disorders of the liver, gall bladder and bile ducts. Researchers examine every facet of the digestive system to find better and improved ways to treat illnesses and other related conditions that originate in the gastrointestinal system, liver and pancreas. The main goal is to identify molecular abnormalities that can improve the outcome of patients with pancreatic cancer and those at risk of developing this disease by focusing on translational research evaluating markers and marker technologies that can help screen patients with an increased risk of developing pancreatic cancer. Aspirin use has been associated with reduced risk of hepatocellular carcinoma (HCC). About 50,000 patients with chronic hepatitis B or C virus infection who were followed for a median of nearly eight years, use of low-dose aspirin was associated with reduced risk of HCC (4 versus 8 percent) and fewer liver-related deaths. The recommended duration for glecaprevir-pibrentasvir for treatment-naive patients with chronic HCV infection has been revised to eight weeks whereas the previous recommended duration was 12 weeks.