Chronic viral hepatitis

Evaluation of novel therapeutic agents for chronic viral hepatitis: Clinical trials are examining, for example, several new interferon-free therapies involving combinations of direct acting antiviral agents as well as novel immunological therapies involving HCV-peptide-treated leucocytes. The role of Vitamin D and a range of host genetic markers (such as IL-28B, ITPA) on both treatment outcomes and the severity of liver histology in CHC, and the immunological mechanisms of HCV clearance and effect of HCV on cognitive function in chronically infected patients are also being investigated. Early phase 1 clinical studies are underway to examine novel immune-mediated and anti-viral treatment options for patients with chronic hepatitis B.

Primary liver cancer

Therapeutic approaches to primary liver cancer: We are evaluating novel first- and second-line therapies options in patients with advanced disease as well as comparing the outcomes of local ablation or hepatic resection in those with early stage disease. In addition, large retrospective studies are being performed to determine whether the aetiology of liver cancer (ie. viral versus non-viral) impacts on patient survival.

Fibroscan evaluation

Evaluation of the Fibroscan: Since acquiring the first Fibroscan machine in Australia 4 years ago to assess liver disease via non-invasive measurement of liver stiffness (LSM), several clinical studies have been performed evaluating LSM as a screening and diagnostic tool for liver disease. Patient populations studied include cystic fibrosis, haemophilia, hepatitis C, NAFLD and diabetes. The utility of LSM is also being evaluated as a predictor of outcome of antiviral therapy in patients with hepatitis C, of complications of liver disease in patients with cirrhosis.

Non-alcoholic fatty liver disease

Management of patients with non-alcoholic fatty liver disease (NAFLD): A pilot study is underway examining the therapeutic effect of high dose Vitamin D in NAFLD. Pilot studies are planned in 2013 to evaluate novel therapeutic agents and the institution of a formal lifestyle programme (in conjunction with members of the Dietetics Department).

Evaluating hepatic encephalopathy

Evaluation of the prevalence, clinical significance and management of minimal hepatic encephalopathy in patients with chronic liver disease.