Hillel Tobias, M.D., Ph.D.

A treatment algorithm for the management of chronic hepatitis B virus infection in the United States: 2008 update
Keeffe, Emmet B; Dieterich, Douglas T; Han, Steven-Huy B; Jacobson, Ira M; Martin, Paul; Schiff, Eugene R; Tobias, Hillel
2008 Dec;6(12):1315-1341, Clinical Gastroenterology & Hepatology
Chronic HBV infection is an important public health problem worldwide and in the United States. A treatment algorithm for the management of this disease, published previously by a panel of U.S. hepatologists, has been revised on the basis of new developments in the understanding of the disorder, the availability of more sensitive molecular diagnostic tests, and the licensure of new therapies. In addition, a better understanding of the advantages and disadvantages of new treatments has led to the development of strategies for reducing the rate of resistance associated with oral agents and optimizing treatment outcomes. This updated algorithm was based primarily on available evidence by using a systematic review of the literature. Where data were lacking, the panel relied on clinical experience and consensus expert opinion. The primary aim of antiviral therapy is durable suppression of serum HBV DNA to low or undetectable levels. Assays can now detect serum HBV DNA at levels as low as 10 IU/mL and should be used to establish a baseline level, monitor response to antiviral therapy, and survey for the development of drug resistance. Interferon alfa-2b, lamivudine, adefovir, entecavir, peginterferon alfa-2a, telbivudine, and tenofovir are approved as initial therapy for chronic hepatitis B and have certain advantages and disadvantages. Although all of these agents can be used in selected patients, the preferred first-line treatment choices are entecavir, peginterferon alfa-2a, and tenofovir. Issues for consideration for therapy include efficacy, safety, rate of resistance, method of administration, and cost
— id: 95018, year: 2008, vol: 6, page: 1315, stat: Journal Article,

HCC recurrence following liver transplantation is associated with older donors
Morgan, GR; Diflo, T; John, D; Fahmy, A; Goldenberg, A; Tobias, H; Teperman, L
2008 MAY ;8(2):383-384, American journal of transplantation
— id: 79108, year: 2008, vol: 8, page: 383, stat: Journal Article,

Drug-induced liver injury associated with ezetimibe therapy
Liu, Qiang; Tobias, Hillel; Petrovic, Lydia M
2007 Feb;52(2):602-605, Digestive diseases & sciences
— id: 71339, year: 2007, vol: 52, page: 602, stat: Journal Article,

Diffusion-weighted MRI for quantification of liver fibrosis: preliminary experience
Taouli, Bachir; Tolia, Anuj J; Losada, Mariela; Babb, James S; Chan, Edwin S; Bannan, Michael A; Tobias, Hillel
2007 Oct;189(4):799-806, American journal of roentgenology
OBJECTIVE: The purpose of this study was to evaluate our preliminary experience using diffusion-weighted MRI for quantification of liver fibrosis. SUBJECTS AND METHODS: Diffusion-weighted MRI with single-shot echo-planar technique at b values of 50, 300, 500, 700, and 1,000 s/mm2 was prospectively performed on 23 patients with chronic hepatitis and on seven healthy volunteers. The apparent diffusion coefficient (ADC) was measured in four locations in the liver. Liver biopsy results (n = 19) were retrospectively reviewed by two hepatopathologists in consensus to determine stage of fibrosis and grade of inflammation. A Mann-Whitney test was used to compare the ADCs between patients classified with respect to having stage 2 or greater versus stage 1 or less fibrosis and stage 3 or greater versus stage or less 2 fibrosis. Receiver operating characteristics analysis was used to assess the performance of ADC in prediction of the presence of stage 2 or greater and stage 3 or greater fibrosis. RESULTS: Using a b value of 500 s/mm2 and all combined b values, we found significantly lower hepatic ADCs in stage 2 or greater versus stage 1 or less fibrosis and stage 3 or greater versus stage 2 or less fibrosis. The mean ADCs (x 10(-3) mm2/s) with all b values were 1.47 +/- 0.11 (SD) versus 1.65 +/- 0.10 for stage 2 or greater versus stage 1 or less fibrosis (p < 0.001) and 1.44 +/- 0.07 versus 1.66 +/- 0.10 for stage 3 or greater versus stage 2 or less fibrosis (p <0.001). Hepatic ADC was a significant predictor of stage 2 or greater and stage 3 or greater fibrosis, with areas under the curve of 0.896 and 0.896, sensitivity of 83.3% and 88.9%, and specificity of 83.3% and 80.0% (ADC with all b values, 1.54-1.53 x 10(-3) mm2/s or less). CONCLUSION: Diffusion-weighted MRI can be used for prediction of the presence of moderate and advanced liver fibrosis
— id: 74407, year: 2007, vol: 189, page: 799, stat: Journal Article,

Treatment of hepatitis C related cryoglobulinemia with Rituxan
Goldenberg, A; Teperman, L; Hong, L; Kelley, P; Tobias, H
2006 ;130(4):A840-A840, Gastroenterology
— id: 92758, year: 2006, vol: 130, page: A840, stat: Journal Article,

A treatment algorithm for the management of chronic hepatitis B virus infection in the United States: an update
Keeffe, Emmet B; Dieterich, Douglas T; Han, Steven-Huy B; Jacobson, Ira M; Martin, Paul; Schiff, Eugene R; Tobias, Hillel; Wright, Teresa L
2006 Aug;4(8):936-962, Clinical Gastroenterology & Hepatology
Chronic hepatitis B (CHB) is an important public health problem worldwide and in the United States, with approximately 25% of patients infected as neonates dying prematurely from cirrhosis or liver cancer. A treatment algorithm for CHB previously developed and published by a panel of United States hepatologists was revised based on new developments in the understanding of CHB, the availability of more sensitive molecular diagnostic testing, the addition of new treatments, and better understanding of the advantages and disadvantages of approved therapies. This updated algorithm is based on available evidence using a systematic review of the scientific literature. Where data are lacking, the panel relied on clinical experience and consensus expert opinion. Serum HBV DNA can be detected at levels as low as 10 IU/mL using molecular assays and should be determined to establish a baseline level before treatment, monitor response to antiviral therapy, and survey for the development of drug resistance. The primary aim of antiviral therapy is durable suppression of serum HBV DNA to the lowest levels possible. The threshold level of HBV DNA for determination of candidacy for therapy is 20,000 IU/mL or more for patients with hepatitis B e antigen-positive CHB. A lower serum HBV DNA threshold of 2000 IU/mL or more is recommended for patients with hepatitis B e antigen-negative CHB, and 200 IU/mL or more for those with decompensated cirrhosis. Interferon alfa-2b, lamivudine, adefovir, entecavir, and peginterferon alfa-2a all are approved as initial therapy for CHB and have certain advantages and disadvantages. Issues for consideration include efficacy, safety, incidence of resistance, method of administration, and cost
— id: 95019, year: 2006, vol: 4, page: 936, stat: Journal Article,

Experience with plasmapheresis and liver transplantation for fulminant hepatic failure
Murakami, T; Fahmy, A; John, DG; Morgan, GR; Diflo, T; Tobias, H; Eperman, LW
2006 MAY ;12(5):C93-C93, Liver transplantation
— id: 64396, year: 2006, vol: 12, page: C93, stat: Journal Article,

Impact of extended criteria donor on hepatitis C recurrence following liver transplantation
Murakami, T; Fahmy, A; John, DG; Morgan, GR; Diflo, T; Tobias, H; Petrovic, L; Teperman, LW
2006 OCT ;44(4):479A-479A, Hepatology
— id: 70932, year: 2006, vol: 44, page: 479A, stat: Journal Article,

Clinical characteristics of Asian Americans infected with hepatitis B diagnosed by community-based screenings in New York City
Pollack, H; Sherman, A; Tsang, T; Wan, K; Lupatkin, H; Villaneuva, G; Tso, A; Angela, T; Michael, P; Pearl, K; Ruchel, R; Rey, M; Tobias, H
2006 OCT ;44(4):568A-568A, Hepatology
— id: 70934, year: 2006, vol: 44, page: 568A, stat: Journal Article,

West Nile virus a deadly event for liver transplantation
Teperman, L; Tobias, H; Fine, A
2006 MAY ;12(5):C116-C116, Liver transplantation
— id: 64397, year: 2006, vol: 12, page: C116, stat: Journal Article,

Successful post transplant treatment of HCV may induce liver allograft rejection
Teperman, LW; Weber, S; Martin, JD; Morgan, G; Tobias, H
2006 MAY ;12(5):C126-C126, Liver transplantation
— id: 64398, year: 2006, vol: 12, page: C126, stat: Journal Article,

An epidemiologic study of hepatitis B virus infection among Asian Americans in New York City
Wan, K; Chen, Y; Tsang, T; Sherman, A; Tso, A; Korenblit, P; Son, S; Poon, E; Ramos, R; Tobias, H; Rey, M; Pollack, H
2006 JUN 1 ;163(11):S252-S252, American journal of epidemiology
— id: 68859, year: 2006, vol: 163, page: S252, stat: Journal Article,

A randomized trial of pegylated interferon alpha-2b plus ribavirin in the retreatment of chronic hepatitis C
Jacobson, Ira M; Gonzalez, Stevan A; Ahmed, Furqaan; Lebovics, Edward; Min, Albert D; Bodenheimer, Henry C Jr; Esposito, Stephen P; Brown, Robert S Jr; Brau, Norbert; Klion, Franklin M; Tobias, Hillel; Bini, Edmund J; Brodsky, Neil; Cerulli, Maurice A; Aytaman, Ayse; Gardner, Peter W; Geders, Jane M; Spivack, Julie E; Rahmin, Michael G; Berman, David H; Ehrlich, James; Russo, Mark W; Chait, Maxwell; Rovner, Deborah; Edlin, Brian R
2005 Nov;100(11):2453-2462, American journal of gastroenterology
OBJECTIVES: The efficacy of combination therapy with pegylated interferon (PEG IFN) alpha plus ribavirin (RBV) in the retreatment of chronic hepatitis C (CHC) in patients who previously failed combination standard IFN plus RBV or IFN monotherapy has not been well established. METHODS: Three hundred and twenty-one CHC patients including virologic nonresponders to combination IFN plus RBV (n = 219) or IFN monotherapy (n = 47), and relapsers to combination therapy (n = 55) were randomized to receive PEG IFN alpha-2b 1.5 microg/kg per wk plus RBV 800 mg per day (Regimen A, n = 160) or PEG IFN alpha-2b 1.0 microg/kg per wk plus RBV 1,000-1,200 mg per day (Regimen B, n = 161) for 48 wks. RESULTS: Sustained virologic response (SVR) occurred in 16% of the overall study population (Regimen A vs B, 18%vs 13%, p= 0.21), in 8% of the combination therapy nonresponders (10%vs 6%, p= 0.35), in 21% of the IFN monotherapy nonresponders (16%vs 27%, p= 0.35), and in 42% of the combination therapy relapsers (50%vs 32%, p= 0.18). In nonresponders to prior combination therapy, HCV ribonucleic acid levels <100,000 copies/mL at the end of the prior treatment course were associated with an increased SVR compared with levels >or=100,000 copies/mL (21%vs 5%, p= 0.002). In the overall study population, genotype 1 patients had lower SVR rates than others (14%vs 33%, p= 0.01), and African Americans had lower SVR than Caucasians (4%vs 18%, p= 0.01). CONCLUSION: Combination therapy with PEG IFN alpha-2b plus RBV is more effective in patients who relapsed after combination standard IFN plus RBV than in nonresponders to either combination therapy or IFN monotherapy. There was no significant effect of dosing regimen
— id: 59373, year: 2005, vol: 100, page: 2453, stat: Journal Article,

Mass screenings in New York City reveal extraordinarily high prevalence of hepatitis B in an urban Asian population
Sherman, A; Tsang, T; Villaneuva, G; Pollack, H; Tobias, H
2005 OCT ;42(4):214A-214A, Hepatology
— id: 59260, year: 2005, vol: 42, page: 214A, stat: Journal Article,

Does the current MELD system disadvantage hepatoma patients?
Teperman, L; Campbell, D; Morgan, G; Harper, A; Fahmy, A; John, D; Diflo, T; Tobias, H; West, B; Goldenberg, A
2005 JUL ;11(7):C62-C62, Liver transplantation
— id: 58643, year: 2005, vol: 11, page: C62, stat: Journal Article,

The canals of hering might represent a target of methotrexate hepatic toxicity
Hytiroglou, Prodromos; Tobias, Hillel; Saxena, Romil; Abramidou, Martha; Papadimitriou, Constantine S; Theise, Neil D
2004 Mar;121(3):324-329, American journal of clinical pathology
Methotrexate treatment for psoriasis is known to cause hepatic fibrosis in some patients, which might progress to cirrhosis. The fine, radiating, fibrous septa developing in this setting have a distribution that is reminiscent of the location of the canals of Hering (coH). To assess the possibility of fibrous obliteration of the coH in patients receiving methotrexate, we developed a staining technique by combining an immunohistochemical stain for cytokeratin 7 with a modified Masson trichrome. Sixteen biopsy specimens from 7 patients were evaluated. The biopsies had a variety of histologic changes, including steatosis, anisonucleosis, multinucleation, chronic inflammation, bile duct damage, and ductular reaction. Fibrosis was present in 13 biopsy specimens (81%) and was mild in 7, moderate in 3, and severe in 3 specimens. Compared with normal (control) liver specimens, biopsy specimensfrom patients receiving methotrexate had decreased numbers of coH (1.9 +/- 0.8 vs 5.2 +/- 1.7; P < .025). In specimens with moderate or severe fibrosis, fibrous septa sometimes extended along the coH. These findings suggest that scarring of the coH might be a consequence of the toxic effects of methotrexate
— id: 44971, year: 2004, vol: 121, page: 324, stat: Journal Article,

Interferon alfa-2b [correction of alpha-2b]and ribavirin for patients with chronic hepatitis C and normal ALT
Jacobson, Ira M; Ahmed, Furqaan; Russo, Mark W; Lebovics, Edward; Dieterich, Douglas T; Esposito, Stephen P; Bach, Nancy; Klion, Franklin; Tobias, Hillel; Antignano, Louis; Brown, Robert S Jr; Gabbaizadeh, David; Geders, Jane; Levendoglu, Hulya
2004 Sep;99(9):1700-1705, American journal of gastroenterology
OBJECTIVES: Most studies establishing the role of antiviral therapy in patients with chronic hepatitis C (CHC) excluded the patients with normal ALT levels. Small trials with interferon monotherapy suggested a limited efficacy and/or de novo ALT elevations. We sought to evaluate the efficacy of two doses of interferon alfa-2b (IFN) with ribavirin (RBV) in patients with normal ALT [correction]. METHODS: Patients with biopsy-proven CHC with detectable HCV RNA and at least two normal ALT levels three or more months apart were randomized to receive either 3 or 5 million units of IFN thrice a week plus RBV 1,000-1,200 mg. Therapy was stopped at 24 wk if HCV RNA remained detectable and continued for an additional 24 wk if HCV RNA was undetectable. A final HCV RNA level was obtained 24 wk after discontinuation of therapy. RESULTS: Fifty-six patients were randomized and received at least one dose of treatment. The overall rate of sustained virologic response (SVR) was 32%. SVR rates were higher in genotype 2 and 3 patients (80%) than in genotype 1 patients (24%, p = 0.002). There was a tendency toward higher SVR in genotype 1 patients treated with the higher IFN dose (36%vs 10%, p = 0.07). Five patients had mild, transient ALT elevations. No sustained ALT elevations were noted. CONCLUSIONS: Patients with normal ALT had a rate of SVR comparable to that reported in patients with elevated ALT. Higher dose of interferon tended to be more effective in genotype 1 infected patients. De novo ALT elevations were transient and not clinically significant. Patients with CHC should not be excluded from treatment on the basis of ALT alone. Combination therapy with pegylated interferon and ribavirin should be evaluated in these patients
— id: 62333, year: 2004, vol: 99, page: 1700, stat: Journal Article,

A treatment algorithm for the management of chronic hepatitis B virus infection in the United States
Keeffe, Emmet B; Dieterich, Douglas T; Han, Steve-Huy B; Jacobson, Ira M; Martin, Paul; Schiff, Eugene R; Tobias, Hillel; Wright, Teresa L
2004 Feb;2(2):87-106, Clinical Gastroenterology & Hepatology
BACKGROUND AND AIMS: Chronic hepatitis B is an important public health problem worldwide and in the United States. A treatment algorithm for chronic hepatitis B virus (HBV) infection was developed by a panel of US hepatologists based on new developments in the understanding of the virology of HBV, availability of more sensitive molecular diagnostic testing, and advantages and disadvantages of currently approved therapies. METHODS: This algorithm is based on available evidence, but where data are lacking, the panel relied on clinical experience and consensus expert opinion. RESULTS: Serum HBV DNA can be detected at levels as low as 100-1000 copies/mL by using molecular assays and should be determined to establish a baseline level before treatment, monitor response to antiviral therapy, and survey for the development of drug resistance. The primary aim of antiviral therapy is durable suppression of serum HBV DNA to the lowest level possible. The threshold level of HBV DNA for determination of candidacy for therapy is >/=10(5) copies/mL for patients with hepatitis B e antigen (HBeAg)-positive chronic hepatitis B. A lower serum HBV DNA threshold is appropriate for patients with HBeAg-negative chronic hepatitis B and those with decompensated cirrhosis, and the panel recommends thresholds of 10(4) copies/mL and 10(3) copies/mL, respectively. CONCLUSIONS: Interferon alfa-2b, lamivudine, and adefovir dipivoxil are all approved as initial therapy for chronic hepatitis B and have certain advantages and disadvantages. Issues for consideration include efficacy, safety, incidence of resistance, method of administration, and cost. Studies are under way to explore the safety and efficacy of combination therapy, which may prove to be more effective than monotherapy in suppressing viral replication and may decrease or delay the incidence of drug resistance
— id: 95020, year: 2004, vol: 2, page: 87, stat: Journal Article,

Pegylated interferon alfa-2b plus ribavirin in patients with chronic hepatitis C: A trial in prior nonresponders to interferon monotherapy or combination therapy and in combination therapy relapsers
Jacobson, I; Russo, MW; Brown, RS; Lebovics, E; Min, A; Esposito, S; Tobias, H; Klion, F; Rovner, D; Brass, C
2002 OCT abstract #782;36(4):358A-358A, Hepatology
— id: 36604, year: 2002, vol: 36, page: 358A, stat: Journal Article,

Recipients are rarely denied right lobe living donor liver transplantation solely because of donor billary anomalies
Morgan, G; Lavelle, M; Krinsky, G; Lee, V; Diflo, T; John, D; Wehbe, M; Tobias, H; Teperman, L
2002 OCT abstract #2047;36(4):675A-675A, Hepatology
— id: 36612, year: 2002, vol: 36, page: 675A, stat: Journal Article,

Variations in risk factors for HCV recurrence after living donor and cadaveric liver transplantation
Teperman, L; Meininger, M; Wehbe, M; Diflo, T; Morgan, G; John, D; Theise, N; Tobias, H
2002 OCT abstract #1965;36(4):654A-654A, Hepatology
— id: 36610, year: 2002, vol: 36, page: 654A, stat: Journal Article,

Recipients of right lobe grafts from live donors experience lower acute rejection rates than recipients of cadaveric whole livers
Wehbe, M; John, D; Diflo, T; Morgan, G; Tobias, H; Teperman, L
2002 OCT abstract #1989;36(4):660A-660A, Hepatology
— id: 36611, year: 2002, vol: 36, page: 660A, stat: Journal Article,

Pegylated interferon alfa-2b plus ribavirin in patients with chronic hepatitis C: A trial in prior nonresponders to interferon monotherapy or combination therapy, and in combination therapy relapsers
Jacobson, IM; Russo, MW; Brown, RS; Lebovics, E; Min, A; Esposito, S; Tobias, H; Klion, F; Pizov, O; Brass, C
2001 OCT ;34(4):338A-338A, Hepatology
— id: 54864, year: 2001, vol: 34, page: 338A, stat: Journal Article,

Pegylated interferon alfa-2b plus ribavirin in patients with chronic hepatitis C: A trial in prior nonresponders to interferon monotherapy or combination therapy, and in combination therapy relapsers
Jacobson, IM; Russo, MW; Brown, RS; Lebovics, E; Min, A; Esposito, S; Tobias, H; Klion, F; Pizov, O; Brass, C
2001 APR ;120(5):A383-A383, Gastroenterology
— id: 55031, year: 2001, vol: 120, page: A383, stat: Journal Article,

Induction interferon alpha 2b 5MU daily for 4 weeks followed by combination interferon-ribavirin venus interferon-ribavirin without induction for previously untreated chronic hepatitis C
Lebovics, E; Castillo, E; Rampersaud, P; Hirsch, J; Casellas, A; McFarlane, C; Esposito, S; Tobias, H; Geders, J; Jacobson, I; Klion, F; Wolf, DC
2001 APR ;120(5):A570-A571, Gastroenterology
— id: 55038, year: 2001, vol: 120, page: A570, stat: Journal Article,

Efficacy of high-dose interferon in combination with ribavirin in patients with chronic hepatitis C resistant to interferon alone
Min AD; Jones JL; Esposito S; Lebovics E; Jacobson IM; Klion FM; Goldman IS; Geders JM; Tobias H; Bodian C; Bodenheimer HC Jr
2001 Apr;96(4):1143-1149, American journal of gastroenterology
OBJECTIVE: Interferon combined with ribavirin has efficacy in the treatment of patients with chronic hepatitis C virus (HCV) infection. However, its utility in patients who have not responded to prior interferon therapy is not clear. Furthermore, the effect of using an increased dose of interferon in combination with ribavirin in patients with chronic hepatitis C resistant to conventional doses of interferon is not known. The aim of our study was to evaluate the effect of high-dose interferon in combination with ribavirin on the efficacy of treating patients with chronic hepatitis C resistant to interferon monotherapy in a large multicenter trial. METHODS: We randomized 154 patients with chronic hepatitis C who failed to achieve a sustained response with prior interferon therapy to receive either 3 or 5 MU of interferon alpha-2b and ribavirin (1000-1200 mg/day) for 12 months. There were 119 patients who had not responded and 35 who initially responded but relapsed after prior interferon monotherapy. Serum HCV RNA levels were measured at entry, 6, and 12 months of treatment and at the end of a 6-month follow-up period. RESULTS: The mean age of the subjects was 47 yr (range 28-68 yr), and 110 (71.4%) were men. One hundred thirty-two patients (86%) had HCV genotype 1, whereas 21 (14%) had cirrhosis. Eighty-one subjects (53%) were randomized to receive 3 MU of interferon alpha-2b. Fifteen of 35 relapse subjects (43%) and 12 of 119 prior nonresponder entrants (10%) achieved a sustained virological response to the 12-month course of treatment. Overall, 11 of 81 patients (14%) receiving 3 MU, and 16 of 73 patients (22%) receiving 5 MU of interferon maintained an undetectable HCV RNA level after cessation of therapy. The difference in sustained response rates between the two interferon dosage groups did not reach statistical significance (p = 0.09). However, among the nonresponder patients alone, there was an increased sustained response in the high-dose interferon group compared with the standard interferon dose group (15.5% vs 4.9%, p = 0.055). Twenty-six patients discontinued therapy before 6 months, including 10 patients (12.3%) in the 3-MU and 16 patients (21.9%) in the 5-MU groups (p = 0.17). CONCLUSIONS: Sustained virological response to combined interferon alpha-2b and ribavirin was significantly higher in relapse patients than those who did not respond to prior interferon monotherapy. Although, when all treated patients were analyzed, there was no significant difference in sustained response between subjects receiving 3 and 5 MU of interferon, among the prior nonresponder patients, treatment with 5 MU of interferon with ribavirin resulted in a slightly increased response compared with treatment with the standard interferon dosage. The tolerability of the treatment regimens was comparable
— id: 36031, year: 2001, vol: 96, page: 1143, stat: Journal Article,

TIPS is not a contraindication for adult living donor liver transplantation
Wehbe, M; John, D; Morgan, G; Diflo, T; Dagher, F; Tobias, H; Teperman, L
2001 OCT ;34(4):654A-654A, Hepatology
— id: 54870, year: 2001, vol: 34, page: 654A, stat: Journal Article,

Adult living donor liver transplantation: Selection process and exclusion criteria
Dagher, FY; Lee, V; Rofsky, N; Morgan, G; Diflo, T; John, D; Tobias, H; Teperman, L
2000 OCT ;32(4):252A-252A, Hepatology
— id: 55259, year: 2000, vol: 32, page: 252A, stat: Journal Article,

Induction Interferon A2B 5 MU daily for 4 weeks followed by combination interferon-ribavirin versus interferon-ribavirin without induction for previously untreated chronic Hepatitis C
Lebovics, E; Raghuraman, UV; Rampersaud, P; Castillo, E; Casellas, A; McFarlane, C; Esposito, S; Tobias, H; Geders, J; Jacobson, I; Klion, F; Min, A
2000 APR ;118(4):A948-A948, Gastroenterology
— id: 54596, year: 2000, vol: 118, page: A948, stat: Journal Article,

Interferon alfa-2b and ribavirin in treatment-naive patients with chronic hepatitis C and normal ALT levels
Jacobson, I; Lebovics, E; Tobias, H; Geders, J; Klion, F; Esposito, S
1999 OCT ;30(4):459A-459A, Hepatology
— id: 53853, year: 1999, vol: 30, page: 459A, stat: Journal Article,

Interferon alfa-2b and ribavirin in treatment-naive patients with chronic hepatitis C and normal ALT levels
Jacobson, I; Lebovics, E; Tobias, H; Geders, J; Klion, F; Esposito, S
1999 APR ;116(4):A1225-A1225, Gastroenterology
— id: 54043, year: 1999, vol: 116, page: A1225, stat: Journal Article,

Induction interferon alpha 2B 5 MU daily for 4 weeks followed by combination interferon-ribavirin versus interferon-ribavirin without induction for previously untreated chronic hepatitis C: Interim results of viral non-detectability at 3 months
Lebovics, E; Raghuraman, UV; Hui, K; Casellas, A; McFarlane, C; Esposito, SP; Tobias, H; Geders, J; Jacobson, I; Klion, F; Wolf, DC; Dworkin, BM
1999 APR ;116(4):A1237-A1237, Gastroenterology
— id: 54044, year: 1999, vol: 116, page: A1237, stat: Journal Article,

Interferon alfa-2b and ribavirin in patients with resistant chronic hepatitis C
Min, AD; Jones, JL; Jacobson, IM; Klion, FM; Goldman, IS; Esposito, S; Geders, JM; Tobias, H; Bodenheimer, HC
1999 OCT ;30(4):192A-192A, Hepatology
— id: 53852, year: 1999, vol: 30, page: 192A, stat: Journal Article,

Accelerated triple dose Hepatitis B vaccination is successful in cirrhotic patients
Teperman, L; Morgan, G; Diflo, T; John, D; Gopalan, V; McCahill, J; Sayed, L; Tobias, H
1999 APR 15 ;67(7):S17-S17, Transplantation
— id: 54029, year: 1999, vol: 67, page: S17, stat: Journal Article,

Immunohistochemical detection of hepatitis C antigen by monoclonal antibody TORDJI-22 compared with PCR viral detection
Brody RI; Eng S; Melamed J; Mizrachi H; Schneider RJ; Tobias H; Teperman LW; Theise ND
1998 Jul;110(1):32-37, American journal of clinical pathology
We sought to determine the sensitivity and specificity of immunohistochemistry using the TORDJI-22 MoAb (BioGenex, San Ramon, Calif), which is specific for the C-100 protein of the hepatitis C virus, compared with reverse transcriptase-polymerase chain reaction (RT-PCR) of tissue for viral RNA. RT-PCR had been performed on 52 fixed tissue specimens. Immunohistochemistry was performed using prediluted antibody with the alkaline phosphatase/fast red (BioGenex) technique. Predigestion with Protease XXIV (BioGenex) and other procedures followed the manufacturer's protocols. Positive immunohistochemistry was narrowly defined as tightly clumped, perinuclear red granules in hepatocytes. Of the specimens, 28 were positive by RT-PCR. With RT-PCR as the standard of comparison, immunohistochemistry yielded a sensitivity of 70% and specificity of 84%. Positive cells, when present, were usually very rare. With stringent criteria, immunohistochemistry with the TORDJI-22 monoclonal antibody is a very specific, fairly sensitive diagnostic test for hepatitis C virus in fixed liver tissues
— id: 7512, year: 1998, vol: 110, page: 32, stat: Journal Article,

The canals of Hering may represent the primary target of methotrexate hepatic toxicity
Hytiroglou, P; Tobias, H; Abramidou, M; Saxena, R; Papadimitriou, CS; Theise, ND
1998 OCT ;28(4):603A-603A, Hepatology
— id: 53702, year: 1998, vol: 28, page: 603A, stat: Journal Article,

Early hepatitis C viral RNA decline during therapy with interferon alpha-2B and ribavirin in patients with chronic hepatitis C without sustained response to prior interferon
Min, A; Jones, J; Esposito, S; Lebovics, E; Klion, F; Jacobson, I; Goldman, I; Geders, J; Tobias, H; Branch, A; Bodenheimer, H
1998 APR 15 ;114(4):A1302-A1302, Gastroenterology
— id: 53473, year: 1998, vol: 114, page: A1302, stat: Journal Article,

Interferon a-2b and ribavirin in patients with chronic hepatitis C without sustained response to prior interferon
Min, AD; Jones, J; Esposito, S; Lebovics, E; Klion, F; Jacobson, I; Goldman, I; Geders, J; Tobias, H; Branch, A; Bodenheimer, H
1998 OCT ;28(4):286A-286A, Hepatology
— id: 53697, year: 1998, vol: 28, page: 286A, stat: Journal Article,

Recurrent hepatitis B: Predictions and prophylaxis following liver transplantation
Morgan, G; Diflo, T; John, D; Tobias, H; Teperman, L
1998 OCT ;28(4):733A-733A, Hepatology
— id: 53703, year: 1998, vol: 28, page: 733A, stat: Journal Article,

Long duration high-dose interferon therapy for hepatitis C is associated with a high sustained response rate
Pasternak, BA; Cohen, J; Weber, SA; Teperman, L; Tobias, H
1998 APR 15 ;114(4):A1320-A1321, Gastroenterology
— id: 53474, year: 1998, vol: 114, page: A1320, stat: Journal Article,

Outcome following transplantation for autoimmune hepatitis
Valdes, MT; Zakai, MD; Cohen, J; Tobias, H; Talal, A; John, D; Teperman, L
1998 APR 15 ;114(4):A1358-A1358, Gastroenterology
— id: 53475, year: 1998, vol: 114, page: A1358, stat: Journal Article,

Plasma exchange (PEx) as a bridge to successful liver transplantation (OLT) in the critically ill patient
Morgan, GR; Chen, D; Goldenberg, A; Tobias, H; Diflo, T; Teperman, L
1997 ;26(4):1748-1748, Hepatology
— id: 92756, year: 1997, vol: 26, page: 1748, stat: Journal Article,

Introduction immunotherapy in liver transplantation with mycophenolate mofetil and steroids
John, D; Morgan, G; Diflo, T; Simons, C; Tobias, H; Teperman, L
1996 OCT ;24(4):1609-1609, Hepatology
— id: 52762, year: 1996, vol: 24, page: 1609, stat: Journal Article,

Waiting time for liver transplantation increases the risk of incidental hepatocellular carcinomas found in explants
Teperman, L; Mizrachi, H; John, D; Diflo, T; Morgan, G; Goldenberg, A; Tobias, H; Theise, N
1996 OCT ;24(4):1843-1843, Hepatology
— id: 52763, year: 1996, vol: 24, page: 1843, stat: Journal Article,

Diltiazem is a safe drug in transplant patients on Prograf and does not affect Prograf levels
Teperman, L; Turgut, S; Negron, C; John, D; Diflo, T; Morgan, G; Tobias, H
1996 OCT ;24(4):214-214, Hepatology
— id: 52761, year: 1996, vol: 24, page: 214, stat: Journal Article,

Chemoembolization of hepatocellular carcinoma induces capsule formation
Theise, N. D.; Mizrachi, H.; Rosen, R.; Goldenberg, A.; Diflo, T.; Tobias, H.; Teperman, L.
1996 ;24(4 PART 2):588A-1845, Hepatology
— id: 92757, year: 1996, vol: 24, page: 588A, stat: Journal Article,

Hepatobiliary tuberculosis
Tobias, Hillel; Sherman, Alex
Tuberculosis Boston : Little Brown, 1996,
— id: 4844, year: 1996, vol: , page: ?, stat: Chapter,

MRI RELIABLY DETECTS MACROREGENERATIVE NODULES AND SMALL HEPATOCELLULAR-CARCINOMA IN CIRRHOTIC LIVERS
THEISE, ND; KRINSKY, G; MIZRACHI, HH; ROFSKY, N; GOLDENBERG, A; TOBIAS, H; DIFLO, T; WEINREB, J; TEPERMAN, L
1995 OCT ;22(4):313-313, Hepatology
— id: 86726, year: 1995, vol: 22, page: 313, stat: Journal Article,

CHANGES IN PLATELET-ASSOCIATED ANTIBODIES WITH ORTHOTOPIC LIVER-TRANSPLANTATION
GOLDENBERG, A; TEPERMAN, L; DIFLO, T; TOBIAS, H
1994 OCT ;20(4):A351-A351, Hepatology
— id: 52318, year: 1994, vol: 20, page: A351, stat: Journal Article,

ELEVATIONS OF PLATELET-ASSOCIATED ANTIBODIES DURING ORTHOTOPIC LIVER-TRANSPLANT REJECTIONS
TEPERMAN, L; GOLDENBERG, A; DIFLO, T; TOBIAS, H
1994 OCT ;20(4):A406-A406, Hepatology
— id: 52319, year: 1994, vol: 20, page: A406, stat: Journal Article,

EFFECTIVENESS OF HIGH-DOSE LONG-TERM ALFA INTERFERON THERAPY IN CHRONIC HEPATITIS-C
TOBIAS, H; SHERMAN, A; MICHAUD, J; TEPPERMAN, L
1994 APR ;106(4):A999-A999, Gastroenterology
— id: 52458, year: 1994, vol: 106, page: A999, stat: Journal Article,

EXAGGERATED CHOLESTASIS AND HEPATIC-FIBROSIS FOLLOWING SIMULTANEOUS ADMINISTRATION OF CHLORPROMAZINE AND SODIUM VALPROATE
Bach, N; Thung, SN; Schaffner, F; Tobias, H
1989 Aug;34(8):1303-1307, Digestive diseases & sciences
— id: 31767, year: 1989, vol: 34, page: 1303, stat: Journal Article,

The role of liver biopsies in psoriatic patients receiving long-term methotrexate treatment. Improvement in liver abnormalities after cessation of treatment
Newman M; Auerbach R; Feiner H; Holzman RS; Shupack J; Migdal P; Culubret M; Camuto P; Tobias H
1989 Sep;125(9):1218-1224, Archives of dermatology
Liver biopsy specimens from 168 patients who underwent a total of 364 biopsies were examined. Of 83 patients receiving biopsies before methotrexate treatment, 14 had one or more risk factors predictive of liver abnormality but they had normal pretreatment biopsy specimens. Among 17 patients with abnormal biopsy specimens before methotrexate treatment, only 1 had an identifiable risk factor and 5 had abnormal results of liver function tests. The probability of a normal biopsy specimen after methotrexate treatment dropped below 50% at a cumulative methotrexate dose of 3115 mg for the 31 patients with biopsy specimens from before and after methotrexate treatment and 5776 mg for those who had biopsies only after methotrexate treatment; this difference was statistically significant and is thought to be related to the fact that the patients who had biopsies before and after methotrexate treatment had received most of their medication by the parenteral rather than the oral route. A significant association existed between biopsy grade after methotrexate treatment and obesity. Other risk factors were not correlated with biopsy grade. Blood chemistry tests were not predictive of histopathologic findings. Eight of 11 patients with fibrosis or cirrhosis showed meaningful improvement in liver histologic findings after methotrexate treatment had been withdrawn for 6 months or more; none had progression of abnormalities
— id: 10501, year: 1989, vol: 125, page: 1218, stat: Journal Article,

Long-term effects of etretinate on the liver in psoriasis
Camuto P; Shupack J; Orbuch P; Tobias H; Sidhu G; Feiner H
1987 Jan;11(1):30-37, American journal of surgical pathology
Etretinate is an aromatic retinoid and derivative of vitamin A soon to be approved for general use in the U.S. as therapy for severe psoriasis. We report on liver morphology and function in 18 subjects who received the drug for at least 5 years as part of a clinical trial. The majority (14) suffered no or mild and reversible structural liver changes; mild transient elevations in serum triglyceride and liver enzymes were noted occasionally. Of the remaining four patients, mild periportal fibrosis was documented in two, another had changes similar to chronic active hepatitis, and a fourth had cirrhosis that was unrelated to alcohol use. Liver function data, cumulative drug dose, and treatment duration were generally not reflective of these changes. The results of this study suggest a need for periodic liver biopsy to monitor patients on long-term etretinate therapy
— id: 16682, year: 1987, vol: 11, page: 30, stat: Journal Article,

REVERSIBILITY OF METHOTREXATE-ASSOCIATED HEPATIC-FIBROSIS
Camuto, P; Newman, M; Culubret, M; Migdal, P; Auerbach, R; Tobias, H; Feiner, H
1987 ;56(Suppl 1):A10-A10, Laboratory investigation
— id: 31287, year: 1987, vol: 56, page: A10, stat: Journal Article,

THE IMPORTANCE OF SERIAL LIVER BIOPSIES IN THE METHOTREXATE TREATMENT OF PSORIASIS
Newman, M; Auerbach, R; Finer, H; Holzman, R; Migdal, P; Culbret, M; Camuto, P; Tobias, H
1987 Sep-Oct;7(5):1088-1088, Hepatology
— id: 31120, year: 1987, vol: 7, page: 1088, stat: Journal Article,

LIVER BIOPSIES IN PSORIATIC PATIENTS ON LONG-TERM ETRETINATE THERAPY
CAMUTO, P; SHUPACK, J; ORBUCH, P; TOBIAS, H; SIDHU, G; FEINER, H
1986 ;54(Suppl 1):A9-A9, Laboratory investigation
— id: 41518, year: 1986, vol: 54, page: A9, stat: Journal Article,

THE CHANGING SPECTRUM OF SPORADIC HEPATITIS IN HIGH-RISK GROUPS IN NEW-YORK
Dieterich, DT; Tobias, H
1982 ;2(5):739-739, Hepatology
— id: 30522, year: 1982, vol: 2, page: 739, stat: Journal Article,

Liver biopsies upsilon liver scans in methotrexate-treated patients with psoriasis
Geronemus RG; Auerbach R; Tobias H
1982 Sep;118(9):649-651, Archives of dermatology
The possibility of hepatotoxic reactions in 24 patients receiving long-term methotrexate therapy for psoriasis was evaluated by both liver biopsies and technetium TC 99 m sulfur-colloid liver scans. The two diagnostic methods were compared in a retrospective analysis. Six of 17 patients with clinically normal liver biopsy interpretations were found to have abnormal liver scans, while three of five patients with histologically proved fibrosis had completely normal liver scans. We conclude that hepatotoxic reactions from long-term methotrexate use in psoriasis cannot be reliably evaluated by the technetium Tc 99m sulfur colloid liver scan.
— id: 9216, year: 1982, vol: 118, page: 649, stat: Journal Article,

Liver involvement in the syndrome of mixed cryoglobulinemia
Levo, Y; Gorevic, P D; Kassab, H J; Tobias, H; Franklin, E C
1977 Sep;87(3):287-292, Annals of internal medicine
A study of liver abnormalities in 36 patients with mixed cryoglobulinemia in the absence of underlying infectious, connective tissue, or lymphoproliferative disorders revealed clinical or biochemical evidence of liver dysfunction in 84%. Hepatomegaly was detected in 77%, splenomegaly in 54%, and abnormalities in bilirubin, alkaline phosphatase, or serum glutamic oxalacetic transaminase in 77%. Only four of the patients had overt liver disease. Of 15 biopsies from 12 patients, there was normal tissue structure in two, minimal nonspecific changes in one, portal fibrosis in three, chronic persistent hepatitis in one, chronic active hepatitis in two, chronic active hepatitis with cirrhosis in four, and postnecrotic cirrhosis in two. These findings, together with the previously reported high incidence of serologic evidence of hepatitis B virus (HBV) infection, support the view that the syndrome of purpura, arthritis, and nephritis is often a consequence of immune-complex vasculitis secondary to HBV infection
— id: 119593, year: 1977, vol: 87, page: 287, stat: Journal Article,

ASANGUINEOUS HYPOTHERMIC TOTAL-BODY WASHOUT (TBW)
Tobias, H; Ackert, J; Isom, W
1977 ;72(5):1174-1174, Gastroenterology
— id: 29582, year: 1977, vol: 72, page: 1174, stat: Journal Article,

ESSENTIAL MIXED CRYOGLOBULINEMIA - ANOTHER CONNECTIVE-TISSUE DISORDER ASSOCIATED WITH HEPATITIS B-VIRUS INFECTION
Tobias, H; Levo, Y; Franklin, E
1977 ;72(5):1186-1186, Gastroenterology
— id: 29583, year: 1977, vol: 72, page: 1186, stat: Journal Article,

OXACILLIN-ASSOCIATED HEPATITIS
Klein, I; Tobias, H
1976 ;65(6):546-547, American journal of gastroenterology
— id: 29446, year: 1976, vol: 65, page: 546, stat: Journal Article,

Carcinoma of the gallbladder: a diagnosis aided by endoscopic retrograde and percutaneous hepatic cholangiography
Musher DR; Madayag MA; Tobias H
1976 Jul;66(1):79-83, American journal of gastroenterology
In a patient with obstructive jaundice, extrinsic compression of the common bile duct (Mirizzi syndrome) due to squamous cell carcinoma of the gallbladder was documented with the combination of endoscopic retrograde cholangiography and pancreatography (ERCP) and percutaneous transhepatic cholangiography (PTC)
— id: 42297, year: 1976, vol: 66, page: 79, stat: Journal Article,

TOTAL-BODY WASHOUT IN HEPATIC-COMA
KLEBANOF.G; LANGDON, D; WILEN, S; TOBIAS, H
1973 ;289(15):807-807, New England journal of medicine
— id: 39850, year: 1973, vol: 289, page: 807, stat: Journal Article,

Hepatotoxicity of long-term methotrexate therapy for psoriasis
Tobias H; Auerbach R
1973 Sep;132(3):391-396, Archives of internal medicine
— id: 38359, year: 1973, vol: 132, page: 391, stat: Journal Article,

TOTAL-BODY PERFUSION IN TREATMENT OF HEPATIC-COMA SECONDARY TO FULMINANT HEPATITIS
TOBIAS, H; ISOM, W
1973 ;64(1):157-157, Gastroenterology
— id: 39821, year: 1973, vol: 64, page: 157, stat: Journal Article,

CRYSTALLOID HEPATIC STRUCTURES IN PATIENTS WITH CUTANEOUS PORPHYRIA
TOBIAS, H; WALDO, E; SUTTON, J; HARBER, L
1973 ;64(1):198-198, Gastroenterology
— id: 39826, year: 1973, vol: 64, page: 198, stat: Journal Article,

Needle-like cytoplasmic inclusions in the liver in prophyria cutanea tarda
Waldo, E D; Tobias, H
1973 Dec;96(6):368-371, Archives of pathology
— id: 112494, year: 1973, vol: 96, page: 368, stat: Journal Article,