Aliment Pharmacol Ther 31, 929–937 Summary Background  Chronic hepatitis C is one of the leading causes for chronic liver disease globally. The past two decades have seen many advances in hepatitis C treatment. Despite these advances, side effects of treatment are common. Haematological complications of treatment can result in treatment cessation and suboptimal results. Recent data have suggested a role for epoetin/granulocyte colony stimulating factor (G‐CSF) in optimizing sustained virological response (SVR). Aim  To investigate the nature, frequency and management of haematological side effects in the treatment of chronic hepatitis C infection. Methods  The terms hepatitis C, hepatitis C virus (HCV), treatment, side effects, interferon, peginterferon, ribavirin, anaemia, haemoglobin, neutropenia, thrombocytopenia, haematological, growth factor, erythropoietin and G‐CSF were searched on MEDLINE for the period 1991–2009. References from selected articles were also included. Results  Haematological side effects such as anaemia, neutropenia and thrombocytopenia are frequent in anti‐HCV treatment. The off‐label use of haematological growth factors is common and effective. Conclusions  Erythropoietic agents are effective in treating anaemia, preventing ribavirin dose reduction, improving patients’ quality of life, but the effect on SVR is not fully elucidated. G‐CSF is effective in raising absolute neutrophil count; however, neutropenic HCV‐infected patients on combination treatment may not experience increased bacterial infections. Eltrombopag, a new oral thrombopoietin mimetic, may allow combination treatment in patients with thrombocytopenia.

Infection with hepatitis B virus (HBV) can result in spontaneous resolution or chronic infection, which can remain asymptomatic or can progress to cirrhosis and/or hepatocellular carcinoma. The host immune response is thought to be a major determinant of the outcome of HBV infection and virus-specific cytotoxic T lymphocytes (CTL) can mediate immunity against the virus and cause liver pathology. Antigen-nonspecific innate lymphocytes may also contribute to HBV infection and liver disease, therefore, we examined the frequencies, phenotypes, cytolytic activities and cytokine profiles of circulating natural killer (NK) cells, CD1d-restricted invariant natural killer T (iNKT) cells and CD56(+) T cells in 102 asymptomatic HBV-infected patients and compared them with those in 66 uninfected control subjects. NK cells expressing low levels of CD56 (CD56(dim)) and CD56(+) T cells were significantly expanded in the circulation of HBV-infected patients compared with control subjects. CD1d expression and iNKT cell frequencies were similar in both groups. Despite these expansions, we did not detect augmented natural or cytokine-induced cytotoxicity in the HBV-infected subjects. All lymphocyte populations studied produced interferon-γ (IFN-γ) significantly more frequently when taken from HBV-infected patients compared with when taken from healthy controls. Additionally, NK cells from the patients more frequently produced interleukin-10. As our HBV-infected cohort consisted of asymptomatic patients with low viral loads, we propose that CD56(dim) NK cells and CD56(+) T cells control HBV infection by noncytolytic mechanisms.

Taper is a common training strategy used to reduce fatigue and enhance athletic performance. However, currently, no review has summarised what psychological research has been conducted examining taper, what this research shows and what future research needs to be undertaken to extend the field. Consequently, a scoping review was conducted with three aims: (a) to determine the characteristics of psychological research examining taper, (b) to summarise psychological research collected during taper with adult athletes and coaches, and (c) to identify gaps in psychological research examining taper. Forty-eight articles were identified following an exhaustive search strategy and charted following scoping review guidelines. Results showed most research was quantitative, used a longitudinal design, was conducted in swimming, triathlon, cycling or across multiple sports, and used a university-, regional- or national-level male athlete sample. Eight themes were developed to summarise the research: Mood, Perception of Effort, Perceived Fatigue and Wellness, Recovery-Stress, Taper as a Stressor, Stress Tolerance, Psychological Preparation and Cognitive Functioning. Additionally, four research recommendations were identified: (a) conducting exploratory research that examines the impact taper has on athletes’ and coaches’ competition preparation and stress experience, (b) asking more advanced psychological questions and conducting multi-disciplinary research, (c) including a more diverse participant sample in studies and (d) examining the impact of psychological interventions during taper. Overall, this scoping review has highlighted the limited research examining the psychology of taper and the need for focused research that asks more complex questions across diverse populations.

Genetic polymorphisms adjacent to IL28B have been previously associated with spontaneous clearance of hepatitis C virus (HCV) and a higher rate of sustained virological response to interferon-based treatment in HCV genotype 1-infected patients. A recent study has shown that patients with the CC genotype of the rs12979860 single nucleotide polymorphism upstream from the IL28B gene are more likely to clear HCV spontaneously relative to the CT or TT genotype. In the liver transplant cohort, HCV recurs almost universally in patients with detectable HCV RNA at the time of transplantation. The spontaneous clearance of HCV infection after transplant is very rare. We report two cases of spontaneous clearance of HCV genotype 1 infection after liver transplantation from homozygous IL28B CC donors. This finding may be explained by alterations in the host immune responses to HCV after transplantation with a CC donor liver, which has potential implications for donor selection in HCV-positive recipients.

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