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Treatment Options for Covert Hepatic Encephalopathy

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Opinion statement

The main issue with treating covert hepatic encephalopathy (HE) is to establish whether it is cost effective to reverse the neuropsychiatric abnormalities that define this mild form of HE. Until fairly recently, covert HE was rarely diagnosed, but advances in computerized psychometric testing have greatly simplified its detection. The many consequences of covert HE are now being identified, and most have been shown to be reversible with standard HE treatment. Perhaps the most enticing possibility will be the potential that standard HE therapies will postpone the onset of overt HE. This will require further evaluation with large placebo-controlled randomized trials.

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Nisheet Waghray declare that he has no conflict of interest.

Abhijeet Waghray declare that he has no conflict of interest.

Kevin Mullen was involved in the Rifaximin trial for overt HE.

Kevin Mullen has been a consultant at Salix pharmaceuticals and Ocera Therapeutics.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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Waghray, N., Waghray, A. & Mullen, K. Treatment Options for Covert Hepatic Encephalopathy. Curr Treat Options Gastro 12, 229–241 (2014). https://doi.org/10.1007/s11938-014-0014-y

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