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WHO:

Dr. Gish is a Hepatologist specializing in all forms of liver disease, liver cancer and liver transplant. Dr. Gish has partnered with TeleMed2U to provide telemedicine consultative services for patients with liver disease.

WHAT:

TeleMed2U is a telemedicine-based multi-specialty clinical practice increasing access to specialist providers providing, “healthcare anywhere and everywhere.” The telemedicine consultation will be conducted through our HIPAA and HITECH compliant platform. Connectivity testing will be done in advance to ensure you can connect via our telemedicine platform. Following the consultation, a clinical note will be provided including a summary of your liver consultation with Dr. Gish and his consultative recommendations.

COST:

Payment will be processed through an online secure transaction portal. The fees for consultative services are:

Initial 60 minute consultation per patient: $500.00
Follow Up 30 minute consultation per patient: $300.00

NEXT STEPS:

If you’d like to continue, please click Next to complete the form and we will contact you to schedule connectivity testing. During the test you will have the opportunity to determine the method of providing medical records, discuss appointment availability as well as discuss any additional questions that you have. If you are a healthcare facility interested in services, please complete the form and we can discuss the options that are right for you and your patients.

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The information contained on this website is not intended, should not substitute for, or be used instead of, a clinical or therapeutic relationship with a health care professional who is fully familiar with the specifics of your case. The information on this site may assist you in your personal, general research but none of it constitutes the practice of medicine or any other health care profession.

Nothing in this site is intended as a recommendation or endorsement of any specific tests, products, procedures, healthcare provider, opinions, or other information that may be mentioned in this site. Any reliance on any information provided by the website personnel, others appearing on the site at the invitation of the website and/or other visitors to the site is solely at the user's risk.

E-mail correspondence with Dr. Robert G. Gish Consultants, LLC or any of its employees, or agents, does not create a physician/patient relationship between us or cause Dr. Gish to create or retain any medical records about you, monitor your care, or communicate with your own health care provider.

Always seek the advice of your physician or other qualified health care provider with any questions you have regarding your medical care. If you suspect that you may have a medical condition, or are seeking medical advice or treatment, we recommend that you consult a qualified health professional as soon as possible.

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ASPINs: Potential agents for chronic HBV cure regimens

Nov 28, 2022

Active site polymerase inhibitor nucleotides (ASPINs): Potential agents for chronic HBV cure regimens

Chronic hepatitis B virus (HBV) infection affects 240 to 300 million people worldwide. In the nucleus of infected hepatocytes, the HBV genome is converted to covalently closed circular DNA (cccDNA), which persists and serves as a transcriptional template for viral progeny. Therefore, a long-term cure for chronic HBV infection will require elimination of cccDNA. Although currently available nucleos(t)ide analogues (eg, tenofovir disoproxil fumarate, tenofovir alafenamide, entecavir) effectively control HBV replication, they are seldom curative (functional cure rate ∼10%) and require lifelong treatment for most patients. As such, antiviral agents with novel mechanisms of action are needed. Active site polymerase inhibitor nucleotides (ASPINs) noncompetitively distort the HBV polymerase active site to completely inhibit all polymerase functions, unlike traditional chain-terminating nucleos(t)ide analogues, which only target select polymerase functions and are consumed in the process. Clevudine, a first-generation ASPIN, demonstrated potent and prolonged HBV suppression in phase 2 and 3 clinical studies, but long-term treatment was associated with reversible myopathy in a small number of patients. ATI-2173, a novel next-generation ASPIN, is structurally similar to clevudine but targets the liver and demonstrates potent anti-HBV activity on and off treatment, and may ultimately demonstrate an improved pharmacokinetic and safety profile by significantly reducing systemic clevudine exposure. Thus, ATI-2173 is currently in clinical development as an agent for HBV cure. Here, we review the mechanism of action and preclinical and clinical profiles of clevudine and ATI-2173 to support the role of ASPINs as part of curative regimens for chronic HBV infection.

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