About Dr. Joe Galati

Dr. Joe Galati is a Liver Specialist practicing in Houston, Texas. His practice, Liver Specialists of Texas is dedicated to the care of patients with all facets of liver disease.
Archive by Author
Annual Liver Meetings -AASLD- in Washington, DC This Week

Annual Liver Meetings -AASLD- in Washington, DC This Week


The annual Liver Meetings are taking place in Washington, DC, and I will report back on the breakthroughs, specifically those related to hepatitis C, cirrhosis, fatty liver, and liver cancer and transplant.

This far, discussion regarding the new hepatitis C therapies continue to report on the impact of new therapies on the cure rates we have been seeing in clinical studies. In addition to the new Gilead drug soon to be released, the FDA is favorably evaluating Simeprevir another soon to be approved hepatitis C drug.

Another popular topic yesterday and today has been non-alcoholic fatty liver disease (NAFLD and NASH). The take home message for both patients and physicians is that those individuals with obesity, diabetes, fatty liver, plus fibrosis on their biopsy have the greatest risk for serious complications.

I will update the blog as new developments are available.

Comments { 0 }

New Hepatitis C Therapy Sofosbuvir to be Released in December 2013

For those following the release of the new medicines for hepatitis C, Gilead is one step closer to FDA approval.

Yesterday, the FDA released further positive feedback that sofosbuvir will receive positive approval in mid-December 2013. This will be the start of yet another new era in the successful treatment of patients with chronic hepatitis C. Based on available research data, sofosbuvir will be associated with a 90% sustained virology response (no detectable virus) in patients naive to any form of HCV therapy.

One major topic of discussion, especially among patients, is whether or not it will be the first interferon-free protocol? The answer is part yes, and part no.

Genotype 2 and 3 patients with hepatitis C will take the combination of sofosbuvir and ribavirin for 12 weeks, while genotype 1 patients, the most common in North America, will have to take a triple combination of PEG-interferon,sofosbuvir and ribavirin for 12 weeks.

While most of us are still waiting for all interferon therapies, 12 weeks of interferon is a vast improvement over the previous 48 weeks of interferon in genotype 1 cases. It is expected that the 12 weeks of interferon will be very well tolerated, considering most symptoms related to interferon develop around 12 weeks.

Our practice is gearing up for patients once approval is announced. Visit us on our website for updated information as well as this blog. Sign up for our newsletter for up-to-date information on the FDA approval.

This new FDA approval of sofasbuvir will not address patients previously treated and failed treatment, those with advanced cirrhosis, transplant patients, those with liver cancer, or co-infected with HIV. Despite a lack of formal FDA approval for these specific patients, I anticipate we will be seriously discussing treatment in this very special group of patients.

To make an appointment, contact Lexa in our office at 713-794-0700; make sure old records are available.

Comments { 7 }

New Research Study: Fatty Liver Disease (NASH)

We have started screening for a new research study for those patients with fatty liver disease, also known as NAFLD and NASH. The study is a randomized, double-blind, controlled, multi-center phase 2 study evaluating the role of two medications called Roflumilast and pioglitazone.

Study candidates will receive one or both medicines, and will be evaluated to determine the degree of fat in the liver, as well as improvements in their liver enzymes (ALT and AST).

Participants will need to first meet all eligibility criteria of the study. Once enrolled in the study, all treatment related medicines, testing, and care will be paid for by the sponsor of the study. The study will last approximately 5 months.

If interest, contact our office at 713-794-0700 and ask for Paula.

Comments { 0 }

Second Opinion in Hepatitis: Videoconferencing Between Houston and the World

Each week, I receive dozens of e-mails from followers of our social media sites (Twitter, YouTube, FaceBook, Your Health First, and Liver Specialists of Texas) seeking assistance regarding some form of liver disease they are suffering from, or one of their relatives. I usually respond back with some direction they should head in, or ask if they are available to travel to Houston for a face-to-face evaluation.

As technology improves, the availability of videoconferencing has never been easier. Working with Houston based software developers, there is now the opportunity to participate in a second opinion program with experts in liver disease in our practice. Because there is such variability in everyone’s home or work connectivity to the internet, we plan on supplying you with the needed technology to connect.

The savings of not having to travel to Houston, hotel and food charges, lost wages, and time, makes this an economically sensible alternative.

Second opinions in all aspects of liver disease will be available, including abnormal liver tests, fatty liver disease, hepatitis C, hepatitis B, cirrhosis, liver cancer, alcohol related liver disease, liver transplant, hemochromatosis, and autoimmune disease of the liver. The cost for this service will be based on a minimum of a 30 minute consultation, allowing for additional time at 15 minute increments. Medical records, x-ray reports and films, biopsies, and past consultations will be reviewed.

Feedback on this program is important to us. Please let us know what you think.

For additional information, contact Dee at (713) 634-5103.

Comments { 1 }

Should Alcoholics Be Allowed to Receive Liver Transplants?

[polldaddy poll=7435594]

Comments { 0 }

Alcohol, Liver, Cirrhosis and Transplant: Dr. Galati Discusses

A segment that I recorded for this weeks Your Health First was with Dr. Howard Monsour. who’s the Chief of hepatology at Houston Methodist. In this two-part interview, we discussed various aspects of alcoholic liver disease, effects of acetaminophen on the liver, and the difference between men and women in their alcohol consumption.

As noted in prior posts, the issue of liver transplant in patients with alcoholism and alcoholic cirrhosis is controversial, but when carefully reviewed, their outcomes following transplant are equal or better than other diseases we transplant livers for.

Watch the video interview here.

Comments { 0 }
Liver Transplant and Alcohol Related Liver Disease: Time to Move the Goal Posts for Alcoholics?

Liver Transplant and Alcohol Related Liver Disease: Time to Move the Goal Posts for Alcoholics?

I spent the day in Minnesota today giving a lecture on the ethics of transplanting patients with alcoholic liver disease. This is one of the more debated issues in medicine as well as in the field of transplantation.

Historically, patients with alcoholic liver disease need to wait six months before being considered a candidate for liver transplant. This so-called “six-month rule” generally requires patients to be abstinent for six months prior to that being seriously considered for transplant. One problem with the six-month rule is that there is no meaningful research indicating that being abstinent for six months reduces the chance of alcohol consumption after a successful transplant.

One of the major concern is the resumption of damaging alcohol use after transplant. Here again, the research is lacking, with no firm evidence that patients transplanted for alcoholic liver disease resume alcohol abuse to the point of damaging the newly transplanted liver.

Patients that are transplant for alcoholic liver disease have some of the best outcome and highest survival, compared to those transplanted for autoimmune or viral hepatitis.

There is a growing sentiment amongst transplant programs around the country that the six-month rule needs to be phased out. From an ethical standpoint, considering patients with alcoholic liver disease have equal or better survival compared to other forms of liver disease that are transplanted, there is no ethical reason to deny patients this opportunity.

Patients with alcohol induced liver disease need a comprehensive evaluation prior to transplant, and will need to participate in rehabilitation before and after successful transplant.

It will take time to implement this type of change in the transplant community. I firmly believe that patients with alcoholic liver disease deserve a second look, and that eventually phasing out the six month rule is the first step.

Public opinion in this area needs work, reassuring the public, and potential organ donors, that these donated organs will be transplanted into worthy candidates that will have excellent outcomes and survival.

For more information or to be evaluated for a liver transplant, contact us at 713-794-0700 or visit us at www.texasLiver.com.
Share your thoughts.

Comments { 0 }
Airport Food: Trying to Eat Health?

Airport Food: Trying to Eat Health?


So as I sit here for an evening flight to Minneapolis, I realize that because of the flight delay, I’m going to have to force myself to eat something at the airport. My original plan was to tough it through the flights with nothing more than water, and eat something on the healthier side once I landed. Strolling around the B terminal of Bush Intercontinental Airport, the selection for healthy food is slim to none. Patrons are surrounded by fast food chains that are high in fat, sugar, and salt. Nothing is nutritious.

After a few laps around the terminal, I settle on a veggie bowl at Bullritos. I’m not denying that this is fast food, but with some careful choices, it can turn into a halfway decent meal.

Skipping the meat is a no-brainer. While the choices are a few different varieties of beef and chicken, they appear to be high in fat and salt. The quality of the meat is also suspect. Sitting in a puddle of grease doesn’t seem all that appealing. My selection tonight includes cilantro rice, grilled onions and peppers, grilled corn, medium hot sauce, pico de gallo, and some chopped romaine lettuce. A small scoop of freshly made guacamole topped it off.

I don’t feel too guilty with the meal I ate at the gate. I was able to manage to get some decent dietary fiber, some vegetables, and most importantly, the avoidance of meat.

So what’s the message for weary travelers, who unfortunately have to do this much more often than I do? The answer is simple. Choose wisely. While it would be optimal to bring food from home, when you are forced to eat the food at the airport, avoid fast food like the plague. Meals where you have the option to add or subtract components gives you the most control, and likely a healthier choice. At the larger terminals, there appears to be a new breed of healthier food choices, including freshly prepared salads and sandwiches. The sandwich choices I’ve seen allows for lots of vegetable toppings, and what would appear to be lean meats. Some even offer a breadless sandwich.

Feel free to share your dietary travel stories with us.

Comments { 0 }

Exercise and Hepatitis C: Information for Patients

This is our latest video discussing the role of exercise and hepatitis C. The bottom line, is that for those with hepatitis C, weight loss is an important part of the overall treatment plan, and must be discussed with your physicians. It is now well known that obese individuals with hepatitis C have a higher chance of developing fibrosis, scarring, and cirrhosis of the liver. Diabetes, a fatty liver, and elevated levels of insulin also contribute to a greater chance of scarring and cirrhosis.

Weight needs to be controlled through both changes in diet (see diet and hepatitis C vide here) and exercise. Exercise in any for will be beneficial. Make it a regular part of your daily schedule.

Let us know what you think and share your comments with us.

Comments { 0 }

Sofosbuvir and Ribavirin for Hepatitis C Genotype 1 in Patients With Unfavorable Treatment Characteristics: New Treatments in Houston Soon

There continues to be good news for those with hepatitis C genotype 1. Gilead is on the verge of FDA approval for their new hepatitis C drug, sofosbuvir, combined with ribavirin, in HCV patients with genotype 1 HCV. The study, available here for review, further shows how effective this combination is in eradicating the HCV virus.

For those of us who have been involved in hepatitis C therapy for the past 20 years, these new agents are a wonderful and welcomed addition to the already excellent therapies we have.

Stay tuned for further developments, and their eventual FDA approval.

Comments { 0 }