Liver Diseases Branch Clinical Fellows
Clinical Fellow Description
Clinical fellows join the Branch for a period of 2-3 years and in special circumstances, additional years may be available. For a total of 2-4 months each year, clinical fellows are responsible for the primary care of patients admitted to the Liver Service and performing hepatology consults within the NIH Clinical Center. The hepatology consult service receives more than 300 consult requests each year. During this period, which constitutes an active learning process in clinical hepatology and liver biopsy interpretation, clinical duties occupy approximately 20 - 50% of the fellow’s time, depending on the year of fellowship, the remainder being available for research activities. Fellows work closely with attending physicians drawn from the staff of the Liver Diseases Branch itself, from other NIH clinical units, and from other hospitals in the greater Washington area. Hence, fellows are exposed to a variety of approaches to the evaluation, diagnosis and management of a wide spectrum of clinical liver diseases. Fellows also participate in various events; in the weekly liver biopsy review conferences, radiology conference once a month, and monthly visiting professor rounds. Typically fellows also attend the annual AASLD meeting. There is also an active Washington inter-hospital Liver Journal Club, which meets every 2 weeks in the homes of senior hepatologists in the Washington area. In view of the active clinical training, when required, and under certain circumstances, the program can constitute partial fulfillment of requirements for Gastroenterology Boards. When not involved in the patient care responsibilities, each fellow is available for essentially full-time research on projects mutually agreeable to the Fellow and preceptor(s). Such projects may involve either full-time laboratory work or clinical investigation of patients. Except when the research project itself involves working with patients, the only clinical activities required during this period are attendance at the outpatient clinic and participation in weekly patient rounds. The fellows are encouraged to take courses offered by NIH on clinical research, biostatistics, epidemiology, clinical pharmacology, medical ethics, and bioinformatics, and have the opportunity to enroll in the NIH-Duke’s Master Program in Clinical Research, which provides a rigorous curriculum in clinical research and is fully funded by NIH.
Hepatology fellows are eligible for appointment in either the Civil Service or the Public Health Service. The salary of clinical fellows is based on post-graduate years and mechanism of appointment, and ranges from $50,000 to $65,000 per year.
Yaron Rotman, M.D.,
The interaction of hepatitis C virus (HCV) with its host is the main focus of my research interest. Specifically, I am interested in the various aspects of HCV influence and lipid metabolism, as well as the unique ability of the virus to evade host antiviral defenses and modify them. Current research projects include:
• Analysis of kinetic pattern of change in serum lipoproteins during antiviral therapy and shedding light on the mechanism underlying these changes.
• Evaluating the effect of HCV infection and its eradication on progression of atherosclerosis and atherosclerotic complications.
• Studying the viral kinetic pattern of response to antiviral treatment in non-genotype 1 infections.
• Determining in vitro the effects of HCV on the interferon signaling pathway and the ability to change the response to exogenous interferon by modulating specific steps in this pathway.
• Detection of the optimal method to obtain high quality coffee in the DC metropolitan region.
Christopher Koh, M.D.,
My current research interests include Nodular Regenerative Hyperplasia (NRH), Non-Alcoholic Steatohepatitis (NASH), and Viral Hepatitis C (HCV). Although NRH is a disease process that may have a long history, it has only recently been described in the literature. There is still much to learn about this disease and its various relationships. Currently we are researching this disease’s possible etiologies in addition to characterizing its various associations. We hope to expand the breadth of knowledge of NRH and its association with portal venopathy and portal hypertension. Nonalcoholic Fatty Liver Disease (NAFLD) has recently been identified as the leading cause of liver disease in Western Industrialized countries, affecting approximately 20-40% percent of the population. NASH, considered a subset of NAFLD, has been identified as a causative factor of cryptogenic cirrhosis, hepatic fibrosis, and cirrhosis. Currently, there have been various experimental treatments for NASH, although there is still no FDA approved treatment. My interest in this rapidly expanding area of hepatic liver disease deals with researching and identifying new effective treatments. HCV is an ever evolving area of hepatology. Although we are learning more about this disease on a daily basis, we still know very little about this disease, especially with regards to acute infection, chronic infection, and treatment efficacy. My interest in this area of hepatology includes acute infection of Hepatitis C as well as predictive models for cirrhosis and decompensation.
Mazen Nourredin, M.D.,My primary research interests are in three areas of liver disease: 1. Primary Biliary Cirrhosis. 2. Hepatitis C. 3. Non-alcoholic Steatohepatitis. In PBC, as the disease is still poorly understood, I am interested in developing a scoring system which will improve correlation with disease severity and progression. In chronic hepatitis C infection, my interests lie in elucidating the specific mechanisms of ribavirin and how it contributes to the efficacy of interferon. In NASH, as there is an increasing population with this disease and a lack of efficacious therapy, I am interested in identifying novel therapies which may ultimately improve outcome in this potentially dangerous disease.
Adil Abdalla, M.D.,My research interest focuses on various aspects of viral hepatitis B and C. In hepatitis C, my interests lie on the impact of infection in the African immigrant population. Although it has been well documented that African Americans respond poorly to Hepatitis C antiviral therapy, such findings have not been thoroughly explored in African immigrants. My goal is to explore the efficacy of various treatment modalities and outcomes of therapy in this population with hopes towards increasing knowledge and awareness in this migrant population.My research interests in viral hepatitis B are twofold. First, I am interested in assessing the long-term efficacy of Hepatitis B immunization. Second, I am interested in identification of markers or variables that may predict progression of liver disease in patients with chronic hepatitis B infection.
Page last updated: January 14, 2009