Clinical Gastroenterology and Hepatology最新文献

{"title":"Metabolic comorbidities accelerate liver fibrosis in chronic hepatitis B - time to act.","authors":"Grace Lai-Hung Wong, Tarik Asselah","doi":"10.1016/j.cgh.2025.10.009","DOIUrl":"https://doi.org/10.1016/j.cgh.2025.10.009","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":12.0,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307269","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Seroprevalence of Helicobacter pylori infection among asymptomatic patients served by a safety-net healthcare system.","authors":"Aaron P Thrift, Peyman Dinarvand, Luis Juarez, Jourdan Brown, Daniel Avila, Jennifer Mistica Zafiro Garcia-Villanueva, Lisa C Danek, Hammad Mahmood, Thomas Porter, Ann Gotschall, Noreen F Pirzada, Jaime J Rueda, Lee B Lu, Afroze Ali, Ijeoma Anyakorah, Sanjana J Bhattarai, Anees Fatima, Jessica Garcia, Hung V Nguyen, Bharat Joshi, Malvika Juneja, Misba S Lateef, Najda Mujtaba, Preethi V Nambi, Jay S Orr, Huma Rahman, Stephanie Nguyen, Amna Waqar, Yanyan Chen, David Y Graham, Hashem B El-Serag, Mimi C Tan","doi":"10.1016/j.cgh.2025.10.005","DOIUrl":"https://doi.org/10.1016/j.cgh.2025.10.005","url":null,"abstract":"<p><strong>Background and aims: </strong>Helicobacter pylori screening and eradication is a cost-effective strategy for primary gastric cancer prevention in high-risk populations outside the U.S. There is a paucity of population-based H. pylori seroprevalence data available in high-risk U.S. groups, particularly data for low income, uninsured patient populations.</p><p><strong>Methods: </strong>We used data from a cross-sectional study of a largely underserved, immigrant, and minority patient population. Inclusion criteria included asymptomatic individuals aged 30-65 years without prior H. pylori testing or treatment. Consented patients completed a study survey and a blood draw to screen for H. pylori using IgG serology. We calculated seroprevalence overall and within sub-groups of the study population.</p><p><strong>Results: </strong>Screening for H. pylori infection was completed in 1,021 individuals. Participants had a mean age of 47.5 years, 69.9% female and 88.7% Hispanic individuals. Overall, 63.9% (95% confidence interval [CI] 60.9-66.8%) of participants were seropositive for H. pylori. H. pylori seroprevalence was similar across age groups, but was higher among males (69.1%, 95% CI 63.9-74.2%) than females (61.6%, 95% CI 58.1-65.2%). Seroprevalence of H. pylori was highest for Hispanic(65.9%, 95% CI 62.8-69.0%) and lowest for non-Hispanic White (45.0%, 95% CI 23.2-66.8%) individuals. H. pylori seroprevalence was highest among individuals born in Central America (75.1%). Risk for infection was no different between second and third generation immigrants.</p><p><strong>Conclusion: </strong>In this population-based study, almost two-thirds of asymptomatic patients were seropositive for H. pylori. Prevalence was over 40% among all sub-groups. Screening solely based on race and ethnicity may inadvertently exacerbate disparities by overlooking confounding factors for infection like low socioeconomic status and regional exposures.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":12.0,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145307272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Capsule Endoscopy in Chronic Mesenteric Ischemia Before and After Revascularization.","authors":"Takuma Iwata, Nobumi Suzuki, Mitsuhiro Fujishiro","doi":"10.1016/j.cgh.2025.10.008","DOIUrl":"https://doi.org/10.1016/j.cgh.2025.10.008","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":12.0,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term safety of vedolizumab in patients with ulcerative colitis/Crohn's disease: A prospective observational study.","authors":"Edouard Louis, Shaji Sebastian, Britta Siegmund, Peter Bossuyt, Silvio Danese, Nanne de Boer, Edward V Loftus, Bjørn Moum, Laurent Peyrin-Biroulet, Stefan Schreiber, Jie Zhou, Edith Angellotti, Shashi Adsul, Stephen Jones, Corey A Siegel","doi":"10.1016/j.cgh.2025.10.006","DOIUrl":"https://doi.org/10.1016/j.cgh.2025.10.006","url":null,"abstract":"<p><strong>Background and aims: </strong>This post-authorization safety study compared long-term safety of vedolizumab or other biologics in patients with ulcerative colitis (UC) or Crohn's disease (CD).</p><p><strong>Methods: </strong>This was a prospective, observational, multicentre, cohort study in patients with UC or CD starting treatment with vedolizumab or other biologics (NCT02674308, EUPAS6469). The primary safety outcome was serious infections compared between cohorts using a Cox proportional hazards model adjusted by propensity score. Clinical effectiveness was a secondary outcome.</p><p><strong>Results: </strong>The full analysis set comprised 5,008 pts (vedolizumab=2,502; other biologic=2,506) and mean (standard deviation) follow-up duration was 37.4 (14.1) months. Patients in the vedolizumab group had greater age, duration of disease, and concomitant medication use at baseline, indicating more advanced disease. In patients with UC, the incidence rate per 100 person-years of serious infections was: 5.5 (95% CI: 4.7, 6.5) [vedolizumab] and 7.0 (5.8, 8.5) [other biologic], with an adjusted hazard ratio (HR) of 0.89 (0.69, 1.15), p=0.38. In patients with CD, corresponding findings were 7.9 (95% CI: 6.8, 9.1) [vedolizumab] and 6.5 (95% CI: 5.7, 7.3) [other biologic] with adjusted HR of 1.15 (0.95, 1.40), p=0.16. There were no safety issues relating to pregnancy and no cases of progressive multifocal leukoencephalopathy were observed. There were 18 deaths in the vedolizumab group and 13 in the other biologic group. Clinical effectiveness was comparable between cohorts and was similar to the levels seen in other prospective observations of vedolizumab.</p><p><strong>Conclusion: </strong>There was no new safety signal identified in relation to vedolizumab. Results regarding safety and effectiveness were consistent with the known profile of vedolizumab.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":12.0,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lymphoepithelial Cyst of the Cervical Esophagus with Distinct Endoscopic Ultrasonography Findings.","authors":"Kanako Higaki, Yukari Koyama, Kensuke Hamada","doi":"10.1016/j.cgh.2025.10.007","DOIUrl":"https://doi.org/10.1016/j.cgh.2025.10.007","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":12.0,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145298445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Changes in HBcAg and HBsAg Expression Following Antiviral Therapy and Their Role in Outcome of Patients with Chronic Hepatitis B.","authors":"Mohammed Rifat Shaik, Lauren Apodaca, Sungyoung Auh, Meera Kattapuram, Gavin A Cloherty, David E Kleiner, Marc G Ghany","doi":"10.1016/j.cgh.2025.10.004","DOIUrl":"https://doi.org/10.1016/j.cgh.2025.10.004","url":null,"abstract":"<p><strong>Background: </strong>Hepatitis B core antigen (HBcAg) and surface antigen (HBsAg) can be detected through immunostaining of liver tissue. This study examined the extent and patterns of HBcAg and HBsAg staining before and after long-term nucleos(t)ide analogue (NA) therapy.</p><p><strong>Methods: </strong>Liver biopsies performed before and after 4 years of NA treatment were analyzed from patients with HBeAg-positive and HBeAg-negative chronic hepatitis B participating in 3 treatment trials. Immunostaining for HBcAg and HBsAg was evaluated using semi-quantitative scales for both extent and distribution. HBV DNA, HBV RNA, HBeAg status and quantitative HBsAg (qHBsAg), were correlated with changes in immunostaining. Baseline HBcAg and HBsAg staining were correlated with clinical outcomes.</p><p><strong>Results: </strong>91 patients had a pre-treatment biopsy, and 81 had paired pre-treatment and year 4 biopsies. Pre-treatment, three-quarters were positive for HBcAg, predominantly in a cytoplasmic staining pattern, and 86% had detectable HBsAg, with 79% exhibiting a scattered granular pattern. Following 4 years of NA treatment, the proportion of biopsies without HBcAg staining increased from 26% to 63% and HBsAg staining from 14% to 26%, compared to baseline. Inhibition of replication was associated with a significant decline in HBcAg staining and loss of HBcAg staining was related to the duration of replication inhibition. In contrast, long-term NA therapy had minimal effect on extent of HBsAg staining. The absence of contiguous granular HBsAg pattern was associated with HBsAg loss.</p><p><strong>Conclusions: </strong>NA-related inhibition of viral replication was associated with marked reduction in HBcAg expression in HBeAg-positive and HBeAg-negative patients but minimal changes in extent of HBsAg staining, likely reflecting HBsAg production from integrated HBV DNA.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":12.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145279066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measles Outbreaks 2025 and Beyond: Implications for Immunosuppressed Patients Managed by Gastroenterologists and Hepatologists.","authors":"Freddy Caldera, James H Conway, Michael J Scolarici, Francis A Farraye, Michael R Lucey, Mary S Hayney","doi":"10.1016/j.cgh.2025.08.038","DOIUrl":"https://doi.org/10.1016/j.cgh.2025.08.038","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":12.0,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-ASSISTED CAPSULE ENDOSCOPY FOR DETECTION OF ULCERS AND EROSIONS IN CROHN'S DISEASE: A MULTICENTER VALIDATION STUDY.","authors":"Patrícia Andrade, Miguel Mascarenhas, Francisco Mendes, Bruno Rosa, Pedro Cardoso, João Afonso, Tiago Ribeiro, Miguel Martins, Joana Mota, Maria João Almeida, Tiago Cúrdia Gonçalves, Pedro Campelo, Cláudia Macedo, António Pinto da Costa, Cecílio Santander, Jack di Palma, João Ferreira, José Cotter, Guilherme Macedo","doi":"10.1016/j.cgh.2025.09.036","DOIUrl":"https://doi.org/10.1016/j.cgh.2025.09.036","url":null,"abstract":"<p><strong>Background and aims: </strong>Small bowel capsule endoscopy (SBCE) is limited by lengthy, variable interpretation. Artificial intelligence (AI) offers a transformative approach, enabling faster and more accurate lesion detection. This multicenter study aimed to validate an AI model for ulcers and erosions across different SBCE devices.</p><p><strong>Methods: </strong>A multicenter, cross-sectional cohort study was conducted from 2021 to 2024, involving centers in Europe and the USA. Two SBCE devices (PillCamSB3™ and Olympus EC-10®) were used. The performance of AI-assisted reading, generated by a deep learning model, was compared with standard-of-care (SoC) reading using a reference standard defined by an independent review board. The study utilized two SBCE devices (PillCamSB3™, Olympus EC-10®) and analyzed 259 SBCE exams. The performance of AI-assisted reading generated by the deep learning model was compared with standard of care (SoC) reading against a reference standard defined by an independent review board.</p><p><strong>Results: </strong>Ulcers and erosions were detected in 93 patients (35.9%). SoC had 69.6% sensitivity, 99.4% specificity, 98.5% PPV, 85.6% NPV, and 88.8% accuracy. AI-assisted reading detected ulcers and erosions with 90.2% sensitivity, 84.4% specificity, 76.1% PPV, 94.0% NPV, and 86.5% accuracy. The detection yield of AI-assisted reading was superior (p<0.001) to conventional SoC reading. The AI-assisted physician SBCE reading identified 568 lesions out of 600 identified by expert board review (94.7%). The median AI-assisted CE reporting time was 172 seconds per exam.</p><p><strong>Conclusions: </strong>The AI-assisted SBCE reading achieved superior diagnostic performance compared to SoC, with a substantial decrease in reading time.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":12.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145273974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Placebo Rates in Metabolic Dysfunction-associated Steatohepatitis Clinical Trials: A Systematic Review and Meta-analysis.","authors":"Francisco Idalsoaga, Luis Antonio Díaz, Saleh Alghsoon, Bishoy Lawendy, Neha Sharma, Hailemichael Desalegn, Yuhong Yuan, My Ha, Jessica Le, John K MacDonald, Marco Arrese, Rohit Loomba, Vipul Jairath, Mohammad Qasim Khan, Juan Pablo Arab","doi":"10.1016/j.cgh.2025.09.035","DOIUrl":"https://doi.org/10.1016/j.cgh.2025.09.035","url":null,"abstract":"<p><strong>Background: </strong>High placebo response rates complicate drug development in metabolic dysfunction-associated steatohepatitis (MASH) clinical trials. We performed a meta-analysis to quantify placebo response and assess influencing factors.</p><p><strong>Methods: </strong>MEDLINE, Embase, and CENTRAL were searched from inception to May 7, 2025 for placebo-controlled trials of pharmacological interventions for MASH. Placebo response rates were pooled by random-effects model and meta-regression was used to evaluate the effects of patient and trial design factors on the primary outcomes.</p><p><strong>Results: </strong>One-hundred and twenty-seven studies (6,880 participants) were included. For the primary outcome, the pooled proportion of non-cirrhotic placebo patients achieving MASH resolution without worsening of fibrosis was 11% (95% CI: 8% to 14%). Meta-regression did not identify any significant patient or trial characteristics associated with placebo response. For the second primary outcome, the proportion of cirrhotic placebo patients whose Model for End-stage Liver Disease score increased from below 12 to ≥15 was 4% (95% CI 1% to 13%). Regarding secondary outcomes, 12% (95% CI: 8% to 18%) of placebo patients achieved normal alanine aminotransferase levels, and 22% (95% CI: 18% to 27%) showed an absolute reduction of 5% in hepatic fat content. Additionally, 19% of placebo patients (95% CI: 16% to 22%) achieved a relative reduction of 30% in fat content, while 2% (95% CI: 0.7% to 3%) progressed to cirrhosis.</p><p><strong>Conclusion: </strong>Placebo response rates among patients with MASH are generally elevated yet vary considerably depending on the outcome measured. This study provides valuable insights to enhance the design of future MASH trials.</p>","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":12.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274076","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Social Determinants of Health on Hepatocellular Carcinoma Surveillance Receipt and Early Detection.","authors":"Mohammed Al-Hasan, Nicole E Rich, Sruthi Yekkaluri, Patricia D Jones, Adam Yopp, Amit G Singal","doi":"10.1016/j.cgh.2025.09.037","DOIUrl":"https://doi.org/10.1016/j.cgh.2025.09.037","url":null,"abstract":"","PeriodicalId":10347,"journal":{"name":"Clinical Gastroenterology and Hepatology","volume":" ","pages":""},"PeriodicalIF":12.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}