Hepatology International最新文献

{"title":"Model of baseline clinicopathological features predicts non-resolution of drug-induced liver injury at 6 months.","authors":"Chhagan Bihari, Shvetank Sharma, Apoorva Giri, Raj Pal Yadav, Sukriti Baweja, Archana Rastogi, Shiv Kumar Sarin","doi":"10.1007/s12072-025-10814-6","DOIUrl":"https://doi.org/10.1007/s12072-025-10814-6","url":null,"abstract":"<p><strong>Introduction: </strong>Chronicity in drug-induced liver injury (DILI) is assessed at 12 months, leading to a large time gap from its initial presentation. In this study, we developed a model that could predict biochemical non-resolution in DILI (DILI-NR) patients at 6 months using baseline clinicopathological data.</p><p><strong>Patients and methods: </strong>Cases of DILI with liver biopsies were enrolled between January 2016 and December 2021. BSEP, MDR3, and MRP2 were assessed immunohistochemically. DILI-NR was considered a biochemical non-resolution 6 months after the onset of DILI. A separate cohort of 126 patients was taken as a validation cohort.</p><p><strong>Results: </strong>DILI-NR was noted in 59/407 patients (14.5%). DILI-NR patients had significantly higher body mass index, lower hemoglobin, more severe disease at the presentation, autoantibody positivity, higher IgG, association with co-morbidities, and were more aged. Pathologically, DILI-NR had increased ductular reaction, duct damage, duct loss, ductular bile plugs, and autoimmune hepatitis-like morphology along with lesser expression of canalicular transporters. On multivariate logistic regression (LR) analysis and XGBoost analysis, BMI, hemoglobin, presence of autoantibodies, disease severity at baseline, and lower expression of any one transporter were associated with DILI-NR (AUROC = 0.92). After calibrating the model on the test cohort, the LR model showed AUROC of 0.89 with an accuracy of 87.3% and precision of 91.5%, confirming the effectiveness of the model.</p><p><strong>Conclusion: </strong>The model encompassing hemoglobin, BMI, presence of autoantibodies, disease severity, and reduced expression of canalicular proteins at baseline predicts the biochemical non-resolution of DILI at six months.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779824","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carvedilol and traditional nonselective beta blockers for the secondary prophylaxis of variceal hemorrhage and portal hypertension related complications among patients with decompensated cirrhosis: a systematic review and network meta-analysis.","authors":"Warunee Mingpun, Agnieszka Sobanska, Mantiwee Nimworapan, Maneerat Chayanupatkul, Teerapon Dhippayom, Piyameth Dilokthornsakul","doi":"10.1007/s12072-025-10812-8","DOIUrl":"https://doi.org/10.1007/s12072-025-10812-8","url":null,"abstract":"<p><strong>Background: </strong>Carvedilol has limited research on decompensated cirrhosis. This study compared the effects of carvedilol, traditional nonselective beta blockers (NSBBs), including propranolol and nadolol, and other interventions in patients using carvedilol or traditional NSBBs for secondary prophylaxis of variceal hemorrhage (VH) and portal hypertension (PH)-related complications.</p><p><strong>Methods: </strong>A systematic search of databases, including PubMed, Embase, Cochrane Library, and Scopus, was conducted through October 2023. Randomized controlled trials (RCTs) evaluating carvedilol or traditional NSBBs for secondary prophylaxis of VH were included. The outcomes were the occurrence of VH and portal PH-related complications, including new or worsening ascites, hepatic encephalopathy, spontaneous bacterial peritonitis, and hepatorenal syndrome. A network meta-analysis was performed using a random-effects model.</p><p><strong>Results: </strong>A total of 60 RCTs involving 5,600 patients with a median Child Pugh score of 8.0 (range 6.8-10) were included. The risk of carvedilol plus variceal band ligation (VBL) on VH was lower than placebo (relative risk (RR) 0.24; 95% confidence interval (CI): 0.10-0.57), and the risk of carvedilol on new or worsening ascites was lower than placebo (RR = 0.10, 95%CI; 0.01-0.93). Traditional NSBBs plus VBL also had preventive effects on VH compared to placebo (RR = 0.31, 95%CI; 0.18-0.54). However, there were no differences between carvedilol and traditional NSBBs in other outcomes.</p><p><strong>Conclusion: </strong>Carvedilol can prevent PH-related complications, including VH and new or worsening ascites, in cirrhosis patients with a history of VH. No significant differences were observed between the effects of carvedilol and traditional NSBBs, both combined with VBL.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772083","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The interplay between lymphatic system and portal hypertension: a comprehensive review.","authors":"Pinky Juneja, Rajni Yadav, Dinesh M Tripathi, Savneet Kaur","doi":"10.1007/s12072-025-10815-5","DOIUrl":"10.1007/s12072-025-10815-5","url":null,"abstract":"<p><strong>Background: </strong>The pathophysiology of portal hypertension revolves around numerous structural and functional changes in the intra- and extra-hepatic vascular compartments. In recent years, a dysfunction of the lymphatic system has garnered increasing attention as one of the key sequelae of portal hypertension.</p><p><strong>Purpose and methods: </strong>The review comprehensively deliberates about the anatomical and functional attributes of the hepatic lymphatic system during portal hypertension. Along with liver lymphatic system, important modifications that occur in extrahepatic lymphatics during advanced liver disease are discussed.</p><p><strong>Results: </strong>During progression of liver disease, elevated portal pressures cause increased sinusoidal blood and enhanced lymph flow, leading to dilation and proliferation of hepatic lymphatic vessels. In advanced liver disease, portal and central lymphatic systems also undergo profound changes to accommodate increased lymph flows. These changes in lymphatic system seem to have evolved as compensatory mechanisms to alleviate enhanced portal pressures. However, further increase in the splanchnic lymph production causes a complete failure of the drainage capacity of local and central lymphatic vessels, leading to maldistribution of extracellular fluid along with immune system anomalies aggravating ascites and pathological bacterial translocation.</p><p><strong>Conclusion: </strong>Lymphatic dysfunction plays a crucial role in the progression and complications of portal hypertension. Development of routine imaging techniques for lymphatic vessels in clinics,  protocols for measuring lymphovenous pressure gradient and in vitro and in vivo experimental studies are requisite to further our understanding in this field. Targeting lymphatic dysfunction could offer promising therapeutic options for managing cirrhosis, portal hypertension and related complications.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":""},"PeriodicalIF":5.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive model for HBsAg clearance rate in chronic hepatitis B patients treated with pegylated interferon α-2b for 48 weeks.","authors":"Zhili Tan, Nan Kong, Qiran Zhang, Xiaohong Gao, Jia Shang, Jiawei Geng, Ruirui You, Tao Wang, Ying Guo, Xiaoping Wu, Wenhong Zhang, Lihong Qu, Fengdi Zhang","doi":"10.1007/s12072-024-10764-5","DOIUrl":"10.1007/s12072-024-10764-5","url":null,"abstract":"<p><strong>Background and aims: </strong>Chronic hepatitis B (CHB) is a major global health concern. This study aims to investigate the factors influencing hepatitis B surface antigen (HBsAg) clearance in CHB patients treated with pegylated interferon α-2b (Peg-IFNα-2b) for 48 weeks and to establish a predictive model.</p><p><strong>Methods: </strong>This analysis is based on the \"OASIS\" project, a prospective real-world multicenter study in China. We included CHB patients who completed 48 weeks of Peg-IFNα-2b treatment. Patients were randomly assigned to a training set and a validation set in a ratio of approximately 4:1 by spss 26.0, and were divided into clearance and non-clearance groups based on HBsAg status at 48 weeks. Clinical data were analyzed using SPSS 26.0, employing chi-square tests for categorical data and Mann-Whitney U tests for continuous variables. Significant factors (p < 0.05) were incorporated into a binary logistic regression model to identify independent predictors of HBsAg clearance. The predictive model's performance was evaluated using ROC curve analysis.</p><p><strong>Results: </strong>We included 868 subjects, divided into the clearance group (187 cases) and the non-clearance group (681 cases). They were randomly assigned to a training set (702 cases) and a validation set (166 cases). Key predictors included female gender (OR = 1.879), lower baseline HBsAg levels (OR = 0.371), and cirrhosis (OR = 0.438). The final predictive model was: Logit(P) = 0.92 + Gender (Female) * 0.66 - HBsAg (log) * 0.96 - Cirrhosis * 0.88. ROC analysis showed an AUC of 0.80 for the training set and 0.82 for the validation set, indicating good predictive performance.</p><p><strong>Conclusion: </strong>Gender, baseline HBsAg levels, and cirrhosis are significant predictors of HBsAg clearance in CHB patients after 48 weeks of Peg-IFNα-2b therapy. The developed predictive model demonstrates high accuracy and potential clinical utility.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"358-367"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003487/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expanding treatment indications in chronic hepatitis B: Should we treat all patients?","authors":"Rex Wan-Hin Hui, Lung-Yi Mak, James Fung, Wai-Kay Seto, Man-Fung Yuen","doi":"10.1007/s12072-025-10785-8","DOIUrl":"10.1007/s12072-025-10785-8","url":null,"abstract":"<p><p>Nucleos(t)ide analogues (NUCs) are first-line agents for chronic hepatitis B (CHB). Current guidelines provide recommendations for NUC initiation, yet the guidelines are complex and restrictive. Accumulating data on hepatitis B virus (HBV) replication and HBV integration suggests that there are no real quiescent disease phases in CHB, and treatment-ineligible patients in current guidelines still have substantial risks of cirrhosis and hepatocellular carcinoma. Expanding CHB treatment indications can effectively reduce the risks of liver-related complications. Furthermore, treatment indication expansion can be cost-effective, and can simplify care pathways to remove treatment barriers. Potential caveats for treatment expansion include risks of non-compliance, long-term side effects from NUCs, and poor patient acceptability. Nonetheless, these caveats are not insurmountable, and the benefits of treatment expansion outweigh the disadvantages. There is consensus among hepatologists in supporting treatment indication expansion, although expert panels have varying recommendations on treatment strategies. A treat-all approach, which involves treating all CHB patients, has also been proposed. A treat-all strategy is straightforward, and should yield the greatest benefits from a population health perspective. However, the feasibility of new treatment strategies, especially the treat-all approach, is influenced by multiple factors including local epidemiology, healthcare resource availability, and socioeconomic factors. A one-size-fits-all approach is not optimal, and treatment expansion strategies that are tailored based on local data should yield the greatest impact toward hepatitis elimination.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"304-314"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003542/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143440698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of dapagliflozin on liver steatosis in patients with nonalcoholic fatty liver disease: a randomized controlled trial.","authors":"Meng-Tzu Weng, Po-Jen Yang, Pan-Fu Liu, Chin-Hao Chang, Hsuan-Shu Lee, Jin-Chuan Sheu, Hsiao-Ching Nien","doi":"10.1007/s12072-024-10758-3","DOIUrl":"10.1007/s12072-024-10758-3","url":null,"abstract":"<p><strong>Background/aims: </strong>Nonalcoholic fatty liver disease (NAFLD) is a common liver comorbidity with considerable global consequences. This study explores the efficacy of dapagliflozin, a sodium-glucose cotransporter 2 inhibitor primarily used to manage type 2 diabetes, in reducing liver steatosis among NAFLD patients.</p><p><strong>Methods: </strong>This randomized, open-label, two-arm, parallel-group trial enrolled patients with NAFLD and a controlled attenuation parameter (CAP) score of ≥ 252 dB/m. Participants were randomized (1:1) into either the control or dapagliflozin groups. The primary outcome was the change in CAP scores, measured with FibroScan after 24 weeks.</p><p><strong>Results: </strong>The trial included 150 patients, 20 of whom (13%) had type 2 diabetes. In week 24, the dapagliflozin group had significantly lower CAP score and fatty liver grade than did the control group (266.3 ± 57.8 50 vs 298.6 ± 59.0 dB/m, respectively [p = 0.002]; 1.7 ± 0.7 vs 2.2 ± 0.8, respectively [p < 0.001]). Liver stiffness, waist circumference, and alanine transaminase levels decreased in both the dapagliflozin and control groups, but the between-group differences were nonsignificant (1.0 ± 0.3 vs 1.1 ± 0.3 [p = 0.678], 94.2 ± 12.7 vs 92.4 ± 11.1 [p = 0.382], and 28.8 ± 18.3 vs 28.3 ± 14.2 U/L [p = 0.856], respectively). In the multivariate analysis, a reduction in CAP was associated with dapagliflozin treatment (p = 0.01) and changes in BMI (p = 0.007). No adverse events were observed.</p><p><strong>Conclusion: </strong>Dapagliflozin can reduce CAP score and fatty liver grade in patients with moderate to severe NAFLD, regardless of their diabetes status.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"405-414"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142768533","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of nomograms to predict outcomes for large hepatocellular carcinoma after liver resection.","authors":"Jianxing Zeng, Guixiang Chen, Jinhua Zeng, Jingfeng Liu, Yongyi Zeng","doi":"10.1007/s12072-024-10754-7","DOIUrl":"10.1007/s12072-024-10754-7","url":null,"abstract":"<p><strong>Background: </strong>Large hepatocellular carcinoma (HCC) is difficult to resect and accompanied by poor outcome. The aim was to evaluate the short-term and long-term outcomes of patients who underwent liver resection for large HCC, eventually drawing prediction models for short-term and long-term outcomes.</p><p><strong>Methods: </strong>1710 large HCC patients were recruited and randomly divided into the training (n = 1140) and validation (n = 570) cohorts in a 2:1 ratio. Independent risk factors were identified by regression model and used to establish three nomograms for surgical risk, overall survival (OS), and recurrence-free survival (RFS) in the training cohort. Model performances were assessed by discrimination and calibration. The three models were also compared with six other staging systems.</p><p><strong>Results: </strong>Platelet (PLT), gamma-glutamyl transpeptidase (GGT), albumin-bilirubin (ALBI) grade, blood transfusion and loss, resection margin, tumor size, and tumor number were established in a nomogram to evaluate surgical risk ( https://largehcc.shinyapps.io/largehcc-morbidity/ ). The model had a good prediction capability with a C-index of 0.764 and 0.773 in the training and validation cohorts. Alpha-fetoprotein (AFP), resection margin, tumor size, tumor number, microvascular invasion, Edmondson-Steiner grade, tumor capsular, and satellite nodules were considered to construct a prognostic nomogram to predict the 1-, 3- and 5-year OS ( https://largehcc.shinyapps.io/largehcc-os/ ). The C-index of the model was 0.709 and 0.702 for the training and validation cohorts. Liver cirrhosis, albumin (ALB), total bilirubin (TBIL), AFP, tumor size, tumor number, microvascular invasion, and tumor capsular were used to draw a prognostic nomogram to predict the 1-, 3- and 5-year RFS ( https://largehcc.shinyapps.io/largehcc-rfs/ ). The C-index of the model was 0.695 and 0.675 in the training and validation cohorts. The discrimination showed that the models had significantly better predictive performances than six other staging systems.</p><p><strong>Conclusions: </strong>Three novel nomograms were developed to predict short-term and long-term outcomes in patients with large HCC who underwent curative resection with adequate performance. These predictive models could help to design therapeutic interventions and surveillance for patients with large HCC.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"428-440"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Asian Pacific association for the study of the liver clinical practice guidelines for the diagnosis and management of metabolic dysfunction-associated fatty liver disease.","authors":"Mohammed Eslam, Jian-Gao Fan, Ming-Lung Yu, Vincent Wai-Sun Wong, Ian Homer Cua, Chun-Jen Liu, Tawesak Tanwandee, Rino Gani, Wai-Kay Seto, Shahinul Alam, Dan Yock Young, Saeed Hamid, Ming-Hua Zheng, Takumi Kawaguchi, Wah-Kheong Chan, Diana Payawal, Soek-Siam Tan, George Boon-Bee Goh, Simone I Strasser, Hang Dao Viet, Jia-Horng Kao, Won Kim, Seung Up Kim, Shelley E Keating, Yusuf Yilmaz, Lubna Kamani, Chia-Chi Wang, Yasser Fouad, Zaigham Abbas, Sombat Treeprasertsuk, Kessarin Thanapirom, Mamun Al Mahtab, Undram Lkhagvaa, Oidov Baatarkhuu, Ashok Kumar Choudhury, Catherine A M Stedman, Abhijit Chowdhury, A Kadir Dokmeci, Fu-Sheng Wang, Han-Chieh Lin, Jee-Fu Huang, Jess Howell, Jidong Jia, Mohamed Alboraie, Stuart K Roberts, Masato Yoneda, Hasmik Ghazinian, Aram Mirijanyan, Yuemin Nan, Cosmas Rinaldi Adithya Lesmana, Leon A Adams, Gamal Shiha, Manoj Kumar, Necati Örmeci, Lai Wei, George Lau, Masao Omata, Shiv K Sarin, Jacob George","doi":"10.1007/s12072-024-10774-3","DOIUrl":"10.1007/s12072-024-10774-3","url":null,"abstract":"<p><p>Metabolic dysfunction-associated fatty liver disease (MAFLD) affects over one-fourth of the global adult population and is the leading cause of liver disease worldwide. To address this, the Asian Pacific Association for the Study of the Liver (APASL) has created clinical practice guidelines focused on MAFLD. The guidelines cover various aspects of the disease, such as its epidemiology, diagnosis, screening, assessment, and treatment. The guidelines aim to advance clinical practice, knowledge, and research on MAFLD, particularly in special groups. The guidelines are designed to advance clinical practice, to provide evidence-based recommendations to assist healthcare stakeholders in decision-making and to improve patient care and disease awareness. The guidelines take into account the burden of clinical management for the healthcare sector.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"261-301"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing pricing and affordability of HBV treatment in Asia-Pacific region: a barrier to elimination.","authors":"Jing Chen, Jidong Jia, Hui Zhuang, Wenhong Zhang, Jin Mo Yang, Tawesak Tanwandee, Diana Payawal, Saeed Hamid, Shiv Kumar Sarin, Masao Omata, Guiqiang Wang, George Lau","doi":"10.1007/s12072-024-10744-9","DOIUrl":"10.1007/s12072-024-10744-9","url":null,"abstract":"<p><strong>Background: </strong>The Asia-Pacific (AP) region carries a substantial burden of HBV. Affordable HBV treatment is crucial to attain WHO's elimination goal. This study assesses the pricing and affordability of HBV treatment in AP.</p><p><strong>Methods: </strong>A survey conducted among APASL members from 2 Aug to 30 Oct, 2023, gathered data on antiviral HBV drugs, treatment costs covering stages of chronic hepatitis B (CHB), compensated cirrhosis (CC), hepatocellular carcinoma (HCC), liver transplant, and monitoring expenses. Drug costs for TDF and ETV were compared to international reference price (TDF: $30, ETV: $36 per person per year), generating a median price ratio (MPR) where MPR < 1 indicated an acceptable local price. Affordability was evaluated by comparing yearly CHB treatment cost to yearly minimum wage in each country/area, all converted to 2023 US$.</p><p><strong>Results: </strong>ETV costs ranged from $42 per person per year in Pakistan to $2640 in Malaysia, while TDF costs varied from $12 in mainland China to $2446 in Hong Kong. Almost all MPR exceeded 1. Affordability of HBV treatment varied, with CHB patients in Australia paying 1.4% of minimum yearly wage to get 1 year CHB treatment, in contrast to Myanmar's 78.6%. Affordability disparities were also evident for patients with CC, HCC, and liver-transplant needs, though monitoring costs were generally affordable.</p><p><strong>Conclusions: </strong>Despite patent expiration and availability of low-cost generics for TDF and ETV, HBV medication costs in Asia-Pacific region remain high. CHB treatment is generally unaffordable for patients, posing a significant barrier to HBV elimination in this endemic region.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"349-357"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comments on: Coronavirus disease (COVID-19) and the liver: a comprehensive systematic review and meta-analysis.","authors":"Ke-Qian Chen, Dan Qiu, Li-Xia Li, Wen-Rui Tang, Shu-Zhi Wang, Xiang Liu","doi":"10.1007/s12072-025-10780-z","DOIUrl":"10.1007/s12072-025-10780-z","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"483"},"PeriodicalIF":5.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}