Hepatology International最新文献

{"title":"Management of acute variceal bleeding: updated APASL guidelines.","authors":"Cosmas Rinaldi Adithya Lesmana, Akash Shukla, Ashish Kumar, Shalimar, Xiaolong Qi, Rino Alvani Gani, Ze-Hao Zhuang, Abdul Kadir Dokmeci, Gin Ho Lo, Hitoshi Maruyama, Ji-Dong Jia, Anand V Kulkarni, Jason Chang, Necati Ormeci, Gamal Shiha, Hasnain Ali Shah, Jose D Sollano, Sahaj Rathi, Tan Soek Siam, George K Lau, Rungsun Rerknimitr, Ming-Chih Hou, Juferdy Kurniawan, Guohong Han, Amar Mukund, Sanjay Saran Baijal, Shiv Kumar Sarin","doi":"10.1007/s12072-025-10894-4","DOIUrl":"10.1007/s12072-025-10894-4","url":null,"abstract":"<p><p>Acute variceal bleeding (AVB) is a common life-threatening complication of portal hypertension (PHT), having a six-week mortality of 10%-20%. Major advances in the hemodynamic management, risk stratification, pharmacotherapy, endoscopy techniques, hemostatic devices and radiological interventions have led to improved management and outcome of AVB patients in the recent past. Therefore, the APASL Portal Hypertension Working Party, chose a panel of experts, primarily from the Asia-Pacific region, to identify important developments and controversial areas in the field of AVB. They discussed through a pre-defined and structured process, advances in the field and proposed updates to the previous APASL AVB guidelines. These included emphasis on safe transportation, defining time frames for AVB episodes and re-bleeding, reporting of clinical outcomes, optimizing early intervention strategies, pharmacotherapy, medical management, endoscopic therapies, and salvage modalities, including TIPS and self-expanding metal stents. The current updates also cover variceal bleeding in special populations and situations, the skill sets required for managing AVB patients, and the research priorities in the field. The updated guidelines are based on the latest evidence and incorporate emerging trends to provide a contemporary template for management of AVB in both patients with cirrhosis and non-cirrhotic portal hypertension.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1003-1031"},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144951755","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":"Response to: Comments on: Functional cure with new antiviral therapy for hepatitis B virus: a systematic review and meta-analysis.","authors":"Jing Chen, George Lau","doi":"10.1007/s12072-025-10873-9","DOIUrl":"10.1007/s12072-025-10873-9","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1262-1263"},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144689996","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":"Reply to letter to the editor \"Comment on: \"Hepatic immune-related adverse event increased the overall survival of patients with malignancies treated with immune checkpoint inhibitors\"\".","authors":"Tatsuo Kanda, Kaori Matsumoto, Shuntaro Obi, Hitoshi Mochizuki, Masao Omata","doi":"10.1007/s12072-025-10887-3","DOIUrl":"10.1007/s12072-025-10887-3","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1258-1259"},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144768594","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":"Preoperative carbohydrate loading reduces perioperative insulin resistance and hastens functional recovery of remnant liver after living donor hepatectomy: An open-label randomized controlled trial.","authors":"Mahendra Kumar, Nilesh Sadashiv Patil, Nihar Mohapatra, Anil Yadav, Gaurav Sindwani, Udit Dhingra, Sherin Thomas, Viniyendra Pamecha","doi":"10.1007/s12072-025-10831-5","DOIUrl":"10.1007/s12072-025-10831-5","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the effect of preoperative carbohydrate (CHO) loading on perioperative insulin resistance (PIR) and outcomes after live donor hepatectomy. The primary objective of the trial was to compare PIR on postoperative day (POD) 2 between preoperative oral carbohydrate (CHO) loading and overnight fasting groups. The secondary objectives were to compare the functional recovery of the remnant liver, incidence of postoperative nausea and vomiting (PONV) up to 72 h after surgery, inflammatory markers, and length of hospital stay (LOS) between both groups.</p><p><strong>Background: </strong>Preoperative fasting increases perioperative insulin resistance (PIR). Insulin resistance has deleterious effects on liver regeneration following partial hepatectomy.</p><p><strong>Methods: </strong>Single-center, open-label, randomized controlled trial. After exclusion, 70 donors were recruited (35 from each group). Donors in the intervention arm received 50 g of maltodextrin at 10 PM the night before surgery and 25 g of maltodextrin 2 h before anesthesia induction on the day of surgery, whereas those in the control arm followed a minimum of 6 h of overnight fasting. The PIR was assessed using the Homeostatic Model for Assessment of Insulin Resistance (HOMA-IR).</p><p><strong>Results: </strong>Baseline and intraoperative parameters were comparable between the two groups. CHO loading provided better postoperative glycemic control (p < 0.01) and reduced PIR by > 50% (p < 0.01) compared to preoperative fasting. Although postoperative complications, inflammatory markers, and LOS were comparable between the groups, there was a significant attenuation of postoperative nausea (p = 0.01) and vomiting (p = 0.013) with early soft diet tolerance (p = 0.002) in the CHO group. In addition, preoperative carbohydrate loading accelerated functional recovery of the remnant liver, with earlier normalization of serum bilirubin levels (p = 0.002).</p><p><strong>Conclusion: </strong>CHO supplementation is safe and effective in shortening preoperative fasting during donor hepatectomy without significant postoperative risks. It can be considered a standard of care in donor surgery ERAS (Enhanced Recovery After Surgery) protocols for live donor liver transplantations.</p><p><strong>Registration number: </strong>NCT05293444 ( www.</p><p><strong>Clinicaltrials: </strong>gov ).</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1151-1161"},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101779","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":"Hepatic irAE, ICI continuation, and survival: need for robust evidence beyond initial observations.","authors":"Lining Huang, Liang Wang, Zhiming Qiao","doi":"10.1007/s12072-025-10853-z","DOIUrl":"10.1007/s12072-025-10853-z","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1252-1253"},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144316781","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":"Hepatitis C virus incidence trend and its risk factors among people who inject drugs in Hai Phong, Vietnam.","authors":"Hong Thi Tran, Huong Thi Duong, Khue Minh Pham, Binh Thanh Nguyen, Roselyne Vallo, Morgana D'Ottavi, Giang Thi Hoang, Vinh Hai Vu, Oanh Thi Hai Khuat, Thanh Tuyet Thi Nham, Duc Quang Nguyen, Catherine Quillet, Delphine Rapoud, Philippe Van de Perre, Jonathan Feelemyer, Laurent Michel, Didier Laureillard, Don Des Jarlais, Jean-Pierre Moles, Nicolas Nagot","doi":"10.1007/s12072-025-10856-w","DOIUrl":"10.1007/s12072-025-10856-w","url":null,"abstract":"<p><strong>Background: </strong>HCV incidence among people who inject drugs (PWID) remains unacceptably high. Using the data from the DRIVE study, we aimed to describe HCV incidence trends and investigate its associated risk factors among PWID in Hai Phong, Vietnam.</p><p><strong>Methods: </strong>Active PWID were recruited through 3 annual respondent-driven sampling (RDS) surveys; part of them were included in the study cohorts. HCV seroincidence was calculated for PWID participating in multiple surveys (recaptures) or in cohorts. A nested case-control design was used for risk factor analysis. Controls were matched to HCV seroconversion cases on age, sex, cohort participation and HCV seroconversion visit. Risk factors were measured over the period preceding the HCV seroconversion visits.</p><p><strong>Results: </strong>There were 83 HCV seroconversions during 844 person-years in 540 included participants. The overall HCV incidence was 9.8/100 person-years (95% CI 7.9-12.2). HCV incidence decreased over follow-up time and was particularly high among PWID living with HIV (PLWH), i.e., 37.2/100 person-years (95% CI 26.4-52.3). HIV infection (OR = 10.0, 95% CI 6.8-16.2) and active heroin injection (OR: 3.2, 95% CI 2.3-4.8) were associated with a higher risk of HCV seroconversion for cohort participants. Among RDS recaptures, living with a sexual partner and currently using methadone had opposite effects on HCV incidence, OR = 2.9, 95% CI 2.2-4.3 and OR = 0.4, 95% CI 0.3-0.5, respectively.</p><p><strong>Conclusion: </strong>HCV incidence among PWID in Hai Phong was still 5 times higher than the WHO target for elimination. Along with strengthened HCV prevention programs, affordable HCV treatment should be made available for PWID to reach the elimination goal.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1077-1086"},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12508010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659099","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":"Antibiotic prophylaxis in upper gastrointestinal bleeding with Child-Pugh A cirrhosis: need for objective infection markers and broader studies.","authors":"Bin Hu","doi":"10.1007/s12072-025-10810-w","DOIUrl":"10.1007/s12072-025-10810-w","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1242-1243"},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143541404","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":"Antibiotic prophylaxis to prevent infection in patients with Child-Pugh A cirrhosis with upper gastrointestinal bleed: an open label randomised controlled trial.","authors":"Anany Gupta, Samagra Agarwal, Sanchit Sharma, Srikanth Gopi, Deepak Gunjan, Anoop Saraya","doi":"10.1007/s12072-024-10767-2","DOIUrl":"10.1007/s12072-024-10767-2","url":null,"abstract":"<p><strong>Background and aims: </strong>Although beneficial in reducing the risk of bacterial infections in patients with advanced decompensated cirrhosis after upper gastrointestinal (GI) bleed, the utility of prophylactic antibiotics in those with Child-Pugh A cirrhosis is not known. We studied if prophylactic antibiotics can be withheld in this cohort.</p><p><strong>Methods: </strong>This was a single-centre, open-label randomised-controlled-trial with non-inferiority design. Patients of Child-Pugh A cirrhosis with upper-GI bleed and hemodynamic stability were randomised to receive either no prophylactic antibiotics (test-group) or ceftriaxone [standard of care (SOC)] for 72 h alongside standard medical management. The primary outcome was infection at day-5 in both arms. Secondary outcomes included failure to control bleed, mortality at day-5, and at 6 weeks.</p><p><strong>Results: </strong>Eligible patients (n = 180; mean age 45.1 ± 13.1 years, 76.9% males; median MELDNa 9 [interquartile-range: 7-12]) of predominant non-viral etiology (alcohol: 43.4%; non-alcoholic steatohepatitis: 21.7%) were randomised, of whom outcomes could be reliably assessed for 172 and 140 patients at 5-day and 6-week follow-up, respectively. Rate of day-5 infections in test-group [7.0% (95% CI 2.8-15.1%)] was non-inferior to SOC arm [11.6% (95% CI 6.02-20.8%); absolute risk difference: -4.7% (95% CI -13.3% to 4.0%; non-inferior at 10% margin)]. Spontaneous bacterial peritonitis following post-bleed ascites was the most common site of infection in both groups (10/16; 66.7%). Rates of failure to control bleed [0% vs 4.9; absolute-risk-difference: -4.6% (95% CI -9.1% to 0.2%)], day-5 mortality [0% vs 2.5%; absolute-risk-difference: -2.3% (-5.5% to 0.9%)], and 6-week mortality [1.4% vs 2.5%; absolute-risk-difference: -1.6% (-6.5% to 3.2%)] were comparable in both arms.</p><p><strong>Conclusion: </strong>Among patients with Child-Pugh A cirrhosis with hemodynamic stability, withholding prophylactic antibiotics after upper GI bleed was not associated with increased risk of post-bleed infections.</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1162-1171"},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921232","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":"Trends in the applications of artificial intelligence in fatty liver diseases.","authors":"Tian-Ao Xie, Li-Li Liufu, Hui-Jin Chen, Hao-Lin Chen, Xin-Ting Hou, Xuan-Rui Wang, Meng-Yi Han, Yu-Kai Shan, Rui-Jing Shen, Zhong-Yu Wu, Shi-Jie Li, Sarun Juengpanich, Win Topatana","doi":"10.1007/s12072-025-10827-1","DOIUrl":"10.1007/s12072-025-10827-1","url":null,"abstract":"<p><strong>Introduction: </strong>Artificial intelligence (AI) has rapidly advanced and shows great potential in the prediction, diagnosis, treatment, and prognosis of fatty liver disease (FLD). This study aims to summarize AI's applications and emerging trends in FLD to inspire future research directions.</p><p><strong>Method: </strong>We analyzed 270 articles sourced from the Web of Science Core Collection published between 2006 and 2024. The study focuses on the medical application of AI in FLD, examining the contributions of authors, institutions, countries, keywords, and cited references.</p><p><strong>Results: </strong>AI is predominantly applied in FLD diagnosis, with progression from simple diagnostic tools to advanced methods for classifying FLD and assessing liver fat content. Moreover, the types of data used in AI development have evolved, incorporating a variety of new image and clinical data sources. AI is also being integrated into drug development and personalized nutritional therapies for FLD. Additionally, researchers are becoming increasingly interested in the application of AI to study FLD genes.</p><p><strong>Conclusion: </strong>We found that the applications of AI in FLD are mainly reflected in the prediction, diagnosis, therapy, and prognosis of FLD. In contrast to traditional medicine, AI has the potential to advance the fields of precision medicine and telemedicine, as well as to conserve additional social resources. Moreover, AI may help medical personnel from the perspective of traditional Chinese medicine, FLD prognosis, and the use of AI to analyze gene prediction and natural language processing (NLP).</p>","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1109-1120"},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143969768","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":"Reply to Letter to the Editor \"Hepatic irAE, ICI continuation, and survival: need for robust evidence beyond initial observations\".","authors":"Tatsuo Kanda, Kaori Matsumoto, Shuntaro Obi, Hitoshi Mochizuki, Masao Omata","doi":"10.1007/s12072-025-10868-6","DOIUrl":"10.1007/s12072-025-10868-6","url":null,"abstract":"","PeriodicalId":12901,"journal":{"name":"Hepatology International","volume":" ","pages":"1254-1255"},"PeriodicalIF":6.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591138","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}