Hepatology Communications最新文献

{"title":"Incidence and diagnostic yield of repeat imaging-based screening for hepatic arteriovenous malformations in patients with HHT.","authors":"Benjamin Cho, Leena Usman, Torianna Lomax Truong, Darcy Phelan, Debajyoti Datta, Mandar A Aras, Steven Hetts, Michael Ohliger, Miles Conrad, Jin Ge","doi":"10.1097/HC9.0000000000001010","DOIUrl":"10.1097/HC9.0000000000001010","url":null,"abstract":"<p><strong>Background and aims: </strong>Hepatic arteriovenous malformations (HAVMs) are a common visceral manifestation of hereditary hemorrhagic telangiectasia that can lead to heart failure and biliary ischemia. Current guidelines recommend baseline hepatic screening in adulthood, but the utility of repeat imaging after an initial negative or nonactionable finding remains unclear. We sought to clarify the prevalence of clinically significant HAVMs following negative or nonactionable imaging.</p><p><strong>Approach and results: </strong>We isolated all adult patients with hereditary hemorrhagic telangiectasia evaluated at the University of California, San Francisco HHT Center of Excellence between 2013 and 2025. HAVM status was determined by natural language processing of unstructured clinical and radiology notes. Of 477 patients, 195 (40.9%) had initial imaging interpreted as either HAVM-negative or nonactionable, defined as HAVM-positive but not clinically significant to warrant further imaging. Of the 195, 30 (15.4%) underwent repeat hepatic imaging. Of the 30, 17 (56.7%) were screened incidentally and 13 (43.3%) were screened due to new signs and/or symptoms. Clinically significant HAVMs were identified in 2 patients, representing a 1.0% frequency of subsequent detection among all patients who were HAVM-negative/nonactionable and 6.7% among those re-imaged. Across 48 total repeat imaging studies, the detection rate per study was 4.2%. Across 386.5 person-years of follow-up, the incidence rate of clinically significant HAVM recognition was 0.52 per 100 person-years.</p><p><strong>Conclusions: </strong>Both instances of HAVM identification reflected evolving clinical features and reinterpretation of prior imaging, not de novo lesion development. These findings support periodic reassessment of initial negative/nonactionable screening studies, with a low threshold for reassessment in the presence of new signs and symptoms.</p>","PeriodicalId":12978,"journal":{"name":"Hepatology Communications","volume":"10 8","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148561850","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":"Running on empty: Fatigue, supplements, and the trials we need.","authors":"Jessica B Rubin","doi":"10.1097/HC9.0000000000001006","DOIUrl":"10.1097/HC9.0000000000001006","url":null,"abstract":"","PeriodicalId":12978,"journal":{"name":"Hepatology Communications","volume":"10 8","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535694","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":"Correspondence: Iron deposition in steatotic liver disease-A matter of compartment, but can it be a target for treatment?","authors":"Noel Ravindranayagam, Karl Vaz, Monique Fernandez, Julie Lokan, Andrew Grigg, Marie Sinclair","doi":"10.1097/HC9.0000000000000995","DOIUrl":"10.1097/HC9.0000000000000995","url":null,"abstract":"","PeriodicalId":12978,"journal":{"name":"Hepatology Communications","volume":"10 8","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148561778","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":"Manufacturing and electrostatic surface optimization of CAR-T cells improve therapeutic efficacy in liver malignancies.","authors":"Linke Bian, Jiufei Zhu, Hongye Wang, Zhaorong Wu, Zhigang Zheng, Yuan Peng, Ying Liu, Xu Fang, Xiaochun Huang, Tianyang Jie, Zheyu Zhang, Hao Zhang, Fan Yang, Dan Cui, Bo Zhai, Feng Xue","doi":"10.1097/HC9.0000000000000982","DOIUrl":"10.1097/HC9.0000000000000982","url":null,"abstract":"<p><strong>Background: </strong>Chimeric antigen receptor T-cell (CAR-T) therapy has achieved remarkable success in hematologic malignancies, yet demonstrates limited efficacy in solid tumors, including hepatic cancers. T-cell exhaustion and insufficient persistence represent major obstacles. We hypothesized that optimizing both manufacturing processes and CAR structural design could reduce exhaustion and enhance therapeutic outcomes in immunocompetent mouse models of primary and metastatic liver malignancies.</p><p><strong>Methods: </strong>We systematically compared antibody-based versus bead-based activation methods, evaluating their effects on T-cell exhaustion phenotypes. Retroviral vector (RVV) production was optimized for murine T-cell transduction, assessing vector stability and T-cell phenotypes. Different cytokine conditions were tested for their impact on T-cell expansion, memory phenotypes, and anti-tumor efficacy using GPC3-targeted CAR-T cells in hepatocellular carcinoma models. Through structural prediction and electrostatic field simulation, we identified that high positive charge patches (PCP) in the EpCAM-targeting G8.8 scFv caused CAR clustering and tonic signaling. We generated charge-optimized variants and evaluated their therapeutic efficacy in an immunocompetent colorectal cancer liver metastasis model.</p><p><strong>Results: </strong>Antibody activation showed superior homogeneity and expansion despite initially higher exhaustion markers, which equilibrated by day 10 without affecting viability. RVV harvested at 72 hours post-transfection yielded optimal titers. RVV remained stable through freeze-thaw cycles. IL-7 supplementation to IL-2 significantly enhanced memory phenotypes, reduced exhaustion, and improved tumor control in GPC3-CAR-T therapy. Electrostatic optimization of G8.8 scFv substantially reduced tonic signaling, decreased T-cell exhaustion, and enhanced anti-tumor efficacy in the MC38-EpCAM model.</p><p><strong>Conclusions: </strong>Systematic optimization of manufacturing conditions and structure-based charge engineering of CAR constructs synergistically enhance therapeutic efficacy against liver malignancies, providing a translatable framework for improving solid tumor CAR-T therapy.</p>","PeriodicalId":12978,"journal":{"name":"Hepatology Communications","volume":"10 8","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148648494","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":"Liver biopsy findings and clinical correlates in immune-mediated liver injury from checkpoint inhibitors.","authors":"Lucy Meunier, David E Kleiner, Benjamin Riviere, Huiman Barnhart, Ronald Kamusiime, Vincent L Chen, Dominique Larrey, Robert J Fontana","doi":"10.1097/HC9.0000000000000988","DOIUrl":"10.1097/HC9.0000000000000988","url":null,"abstract":"<p><strong>Background: </strong>Immune-mediated liver injury from checkpoint inhibitors develops in up to 10% of treated patients. The aim of this study was to describe the relationship between standard liver histopathological findings and clinical presentation and outcomes in a cohort of 67 adult patients.</p><p><strong>Methods: </strong>Liver biopsies from 67 ICI-treated patients enrolled in the Drug-Induced Liver Injury Network and from the Montpellier, France, registry were scored for 42 features. Exploratory analyses of histological features with clinical presentation and outcomes are provided.</p><p><strong>Results: </strong>The median age of patients was 62.5 years, 45% received pembrolizumab, and 24% received ipilimumab-nivolumab. The median latency to liver injury onset was 72 days, and the median time to liver biopsy was 20 days. The 52% with acute hepatocellular injury were significantly younger and had more severe inflammatory scores, granulomas, and necrosis on biopsy than those with mixed- or cholestatic injury, who had more ductular reaction and cholangitis. Patients biopsied on corticosteroids had significantly less severe inflammation, fewer granulomas, and less cholestasis. Mild macrovesicular steatosis was common (65%) and associated with diabetes and patient BMI but not corticosteroid use. Pembrolizumab-treated patients presented later and were more likely to have a cholestatic enzyme pattern and ductular injury on biopsy compared with those with hepatitis from ipilimumab/nivolumab.</p><p><strong>Conclusions: </strong>Liver histology findings were associated with presenting laboratory features in this retrospective, exploratory study of 67 ICI hepatitis patients. Necroinflammatory activity was substantially less in subjects biopsied while on corticosteroids, which may impact clinical management decisions.</p>","PeriodicalId":12978,"journal":{"name":"Hepatology Communications","volume":"10 8","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148561873","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":"Extended haplotypes at the complement factor H gene locus are associated with liver transplant rejection.","authors":"Lianne M Nieuwenhuis, Bao-Li Loza, Stefan P Berger, Bernadien H Jansen, Hans Blokzijl, Mohamed R Daha, Rosa G M Lammerts, Abraham Shaked, Sumeet Asrani, Ton Lisman, Rinse K Weersma, Eleonora A M Festen, Vincent E de Meijer, Felix Poppelaars","doi":"10.1097/HC9.0000000000000997","DOIUrl":"10.1097/HC9.0000000000000997","url":null,"abstract":"<p><strong>Background: </strong>Acute T-cell-mediated rejection (ACR) remains an important complication after liver transplantation. Polymorphisms in the factor H gene (CFH) and factor H-related protein genes (CFHRs) affect the risk of multiple complement-related diseases. Given the complement system's key role in alloimmunity, we hypothesized that variants in CFH and CFHRs associate with ACR risk after liver transplantation.</p><p><strong>Methods: </strong>In 689 donor-recipient pairs, the deletion of CFHR1 and CFHR3 (CFHR3,1Δ), a low-expression variant of CFHR2, and CFH haplotypes were extracted from both donor and recipient genotypes following appropriate imputation and quality control steps.</p><p><strong>Results: </strong>Kaplan-Meier survival curves and multivariable Cox regression analysis showed increased ACR incidence after transplantation of donor livers carrying 2 copies of the CFHR3,1Δ (log-rank p=0.03, HR: 2.76, 95% CI: 1.18-6.45) or the related CFH-H4a haplotype (log-rank p=0.03, HR: 1.65, 95% CI: 1.04-2.63). In contrast, a lower ACR incidence was observed after transplanting donor livers with a low-expressing CFHR2 variant (log-rank p=0.04, HR: 0.66, 95% CI: 0.45-0.96) or the related CFH-H2 haplotype (log-rank p=0.01, HR: 0.58, 95% CI: 0.37-0.92). When analyzing recipient genotypes, only CFHR3,1Δ was associated with ACR (log-rank: p=0.01, HR: 2.55, 95% CI: 1.15-5.65).</p><p><strong>Conclusions: </strong>Common functional variants in the CFH-CFHR region are associated with rejection risk after liver transplantation, highlighting a previously overlooked relevance of the complement system in liver transplantation.</p>","PeriodicalId":12978,"journal":{"name":"Hepatology Communications","volume":"10 8","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148561752","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":"Safety and efficacy of libevitug in patients with chronic hepatitis B and D virus coinfection: A single-center, open-label, phase IIa trial in China.","authors":"Xinrui Wang, Xiumei Chi, Yingyu Zhang, Fei Kong, Xin Zhou, Yumei Gu, Yonghe Qi, Liangfeng Zou, Zhongmin Zhou, Jiaying Wen, Pan Chen, Guangyu Li, Yin Zhang, Bin Ye, Bin Chen, Jianhua Sui, Wenhui Li, Hao Zhou, Junqi Niu","doi":"10.1097/HC9.0000000000000974","DOIUrl":"10.1097/HC9.0000000000000974","url":null,"abstract":"<p><strong>Background: </strong>Chronic HBV and HDV coinfection represents the most severe form of viral hepatitis. This study aimed to assess the safety and efficacy of libevitug (HH-003), a novel human monoclonal antibody targeting the PreS1 domain of the HBV large envelope protein, in patients with chronic HBV and HDV coinfection.</p><p><strong>Methods: </strong>This single-center, open-label, proof-of-concept phase IIa clinical trial enrolled 9 participants who received i.v. infusion of 20 mg/kg libevitug every 2 weeks for 24 weeks, followed by a 24-week follow-up period.</p><p><strong>Results: </strong>At week 24, 8 participants (88.9%) exhibited a reduction in HDV RNA ≥1 log10 from baseline, with 4 (44.4%) achieving undetectable levels. 7 participants (77.8%) achieved virological response (undetectable HDV RNA or ≥2 log10 decline from baseline). Among the 5 participants with elevated baseline ALT, 3 (60.0%) achieved a combined virological and biochemical response (ALT normalization). At week 48, 6 participants (66.7%) maintained the virological response achieved at the end of treatment (week 24), with 3 (33.3%) maintaining undetectable HDV RNA levels. Among the 7 participants with quantifiable HBV DNA at baseline, 2 (28.6%) achieved undetectable HBV DNA or ≥1 log10 reduction at week 24. Serum HBsAg levels remained unchanged throughout the study period. Treatment-emergent adverse events were reported in 8 participants (88.9%), with only 1 participant (11.1%) experiencing treatment-related adverse events. No grade 3 or serious adverse events were reported, and no discontinuations due to adverse events occurred.</p><p><strong>Conclusions: </strong>Libevitug demonstrated promising antiviral activity, achieving substantial HDV RNA reduction, a high rate of ALT normalization, and favorable safety and tolerability in participants with chronic HBV and HDV coinfection.</p>","PeriodicalId":12978,"journal":{"name":"Hepatology Communications","volume":"10 8","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148561876","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":"Efficacy, safety, and pharmacokinetics of rifaximin in pediatric patients with hepatic encephalopathy in Japan: An open-label study.","authors":"Hideaki Okajima, Masashi Tagawa, Masaki Fujisawa, Kaoru Ueda","doi":"10.1097/HC9.0000000000001002","DOIUrl":"10.1097/HC9.0000000000001002","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the efficacy, safety, and pharmacokinetics of rifaximin in children with hepatic encephalopathy (HE).</p><p><strong>Methods: </strong>We conducted a multicenter, open-label, phase II/III study, comprising a 12-week treatment period, in children aged <18 years with hyperammonemia (≥66 μg/dL) and grade I or II HE or suspected HE, and compared the results with those previously obtained in adults. Patients were treated with 400 mg rifaximin 3 times daily, as for adults. The primary endpoint was the blood ammonia concentration, and other endpoints were changes in mental state and number connection test (NCT)-A and -B results from baseline. The safety endpoints were adverse events and fecal microbial composition. The pharmacokinetics of rifaximin were also assessed.</p><p><strong>Results: </strong>Of 21 patients (median age 11.0 years old, Q1-Q3 [8.0-14.0]), 18 completed the study, with a median [Q1-Q3] treatment duration of 84.0 [83.0-85.0] days. The most common underlying disease was a congenital portosystemic shunt. Thirteen patients were suspected of having HE, and 8 were diagnosed with coma grade I. The serum ammonia concentration remained lower than that at baseline during treatment with rifaximin, although the difference did not reach statistical significance. There were significant reductions from baseline in the mental state associated with HE and NCT-B results at all time points. No new clinically relevant safety issues or marked changes in the composition of the gut microbiota were identified.</p><p><strong>Conclusion: </strong>This is the first pediatric clinical study to demonstrate the efficacy, safety, and pharmacokinetics of rifaximin in pediatric patients with HE. The efficacy signals were driven primarily by clinical and neurocognitive measures rather than biochemical (ammonia) changes. The safety and pharmacokinetics of rifaximin were similar to those for adult patients.</p>","PeriodicalId":12978,"journal":{"name":"Hepatology Communications","volume":"10 8","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148561820","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":"The role of ammonia in chronic liver disease.","authors":"Annarein J C Kerbert, Maria Pilar Ballester, Christopher F Rose, Rajiv Jalan","doi":"10.1097/HC9.0000000000000993","DOIUrl":"10.1097/HC9.0000000000000993","url":null,"abstract":"<p><p>Hepatic encephalopathy (HE) is a major neuropsychiatric complication of chronic liver disease that contributes substantially to morbidity, mortality, and healthcare burden. Ammonia, a neurotoxic metabolite, plays a central role in its pathogenesis. Although traditionally considered a byproduct of liver failure, growing evidence supports a more direct and causal role for ammonia, linking it not only to the clinical features of HE but also to key processes involved in disease progression, including liver injury, inflammation, immune dysfunction, muscle wasting, and impaired cellular energetics. Beyond its mechanistic implications, renewed interest has focused on ammonia as a clinically useful biomarker. Advances in risk stratification, dynamic testing, and longitudinal monitoring are improving the ability to use ammonia levels to identify patients at high risk of HE, predict clinical outcomes, and assess response to therapy. At the same time, emerging ammonia-lowering therapies are reshaping the treatment landscape. Whether these therapies may modify disease trajectory, beyond reversing HE, is an interesting hypothesis requiring validation in future studies. This review summarises current knowledge on ammonia metabolism, its role in the pathophysiology of HE and chronic liver disease, and its evolving clinical utility. By integrating molecular mechanisms with advances in measurement and treatment, we propose a reframing of ammonia as a central driver of liver-brain axis dysfunction and a meaningful target for precision-based therapeutic strategies.</p>","PeriodicalId":12978,"journal":{"name":"Hepatology Communications","volume":"10 8","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470285","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":"Vitamin D supplementation is associated with reduced risk of hepatobiliary malignancy in patients with primary sclerosing cholangitis.","authors":"Katherine M Cooper, Connor Mulligan, Henry E Pratt, Vanessa Mitsialis, Daniel S Pratt","doi":"10.1097/HC9.0000000000000929","DOIUrl":"10.1097/HC9.0000000000000929","url":null,"abstract":"<p><strong>Background: </strong>Vitamin D deficiency has been implicated in cancer risk across several organ systems, but its role in hepatobiliary malignancy (HBM) remains unclear. We evaluated whether vitamin D supplementation (VDS) was associated with a lower risk of HBM specifically in patients with primary sclerosing cholangitis (PSC).</p><p><strong>Methods: </strong>Patients enrolled in the PSC registry at our quaternary care and liver transplant (LT) center from 2010 to 2020 were analyzed. The primary exposure was VDS, modeled as a time-dependent variable. The primary outcome was HBM. Inverse probability of treatment weighting (IPTW) was used to balance baseline characteristics, and Cox proportional hazards models were employed to estimate marginal hazard ratios (HRs). Cumulative incidence functionsfor HBM were estimated using a competing risks analysis treating death, and LT was as competing events.</p><p><strong>Results: </strong>A total of 160 patients (mean age 42 years; 66% male) were included, of whom 76 (47.5%) reported baseline VDS. Over a median follow-up of 7 years, 15 patients developed HBM, corresponding to an incidence rate of 12.3 per 1000 person-years. VDS was associated with a significantly lower risk of HBM in both conventional (HR 0.16, 95% CI 0.05-0.57) and IPTW (HR 0.15, 95% CI 0.03-0.41) analyses. This association was consistent across baseline vitamin D strata, including <30 ng/mL (HR 0.12, 95% CI 0.02-0.79) and ≥30 ng/mL (HR 0.18, 95% CI 0.05-0.65). Accounting for competing risks, the 5-year cumulative incidence of HBM was 1.1% among patients receiving VDS versus 11.5% without VDS (p<0.01).</p><p><strong>Discussion: </strong>VDS was associated with a significantly lower risk of HBM in this longitudinally followed cohort of patients with PSC. These findings support the consideration of VDS in all patients with PSC and underscore the need for mechanistic and interventional studies to further evaluate this association.</p>","PeriodicalId":12978,"journal":{"name":"Hepatology Communications","volume":"10 8","pages":""},"PeriodicalIF":6.0,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13671624/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470253","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}