Hepatology Research最新文献

{"title":"Evolving Strategies in HBV Management: Insights From Updated International Guidelines","authors":"Masaru Enomoto,&nbsp;Grace Lai-Hung Wong,&nbsp;Rui Huang,&nbsp;Mindie H. Nguyen","doi":"10.1111/hepr.70205","DOIUrl":"10.1111/hepr.70205","url":null,"abstract":"<div>\u0000 \u0000 <p>Recent updates to the international guidelines for chronic hepatitis B virus (HBV) infection reflect evolving concepts in disease monitoring and antiviral treatment strategies. The 2024–2025 guidelines from the World Health Organization (WHO), the European Association for the Study of the Liver (EASL), and the American Association for the Study of Liver Diseases (AASLD) incorporate new evidence on treatment eligibility, biomarkers, and long-term management of nucleos(t)ide analogue (NA) therapy. A key shift across these guidelines is the expansion of treatment eligibility beyond traditional alanine aminotransferase and HBV DNA thresholds, with increasing emphasis on fibrosis stage, age, and risk-based assessment. Emerging viral biomarkers—including quantitative HBsAg, HBV RNA, and HBcrAg—are also gaining attention as tools to refine disease stratification and guide treatment decisions, although their recommended roles vary among guidelines. Another area of evolving practice involves the concept of finite NA therapy. Although long-term antiviral therapy remains the standard approach, selected patients may be considered for treatment withdrawal under careful monitoring. However, recommendations differ substantially across guidelines, with WHO adopting a more conservative position, whereas EASL and AASLD allow individualized consideration of treatment discontinuation in selected noncirrhotic patients. Overall, these updated guidelines highlight both areas of convergence and ongoing controversy in HBV management. Understanding these differences is essential for clinicians to interpret guideline recommendations in the context of local practice settings and to guide future research aimed at achieving functional cure.</p>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"56 7","pages":"1070-1078"},"PeriodicalIF":3.7,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147963561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective Seroepidemiological Study of Hepatitis E Virus Infection in an Occupational Health-Checkup Cohort in Mie Prefecture, Japan.","authors":"Tatsunori Nakano, Masaharu Takahashi, Yoshinori Itani, Kiriha Suzaki, Kaho Tanaka, Rune Fujimoto, Kazumoto Murata, Hiroaki Okamoto","doi":"10.1111/hepr.70233","DOIUrl":"10.1111/hepr.70233","url":null,"abstract":"<p><strong>Aims: </strong>Reported cases of hepatitis E have increased in Japan; however, the true burden of hepatitis E virus (HEV) infection is likely underestimated due to the high proportion of asymptomatic infections. We prospectively evaluated anti-HEV immunoglobulin G (IgG) seroprevalence, seroconversion-based incidence, and questionnaire-reported exposures in an occupational health-checkup cohort in Mie Prefecture, central Japan.</p><p><strong>Methods: </strong>A total of 608 individuals (189 men and 419 women) who underwent annual health checkups between fiscal years 2023 and 2025 were included. Serum anti-HEV IgG was measured. At baseline, participants completed a 10-item questionnaire on potential HEV-related exposures. Incident infection was evaluated by identifying IgG seroconversion during follow-up.</p><p><strong>Results: </strong>Anti-HEV IgG was detected in 5 of 608 participants (0.82%), all of whom were men (5/189, 2.65% vs. 0/419 women, 0%; p = 0.0028). Age was not significantly associated with IgG seropositivity. As no women were seropositive, exploratory age-adjusted analyses were conducted among men only; no questionnaire item was significantly associated with IgG positivity. Sex differences were observed in reported consumption of pork liver/offal, pork tongue, and venison/wild boar meat. One participant seroconverted during follow-up, corresponding to an incidence of 138 per 100,000 (1/724; 95% CI, 3-770) person-years. The seroconverter reported frequent consumption of raw or undercooked pork products.</p><p><strong>Conclusions: </strong>Anti-HEV IgG seroprevalence was low in this relatively young, predominantly female cohort. However, prospective follow-up identified incident infections, with an incidence consistent with previous domestic estimates, suggesting that a substantial proportion of the Japanese population remains at risk of HEV infection.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148396705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suppression of Indoleamine 2,3-Dioxygenase Enhances Immune Responses to the Therapeutic Vaccine for Chronic Hepatitis B","authors":"Yohei Shirakami,&nbsp;Soranobu Ninomiya,&nbsp;Takayasu Ideta,&nbsp;Ayumu Kanbe,&nbsp;Toshihide Maeda,&nbsp;Daisuke Minowa,&nbsp;Daisuke Taguchi,&nbsp;Masaya Kubota,&nbsp;Hiroyasu Sakai,&nbsp;Kenji Imai,&nbsp;Yasuko Yamamoto,&nbsp;Hiroyasu Ito,&nbsp;Kuniaki Saito,&nbsp;Osamu Yoshida,&nbsp;Yoichi Hiasa,&nbsp;Masahito Shimizu","doi":"10.1111/hepr.70165","DOIUrl":"10.1111/hepr.70165","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Chronic hepatitis B virus (HBV) infection remains a major cause of liver cirrhosis and hepatocellular carcinoma. NASVAC is a therapeutic vaccine containing hepatitis B surface antigen (HBsAg) and hepatitis B core antigen (HBcAg), which has shown clinical potential to induce loss of HBsAg and acquisition of anti-HBs antibodies. Indoleamine 2,3-dioxygenase (IDO), an enzyme that degrades tryptophan into kynurenine, plays a key role in viral persistence by suppressing effector T cell activity and promoting immunoregulatory pathways. This study aimed to elucidate the role of IDO in modulating immune responses to NASVAC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Wild-type and IDO knockout (KO) mice were immunized with NASVAC, and some wild-type mice received an IDO inhibitor. Serum amino acids and anti-HBc and anti-HBs titers, cellular immune responses, splenic CD4/CD8 T cell ratios, and IL-2 production from splenocytes were assessed. Additionally, pretreatment and posttreatment serum samples from NASVAC clinical trial were analyzed for tryptophan and kynurenine levels to assess their association with the efficacy of vaccination.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Genetic deletion of IDO markedly enhanced NASVAC-induced humoral and cellular immune responses in mice, whereas pharmacological inhibition partially increased cellular responses. NASVAC treatment modulated the splenic CD4/CD8 ratio, with more pronounced effects in IDO-KO mice. In human participants, lower pretreatment serum kynurenine level was associated with successful acquisition of anti-HBs following NASVAC administration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These findings suggest that IDO activity negatively regulates both humoral and cellular immune responses to NASVAC. Modulation or suppression of IDO may potentially enhance the therapeutic efficacy of NASVAC, and serum kynurenine may represent a predictive biomarker for treatment outcomes in chronic HBV infection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Registry and the Registration No. of the study/trial</h3>\u0000 \u0000 <p>The clinical trial was registered in the UMIN Clinical Trials Registry (no. UMIN000027442) and the Japan Registry of Clinical Trials (no. jRCTs061180100).</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"56 7","pages":"1140-1151"},"PeriodicalIF":3.7,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hepr.70165","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147493383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-MRPS27 Antibody: A Novel Diagnostic Biomarker for Autoimmune Hepatitis Identified via a Human Proteome Microarray","authors":"Jun Wada,&nbsp;Kazumichi Abe,&nbsp;Naoto Abe,&nbsp;Tatsuro Sugaya,&nbsp;Yosuke Takahata,&nbsp;Masashi Fujita,&nbsp;Manabu Hayashi,&nbsp;Yoshihiro Nozawa,&nbsp;Hiromasa Ohira","doi":"10.1111/hepr.70169","DOIUrl":"10.1111/hepr.70169","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To identify autoimmune hepatitis (AIH)-specific autoantibodies using a high-content human protein microarray and evaluate their diagnostic performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Pretreatment sera from untreated patients with AIH (<i>n</i> = 68), primary biliary cholangitis (PBC, <i>n</i> = 19), metabolic dysfunction-associated steatotic liver disease (MASLD, <i>n</i> = 39), chronic hepatitis C (CHC, <i>n</i> = 27), and drug-induced liver injury (DILI, <i>n</i> = 18) and healthy controls (HC, <i>n</i> = 37) were screened with a wheat-germ, cell-free microarray displaying &gt; 16,000 proteins. Candidate antigens were validated by ELISA, and antibody titers were correlated with clinical variables, treatment response, and outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Mitochondrial ribosomal protein S27 (MRPS27) emerged as the dominant AIH-associated antigen. The mean anti-MRPS27 antibody titer in untreated patients with AIH (50.2 AU) exceeded that in patients with PBC (9.3 AU), MASLD (12.8 AU), CHC (24.8 AU), DILI (19.8 AU), and HC (7.5 AU, all <i>p</i> &lt; 0.01). A cutoff of 35.4 AU (HC mean + 2 SD) yielded a sensitivity of 61.8%, a specificity of 87.1%, a positive predictive value of 70.0%, and a negative predictive value of 82.4%. Positivity was unrelated to baseline histology, biochemistry or IgG, and titers were unchanged after corticosteroid induction. Interestingly, patients with low titers experienced more liver-related events during follow-up.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The anti-MRPS27 antibody is a promising adjunctive serological marker that enhances the specificity of AIH diagnosis. The pathogenic significance and prognostic value of this antibody warrant prospective validation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"56 7","pages":"1127-1139"},"PeriodicalIF":3.7,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147503646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking Progression in Hepatocellular Carcinoma: Is Oligoprogression a Window for Local Ablation?","authors":"Hisashi Hidaka","doi":"10.1111/hepr.70218","DOIUrl":"10.1111/hepr.70218","url":null,"abstract":"","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"56 7","pages":"1067-1069"},"PeriodicalIF":3.7,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148217043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Statin Use Is Associated With Improved Survival But Not Progression-Free Outcomes in Patients With Unresectable Hepatocellular Carcinoma Receiving Atezolizumab-Bevacizumab.","authors":"Toshinori Toyota, Satoshi Narahara, Haruki Uojima, Yuki Kitano, Takahiro Mizuta, Daiki Maeda, Soutarou Kurano, Kentaro Tanaka, Hiroki Inada, Munenori Honda, Yoko Yoshimaru, Takehisa Watanabe, Katsuya Nagaoka, Hiroko Setoyama, Hiromitsu Hayashi, Takanori Suzuki, Kentaro Matsuura, Shuichiro Iwasaki, Nao Nomura, Shiho Miyase, Hideto Yuruki, Yoshinari Sakai, Koichi Kudo, Hisashi Hidaka, Masaaki Iwatsuki, Yasuhito Tanaka","doi":"10.1111/hepr.70232","DOIUrl":"https://doi.org/10.1111/hepr.70232","url":null,"abstract":"<p><strong>Aim: </strong>Statins contribute to the preservation of hepatic function and reduce the risk of hepatocellular carcinoma (HCC) in patients with chronic liver disease; however, their clinical significance during systemic therapy for unresectable HCC remains unclear. Therefore, we investigated whether baseline statin use influences clinical outcomes in patients with unresectable HCC treated with atezolizumab plus bevacizumab.</p><p><strong>Methods: </strong>We conducted a multicenter, retrospective cohort study of patients with unresectable HCC treated with atezolizumab-bevacizumab. Patients were classified as statin users or non-users at treatment initiation. The primary outcome was overall survival (OS), and secondary outcomes included progression-free survival (PFS) and post-progression survival (PPS). To adjust for baseline imbalances, inverse probability of treatment weighting (IPTW) was applied, and propensity score (PS) matching was performed as a sensitivity analysis.</p><p><strong>Results: </strong>A total of 284 patients were included, of whom 50 received statins. In the unadjusted cohort, OS was significantly longer in statin users than in non-users (p = 0.026). After IPTW adjustment, this OS benefit remained significant (p = 0.031). In contrast, PFS did not differ significantly between groups in either the unadjusted (p = 0.291) or IPTW-adjusted cohorts (p = 0.117). PPS was significantly prolonged in the statin group (p = 0.006), with consistent findings after IPTW adjustment (p = 0.018). In addition, deterioration in ALBI score was attenuated in statin users, suggesting better preservation of hepatic functional reserve.</p><p><strong>Conclusions: </strong>Statin use was associated with significantly improved OS and PPS without affecting PFS, likely reflecting host-related benefits through preservation of hepatic function.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148390463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to the Letter Regarding \"Efficacy and Safety of Hypofractionated Radiation Therapy Combined With Immunotherapy for Hepatocellular Carcinoma With Vp4 Portal Vein Tumor Thrombosis\".","authors":"Masahiko Tameda, Hayato Nakagawa","doi":"10.1111/hepr.70236","DOIUrl":"https://doi.org/10.1111/hepr.70236","url":null,"abstract":"","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148375265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Interval as a Prognostic Marker in Patients Undergoing Repeated Curative-Intent Local Treatment for Recurrent Hepatocellular Carcinoma.","authors":"Katsunori Sakamoto, Tomoaki Yoh, Satoshi Nomura, Kentaro Kadono, Hidenobu Kojima, Asahi Sato, Shoichi Kageyama, Hirofumi Hirao, Takahiro Nishio, Shinya Okumura, Daisuke Ueda, Masayuki Okuno, Hiroto Nishino, Kei Yamane, Masaaki Hirata, Satoshi Ogiso, Tatsuya Okamoto, Kazuyuki Nagai, Yoichiro Uchida, Takashi Ito, Takamichi Ishii, Etsuro Hatano","doi":"10.1111/hepr.70235","DOIUrl":"https://doi.org/10.1111/hepr.70235","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to investigate the prognostic impact of the interval between curative-intent local treatments in patients undergoing repeated therapies for recurrent hepatocellular carcinoma after hepatectomy.</p><p><strong>Methods: </strong>The present retrospective cohort study included 890 patients who underwent hepatectomy for HCC at our hospital between 2001 and 2020. Overall survival (OS) was evaluated from the time of each curative-intent local treatment, according to the number of treatments received and the intervals between consecutive curative-intent treatments for intrahepatic recurrence, up to the fourth session.</p><p><strong>Results: </strong>During follow-up, 625 patients (65.9%) developed intrahepatic recurrence. The median intervals gradually shortened to 24.9, 14.5, 12.4, and 12.8 months from hepatectomy to the first curative treatment, from the first to the second, from the second to the third, and from the third to the fourth treatments, respectively. For the first and second curative treatments, the pretreatment interval was not an independent predictor of OS. At the third curative treatment, an interval < 18.6 months between the second and third curative treatments independently predicted poorer OS (hazard ratio [HR] 2.280 and 95% confidence interval [CI] 1.046-4.967). For the fourth curative treatment, an interval < 14.1 months between the third and fourth treatments was an independent adverse prognostic factor (HR 4.961, 95% CI 1.607-15.319). The prognostic impact of treatment interval was more pronounced in patients who underwent ≥ 3 treatments, with a significant interaction compared with < 3 treatments.</p><p><strong>Conclusions: </strong>Among patients who remained eligible for repeated curative-intent local treatment, a shortened interval between treatments in late-phase recurrence was an independent predictor of poor prognosis.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148360587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on \"The Advanced Lung Cancer Inflammation Index as a Prognostic Indicator in Patients With Unresectable Hepatocellular Carcinoma Receiving Atezolizumab and Bevacizumab Therapy\".","authors":"Yingzhe Zhang","doi":"10.1111/hepr.70227","DOIUrl":"https://doi.org/10.1111/hepr.70227","url":null,"abstract":"","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biliary Abnormality on Imaging During Lenvatinib Plus Hepatic Arterial Infusion Chemotherapy With Cisplatin for Hepatocellular Carcinoma: A Pilot Descriptive Study.","authors":"Hirohito Osanai, Kazuto Kozaka, Takashi Matsubara, Norihide Yoneda, Takahiro Ogi, Kenichiro Okumura, Atsushi Takamatsu, Azusa Kitao, Shintaro Yagi, Taro Yamashita, Satoshi Kobayashi","doi":"10.1111/hepr.70228","DOIUrl":"https://doi.org/10.1111/hepr.70228","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the frequency, imaging characteristics, associated factors, and clinical significance of biliary abnormalities on imaging in patients receiving lenvatinib (LEN) plus cisplatin hepatic arterial infusion chemotherapy (HAIC) for hepatocellular carcinoma (HCC).</p><p><strong>Methods: </strong>This retrospective single-center study included 62 patients with HCC treated with LEN + Cisplatin HAIC. Three radiologists reviewed dynamic contrast-enhanced CT and gadoxetic acid-enhanced MRI to identify biliary findings. The incidence, associated factors, and clinical courses were examined.</p><p><strong>Results: </strong>Sixty-two patients with HCC underwent 295 CT and 59 MRI examinations during a median follow-up of 21 weeks. Biliary abnormalities were observed in 58.1% (36/62) of patients at a median of 6 weeks after treatment initiation. Hilar bile duct wall thickening occurred in 24.2% (15/62), hilar bile duct stricture in 14.5% (9/62), biloma in 1.6% (1/62), and gallbladder wall thickening in 35.5% (22/62). Initial treatment response per mRECIST was associated with biliary abnormalities (adjusted odds ratio: 5.19, p = 0.011). Symptoms developed in 22.2% (8/36) of patients with imaged biliary abnormalities. Symptom occurrence varied by imaging patterns: all 15 patients with bile duct wall thickening remained asymptomatic, whereas 40% (4/10) of those with bile duct stricture or biloma developed jaundice or cholangitis, requiring biliary interventions in three patients. Cholecystitis occurred in 18.2% (4/22) of patients with gallbladder wall thickening.</p><p><strong>Conclusions: </strong>A substantial proportion of patients treated with LEN + Cisplatin HAIC developed biliary abnormalities on imaging, particularly those with an initial treatment response. Most abnormalities were asymptomatic; however, bile duct stricture may represent a crucial imaging finding even in the absence of symptoms.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148307981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}