Hepatology Research最新文献

{"title":"Association of proteinuria with improved prognosis in unresectable hepatocellular carcinoma treated with atezolizumab and bevacizumab, and the predictive role of serum vascular endothelial growth factor D levels: A multicenter retrospective study","authors":"Zijian Yang,&nbsp;Goki Suda,&nbsp;Takuya Sho,&nbsp;Osamu Maehara,&nbsp;Masatsugu Ohara,&nbsp;Tomoka Yoda,&nbsp;Qingjie Fu,&nbsp;Takashi Sasaki,&nbsp;Risako Kohya,&nbsp;Sonoe Yoshida,&nbsp;Shunichi Hosoda,&nbsp;Takashi Kitagataya,&nbsp;Naoki Kawagishi,&nbsp;Masato Nakai,&nbsp;Mitsuteru Natsuizaka,&nbsp;Koji Ogawa,&nbsp;Shunsuke Ohnishi,&nbsp;Yoshiya Yamamoto,&nbsp;Masaru Baba,&nbsp;Ren Yamada,&nbsp;Tomoe Kobayashi,&nbsp;Minhu Chen,&nbsp;Naoya Sakamoto,&nbsp;for the NORTE Study Group","doi":"10.1111/hepr.14139","DOIUrl":"10.1111/hepr.14139","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Atezolizumab/bevacizumab is a first-line therapy for unresectable hepatocellular carcinoma (HCC). Among several adverse events, grade ≥2 proteinuria is considered a significant adverse event that may cause bevacizumab interruption. Studies have shown that proteinuria might predict improved prognosis, although data are scarce and the association remains controversial, and the mechanisms and predictive factors remain unclear. We aimed to clarify these.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this multicenter retrospective study, we screened patients with HCC treated with atezolizumab/bevacizumab. The prognostic impact of grade ≥2 proteinuria was examined in patients with proper clinical data and preserved serum for growth factor analysis. For biomarker analysis predicting proteinuria, baseline serum vascular endothelial growth factor (VEGF)-A, VEGF-C, and VEGF-D levels were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study included 75 patients, and 32 (42.7%) experienced grade ≥2 proteinuria. No significant differences were observed between those with or without proteinuria, except for aspartate transaminase and alanine transaminase levels. Time-dependent Cox proportional hazards analysis revealed that grade ≥2 proteinuria was significantly associated with better prognosis (hazard ratio 0.221; 95% confidence interval 0.082–0.592; <i>p</i> = 0.003). In biomarker analysis, low baseline serum VEGF-C and VEGF-D levels were significantly associated with proteinuria, and multivariate analysis demonstrated that baseline serum VEGF-D level was significantly associated with grade ≥2 proteinuria (hazard ratio 0.101; 95% confidence interval 0.029–0.357; <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Grade ≥2 proteinuria in patients with unresectable HCC treated with atezolizumab/bevacizumab indicates a better prognosis, and baseline serum VEGF-D levels can help predict its occurrence. These findings can help in managing adverse events and prognosis in advanced HCC treated with atezolizumab/bevacizumab.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"55 3","pages":"433-443"},"PeriodicalIF":3.9,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142710024","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":"Efficacy of durvalumab plus tremelimumab treatment for unresectable hepatocellular carcinoma in immunotherapy era clinical practice","authors":"Atsushi Hiraoka,&nbsp;Toshifumi Tada,&nbsp;Masashi Hirooka,&nbsp;Kazuya Kariyama,&nbsp;Joji Tani,&nbsp;Masanori Atsukawa,&nbsp;Koichi Takaguchi,&nbsp;Ei Itobayashi,&nbsp;Shinya Fukunishi,&nbsp;Kunihiko Tsuji,&nbsp;Toru Ishikawa,&nbsp;Kazuto Tajiri,&nbsp;Hideko Ohama,&nbsp;Hidenori Toyoda,&nbsp;Chikara Ogawa,&nbsp;Takashi Nishimura,&nbsp;Takeshi Hatanaka,&nbsp;Satoru Kakizaki,&nbsp;Kazuhito Kawata,&nbsp;Atsushi Naganuma,&nbsp;Hisashi Kosaka,&nbsp;Tomomitsu Matono,&nbsp;Hidekatsu Kuroda,&nbsp;Yutaka Yata,&nbsp;Hiroki Nishikawa,&nbsp;Michitaka Imai,&nbsp;Tomoko Aoki,&nbsp;Hironori Ochi,&nbsp;Fujimasa Tada,&nbsp;Shinichiro Nakamura,&nbsp;Yoshiko Nakamura,&nbsp;Kazuhiro Nouso,&nbsp;Asahiro Morishita,&nbsp;Norio Itokawa,&nbsp;Tomomi Okubo,&nbsp;Taeang Arai,&nbsp;Akemi Tsutsui,&nbsp;Takuya Nagano,&nbsp;Kazunari Tanaka,&nbsp;Hironori Tanaka,&nbsp;Yuichi Koshiyama,&nbsp;Yuki Kanayama,&nbsp;Hidenao Noritake,&nbsp;Hirayuki Enomoto,&nbsp;Masaki Kaibori,&nbsp;Yoichi Hiasa,&nbsp;Masatoshi Kudo,&nbsp;Takashi Kumada,&nbsp;RELPEC Group and HCC 48 Group","doi":"10.1111/hepr.14136","DOIUrl":"10.1111/hepr.14136","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Since the development of tremelimumab plus durvalumab (Dur/Tre) for unresectable hepatocellular carcinoma (uHCC), it has been used as not only an initial but also later line treatment in clinical practice. This study aimed to elucidate clinical prognostic factors for progression-free survival (PFS) in Dur/Tre treatment cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Enrolled were 183 uHCC patients treated with Dur/Tre from 2023 to May 2024 (median age, 74 years; male patients, 152; Child–Pugh class A:B, 150:33; Barcelona Clinic Liver Cancer stage B:C, 59:124; initial line use, 64). Clinical factors with prognostic influence on PFS in these patients were retrospectively evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median observation period was 7.2 months (interquartile range, 3.2–10.4). History of atezolizumab plus bevacizumab (Atz/Bev) treatment was the only significant prognostic factor for PFS at introduction of Dur/Tre in multivariate analysis (hazard ratio 2.040, <i>p</i> = 0.028) (median PFS: without vs. with = 5.6 vs. 2.7 months, <i>p</i> &lt; 0.001). Although immune-mediated adverse events (imAE) occurrence was only significant in univariate analysis, when objective response and disease control rates were examined according to imAE positivity (any grade) at the time of analysis, those were noted in 14.4% and 39.2%, respectively, of patients without imAE, while in patients with imAE (any grade), they were noted in 18.2% and 56.1%, respectively (<i>p</i> = 0.523 and <i>p</i> = 0.038, respectively).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>History of Atz/Bev treatment may be an independent clinical factor for poor PFS at Dur/Tre introduction.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"55 3","pages":"444-453"},"PeriodicalIF":3.9,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hepr.14136","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142619102","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":"Refining the predictive utility of aspartate aminotransferase to platelet ratio index in nonalcoholic fatty liver disease patients with COVID-19","authors":"Kengo Matsumoto,&nbsp;Tsutomu Nishida","doi":"10.1111/hepr.14137","DOIUrl":"10.1111/hepr.14137","url":null,"abstract":"","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"55 3","pages":"465-467"},"PeriodicalIF":3.9,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604402","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":"Distinct characteristics of MetALD (metabolic dysfunction-associated steatotic liver disease with greater alcohol consumption) in the general population","authors":"Eileen L. Yoon,&nbsp;Huiyul Park,&nbsp;Han Pyo Hong,&nbsp;Chul-Min Lee,&nbsp;Mimi Kim,&nbsp;Bo-Kyeong Kang,&nbsp;Dae Won Jun","doi":"10.1111/hepr.14133","DOIUrl":"10.1111/hepr.14133","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The term MetALD has been introduced to describe individuals who have metabolic dysfunction-associated steatotic liver disease (MASLD) with greater alcohol consumption, according to the new nomenclature for steatotic liver disease (SLD). This study aims to evaluate the prevalence and clinical characteristics of MetALD in the general population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study is a retrospective, cross-sectional analysis that utilizes the population-based data from the Korea National Health and Nutrition Examination Survey (KNHANES) undertaken between 2019 and 2021. A total of 16 521 participants aged over 18 years were included in the analysis. The presence of hepatic steatosis was determined based on a hepatic steatosis index of 36 or higher.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The prevalence of MetALD was 2.8% (95% confidence interval, 2.5–3.2). Individuals with MetALD were predominantly men (85.4%) and tended to be younger compared to those with MASLD. They showed a higher prevalence of hypertension and had significantly higher levels of fasting glucose, triglycerides, high-density lipoprotein cholesterol, and creatinine compared to individuals with MASLD. The average daily total energy intake was higher in the MetALD group. In addition, the MetALD group had a lower proportion of unemployment with higher income compared to the MASLD group.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients with MetALD showed distinct clinical characteristics from those with MASLD. The characteristics of MetALD were similar to those with alcohol-related liver disease. Further analysis of MetALD across various regions and ethnic groups would be needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"55 3","pages":"410-421"},"PeriodicalIF":3.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hepr.14133","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582018","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":"Unveiling the dynamics of hepatitis C virus transmission among injection drug users and men who have sex with men: A comprehensive study in Japan","authors":"Zayar Phyo,&nbsp;Satoshi Tanaka,&nbsp;Aya Sugiyama,&nbsp;Ko Ko,&nbsp;Kazuaki Takahashi,&nbsp;Ulugbek Khudayberdievich Mirzaev,&nbsp;Golda Ataa Akuffo,&nbsp;Chanroth Chhoung,&nbsp;Tomoyuki Akita,&nbsp;Miho Kozuki,&nbsp;Ryotaro Sakamori,&nbsp;Junko Tanaka","doi":"10.1111/hepr.14135","DOIUrl":"10.1111/hepr.14135","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>In Japan, despite low nationwide hepatitis C (HCV) incidence, new infections among people who inject drugs (PWID) and men who have sex with men (MSM) hinder HCV elimination. We explored HCV transmission dynamics and screened HCV recombination within these populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This cross-sectional study recruited HCV-infected patients from Osaka National Hospital, Osaka, Japan, from January 2010 to September 2023. Data from questionnaires and medical records were analyzed. Serum samples collected before anti-HCV treatment underwent HCV RNA extraction, and sequencing of full core (576 bp) and NS5B (267 bp) regions using the Sanger method. Genotype distribution was determined by phylogenetic analysis, and recombinant screening was conducted.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 115 patients were categorized into non-MSM PWID (31), MSM PWID (15), MSM non-PWID (25), and non-MSM non-PWID (44). Positive amplification rates were 99.1% (114/115) for the full-core region, and 96.5% (111/115) for NS5B. No intergenotypic recombination was detected. The predominant genotype in non-MSM PWID was 2a (58%), whereas genotype 1b was most common in MSM PWID, MSM non-PWID, and non-MSM non-PWID groups (79%, 64%, and 68%, respectively). Nucleotide sequence similarity of 94.75%–100% was found in HCV strains from MSM PWID and MSM non-PWID in both full-core and NS5B regions, whereas strains from non-MSM PWID and non-MSM non-PWID were distinct.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The findings suggest that the transmission route in PWID is determined by MSM status, whereas MSM groups showed the same transmission route regardless of PWID. HCV control measures should be focused not only on PWID, but also on MSM to achieve HCV elimination in Japan.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"55 3","pages":"333-345"},"PeriodicalIF":3.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hepr.14135","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567330","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":"Risk model for predicting failure to rescue after hepatectomy: Cohort study of 1371 consecutive patients","authors":"Jiro Kimura,&nbsp;Kosei Takagi,&nbsp;Yuzo Umeda,&nbsp;Tomokazu Fuji,&nbsp;Kazuya Yasui,&nbsp;Motohiko Yamada,&nbsp;Takeyoshi Nishiyama,&nbsp;Yasuo Nagai,&nbsp;Noriyuki Kanehira,&nbsp;Toshiyoshi Fujiwara","doi":"10.1111/hepr.14134","DOIUrl":"10.1111/hepr.14134","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Although hepatectomy is a complex surgical procedure, its incidence among older patients has increased due to global aging. However, few studies have focused on the association between age and failure to rescue (FTR) posthepatectomy. This study aimed to investigate the association between age and FTR and develop a risk model for FTR following hepatectomy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analyzed a total of 1371 consecutive patients who underwent primary hepatectomy between July 2003 and September 2022. The patients were divided into three groups according to their age: young-old (&lt;65 years), pre-old (65–74 years), and old group (≥75 years). Additionally, the associations among age, FTR, and risk factors for FTR were investigated. Subsequently, a risk model was developed to predict the FTR.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 1371 patients, 373 (27.2%) experienced major complications, and FTR occurred in 15 patients. The older group showed a higher FTR rate (8.4%) than the young-old (1.3%) and pre-old (4.3%) groups (<i>p</i> = 0.03). Multivariate analyses indicated that older age (odds ratio [OR] 1.07; 95% confidence interval [CI] 1.00–1.15; <i>p</i> = 0.045) and American Society of Anesthesiologists Physical Status score ≥3 (OR 4.35; 95% CI 1.24–15.2; <i>p</i> = 0.02) were independent predictive factors for FTR. The risk model exhibited an accuracy with an area under the curve of 0.80 (95% CI 0.69–0.92). Calibration plots of the model revealed a concordance index of 0.73.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study identified an association between age, FTR, and risk factors for FTR posthepatectomy. Together, our risk model is a clinically relevant, internally validated, and useful tool for predicting FTR posthepatectomy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"55 3","pages":"454-464"},"PeriodicalIF":3.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hepr.14134","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564369","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":"Diagnostic accuracy of hepatitis E virus antibody tests: A comprehensive meta-analysis","authors":"Ulugbek Khudayberdievich Mirzaev,&nbsp;Yayoi Yoshinaga,&nbsp;Mirzarakhim Baynazarov,&nbsp;Serge Ouoba,&nbsp;Ko Ko,&nbsp;Zayar Phyo,&nbsp;Chanroth Chhoung,&nbsp;Golda Ataa Akuffo,&nbsp;Aya Sugiyama,&nbsp;Tomoyuki Akita,&nbsp;Kazuaki Takahashi,&nbsp;Shingo Fukuma,&nbsp;Junko Tanaka","doi":"10.1111/hepr.14132","DOIUrl":"10.1111/hepr.14132","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Hepatitis E virus (HEV) is a major global health issue, with an estimated 20 million infections annually. Although polymerase chain reaction (PCR) is the diagnostic gold standard due to its precision, it is expensive and technically demanding. Antibody tests offer a more practical and cost-effective alternative, although their accuracy can vary due to factors, such as test manufacturer, antigen composition, HEV genotype, and host immune status.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive search was conducted in PubMed, Cochrane, Scopus, and Web of Science databases. Studies included comparing the sensitivity and specificity of immunoglobulin M or immunoglobulin G antibody tests to PCR. Exclusion criteria were non-PCR comparisons, sample sizes under 10, IgA or antigen tests, non-human samples, or missing sensitivity and specificity data. Only English-language full-texts or abstracts were considered. Data analysis was performed using Meta-DTA v2.1.1 and Stata 16.0.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The meta-analysis evaluated 8054 blood samples from 21 studies. Immunoglobulin M antibody tests demonstrated an overall sensitivity of 83% (95% CI 76–88) and specificity of 98% (95% CI 97–99). Immunoglobulin G tests showed a sensitivity of 74% (95% CI 62–82) and specificity of 89% (95% CI 84–93). Among manufacturers, Wantai was the most accurate for immunoglobulin M detection, whereas MP led for immunoglobulin G. Notably, test sensitivity improved when the test protein genotype aligned with the HEV genotype.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This meta-analysis confirmed that antibody assays have a good sensitivity and high specificity to detect HEV infection in situations where PCR is not feasible, highlighting their potential as a practical diagnostic tool.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"55 3","pages":"346-362"},"PeriodicalIF":3.9,"publicationDate":"2024-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hepr.14132","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142564368","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":"Factors involved in gastroesophageal varix-related events in patients with hepatitis C virus-related compensated and decompensated cirrhosis after direct-acting antiviral therapy","authors":"Yuki Tahata,&nbsp;Hayato Hikita,&nbsp;Satoshi Mochida,&nbsp;Nobuyuki Enomoto,&nbsp;Norifumi Kawada,&nbsp;Akio Ido,&nbsp;Daiki Miki,&nbsp;Masayuki Kurosaki,&nbsp;Hitoshi Yoshiji,&nbsp;Ryotaro Sakamori,&nbsp;Hidekatsu Kuroda,&nbsp;Hiroshi Yatsuhashi,&nbsp;Taro Yamashita,&nbsp;Yoichi Hiasa,&nbsp;Naoya Kato,&nbsp;Hisamitsu Miyaaki,&nbsp;Yoshiyuki Ueno,&nbsp;Yoshito Itoh,&nbsp;Kentaro Matsuura,&nbsp;Taro Takami,&nbsp;Yasuhiro Asahina,&nbsp;Goki Suda,&nbsp;Norio Akuta,&nbsp;Ryosuke Tateishi,&nbsp;Yasunari Nakamoto,&nbsp;Eiji Kakazu,&nbsp;Shuji Terai,&nbsp;Masahito Shimizu,&nbsp;Masanori Miyazaki,&nbsp;Yasutoshi Nozaki,&nbsp;Satoshi Sobue,&nbsp;Hiroki Yano,&nbsp;Tomokatsu Miyaki,&nbsp;Akihiro Moriuchi,&nbsp;Takeshi Hori,&nbsp;Kumiko Shirai,&nbsp;Kazuhiro Murai,&nbsp;Yoshinobu Saito,&nbsp;Takahiro Kodama,&nbsp;Tomohide Tatsumi,&nbsp;Tomomi Yamada,&nbsp;Tetsuo Takehara","doi":"10.1111/hepr.14131","DOIUrl":"10.1111/hepr.14131","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The incidence of and factors involved in gastroesophageal varix-related events in hepatitis C virus-related cirrhosis patients, including decompensated cirrhosis, after direct-acting antiviral therapy are unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a multicenter study using prospective data from 478 hepatitis C virus-related cirrhosis patients treated with direct-acting antiviral therapy from February 2019 to December 2021 at 33 Japanese hospitals. Gastroesophageal varices were classified as F1 (small-caliber), F2 (moderately enlarged), or F3 (markedly enlarged) according to the Japanese criteria. Patients without varix or with F1 without red color signs were defined as low-risk varix, and patients with ≥F2 or red color signs or a history of rupture were defined as high-risk varix. Varix-related events were defined as prophylactic treatment or rupture of gastroesophageal varix.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median age was 70 years, 43% of patients had decompensated cirrhosis, and 16% had high-risk varices (13% in compensated and 33% in decompensated, <i>p</i> &lt; 0.001). Sustained virologic response rates were 94.9% for compensated cirrhosis and 91.3% for decompensated cirrhosis (<i>p</i> = 0.120). Across 35.7 months, 25 patients received prophylactic treatment, and four experienced varix rupture. The 3-year incidence rate of varix-related events was 6.2% (3.5% in compensated and 9.9% in decompensated, <i>p</i> = 0.001). In the multivariate analysis, high-risk varix (<i>p</i> &lt; 0.001), high baseline gamma-glutamyl transpeptidase levels (<i>p</i> &lt; 0.001), and virologic failure (<i>p</i> = 0.004) were significantly involved in varix-related events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The cumulative incidence rate of varix-related events was significantly higher in decompensated cirrhosis than in compensated cirrhosis. Baseline varix status, baseline gamma-glutamyl transpeptidase levels, and virologic response were related to varix-related events after direct-acting antiviral therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"55 3","pages":"319-332"},"PeriodicalIF":3.9,"publicationDate":"2024-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hepr.14131","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521766","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":"Factors associated with low hepatitis B surface antigen levels in chronic hepatitis B patients treated with nucleot(s)ide analogs","authors":"Takanori Suzuki,&nbsp;Kentaro Matsuura,&nbsp;Takako Inoue,&nbsp;Hayato Kawamura,&nbsp;Kei Fujiwara,&nbsp;Hiromi Kataoka,&nbsp;Yasuhito Tanaka","doi":"10.1111/hepr.14129","DOIUrl":"10.1111/hepr.14129","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Several studies have reported that chronic hepatitis B (CHB) patients with low hepatitis B surface antigen (HBsAg) levels (100 or 10 IU/mL) at the cessation of nucleot(s)ide analogs (NA) have a favorable prognosis. In this retrospective study, we evaluated the duration of NA treatment and the factors associated with achieving these low HBsAg levels. We also examined the relationship between HBsAg and hepatitis B core-related antigen (HBcrAg) levels at the time of NA discontinuation and subsequent clinical outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study included 153 CHB patients who initiated NA therapy at our hospital, received treatment, and were followed up for over 1 year.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The cumulative incidence rates of achieving low HBsAg levels at 5 and 10 years post-NA administration were as follows: 19.0% and 29.2% for HBsAg &lt;100 IU/mL, 13.8% and 17.6% for HBsAg &lt;10 IU/mL, and 9.5% and 13.5% for HBsAg &lt;0.05 IU/mL, respectively. Hepatitis B virus genotypes other than genotype C (hazard ratio [HR] 3.47; <i>p</i> &lt; 0.001) and an HBsAg level &lt;1000 IU/mL at the start of NA therapy (HR 2.49; <i>p</i> = 0.008) were significantly associated with achieving HBsAg levels &lt;100 IU/mL. Among 27 patients who discontinued NA therapy, 5 patients with HBsAg levels &lt;100 IU/mL and HBcrAg levels &lt;3 log U/mL at the time of discontinuation did not experience virological relapse.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The cumulative rates of achieving HBsAg levels &lt;100 IU/mL were relatively high. Discontinuation of NA may be considered based on HBsAg and HBcrAg levels during the course of NA therapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"55 3","pages":"309-318"},"PeriodicalIF":3.9,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499349","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":"Time trend of outcomes according to systemic therapy for patients with unresectable hepatocellular carcinoma: A single-institution study","authors":"Shinsuke Uchikawa,&nbsp;Tomokazu Kawaoka,&nbsp;Serami Murakami,&nbsp;Ryoichi Miura,&nbsp;Yuki Shirane,&nbsp;Yusuke Johira,&nbsp;Masanari Kosaka,&nbsp;Yasutoshi Fujii,&nbsp;Hatsue Fujino,&nbsp;Atsushi Ono,&nbsp;Eisuke Murakami,&nbsp;Daiki Miki,&nbsp;C. Nelson Hayes,&nbsp;Masataka Tsuge,&nbsp;Shiro Oka","doi":"10.1111/hepr.14130","DOIUrl":"10.1111/hepr.14130","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>We have been able to use molecular targeted agents for unresectable hepatocellular carcinoma since 2009, and immune checkpoint inhibitors have been approved in recent years. We assessed the efficacy of systemic therapy in Hiroshima University Hospital by each era.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 357 patients who were treated with sorafenib, lenvatinib, atezolizumab plus bevacizumab combination therapy, or durvalumab plus tremeliumab combination therapy as first-line systemic therapy in our hospital from November 2009 to December 2023 were enrolled in this retrospective cohort study. We divided the years from 2009 to 2023 into the following three periods: cohort I, 2009–2016, the single-molecular targeted agent era; cohort II, 2017–2020, the multi-molecular targeted agent era; and cohort III, 2020–2023, the immuno-oncology era.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median survival time was 9.5 months in cohort I, 15.8 months in cohort II, and 20.2 months in cohort III. The median survival time in cohort III was significantly (<i>p</i> &lt; 0.01) longer than in the other cohorts. The overall response rate by mRECIST was 4.1% in cohort I, 28.7% in cohort II, and 47.2% in cohort III. The disease control rate was 41.6% in cohort I, 61.2% in cohort II, and 73.6% in cohort III. Both overall response rate and disease control rate significantly increased by era.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We consider that advancements in systemic therapy, along with changes in treatment strategies, such as sequential therapy after progression, contribute to the prolonged prognosis across different eras.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"55 2","pages":"283-290"},"PeriodicalIF":3.9,"publicationDate":"2024-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hepr.14130","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142499351","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}