Hepatology Research最新文献

{"title":"Response to ‘Letter to the Editor: “Effect of Direct-Acting Antivirals on Prognosis in Older Patients With Hepatitis C Virus-Related Hepatocellular Carcinoma After Curative Therapy: A Retrospective Study by the Red Cross Liver Study Group in Japan”","authors":"Hironori Ochi, Masayuki Kurosaki","doi":"10.1111/hepr.70181","DOIUrl":"10.1111/hepr.70181","url":null,"abstract":"","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"56 8","pages":"1299-1300"},"PeriodicalIF":3.7,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645040","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":"Safety and Effectiveness of Glecaprevir/Pibrentasvir in Children and Adolescents With Chronic Hepatitis C: Reports From All-Case Post-Marketing Surveillance in Japan","authors":"Tatsuki Mizuochi,&nbsp;Katsuyoshi Kawana,&nbsp;Mariko Kobayashi,&nbsp;Eri Iwashita,&nbsp;Itaru Iwama,&nbsp;Daiki Abukawa,&nbsp;Hitoshi Tajiri","doi":"10.1111/hepr.70173","DOIUrl":"10.1111/hepr.70173","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The aim of this all-case post-marketing study was to evaluate the real-world safety and effectiveness in all children and adolescents with chronic hepatitis C with or without compensated cirrhosis treated with glecaprevir/pibrentasvir (G/P) in Japan.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This prospective, observational post-marketing surveillance study was conducted at 67 medical institutions from 2019 to 2024. Eligible patients were aged 3 to &lt; 18 years (children: 3 to &lt; 12 years; and adolescents: 12 to &lt; 18 years), with chronic Hepatitis C virus (HCV) infection with or without compensated cirrhosis. Patients were treated with G/P for 8 or 12 weeks and followed-up for 24 weeks. The primary endpoints included adverse drug reactions (ADRs) and serious adverse events (AEs). The secondary endpoints included sustained virologic response at 12 weeks after treatment completion (SVR12).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>None of the 103 patients had compensated cirrhosis or prior exposure to direct-acting antiviral therapy; the majority had either genotype 1/serogroup 1 or genotype 2/serogroup 2 HCV infections. All children (100.0%, 26/26) and most adolescents (97.4%, 75/77) completed G/P treatment; the two adolescents discontinued owing to pregnancy/transfer and insufficient drug administration. No AEs led to treatment discontinuation. No serious AEs were observed. ADRs did not occur in children (0.0%, 0/26) but occurred in nine adolescents (11.7%, 9/77). Post-treatment virologic failure (relapse) was observed in one child and no adolescents, and the remaining children (96.2%, 25/26) and all adolescents (100%, 66/66) achieved SVR12.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our real-world findings suggest that G/P is a potentially safe and efficacious treatment option for children and adolescents with chronic HCV infection. Further data on patients with compensated cirrhosis and long-term post-SVR outcomes would be valuable.</p>\u0000 </section>\u0000 </div>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":"56 8","pages":"1202-1212"},"PeriodicalIF":3.7,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/hepr.70173","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716765","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":"Serum Agalactosyl IgG Predicts Hepatocellular Carcinoma and All-Cause Mortality After SVR in Advanced Chronic Hepatitis C.","authors":"Daisuke Sakon, Jumpei Kondo, Yuki Tahata, Hayato Hikita, Maki Iwaisako, Muya Matsumoto, Asuka Ogata, Shinji Takamatsu, Yasutoshi Nozaki, Naruyasu Kakita, Hisashi Ishida, Fumihiko Nakanishi, Yuichi Yoshida, Masanori Nakahara, Kazuho Imanaka, Mitsuru Sakakibara, Takayuki Yakushijin, Tetsuo Takehara, Takahiro Kodama, Eiji Miyoshi","doi":"10.1111/hepr.70255","DOIUrl":"https://doi.org/10.1111/hepr.70255","url":null,"abstract":"<p><strong>Background and aims: </strong>Patients with chronic hepatitis C and advanced fibrosis remain at substantial risk of hepatocellular carcinoma (HCC) and non-liver-related death even after sustained virological response (SVR) to direct-acting antivirals (DAA). Serum agalactosyl IgG (agal-IgG) reflects chronic inflammation and fibrogenic activity, but its prognostic value after SVR is unknown. We investigated whether serum agal-IgG at end of treatment (EOT) predicts HCC and all-cause mortality in DAA-treated patients with advanced fibrosis.</p><p><strong>Methods: </strong>Among 3550 patients with chronic hepatitis C treated with DAAs at Osaka University Hospital and affiliated centers, the stored sera of 136 patients with biopsy-proven F3-F4 fibrosis before DAA treatment, who achieved SVR, and had no history of HCC were available at EOT. Serum agal-IgG at EOT was measured using a 42B1-based ELISA.</p><p><strong>Results: </strong>During a median follow-up of 68.7 months (interquartile range, 36.8-84.9) for HCC surveillance, 15 patients developed HCC. Over a median overall follow-up of 73.7 months (54.5-86.7), 11 patients died. Higher EOT agal-IgG levels were significantly associated with both HCC occurrence and all-cause mortality, and these associations remained independent after adjustment for age, sex, and baseline fibrosis (FIB-4 index). The adjusted hazard ratios per 1-unit increase in agal-IgG were 1.050 (95% CI, 1.008-1.094) for HCC and 1.085 (95% CI, 1.035-1.137) for all-cause mortality. Patients with EOT agal-IgG levels above the cohort median also showed significantly higher cumulative incidences of HCC and all-cause death than those with lower levels.</p><p><strong>Conclusions: </strong>Serum agalactosyl IgG measured at the end of DAA therapy independently predicts HCC and all-cause mortality after SVR in patients with chronic hepatitis C and advanced fibrosis. EOT agal-IgG may offer additional prognostic information for post-SVR risk stratification and help identify patients at higher risk of HCC and all-cause mortality after SVR.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653488","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":"Correction to \"Multicenter, Retrospective, Cohort Study Shows Platelet Counts Predict Hepatocellular Carcinoma Development in Patients With Nonalcoholic Fatty Liver Disease\".","authors":"","doi":"10.1111/hepr.70250","DOIUrl":"https://doi.org/10.1111/hepr.70250","url":null,"abstract":"","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653223","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":"Psoas Muscle Index in Autoimmune Hepatitis: Prognostic and Reporting Considerations.","authors":"Xiaohe Zhang, Chaochi Yue","doi":"10.1111/hepr.70252","DOIUrl":"https://doi.org/10.1111/hepr.70252","url":null,"abstract":"","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630221","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":"Histological AI-Assisted Analysis Outperforms Pathologist Assessment in Predicting Disease Outcomes in PSC Patients.","authors":"Anna M Salonen, Iiris Nyholm, Linn Tähti, Matilda Sinkko, Darshan Kumar, Martti Färkkilä, Johanna Arola, Mikko P Pakarinen, Sonja Boyd, Nelli Sjöblom","doi":"10.1111/hepr.70254","DOIUrl":"https://doi.org/10.1111/hepr.70254","url":null,"abstract":"<p><strong>Aims: </strong>Liver biopsy has shown prognostic significance in primary sclerosing cholangitis (PSC). However, histology is typically assessed manually based on coarse grading scales, making precise quantification difficult. We developed a neural network model to address the key histological features of liver tissue, including portal tracts, fibrosis, biliary epithelium, portal inflammation, and vasculature.</p><p><strong>Methods and results: </strong>Our training data included 603 liver sections from patients with PSC (n = 478), other hepatobiliary diseases (n = 119), and normal controls (n = 6), ensuring heterogeneity of the sample material. The model was validated and evaluated for its ability to predict key clinical endpoints in PSC: liver transplantation (LT) due to end-stage liver disease (ESLD), and a composite endpoint comprising LT, cholangiocarcinoma (CCA), and liver-related death, allowing evaluation with all relevant clinical outcomes. The model reliably identified the targeted histological features. AI-derived portal inflammation and fibrosis demonstrated superior discriminatory performance compared with manual scoring, particularly for prediction of LT due to ESLD (AUC 0.81-0.82 vs. 0.86-0.87). AI-derived blood vessels and biliary epithelium were also prognostic for LT due to ESLD (AUC 0.80, 0.83). In multivariable analysis adjusted for age and sex, AI-derived portal inflammation remained independently associated with the composite endpoint (HR 2.51, 95% CI 1.04-6.05).</p><p><strong>Conclusions: </strong>AI-measured portal inflammation is a robust predictor of clinical endpoints. Additionally, vascular area, fibrosis, and biliary epithelium showed prognostic value. AI-based measures outperformed manual scores for several parameters. Overall, multiple AI-derived parameters predicted LT due to ESLD, and comparable trends were observed for the composite endpoint. These findings highlight the importance of liver histology as a surrogate endpoint in patients with PSC.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148619475","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":"Recombinant ADAMTS13 Ameliorates Liver Injury and Improves Hepatic Microcirculation in a Murine Acute-on-Chronic Liver Failure Model.","authors":"Jun-Ichi Hanatani, Norihisa Nishimura, Kosuke Kaji, Masayoshi Takami, Hiroyuki Masuda, Hiroaki Takaya, Koh Kitagawa, Shinya Sato, Tadashi Namisaki, Hitoshi Yoshiji","doi":"10.1111/hepr.70253","DOIUrl":"https://doi.org/10.1111/hepr.70253","url":null,"abstract":"<p><strong>Aim: </strong>The therapeutic significance of recombinant a disintegrin-like and metalloprotease with thrombospondin type 1 motif 13 (rADAMTS13) in acute-on-chronic liver failure (ACLF) remains unclear. We aimed to investigate the therapeutic effects of rADAMTS13 in a murine model of ACLF-like liver injury.</p><p><strong>Methods: </strong>Male C57BL/6J mice were subjected to chronic carbon tetrachloride (CCl₄) administration followed by acute CCl₄ and lipopolysaccharide challenge to induce ACLF-like liver injury. Mice were assigned to control, ACLF, and ACLF + rADAMTS13 groups. Plasma ADAMTS13 activity, VWF antigen, platelet counts, hepatic microcirculatory blood flow, histological changes, and hepatic gene expression were evaluated. Endothelial tube formation assays were performed using human umbilical vein endothelial cells (HUVECs) under oxidative stress conditions.</p><p><strong>Results: </strong>rADAMTS13 treatment improved plasma ADAMTS13 activity, reduced VWF antigen levels, and attenuated intrahepatic platelet accumulation in ACLF mice. These changes were accompanied by improved hepatic microcirculatory blood flow, reduced plasma transaminase levels, and decreased hepatic necrosis and macrophage infiltration. rADAMTS13 also reduced oxidative stress-related markers and fibrosis-related readouts in the acute setting. The treatment was associated with increased hepatic CD34 staining, upregulation of Vegfa, and increased regeneration-related markers, including Ki67, A6, Hgf, and Egf. In vitro, rADAMTS13 partially restored impaired tube formation and increased VEGFA and VEGFR2 expression in HUVECs exposed to oxidative stress.</p><p><strong>Conclusion: </strong>rADAMTS13 attenuated liver injury in a murine ACLF-like model and was associated with restoration of the ADAMTS13/VWF axis, improved hepatic microcirculation, and increased angiogenesis- and regeneration-related responses. These findings suggest that rADAMTS13 may represent a potential therapeutic approach for ACLF.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148602407","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":"Association Between Locomotive Syndrome and Metabolic Dysfunction-Associated Steatotic Liver Disease in a Health Examination Cohort: A Cross-Sectional Study.","authors":"Shinya Yokoyama, Takanori Ito, Taku Tanaka, Hiroaki Hiraiwa, Takashi Honda, Yoji Ishizu, Norihiro Imai, Kenta Yamamoto, Kazuki Sahara, Tetsuhito Kojima, Naoyoshi Kariya, Hiroki Kawashima","doi":"10.1111/hepr.70248","DOIUrl":"https://doi.org/10.1111/hepr.70248","url":null,"abstract":"<p><strong>Aim: </strong>Early mobility impairment is increasingly recognized as an early manifestation of systemic and metabolic dysfunction. Although metabolic dysfunction-associated steatotic liver disease (MASLD) is considered a hepatic component of metabolic disease, its association with early functional decline remains unclear. We investigated whether early mobility impairment is associated with MASLD in a large health examination cohort.</p><p><strong>Methods: </strong>This retrospective cross-sectional study included 7776 adults who underwent abdominal ultrasonography and mobility assessment. MASLD was defined as hepatic steatosis, at least one cardiometabolic risk factor, and alcohol intake below the established thresholds. Early mobility impairment was assessed using the locomotive syndrome framework based on the stand-up test, two-step test, and 25-question Geriatric Locomotive Function Scale. Multivariable logistic regression analyses were performed after adjusting for demographic, lifestyle, and comorbidity factors.</p><p><strong>Results: </strong>MASLD was present in 27.5% of participants. Early mobility impairment was more frequent in participants with MASLD than in those without MASLD (29.4% vs. 22.5%; p < 0.001). In the fully adjusted model, early mobility impairment was independently associated with MASLD (odds ratio 1.54, 95% confidence interval 1.36-1.74; p < 0.001). Using modified Poisson regression with robust variance, the association remained significant in the same direction as that of the logistic regression models (prevalence ratio 1.315, 95% CI 1.215-1.424; p < 0.001). The association was stronger in participants aged < 65 years than in those aged ≥ 65 years (p for interaction = 0.0097).</p><p><strong>Conclusions: </strong>Early mobility impairment was independently associated with MASLD. Incorporating mobility-oriented assessments into MASLD care may broaden risk evaluation.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535631","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":"The Visceral Fat-Muscle Trade-off in Obese Chronic Liver Disease: Insights From SMA-Level Periportal VAT.","authors":"Atsushi Nakamura, Takeshi Ichikawa, Keiji Okuyama","doi":"10.1111/hepr.70249","DOIUrl":"https://doi.org/10.1111/hepr.70249","url":null,"abstract":"<p><strong>Background and aims: </strong>Visceral adipose tissue (VAT) contributes to MASLD pathophysiology via the portal circulation, and weight loss is a cornerstone of treatment; however, its effect on skeletal muscle remains unclear. This study evaluated intra-abdominal area (IAA) at the superior mesenteric artery (SMA) level-a site capturing periportal adipose tissue-and examined the association between weight loss and muscle loss in non-cirrhotic obese chronic liver disease (CLD).</p><p><strong>Methods: </strong>IAA and paraspinal muscle area were quantified by MRI at the SMA level. Longitudinal changes in IAA, muscle mass, proton density fat fraction (PDFF), ALT, and liver stiffness (LS) were annualized. Cross-sectional associations were evaluated in the overall cohort (BMI ≥ 25 kg/m², n = 286); longitudinal relationships were assessed in CLD undergoing lifestyle intervention (n = 141, median follow-up: 36 months).</p><p><strong>Results: </strong>In the cohort (MASLD 60%), IAA was independently associated with lower muscle mass and higher LS beyond FIB-4. In the longitudinal cohort, IAA reduction was independently associated with improvements in PDFF and LS, whereas muscle mass declined nonlinearly with greater IAA reduction (R² = 0.336, p < 0.001). In MASLD, a ≥ 4% IAA reduction significantly improved PDFF, ALT, and LS but was accompanied by muscle loss (-3.9%/y), whereas albumin remained unchanged (p = 0.968).</p><p><strong>Conclusions: </strong>In obese CLD, IAA at the SMA level serves as a practical marker of periportal VAT. Although its reduction benefits the liver, it may be accompanied by muscle loss. Preserved serum albumin does not exclude ongoing skeletal muscle catabolism. Enhanced protein intake during weight loss may help mitigate muscle catabolism.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535658","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":"Stability and Variability of Symptom Burden in Primary Biliary Cholangitis: Insights From a Decade of Follow-Up.","authors":"Akihito Takeuchi, Atsumasa Komori, Kazuhito Kawata, Osamu Yoshida, Kazunari Tanaka, Kazumichi Abe, Yukihisa Fujinaga, Tadashi Namisaki, Naruhiro Kimura, Tomohiro Katsumi, Ryo Miura, Naoko Tachizawa, Yoshinari Asaoka, Yoshiyuki Ueno, Shuji Terai, Hiromasa Ohira, Hitoshi Yoshiji, Kentaro Kikuchi, Takeshi Matsui, Tadashi Ikegami, Akira Honda, Masanori Abe, Atsushi Tanaka","doi":"10.1111/hepr.70246","DOIUrl":"https://doi.org/10.1111/hepr.70246","url":null,"abstract":"<p><strong>Background and aims: </strong>Primary biliary cholangitis (PBC) frequently impairs health-related quality of life (HRQOL); however, longitudinal changes in symptoms and their relationship with prognosis remain unclear. We aimed to elucidate the current status of symptoms and HRQOL in Japanese patients with PBC, evaluate 10-year changes in PBC-40 scores, and examine associations with long-term outcomes.</p><p><strong>Methods: </strong>This multicenter observational study comprised three analyses: (i) a 2025 cross-sectional study assessing associations between clinical parameters, PBC-40 (symptom indicators), and EQ-5D-5 L (HRQOL indicators); (ii) a longitudinal PBC-40 study comparing scores from 2015 to 2025; and (iii) a longitudinal outcome study evaluating 2015 PBC-40 scores and clinical parameters in relation to survival through 2025.</p><p><strong>Results: </strong>In 2025%, 20%-50% of all patients (n = 239) had moderate/severe PBC-40 scores in each domain. EQ-5D-5L scores were significantly lower in women < 59 years versus general population, with multivariable analysis identifying itch, fatigue, and social domains as independent contributors to impaired HRQOL. Across a 10-year follow-up, overall significant deterioration was observed in symptoms (p = 0.0015), itch (p = 0.0039), and cognitive (p = 0.0011) domains, while interindividual variability was greatest in itch and emotional and smallest in symptoms. In longitudinal outcome study (n = 410), no PBC-40 domain predicted death or liver transplantation.</p><p><strong>Conclusions: </strong>HRQOL in patients with PBC was significantly impaired in younger female. Over 10 years, overall and interindividual changes in domain scores greatly varied, suggesting that symptom burdens are driven by heterogeneous underlying mechanisms. HRQOL impairment represents distinct dimensions of disease impact in PBC, independently of long-term outcomes.</p>","PeriodicalId":12987,"journal":{"name":"Hepatology Research","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470277","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}