JHEP Reports最新文献

{"title":"Incidence and mortality of alcohol-related hepatitis in Denmark – an update, 2016–2023","authors":"Khaibar Ghulam Hazrat ,&nbsp;Sidsel Hyldgaard Støy ,&nbsp;Thomas Damgaard Sandahl ,&nbsp;Peter Jepsen","doi":"10.1016/j.jhepr.2025.101390","DOIUrl":"10.1016/j.jhepr.2025.101390","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Alcohol-related hepatitis (AH) is a severe liver disease associated with high mortality. This study provides data on the incidence and mortality of AH in Denmark from 2016 to 2023.</div></div><div><h3>Methods</h3><div>We identified all patients with a first-time hospital discharge diagnosis of AH and a serum bilirubin level &gt;3 mg/dl in 2016–2023. We computed the standardized incidence rate of AH in the Danish population and mortality from admission with AH. We compared the results to our previously published findings for the 1999-2008 period.</div></div><div><h3>Results</h3><div>We included 1,016 patients with a median age of 54.7 years (66% men). The standardized incidence rate was 21.7 per million per year, which remained stable during the study period for both men and women. Mortality was high: 18% at 28 days, 26% at 84 days, and 40% at 365 days. Although 28-day and 84-day mortality risks were lower in 2023 compared to earlier years, no overall trend of improvement was observed. The median MELD score at admission, available for 846 patients, was consistently high at 26, and 75% had severe AH (MELD &gt;21). Compared to an incidence rate of approximately 45 per million per year in 2009, the incidence of AH has since decreased dramatically, mirroring Danish alcohol sales.</div></div><div><h3>Conclusions</h3><div>The incidence of AH in Denmark markedly declined from 2009 but stabilized between 2016 and 2023. Mortality remains high, emphasizing the need for better treatment strategies.</div></div><div><h3>Impact and implications</h3><div>This study investigated the incidence and mortality of alcohol-related hepatitis (AH) in Denmark from 2016 to 2023, providing updated data in the context of declining alcohol consumption. While AH incidence has decreased since 2009, mirroring reduced alcohol intake, it has stabilized in recent years, and mortality remains high. These findings highlight the ongoing burden of AH for healthcare providers, researchers, and policymakers. Our results can support early interventional strategies, guide clinical management, and reinforce public health efforts to reduce alcohol consumption. Limitations, such as the lack of detailed treatment data, should be considered to avoid overgeneralization.</div></div>","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"7 6","pages":"Article 101390"},"PeriodicalIF":9.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144069565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of long-term HBsAg seroclearance in patients with HBeAg-negative chronic hepatitis B","authors":"Hae Lim Lee ,&nbsp;Soon Kyu Lee ,&nbsp;Ji Won Han ,&nbsp;Hyun Yang ,&nbsp;Heechul Nam ,&nbsp;Pil Soo Sung ,&nbsp;Hee Yeon Kim ,&nbsp;Sung Won Lee ,&nbsp;Do Seon Song ,&nbsp;Jung Hyun Kwon ,&nbsp;Chang Wook Kim ,&nbsp;Si Hyun Bae ,&nbsp;Jong Young Choi ,&nbsp;Seung Kew Yoon ,&nbsp;Jeong Won Jang","doi":"10.1016/j.jhepr.2025.101391","DOIUrl":"10.1016/j.jhepr.2025.101391","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Predicting the long-term HBsAg seroclearance, an ideal endpoint, is relevant for decision-making regarding antiviral therapy for patients with chronic hepatitis B (CHB). This study aimed to identify predictors and develop a prediction model for HBsAg seroclearance in patients with HBeAg-negative CHB.</div></div><div><h3>Methods</h3><div>A total of 2,032 untreated HBeAg-negative patients who underwent a 2-year baseline observation period were enrolled. Prediction models were developed using independent predictors of seroclearance, and their performance was evaluated through internal and external validation using an independent cohort of 753 patients, along with sensitivity analyses.</div></div><div><h3>Results</h3><div>The estimated annual incidence of HBsAg seroclearance was 2.22% (15,508 person-years). <strong>Hep</strong>atitis <strong>B</strong> virus DNA <strong>L</strong>evel (Low-to-intermittently high-level viremia), <strong>O</strong>ld age, male <strong>S</strong>ex, and hepatitis B <strong>S</strong>urface antigen level &lt;250 IU/ml independently predicted seroclearance. Subsequently, two prediction models were developed: HepBLOSS-1 and a simplified version, HepBLOSS-2. These models demonstrated excellent performance in predicting seroclearance at 5, 10, and 15 years, with C-indices and time-dependent area under the receiver operating characteristics curve (AUROC) values of 0.81–0.89. The 10-year cumulative incidence rate in patients with scores of ≥13 in HepBLOSS-1 and those with scores of 8 in HepBLOSS-2 was over 50%. Both models underwent rigorous internal and external validation, demonstrating good predictability with time-dependent AUROCs exceeding 0.80. The predicted seroclearance rate closely aligned with the observed rate in both models.</div></div><div><h3>Conclusions</h3><div>The HepBLOSS models for HBsAg seroclearance exhibited an outstanding ability to stratify the probability of seroclearance over a 15-year period. These models hold promising potential to guide treatment decisions, aiming to achieve a functional cure in patients with CHB.</div></div><div><h3>Impact and implications</h3><div>Achieving a functional cure for chronic hepatitis B, defined as HBsAg seroclearance, is a realistic treatment endpoint, especially given the virus’s lifelong persistence in hepatocytes and its significant association with improved prognosis. This study identified independent predictors of seroclearance, including HBV DNA levels, age, sex, and HBsAg levels, and developed a robust prediction model based on these factors. The models demonstrated strong predictive accuracy over a 15-year period, offering valuable guidance for clinicians in establishing treatment strategies and predicting patient prognosis.</div></div>","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"7 7","pages":"Article 101391"},"PeriodicalIF":9.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144205552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to: “Surveillance for hepatocellular carcinoma in patients with primary biliary cholangitis: For all or just for some?”","authors":"Jihye Lim ,&nbsp;Jonggi Choi","doi":"10.1016/j.jhepr.2025.101395","DOIUrl":"10.1016/j.jhepr.2025.101395","url":null,"abstract":"","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"7 6","pages":"Article 101395"},"PeriodicalIF":9.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep learning empowered gadolinium-free contrast-enhanced abbreviated MRI for diagnosing hepatocellular carcinoma","authors":"Yunfei Zhang ,&nbsp;Ruofan Sheng ,&nbsp;Xianling Qian ,&nbsp;Heqing Wang ,&nbsp;Fei Wu ,&nbsp;Haoran Dai ,&nbsp;Mingyue Song ,&nbsp;Chun Yang ,&nbsp;Jianjun Zhou ,&nbsp;Weiguo Zhang ,&nbsp;Mengsu Zeng","doi":"10.1016/j.jhepr.2025.101392","DOIUrl":"10.1016/j.jhepr.2025.101392","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background &amp; Aims&lt;/h3&gt;&lt;div&gt;By reducing some magnetic resonance imaging (MRI) sequences, abbreviated MRI (aMRI) has shown extensive promise for detecting hepatocellular carcinoma (HCC). We aim to develop deep learning (DL)-based gadolinium-free contrast-enhanced (CE) aMRI protocols (DL-aMRI) for detecting HCC.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;In total, 1,769 patients (913 with HCC) were retrospectively included from three institutions for training, testing, and external validation. Stable diffusion-based DL models were trained to generate CE-MRI, including T1-weighted arterial, portal venous, transitional, and hepatobiliary phase images (AP-syn, VP-syn, TP-syn, and HBP-syn, respectively). Non-contrast-MRI (NC-MRI), including T2-weighted, diffusion-weighted, and pre-contrast T1-weighted (Pre) sequences, along with either actual or DL-synthesized CE-MRI (AP, VP, TP, and HBP or AP-syn, VP-syn, TP-syn, and HBP-syn), were used to create conventional complete MRI (cMRI) and DL-aMRI protocols. An inter-method comparison of image quality between DL-aMRI and cMRI was conducted using a non-inferiority test. The sensitivity and specificity of DL-aMRI and cMRI for detecting HCC were statistically compared using the non-inferiority test and generalized estimating equations models.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;DL-aMRI showed a remarkable reduction in acquisition time compared with cMRI (4.1 &lt;em&gt;vs.&lt;/em&gt; 28.1 min). The image quality of DL-synthesized CE-MRI was not inferior to that of actual CE-MRI (&lt;em&gt;p&lt;/em&gt; &lt;0.001). There was an excellent inter-method agreement between the HCC sizes measured by the two protocols (R&lt;sup&gt;2&lt;/sup&gt; = 0.9436–0.9683). The pooled sensitivity and specificity of cMRI and DL-aMRI were 0.899 and 0.925 and 0.866 and 0.922, respectively. No significant differences were found between the sensitivity and specificity of the two protocols.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;The proposed DL-aMRI could facilitate precise HCC diagnosis with no need for contrast agents, a substantial reduction in acquisition time, and preservation of both NC-MRI and CE-MRI data. DL-aMRI may serve as a valuable tool for HCC diagnosing.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Impact and implications&lt;/h3&gt;&lt;div&gt;In this multi-center study involving 1,769 participants, we developed a generative deep learning-based abbreviated MRI (DL-aMRI) strategy that provides an efficient, contrast-agent-free alternative for detecting HCC with accuracy comparable to that of conventional complete MRI, significantly reducing acquisition time from 28.1 min to just 4.1 min. This strategy is valuable for clinicians who face significant workloads resulting from long MRI scanning times and the potential adverse effects of contrast agents, as well as for researchers focused on developing cost-effective and accessible diagnostic tools for HCC detection. The proposed DL-aMRI protocol has practical implications for clinical settings, enhancing diagnostic efficiency while maintainin","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"7 5","pages":"Article 101392"},"PeriodicalIF":9.5,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143870818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recurrence of autoimmune hepatitis cholestatic variant syndromes after liver transplantation affects graft and patient survival","authors":"Vincenzo Ronca ,&nbsp;Alessandro Parente ,&nbsp;Ellina Lytvyak ,&nbsp;Bettina E. Hansen ,&nbsp;Gideon Hirschfield ,&nbsp;Alan Bonder ,&nbsp;Maryam Ebadi ,&nbsp;Saleh Elwir ,&nbsp;Mohamad Alsaed ,&nbsp;Piotr Milkiewicz ,&nbsp;Maciej K. Janik ,&nbsp;Hanns-Ulrich Marschall ,&nbsp;Maria Antonella Burza ,&nbsp;Cumali Efe ,&nbsp;Ali Rıza Calışkan ,&nbsp;Murat Harputluoglu ,&nbsp;Gökhan Kabaçam ,&nbsp;Débora Terrabuio ,&nbsp;Fernanda de Quadros Onofrio ,&nbsp;Nazia Selzner ,&nbsp;Aldo J. Montano-Loza","doi":"10.1016/j.jhepr.2025.101332","DOIUrl":"10.1016/j.jhepr.2025.101332","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background &amp; Aims&lt;/h3&gt;&lt;div&gt;A significant proportion of patients with variant syndromes (VSs), namely autoimmune hepatitis/primary biliary cholangitis or autoimmune hepatitis/primary sclerosing cholangitis, require liver transplantation (LT) despite treatment. The frequency of disease recurrence and the effect on graft survival are yet to be clarified. The aim of this international, multicentric, retrospective study is to evaluate the risk factors associated with recurrence and the impact of the disease recurrence after LT on graft and patient survival.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;We evaluated 166 patients undergoing LT for VS in 33 centers in North America, South America, Europe, and Asia. Clinical data before and after LT, biochemical data within the first 12 months after LT, and immunosuppression after LT were analyzed to identify patients with a higher risk of recurrence of autoimmune disease based on a histological and radiological diagnosis. Cumulative probabilities of graft and overall survival after LT were calculated using a semi-Markov model.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The autoimmune pattern of recurrence resembled the original VS in 19 cases (61%). Recurrence of autoimmune liver disease (&lt;em&gt;r&lt;/em&gt;ALD) after LT was observed in 23% and 33% of patients after 5 and 10 years, respectively. Increased alkaline phosphatase (hazard ratio [HR] 1.60, 95% confidence interval [CI] 1.13–2.25, &lt;em&gt;p&lt;/em&gt; &lt;0.01) and alanine aminotransferase (HR 1.25, 95% CI 1.01–1.53, &lt;em&gt;p&lt;/em&gt; = 0.03) at 12 months after LT and acute rejection (HR 3.58, 95% CI 1.60–7.73, &lt;em&gt;p&lt;/em&gt; &lt;0.01) were associated with a higher risk of VS recurrence, whereas the use of predniso(lo)ne was associated with a reduced risk (HR 0.30, 95% CI 0.14–0.64, &lt;em&gt;p&lt;/em&gt; &lt;0.01). After adjusting for alanine aminotransferase and alkaline phosphatase at 12 months, the use of predniso(lo)ne was found to be independently and negatively associated with recurrent disease. The &lt;em&gt;r&lt;/em&gt;ALD was found to be significantly associated with graft loss and patient survival in the multivariate Cox regression analysis with a time-dependent covariate. The 5- and 10-year probabilities of graft survival were 68% and 41% in patients with recurrent VS compared with 83% and 60% in patients without recurrent disease, respectively (&lt;em&gt;p&lt;/em&gt; = 0.01). The overall survival was significantly reduced in patients with recurrent disease (&lt;em&gt;p&lt;/em&gt; = 0.01), with event probability at 5 and 10 years of 75% and 49% &lt;em&gt;vs&lt;/em&gt;. 84% and 60% in patients without recurrence, respectively.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;&lt;em&gt;r&lt;/em&gt;ALD after LT is frequent and is associated with elevation in liver enzymes within the first year after LT and rejection episodes. According to our data, VS recurrence appears to be associated with poorer graft and patient survival. Further studies are needed to explore strategies that can prevent VS recurrence or mitigate its potential impact.&lt;/div&gt;&lt;/d","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"7 5","pages":"Article 101332"},"PeriodicalIF":9.5,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143815575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proinflammatory macrophages release CXCL5 to regulate T cell function and limit effects of αPD-1 in steatosis-driven liver cancer","authors":"Taojian Tu ,&nbsp;Handan Hong ,&nbsp;Diala Alhousari ,&nbsp;Lina He ,&nbsp;Mario Alba ,&nbsp;Yiwei Gu ,&nbsp;Brittney Hua ,&nbsp;Phillip Nguyen ,&nbsp;Qi Tang ,&nbsp;Tianyi Xia ,&nbsp;Karam Ashouri ,&nbsp;Anastasia Martynova ,&nbsp;Christina Nakhoul ,&nbsp;Whitaker Cohn ,&nbsp;Genshu Wang ,&nbsp;Geyang Xu ,&nbsp;Zhang-Xu Liu ,&nbsp;Curtis Okamoto ,&nbsp;Enrique Cadenas ,&nbsp;Julian Whitelegge ,&nbsp;Bangyan L. Stiles","doi":"10.1016/j.jhepr.2025.101385","DOIUrl":"10.1016/j.jhepr.2025.101385","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Steatosis is a comorbid factor for cancer development. Patients with steatosis do not respond well to current immune checkpoint therapy (CPI) treatment. We explored the roles of neutrophil-activating chemokines (NACs) in the response of steatosis/liver cancer to CPI.</div></div><div><h3>Methods</h3><div>We used a steatosis-driven liver cancer model induced by the deletion of <em>Pten</em> in the liver (LiPten) and a high-fat diet + carbon tetrachloride (CCl₄) fibrosis model to study the effects of targeting CXCL5. We also studied the role of CXCL5 in the liver immune microenvironment <em>in vitro</em> and <em>in vivo</em>. ANOVA/<em>t</em> tests were used for data analysis.</div></div><div><h3>Results</h3><div>Using LiPten steatosis-tumor mice, we identified CXCL5 as the NAC most robustly upregulated as steatosis progresses to cancer (&gt;100 fold, n = 6–11). We also validated this observation in patient samples. When used together with αPD-1, inhibiting the NAC receptor CXCR2 promoted (100% <em>vs.</em> 80% in untreated LiPten mice), whereas anti-CXCL5 suppressed (25%), tumor progression (n = 4–6) suggesting unique functions of CXCL5 independent of CXCR2. Similar effects were observed for anti-CXCL5 (0/4 with fibrosis) <em>vs.</em> CXCR2 inhibition (4/4 with fibrosis) of fibrosis in the HFD + CCl₄ model. Using a Transwell assay, we identified a novel inhibitory function of CXCL5 in the recruitment of CD4⁺ T cells (<em>p</em> &lt;0.02, n = 4) and potentiation of CD8⁺ T cell cytotoxicity (<em>p</em> &lt;0.001, n = 4). <em>In vivo</em>, we showed that neutralizing CXCL5 increased the CD8/CD4 ratio (<em>p</em> = 0.03 and 0.07) and synergized with αPD-1 for its anti-tumor and anti-fibrosis activity (n = 4–6).</div></div><div><h3>Conclusions</h3><div>Our discovery of the novel inhibitory role of CXCL5 in T cells suggests that NACs have additional functions in modulating the immune system beyond neutrophil chemotaxis. The discovery of this novel CXCL5 role presents additional therapeutical targets alongside current immune checkpoint therapy.</div></div><div><h3>Impact and implications</h3><div>In this study, we investigated the role of CXCL5 in the progression from steatosis to liver cancer. We uncovered a novel inhibitory role of CXCL5 in T cell recruitment, with implications for NAC-targeted therapy and immune checkpoint synergy in liver cancer. We believe our findings will be of interest to physicians, researchers, and patients interested in therapeutic development and translational research in liver disease.</div></div>","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"7 6","pages":"Article 101385"},"PeriodicalIF":9.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-based disparities in liver transplantation: Evidence from a nationwide Italian cohort","authors":"Chiara Becchetti ,&nbsp;Silvia Trapani ,&nbsp;Lucia Masiero ,&nbsp;Silvia Testa ,&nbsp;Francesca D’Arcangelo ,&nbsp;Lucia Lapenna ,&nbsp;Manuela Merli ,&nbsp;Valentina Cossiga ,&nbsp;Maria Guarino ,&nbsp;Filomena Morisco ,&nbsp;Marta Cilla ,&nbsp;Federica Invernizzi ,&nbsp;Elisabetta Cerutti ,&nbsp;Pierluigi Toniutto ,&nbsp;Francesca Puoti ,&nbsp;Massimo Cardillo ,&nbsp;Giuseppe Feltrin ,&nbsp;Patrizia Burra ,&nbsp;Special Interest Group (SIG) Gender in Hepatology of the Associazione Italiana Studio del Fegato (AISF)","doi":"10.1016/j.jhepr.2025.101387","DOIUrl":"10.1016/j.jhepr.2025.101387","url":null,"abstract":"<div><h3>Background &amp; Aims</h3><div>Although sex-based disparities in the liver transplantation (LT) setting have been acknowledged for several years, particularly by studies conducted in the USA, data from European countries are scarce.</div></div><div><h3>Methods</h3><div>We conducted a nationwide, retrospective, observational study on candidates identified for LT in Italy between January 2017 and December 2021 using national registry data with follow-up until June 2023. The primary aim was to assess sex-based differences in LT access, analyzing delisting, retransplantation, and mortality rates. Patients were monitored from waitlist admission to transplant, removal, or death, with competing risks modeled (Fine and Gray) multivariable analysis. Survival outcomes were evaluated using Kaplan–Meier estimates, time-dependent Cox models, and stratified log-rank tests.</div></div><div><h3>Results</h3><div>In total, 7,563 patients were included in the analysis, 5,575 (73.7%) of whom were men. Men had higher 1- and 2-year probabilities of undergoing LT compared with women for both liver cirrhosis (subdistribution hazard ratio [sHR] 1.13, 95% CI 1.02–1.26, <em>p</em> = 0.02 and sHR 1.12, 95% CI 1.01–1.24, <em>p</em> = 0.03, respectively) and hepatocellular carcinoma (HCC) (sHR 1.20, 95% CI 1.07–1.36, <em>p</em> = 0.003 and sHR 1.21, 95% CI 1.08–1.35, <em>p</em> = 0.001, respectively). The wait list (WL) dropout rate in men did not differ significantly to that for women (12.6% <em>vs.</em> 13.9%, <em>p</em> = 0.14) except when the indication to LT was HCC (10.6% <em>vs.</em> 14.2%, <em>p</em> = 0.035). In addition, men had a lower wait list (WL) mortality rate compared with women (7.0% <em>vs.</em> 8.5%, <em>p</em> = 0.04). Post-LT survival rates were similar for both sexes.</div></div><div><h3>Conclusions</h3><div>In this large Italian cohort, female standard allocation patients appeared to be at a disadvantage compared with men, because they received LT less frequently, but with similar post-LT outcomes.</div></div><div><h3>Impact and implications</h3><div>Although sex-based disparities in the LT setting have been acknowledged for several years, particularly in studies conducted in the USA, few data are available in Europe. Our study provides an exhaustive overview regarding the disadvantage facing women outside the USA in accessing LT. By detailing these differences, it provides solid arguments for developing equitable health policy. Given that these differences are affected by the national scenario, having local data is crucial for defining possible targeted actions.</div></div>","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"7 6","pages":"Article 101387"},"PeriodicalIF":9.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143921797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to: “Trans-splenic anterograde coil assisted transvenous obliteration vs. retrograde transvenous obliteration: Are we heading the right way?”","authors":"Marco Senzolo ,&nbsp;Michele Battistel ,&nbsp;Stefano Groff ,&nbsp;Alberto Zanetto ,&nbsp;Giulio Barbiero ,&nbsp;Sarah Shalaby","doi":"10.1016/j.jhepr.2025.101389","DOIUrl":"10.1016/j.jhepr.2025.101389","url":null,"abstract":"","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"7 5","pages":"Article 101389"},"PeriodicalIF":9.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143748547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of cardiometabolic risk factors on hepatic fibrosis and clinical outcomes in MASLD: A population-based multi-cohort study","authors":"Huiyul Park ,&nbsp;Terry Cheuk-Fung Yip ,&nbsp;Eileen L. Yoon ,&nbsp;Grace Lai-Hung Wong ,&nbsp;Hye Sun Lee ,&nbsp;Vincent Wai-Sun Wong ,&nbsp;Jimmy Che-To Lai ,&nbsp;Dae Won Jun","doi":"10.1016/j.jhepr.2025.101388","DOIUrl":"10.1016/j.jhepr.2025.101388","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background &amp; Aims&lt;/h3&gt;&lt;div&gt;Evaluating five cardiometabolic risk factors (CMRFs) is crucial for diagnosing metabolic dysfunction-associated steatotic liver disease (MASLD). This study investigated the impact of CMRFs on hepatic fibrosis and long-term clinical outcomes in patients with MASLD.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Two cross-sectional cohorts (Korean magnetic resonance elastography [n = 6,684] and US vibration-controlled transient elastography [n = 6,230]) were included to assess the impact of five CMRFs and their combinations on hepatic fibrosis. Two longitudinal cohorts (UK Biobank [n = 408,544; mean follow-up, 14.3 years] and Korea National Health Insurance data [n = 355,640; mean follow-up, 11.7 years]) were included to evaluate long-term outcomes, including liver-related events, hepatocellular carcinoma events, and overall, cardiovascular, and liver-related death. The risk of MASLD associated with CMRFs was assessed using logistic or Cox regression analysis, referencing participants without steatotic liver disease.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Across all four cohorts, patients with type 2 diabetes mellitus had the highest risk of hepatic fibrosis and long-term clinical outcomes. Among the five CMRFs, impaired fasting glucose (CMRF2) was the most significant risk factor for both hepatic fibrosis and long-term clinical outcomes. High blood pressure (CMRF3) was the second most significant risk factor for hepatic fibrosis, following CMRF2. Low high-density lipoprotein cholesterol level (CMRF5) exhibited comparable significance for long-term clinical outcomes. These clinical outcomes worsened with increasing severity of glucose abnormalities (normal and impaired fasting glucose levels and type 2 diabetes mellitus). Patients with MASLD and CMRF2 exhibited a two-to-four times higher risk of hepatic fibrosis and liver-related events compared with those without impaired fasting glucose levels, similar to MASLD accompanied by any four CMRFs.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;The impact of the five CMRFs on hepatic fibrosis and long-term clinical outcomes varied across different clinical outcomes and population characteristics. However, impaired fasting glucose (CMRF2) consistently demonstrated the highest risk.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Impact and implications&lt;/h3&gt;&lt;div&gt;Understanding the impact of the five cardiometabolic risk factors (CMRFs) used in the diagnosis of metabolic dysfunction-associated steatotic liver disease (MASLD) on hepatic fibrosis and long-term clinical outcomes can improve the quality of care in the general population by facilitating the identification of at-risk individuals with MASLD. In our results, although the impact of each of the five CMRFs on hepatic fibrosis and long-term clinical outcomes varied depending on the type of clinical outcomes and the characteristics of the population, impaired fasting glucose (CMRF2) consistently showed the highest risk. Patients with MASLD and CMRF2 exhibited","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"7 6","pages":"Article 101388"},"PeriodicalIF":9.5,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144115743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to: “Dynamic imaging of macrophages in MASLD: A major interest in insulin resistance and outside the liver”","authors":"Yongjian Liu ,&nbsp;Joel D. Schilling","doi":"10.1016/j.jhepr.2025.101386","DOIUrl":"10.1016/j.jhepr.2025.101386","url":null,"abstract":"","PeriodicalId":14764,"journal":{"name":"JHEP Reports","volume":"7 5","pages":"Article 101386"},"PeriodicalIF":9.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143738818","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}