Liver International最新文献

{"title":"Mature Adipocyte-Derived Extracellular Vesicles Activate Hepatic Stellate Cells and Promote Liver Fibrosis via Inflammation","authors":"Venkat Prashanth,&nbsp;Sachin Thomas,&nbsp;Anbarasu Kannan,&nbsp;Madan Kumar Perumal","doi":"10.1111/liv.70914","DOIUrl":"10.1111/liv.70914","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Extracellular vesicles (EVs) play a crucial role in intercellular communication, particularly in metabolic regulation and liver disease. This study aimed to investigate the differential effects of EVs derived from pre-adipocytes (PA) and mature adipocytes (MA) on hepatic stellate cell (HSC) activation in vitro and their role in promoting liver fibrosis in high-fat diet (HFD)-fed mice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>EVs were isolated from PA and MA following transdifferentiation, which was confirmed by assessing adipogenic markers (PPAR-γ, perilipin, adiponectin, leptin, and Glut4). EVs were characterized by size and CD9 expression. LX-2 cells were treated with PA- or MA-derived EVs to assess fibrotic and inflammatory gene expression. In vivo, C57BL/6 mice on HFD were administered PA-EVs or MA-EVs to evaluate liver pathology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>MA-EVs exhibited a distinct transcriptomic profile and significantly upregulated fibrotic (α-SMA, COL1A1) and inflammatory markers in LX-2 cells, indicating HSC activation. Conversely, PA-EVs had minimal effects. In HFD-fed mice, MA-EVs injection led to pronounced liver damage, including steatosis, inflammation, and fibrosis, compared with mice receiving PA-EVs, which showed no major pathological changes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>MA-EVs aggravate liver fibrosis and inflammation both in vitro and In vivo, while PA-EVs appear to have relatively limited effects. These findings highlight the functional heterogeneity of adipocyte-derived EVs and suggest MA-EVs as potential contributors to the pathogenesis of metabolic dysfunction-associated steatotic liver disease (MASLD). Targeting specific EV subpopulations may present novel therapeutic strategy for MASLD.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 11","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Hepatic Neuroendocrine Neoplasms: Systematic Review and Expert Pathologist Reappraisal Using the WHO 6th Edition Framework","authors":"Marcello Maestri,&nbsp;Ottavia Cicerone,&nbsp;Alessandro Gambella,&nbsp;Federica Grillo,&nbsp;Stefano La Rosa,&nbsp;Silvia Uccella,&nbsp;Alessandro Vanoli","doi":"10.1111/liv.70921","DOIUrl":"10.1111/liv.70921","url":null,"abstract":"<p>Primary hepatic neuroendocrine neoplasms (PHNENs) are exceedingly rare. Published evidence often lacks adequate clinicopathological support for a primary hepatic origin and uses inconsistent historical terminology. Previous reviews have pooled well-differentiated neuroendocrine tumours (NETs), poorly differentiated neuroendocrine carcinomas (NECs), and mixed neuroendocrine–non-neuroendocrine neoplasms (MiNENs), despite differences in biology, prognosis, and management. We systematically reviewed reported PHNENs using PRISMA-based screening and expert pathology reappraisal within the WHO 6th edition morphology-first framework. A systematic literature search was conducted in PubMed/MEDLINE, Scopus, and Web of Science. Titles, abstracts, and full texts were screened according to predefined eligibility criteria; eligible articles underwent second-level expert assessment of pathology, including morphology (including NET G3 vs. NEC and MiNEN vs. amphicrine carcinoma), immunohistochemistry (expression of at least two NE markers), proliferation (Ki-67/mitotic activity), as well as clinical/imaging work-up to exclude metastases from extrahepatic primaries. Of the 67 potentially eligible studies submitted to expert pathology-based reappraisal, 28 studies (49.1%) were retained in the final dataset with 57 likely NEN cases (mainly case reports/small case series). Among the 57 cases, most were well-differentiated NETs (78.9%); NECs (8.8%), MiNENs (3.5%), and amphicrine carcinomas (1.8%) were less frequent. Some cases were high-grade NENs that could not be distinguished as well or poorly differentiated (7%). PHNEN literature is constrained by rarity, uncertainty of hepatic origin, and historical misclassification. Future studies and registries should report a minimum diagnostic dataset with standardised terminology according to the WHO 6th edition framework and in-depth clinical/imaging studies.</p>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 11","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drug-Induced Ductopenia in Two Prospective Registries: Favourable Outcomes and Late Recovery Despite Prolonged Cholestasis","authors":"Fernando Bessone,&nbsp;Nelia Hernandez,&nbsp;Maria Isabel Schinoni,&nbsp;Javier Brahm,&nbsp;Inmaculada Medina-Caliz,&nbsp;Daniela Chiodi,&nbsp;Mercedes Robles-Díaz,&nbsp;Ismael Alvarez-Alvarez,&nbsp;Hao Niu,&nbsp;Mercedes Cortese,&nbsp;Hugo Tanno,&nbsp;Maria Virginia Reggiardo,&nbsp;Federico Tanno,&nbsp;Raymundo Paraná,&nbsp;Eduardo Fassio,&nbsp;Andrea Jimenez,&nbsp;Maria Isabel Lucena,&nbsp;Raul Jesus Andrade","doi":"10.1111/liv.70917","DOIUrl":"10.1111/liv.70917","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background &amp; Aims</h3>\u0000 \u0000 <p>Drug-induced ductopenia (DID) represents a rare histological phenotype of drug-induced liver injury (DILI), typically associated with prolonged cholestasis and historically linked to poor outcomes. This study aimed to characterize the clinical presentation, histological features and outcomes of DID using data from the two prospective DILI registries.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Liver biopsy was performed in 298 patients from the Spanish DILI Registry and the LATINDILI Network. Ten cases (3.4%) fulfilled histological criteria for DID, defined as absence of interlobular bile ducts in more than 50% of portal tracts. Clinical characteristics, biochemical parameters, histological features and outcomes were analysed and compared with those of non-ductopenic DILI cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Patients with DID had a mean age of 47 ± 18 years, and 50% were female. Mixed liver injury predominated (50%). Causative drugs included amoxicillin-clavulanate, ciprofloxacin, carbamazepine, sertraline, ibuprofen, droxicam, captopril, metformin, ticlopidine and stanozolol. All DID cases had jaundice, and rash was more frequent (40%) compared with 9.4% in non-ductopenic DILI patients (<i>p</i> = 0.013). Total bilirubin was significantly higher in DID (median 12 mg/dL vs. 6.6 mg/dL in non-ductopenic DILI patients; <i>p</i> = 0.027). Histology revealed bile duct loss accompanied by cholestasis, portal inflammation, ductular reaction, fibrosis and occasional interface hepatitis. Despite marked cholestasis, no deaths or liver transplantation occurred in DID cases and biochemical recovery was achieved in most patients. Median follow up was 156 and 116 days in patients with DID and non-ductopenic DILI cases, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>DID is an uncommon phenotype of DILI, characterized by marked hyperbilirubinemia and a frequent association with hypersensitivity features. Most cases exhibited moderate liver injury and followed a benign, reversible clinical course, with no reports of poor outcome. However, delayed recovery was observed in a subset of patients.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 11","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"C. butyricum Combined With Resmetirom Provides Therapeutic Benefits in MASH Associated With Gut–Liver–Brain Axis Modulation","authors":"Kaige Zhang,&nbsp;Yuyu Zeng,&nbsp;Jianhua Wu,&nbsp;Yicheng Liu,&nbsp;Yue Zhang,&nbsp;Zhaohui Liao,&nbsp;Yangyang Li,&nbsp;Junqiang Zhong,&nbsp;Zhengyuan Xie,&nbsp;Tingtao Chen","doi":"10.1111/liv.70905","DOIUrl":"10.1111/liv.70905","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Resmetirom has emerged as a major advance in MASH pharmacotherapy as the first approved liver-targeted THR-β agonist; however, variable therapeutic efficacy and adverse responses may limit its clinical benefits. This study investigated whether <i>C. butyricum</i> could provide additional therapeutic benefits when combined with resmetirom and attenuate nausea/vomiting-like responses in association with changes across the gut–liver–brain axis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this study, we established a high-fat diet-induced MASH mouse model and administered <i>C. butyricum</i>, resmetirom, or their combination. Comprehensive biochemical, histological, molecular, 16S rRNA sequencing-based microbiome profiling, and gut–brain axis-related analyses were performed to evaluate the effects of combination therapy on hepatic metabolism, inflammation, fibrosis, intestinal barrier integrity, gut microbiota remodelling, microbial metabolites, and resmetirom-associated adverse responses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Combined treatment with <i>C. butyricum</i> and resmetirom produced additional therapeutic benefits compared with either monotherapy, markedly improving hepatic steatosis, lipid accumulation, insulin resistance, inflammation, oxidative stress, and fibrosis in MASH mice. At the molecular level, combination treatment was associated with increased hepatic THR-β expression and coordinated changes in AMPK-related lipid metabolism, NRF2/HO-1 antioxidant, and TLR4/MyD88/NF-κB inflammatory markers. Furthermore, combination therapy restored intestinal barrier integrity, alleviated MASH-associated gut microbial dysbiosis, increased beneficial bacterial taxa, and increased faecal butyrate levels. Notably, <i>C. butyricum</i> attenuated resmetirom-induced nausea/vomiting-like responses, accompanied by reduced colonic and cerebral 5-HT/SP signalling, decreased brain <i>Htr3a</i> and <i>Tacr1</i> mRNA expression, and suppressed neuronal FOS activation. Faecal butyrate levels were inversely associated with hepatic lipid burden and brain 5-HT/SP levels.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p><i>C. butyricum</i> combined with resmetirom provides additional therapeutic benefits and attenuates nausea/vomiting-like responses in MASH, accompanied by coordinated changes across the gut–liver–brain axis. This combination strategy provides a potential microbiota-based adjunctive approach for optimizing the therapeutic benefits of resmetirom in MASH.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 11","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to: Biological Selection: The Next Frontier in Liver Transplantation for Perihilar Cholangiocarcinoma?","authors":"Edoardo Poletto,&nbsp;Pim B. Olthof,&nbsp;Andrea Ruzzenente,&nbsp;Robert J. Porte,&nbsp;Frederik J. H. Hoogwater,&nbsp;Bas Groot Koerkamp","doi":"10.1111/liv.70876","DOIUrl":"10.1111/liv.70876","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 11","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149127364","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stratifying Cardiovascular Risk in Patients With HCC Receiving Atezolizumab/Bevacizumab: A Comparison of ESC and CARDIOSOR Scores","authors":"Bernardo Stefanini,&nbsp;Lorenza Rimassa,&nbsp;Massimo Iavarone,&nbsp;Giuseppe Cabibbo,&nbsp;Fabio Marra,&nbsp;Caterina Vivaldi,&nbsp;Andrea Dalbeni,&nbsp;Francesca Romana Ponziani,&nbsp;Andrea Palloni,&nbsp;Sara Lonardi,&nbsp;Lorenzo Lani,&nbsp;Piera Federico,&nbsp;Gianluca Svegliati-Baroni,&nbsp;Tiziana Pressiani,&nbsp;Luca Ielasi,&nbsp;Chiara Mazzarelli,&nbsp;Stefania De Lorenzo,&nbsp;Rodolfo Sacco,&nbsp;Mariangela Bruccoleri,&nbsp;Ciro Celsa,&nbsp;Alessio Mastro,&nbsp;Gianluca Masi,&nbsp;Alessandra Auriemma,&nbsp;Leonardo Stella,&nbsp;Pierluigi Toniutto,&nbsp;Rosanna Villani,&nbsp;Chiara Deiana,&nbsp;Sara Ascari,&nbsp;Mariarosaria Marseglia,&nbsp;Alessandro Granito,&nbsp;Fabio Piscaglia,&nbsp;Francesco Tovoli,&nbsp;the ARTE Study Group","doi":"10.1111/liv.70909","DOIUrl":"10.1111/liv.70909","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background &amp; Aims</h3>\u0000 \u0000 <p>The management of comorbidities has become increasingly relevant in unresectable hepatocellular carcinoma (uHCC) as immunotherapy prolongs survival. Atezolizumab plus bevacizumab (AB) is a standard first-line option, but bevacizumab carries a risk of cardiovascular toxicities. Data on cardiovascular risk stratification in patients with cirrhosis remain limited. Identifying patients at increased cardiovascular risk is therefore clinically important, particularly given the availability of bevacizumab-free alternatives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We retrospectively analysed prospectively collected data from the multicenter Italian ARTE database, including patients with uHCC treated with first-line AB between June 2022 and July 2025. Traditional major adverse cardiovascular events (tMACE) were defined as acute coronary syndromes, heart failure, cerebrovascular events, or peripheral ischemia, while an extended composite (eMACE) additionally included venous thromboembolism and immune-related myocarditis. Cardiovascular risk was stratified using the European Society of Cardiology (ESC) Cardio-Oncology classification and the CARDIOSOR score. Competing-risk analyses were performed considering treatment discontinuation as a competing event.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study included 538 patients (median age 69.8 years). During follow-up, 20 patients (3.7%) experienced tMACE, and 30 (5.6%) experienced eMACE. Patients assigned to the very high-risk category by ESC criteria and those with a high-risk CARDIOSOR score had a significantly increased risk of tMACE and eMACE. Both scores demonstrated a moderate ability to stratify cardiovascular risk (Harrell's c-index 0.68 for ESC and 0.59 for CARDIOSOR).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Cardiovascular adverse events were uncommon overall, but their incidence was not negligible in patients in high-risk subgroups. Risk scores may help identify vulnerable subgroups and support patient-tailored treatment strategies, including consideration of bevacizumab-free regimens in selected cases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>Multicenter ARTE database (NCT06806579)</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 11","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13643190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrahepatic Tissue-Resident CD8+ T-Cell Programmes Associate With Fibrosis and Local Immune Remodelling in Autoimmune Hepatitis","authors":"Victoria Stary,&nbsp;Sarah Losek,&nbsp;Magdalena Mairinger,&nbsp;Gerhard Prager,&nbsp;Jonas Santol,&nbsp;Patrick P. Starlinger,&nbsp;Thomas Reiberger,&nbsp;Albert F. Stättermayer,&nbsp;Georg Stary","doi":"10.1111/liv.70897","DOIUrl":"10.1111/liv.70897","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Autoimmune hepatitis is an immune-mediated liver disease characterized by chronic inflammation and progressive fibrosis. Tissue-resident memory T cells mediate organ-specific immunity, but their role in autoimmune hepatitis remains poorly understood. We characterized tissue-residency-associated T-cell populations and their cytokine profiles, assessed associations with disease severity and determined whether these signatures were reflected in peripheral blood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Paired blood and liver samples were obtained from 19 patients with autoimmune hepatitis. Comparator cohorts included 20 patients with metabolic dysfunction-associated steatotic liver disease and 20 surgical patients providing non-inflamed adjacent non-tumorous liver tissue. Multiparameter flow cytometry assessed tissue-residency markers, T-cell differentiation and cytokine production after polyclonal stimulation. Immune phenotypes were correlated with histological and clinical parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Autoimmune hepatitis was associated with compartment-specific remodelling of T-cell differentiation states and intrahepatic enrichment of CD8⁺ T cells expressing CD69, CD103 and CXCR6 relative to paired blood and comparator liver tissues. Intrahepatic CD8⁺ T cells exhibited an interferon-γ-dominant cytokine profile, whereas CD4⁺ T cells showed broader interferon-γ-, interleukin-17A- and interleukin-4-associated responses. Despite the enrichment of tissue-residency-associated CD8⁺ T cells, cytokine-producing CD8⁺ T-cell populations with and without a tissue-resident memory phenotype contributed comparably to the hepatic T-cell compartment. Tissue-residency-associated phenotypes correlated positively with Ishak fibrosis stage, whereas the frequency of interferon-γ-positive intrahepatic CD8⁺ T cells correlated inversely with fibrosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Autoimmune hepatitis was characterized by intrahepatic accumulation of phenotypically distinct and functionally active CD8⁺ tissue-resident memory T cells associated with fibrosis. This immune profile was not reflected in paired blood, indicating compartmentalized hepatic immune remodelling.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 11","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13639376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Residual Liver Stiffness May Complement Dynamic Change in HCC Risk Prediction","authors":"Danping Huang,&nbsp;Weiqu Yuan","doi":"10.1111/liv.70919","DOIUrl":"10.1111/liv.70919","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 11","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in Hepatitis D Virus Prevalence Among HBsAg-Positive Individuals With and Without HIV in Italy: A Converging Epidemiology","authors":"Massimo Puoti,&nbsp;Alessandro Tavelli,&nbsp;Giuseppina Brancaccio,&nbsp;Maria Giovanna Quaranta,&nbsp;Maria Elena Tosti,&nbsp;Giovanni Battista Gaeta,&nbsp;Loreta A. Kondili,&nbsp;Antonella d’Arminio Monforte,&nbsp;the PITER, MASTER and ICONA Study Groups","doi":"10.1111/liv.70913","DOIUrl":"10.1111/liv.70913","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Hepatitis D virus (HDV) infection has historically been more prevalent among people with HIV (PWH) due to shared transmission routes. Whether HIV status still identifies a subgroup at higher risk of HDV in contemporary settings remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We performed two cross-sectional analyses assessing anti-HDV prevalence among HBsAg-positive PWH enrolled in the ICONA cohort in 2009–2012 and 2019–2023, compared with HIV-negative individuals from the MASTER and PITER cohorts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Anti-HDV prevalence among PWH declined from 19.1% to 12.5%, converging with that observed in HIV-negative individuals (12.7%). Injection drug use markedly decreased over time among PWH and remained the strongest determinant of HDV infection. In multivariable analyses, HDV seropositivity was associated with age, injection drug use, and birth outside Italy, but not with HIV infection in the contemporary period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>These findings indicate that HIV infection is no longer independently associated with HDV infection in this setting and support universal HDV screening strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 11","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Alcohol Intake and Incident Major Adverse Liver Outcomes Remains Stable Despite Rising Metabolic Risk","authors":"Eneli Katunin,&nbsp;Ville Männistö,&nbsp;Fredrik Åberg","doi":"10.1111/liv.70912","DOIUrl":"10.1111/liv.70912","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Alcohol consumption is a leading cause of liver-related morbidity and mortality, with dose-dependent effects on liver outcomes. However, a weakening association between alcohol consumption and liver-related mortality has been suggested. As metabolic burden increases and may act synergistically with alcohol, we assessed whether the association between alcohol intake and major adverse liver outcomes (MALOs) has changed over time.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We analysed 34 756 participants from five population-based FINRISK health examination surveys (1992–2012) linked to nationwide registry data. Associations between self-reported alcohol intake and MALOs and all-cause mortality were evaluated across survey waves using Cox proportional hazards regression, with or without metabolic adjustment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From 1992 to 2012, metabolic risk factors increased markedly, with high waist–hip ratio rising from 11.0% to 34.7% and diabetes from 3.7% to 10.8%. Alcohol consumption patterns showed only modest changes over time. The association between alcohol intake and MALOs remained stable across survey waves with HR 1.28 (95% CI 1.19–1.38) in 1992 and 1.33 (95% CI 1.17–1.52) in 2012 (p for interaction = 0.94), and was not attenuated after metabolic adjustment. For all-cause mortality, HRs decreased from 1.17 (95% CI 1.12–1.22) in 1992 to 0.99 (95% CI 0.89–1.10) in 2012 (p for interaction = 0.027), with similar findings after metabolic adjustment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The association between alcohol intake and MALOs remained stable over time despite increasing metabolic burden. These findings suggest that increasing metabolic burden has not modified the association between alcohol intake and liver outcomes at the population level.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 11","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}