Liver International最新文献

{"title":"The Shunting Puzzle: Congenital Portosystemic Shunts With Multisystem Manifestations","authors":"Maofeng Gong, Jianping Gu","doi":"10.1111/liv.70167","DOIUrl":"https://doi.org/10.1111/liv.70167","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 7","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144197536","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":"Rationalising Hepatocellular Carcinoma Screening in Chronic Hepatitis B: Evaluation of Predictive Scores in an Australian Cohort","authors":"Thisuri Jayawardena,&nbsp;Zein Salim,&nbsp;Luis Calzadilla Bertot,&nbsp;Joanne Bunney,&nbsp;Nicolas Demasi,&nbsp;Joanne Vallve,&nbsp;Leon Adams,&nbsp;Gary Jeffrey,&nbsp;David Speers,&nbsp;Gerry MacQuillan,&nbsp;Tim Mitchell","doi":"10.1111/liv.70154","DOIUrl":"https://doi.org/10.1111/liv.70154","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Several predictive scores have been developed internationally to rationalise hepatocellular carcinoma screening in patients with chronic hepatitis B. This study evaluated the performance of these scores in a large Australian cohort.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective analysis was undertaken on patients with chronic hepatitis B attending two tertiary hospitals from 1st January 2017 to 30th June 2023. Predictive scores were calculated at baseline and patients were followed for the development of hepatocellular carcinoma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 1080 patients were included. The average age was 48 years, 43% were female, 91% were non-cirrhotic, and 51% received antivirals. Most patients (62%) were of Asian ethnicity, 13% African, and 9% Caucasian. Twenty-one patients (1.9%) developed hepatocellular carcinoma during a median follow-up of 5.2 years. The calculated sensitivity was 90.5% for PAGE-B and modified PAGE-B, and 42.9% for REACH-B. Positive predictive values were below 4%, and negative predictive values exceeded 98% for all scores. The time-dependent area under the curve at 5 years for PAGE-B, modified PAGE-B, and REACH-B were 0.74, 0.80, and 0.68 respectively. The 5-year cumulative incidence of hepatocellular carcinoma for patients with low, intermediate, and high PAGE-B scores was 0.33%, 2.1% and 4.9% respectively (log-rank, <i>p</i> &lt; 0.001) and for modified PAGE-B was 0.44%, 1.0% and 7.1% respectively (<i>p</i> &lt; 0.001). REACH-B was unable to accurately stratify hepatocellular carcinoma risk (<i>p</i> = 0.19).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>In our Australian cohort of diverse ethnicity, cirrhosis and treatment status, both PAGE-B and modified PAGE-B scores performed well with respect to hepatocellular carcinoma risk stratification and identifying low-risk patients who may safely avoid screening.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 7","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171751","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":"MASLD and MASH Risk: Does Losing Obesity Reverse the Metabolic Footprint","authors":"Laurens A. van Kleef,&nbsp;Jesse Pustjens,&nbsp;Willem Pieter Brouwer","doi":"10.1111/liv.70161","DOIUrl":"https://doi.org/10.1111/liv.70161","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 7","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171750","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":"A Commentary on ‘Safety, Pharmacokinetics and Antiviral Efficacy of Capsid Assembly Modulator Freethiadine in Healthy Volunteers and Chronic Hepatitis B Patients’","authors":"Shuo Zhou,&nbsp;Chujun Luo,&nbsp;Liangliang Chen","doi":"10.1111/liv.70136","DOIUrl":"https://doi.org/10.1111/liv.70136","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 7","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171752","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":"SuPAR Beyond MELD: An Inflammation-Informed Lens on Compensated Cirrhosis and ICI-Treated HCC","authors":"Haixing Cao,&nbsp;Yujie Zhang,&nbsp;Xiang Ma","doi":"10.1111/liv.70158","DOIUrl":"https://doi.org/10.1111/liv.70158","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 6","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148350","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 Xu and Gao: Robustness of Butyrylcholinesterase Associations With Liver Fat and Insulin Sensitivity","authors":"Martin Heni,&nbsp;Julia Hummel,&nbsp;Andreas Fritsche,&nbsp;Andreas Peter","doi":"10.1111/liv.70160","DOIUrl":"https://doi.org/10.1111/liv.70160","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 6","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148370","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":"Hepatic Phenotype in NBAS-Associated Disease: Clinical Course, Prognostic Factors and Outcome in 230 Patients","authors":"Bianca Peters,&nbsp;Lea Dewi Schlieben,&nbsp;Heiko Brennenstuhl,&nbsp;Cigdem Arikan,&nbsp;Sarah M. Bedoyan,&nbsp;Fatma Derya Bulut,&nbsp;Ellen Crushell,&nbsp;Carlo Dionisi-Vici,&nbsp;Ada Drab,&nbsp;Alexander Fichtner,&nbsp;Aixa Gonzalez Garcia,&nbsp;Deanna Fry,&nbsp;Sven F. Garbade,&nbsp;Nicole Hammann,&nbsp;Nedim Hadzic,&nbsp;Robert Hegarty,&nbsp;Marianne Hørby Jørgensen,&nbsp;Martin Laaß,&nbsp;Elke Lainka,&nbsp;Lina Leghlam,&nbsp;Eberhard Lurz,&nbsp;Halise Neslihan Önenli Mungan,&nbsp;Andrea Pietrobattista,&nbsp;Begona Polo,&nbsp;Piotr Socha,&nbsp;James E. Squires,&nbsp;Tian Sun,&nbsp;Georg F. Vogel,&nbsp;Holger Prokisch,&nbsp;Stefan Kölker,&nbsp;Georg F. Hoffmann,&nbsp;Christian Staufner,&nbsp;Dominic Lenz","doi":"10.1111/liv.70146","DOIUrl":"https://doi.org/10.1111/liv.70146","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Since described in 2015, NBAS-associated disease has emerged as an important cause of acute liver failure (ALF) in children. We analysed the variable expression, genotype–phenotype association, outcome and prognostic factors of the hepatic involvement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Individuals with biallelic pathogenic <i>NBAS</i> variants were recruited within an international observational study, including new and previously published patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We studied 230 individuals, including 13 previously unreported patients. The liver was the most frequently affected organ (63.4%), with 41.3% experiencing at least one ALF. The median age at onset was 0.9 years, the median age at last ALF 5 years, the latest ALF occurred at 24 years. Liver crises were triggered by febrile infections and presented with highly increased hepatic transaminases. Liver involvement varied significantly between the subgroups: 91.7% of patients with infantile liver failure syndrome type 2 and 88.9% of patients from the combined subgroup (variants affecting β-propeller domain) presented with ALF, whereas SOPH (stature, optic atrophy, Pelger–Huët anomaly) patients mostly had either no liver involvement (66.4%) or persistently elevated transaminases without ALF (28%). The rate of native liver survival was 83.9%; 16 individuals underwent liver transplantation and 24 died.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Liver abnormalities are common and the leading cause of death in NBAS-associated disease. There is a clear genotype–phenotype association regarding the hepatic involvement. Liver crises occur primarily during infancy; however, early medical attention in case of febrile infections is necessary at all ages. Liver transplantation prevents ALF, but its risks must be weighed against the frequency and severity of liver crises decreasing with age.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 7","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70146","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148435","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":"Promise, Pitfalls and the Path Ahead for LLMs as Diagnostic Assistants for Focal Liver Lesions","authors":"Yazhou Chen,&nbsp;Carolin V. Schneider","doi":"10.1111/liv.70153","DOIUrl":"https://doi.org/10.1111/liv.70153","url":null,"abstract":"&lt;p&gt;A recent study by Sheng et al. highlighted the growing role of artificial intelligence (AI) in analysing CT and MRI reports of patients with histopathologically confirmed focal liver lesions (FLLs) [&lt;span&gt;1&lt;/span&gt;]. This reflects a broader trend in healthcare, where AI is increasingly being adopted to address complex clinical challenges [&lt;span&gt;2&lt;/span&gt;]. Among these AI tools, large language models (LLMs), a type of transformer-based neural network, have gained significant attention. Trained on vast text amounts from diverse sources, LLMs, with billions of parameters, have shown promise as powerful tools, particularly in the management of complex diseases in hepatology [&lt;span&gt;3&lt;/span&gt;]; they have the potential to improve healthcare due to their capability to analyse complex concepts and generate context-based responses [&lt;span&gt;4, 5&lt;/span&gt;]. FLLs present a diagnostic challenge due to their diverse aetiologies and overlapping imaging features. According to the latest ACG clinical guideline, accurate diagnosis requires careful integration of imaging findings, clinical history and laboratory results, with recommendations for advanced imaging or biopsy in indeterminate cases [&lt;span&gt;6, 7&lt;/span&gt;]. In this setting, LLMs have the potential to aid future clinicians by integrating imaging reports and clinical data to inform diagnoses, demonstrating significant strengths alongside recognised limitations (Figure 1).&lt;/p&gt;&lt;p&gt;In this context, Sheng et al. investigated the performance of two LLMs, ChatGPT-4o and Gemini, for the diagnosis of FLLs [&lt;span&gt;1&lt;/span&gt;]. They were prompted with both clinical information and the ‘findings’ section of radiology reports to generate differential diagnoses. This study directly compared the two LLMs against radiologists of varying experience levels, both junior and middle-level, assessed independently and subsequently with LLM assistance as well as the evaluation of single-step versus two-step prompting strategies for ChatGPT-4o.&lt;/p&gt;&lt;p&gt;This study provides early evidence supporting the potential role of LLMs in clinical decision support. Remarkably, even without domain-specific fine-tuning, the performance of two-step ChatGPT-4o in particular approached that of real-world radiology reports and junior radiologists in the differential diagnosis of FLLs. This highlights the inherent capability of general-purpose LLMs to analyse clinical data and produce clinically meaningful outputs, positioning them as valuable diagnostic aids or second-opinion generators to enhance workflow efficiency. Recent work by Clusmann et al. further supports the notion that LLMs can extract relevant clinical concepts and reasoning patterns from complex medical texts, reinforcing their potential role in clinical decision support [&lt;span&gt;8&lt;/span&gt;]. FLL diagnosis represents an ideal test case for such applications, given its reliance on the integration of imaging reports and clinical information, frequent diagnostic ambiguity and significant impact on patien","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 6","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70153","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148369","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":"Challenges of UDCA Monotherapy for CHILI: High Recurrence Rate of Bile Duct Injury With Potential Immune Interference","authors":"Liqiu Kou,&nbsp;Zongyu Yang,&nbsp;Fusong Liu,&nbsp;Songjie Liao","doi":"10.1111/liv.70157","DOIUrl":"https://doi.org/10.1111/liv.70157","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 6","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148371","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":"Blowin' in the Wind: Air Pollution and the Risk of Hepatocellular Carcinoma","authors":"Eiichi Ogawa,&nbsp;Masaru Enomoto","doi":"10.1111/liv.16171","DOIUrl":"https://doi.org/10.1111/liv.16171","url":null,"abstract":"&lt;p&gt;Hepatocellular carcinoma (HCC) ranks as the sixth most common malignancy and the third leading cause of cancer-related death globally, with approximately 900 000 new cases and 830 000 deaths reported in 2020 [&lt;span&gt;1&lt;/span&gt;]. Recent data highlight a rising trend in mortality from viral hepatitis, with 83% of these deaths attributed to hepatitis B virus (HBV) infection. Despite this, at the end of 2022, only 13% of individuals living with chronic hepatitis B (CHB) had been diagnosed and a mere 3% had received antiviral therapy [&lt;span&gt;2&lt;/span&gt;]. Achieving universal access to prevention, timely diagnosis and effective treatment will be essential to meet the World Health Organization (WHO) targets of eliminating viral hepatitis and reducing new hepatitis infections by 90% and deaths by 65% by 2030. Identifying antiviral therapies that effectively reduce HCC risk is crucial. The long-term efficacy of nucleos(t)ide analogues (NUCs) as antiviral therapy for CHB patients has been well established [&lt;span&gt;3, 4&lt;/span&gt;]. In particular, numerous studies have shown that long-term NUC treatment significantly reduces the risk of HCC compared to no treatment [&lt;span&gt;5, 6&lt;/span&gt;]. However, HCC sometimes develops despite NUC treatment. The risk factors for developing HCC include viral factors (such as viral load), host viral factors (such as older age, male sex and cirrhosis) and environmental factors [&lt;span&gt;7, 8&lt;/span&gt;], but the association of environmental factors with HCC remains to be elucidated.&lt;/p&gt;&lt;p&gt;In this issue of &lt;i&gt;Liver International&lt;/i&gt;, Jang et al. [&lt;span&gt;9&lt;/span&gt;] enrolled 1298 CHB patients undergoing NUC treatment in Taiwan to evaluate the association between air pollution and HCC incidence during the treatment period (median follow-up: 33 months). Individual exposure to air pollutants was assessed using data for four key measurements: particulate matter ≤ 2.5 μm in diameter (PM&lt;sub&gt;2.5&lt;/sub&gt;), particulate matter ≤ 10 μm in diameter (PM&lt;sub&gt;10&lt;/sub&gt;), nitrogen dioxide (NO&lt;sub&gt;2&lt;/sub&gt;) and ozone (O&lt;sub&gt;3&lt;/sub&gt;): collected from Taiwan Air Quality Monitoring (TAQM) stations. The township-level average concentrations of these pollutants were calculated based on each patient's residential address. The results revealed a significant association between air pollutant levels and the development of HCC by patients with cirrhosis, while no such association was observed for non-cirrhotic patients. In particular, NO&lt;sub&gt;2&lt;/sub&gt; levels emerged as an independent risk factor for HCC incidence in multivariable Cox regression analysis, alongside male sex.&lt;/p&gt;&lt;p&gt;In general, air pollution is a significant contributor to the global burden of disease, leading to increased mortality, morbidity and reduced life expectancy [&lt;span&gt;10&lt;/span&gt;]. Air pollution-related carcinogenesis is likely to follow a multistep process: initiation, promotion and progression [&lt;span&gt;11&lt;/span&gt;]. Long-term exposure to PM&lt;sub&gt;2.5&lt;/sub&gt; and NO&lt;sub&gt;2&lt;/sub&gt; has been clearly associated with the inc","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 6","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.16171","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144140693","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}