Liver International最新文献

{"title":"Response to “Case-Crossover Design Is Not Immune to All Unmeasured Confounders and Time-Trend Bias”","authors":"Frederik Kraglund, Thomas Deleuran, Marie Aarup Storgaard, Eva Sædder, Peter Jepsen","doi":"10.1111/liv.70821","DOIUrl":"10.1111/liv.70821","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 9","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818913","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":"Hepatology: Emerging Paradigms in MASLD, Viral Hepatitis, Cholestatic Liver Disease, Portal Hypertension and Hepatocellular Carcinoma","authors":"Zobair M. Younossi,&nbsp;George Papatheodoridis,&nbsp;Emmanuel Tsochatzis,&nbsp;Maria Buti,&nbsp;Lorenza Rimassa,&nbsp;Massimo Pinzani,&nbsp;Ana Lleo,&nbsp;Debbie Shawcross,&nbsp;Frank Tacke,&nbsp;Vincent Wai-Sun Wong,&nbsp;Shira Zelber-Sagi,&nbsp;Andreas E. Kremer,&nbsp;David J. Pinato,&nbsp;Josep M. Llovet,&nbsp;Paolo Angeli,&nbsp;Tarik Asselah,&nbsp;Nicola Pugliese,&nbsp;Cyrielle Caussy,&nbsp;Annalisa Berzigotti,&nbsp;Pietro Lampertico,&nbsp;Markus Cornberg,&nbsp;Mads Israelsen,&nbsp;Pere Gines,&nbsp;Sabela Lens,&nbsp;Hannes Hagström,&nbsp;Michael Trauner,&nbsp;Paul Brennan,&nbsp;Jérôme Boursier,&nbsp;Maurizia Brunetto,&nbsp;Mark Thursz,&nbsp;Elisabetta Bugianesi,&nbsp;Claire Carette,&nbsp;Elisabetta Degasperi,&nbsp;François Durand,&nbsp;Jean-François Dufour,&nbsp;Sven Francque,&nbsp;Claire Francoz,&nbsp;Jean-François Gautier,&nbsp;Helena Hernandez-Evole,&nbsp;David Jones,&nbsp;Maurice Michel,&nbsp;Christophe Moreno,&nbsp;Thomas Mouillot,&nbsp;Lucia Parlati,&nbsp;Jean-Michel Pawlotsky,&nbsp;Pierre-Emmanuel Rautou,&nbsp;Thomas Reiberger,&nbsp;Olivier Roux,&nbsp;Michael Betel,&nbsp;Dominique Thabut,&nbsp;Mazen Noureddin,&nbsp;Valérie Vilgrain,&nbsp;Elise Vuille-Lessard,&nbsp;Yusuf Yilmaz,&nbsp;Adrian Gadano,&nbsp;Vlad Ratziu,&nbsp;Jörn M. Schattenberg,&nbsp;Ramon Bataller,&nbsp;Lawrence Serfaty,&nbsp;Maja Thiele,&nbsp;Alessio Aghemo,&nbsp;Laurent Castera","doi":"10.1111/liv.70806","DOIUrl":"https://doi.org/10.1111/liv.70806","url":null,"abstract":"<div>\u0000 \u0000 <p>The Paris International Liver Meeting (January 19–21, 2026) brought together leading hepatology experts to discuss transformative advances in chronic liver disease management. The meeting highlighted pivotal developments reflecting the field's evolution from disease characterisation toward precision, mechanism-based therapeutics. Metabolic dysfunction-associated steatotic liver disease (MASLD) and its progressive form, metabolic dysfunction-associated steatohepatitis (MASH), were highlighted, marking the transition to an era of approved disease-modifying therapies. Resmetirom and semaglutide are now approved for MASH with F2–F3 fibrosis, with a robust pipeline generating anti-fibrotic signals through FGF21 analogs, pan-peroxisome proliferator-activated receptor (PPAR) agonists, and incretin-based dual and triple agonists. Non-invasive tests have evolved beyond their original diagnostic role to enable prognostic stratification, screening of at-risk populations, treatment selection, and monitoring of therapeutic response. This evolution is not limited to MASLD, but extends to other chronic liver diseases, including primary biliary cholangitis (PBC) and portal hypertension, as highlighted by the recommendations of the Baveno Consensus Workshops. Hepatitis B and D are moving toward functional cure strategies, with simplified HBV treatment algorithms based on fibrosis and viral load, supported by biomarkers for risk stratification and safe treatment discontinuation. In parallel, HDV management is transitioning from a severe disease to one with emerging suppressive and potential curative l through bulevirtide and novel HBsAg-targeting and RNA-silencing therapies, respectively. Management of PBC has advanced with novel PPAR agonists that improve cholestatic biochemistry and pruritus, supported by individualised risk stratification. However, significant treatment gaps persist, with fewer than half of eligible PBC patients receiving second-line therapy, and fatigue remains a major unmet clinical need. Furthermore, effective pharmacotherapies for primary sclerosing cholangitis (PSC) remain a major challenge, and no approved disease-modifying treatments are currently available. Finally, for patients with hepatocellular carcinoma (HCC), immunotherapy combinations can achieve unprecedented long-term survival in selected populations of patients. Collectively, these advances define a new era of hepatology centered on precision medicine, earlier intervention, and mechanism-driven therapeutic strategies.</p>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 9","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148784870","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":"Revisiting Obesity Definitions: Impact of the 2025 Lancet Commission Criteria on Obesity Prevalence Among People With MASLD","authors":"Qi Feng,&nbsp;Fernando Q. Iorra,&nbsp;Pinelopi Manousou","doi":"10.1111/liv.70822","DOIUrl":"10.1111/liv.70822","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 9","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148760925","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":"On the History of Hepatic Vein Catheterization","authors":"Jens Henrik Henriksen,&nbsp;Flemming Bendtsen,&nbsp;Søren Møller","doi":"10.1111/liv.70827","DOIUrl":"https://doi.org/10.1111/liv.70827","url":null,"abstract":"<p>Hepatic vein catheterization (HVC) in man was first performed 80 years ago in the wake of right-sided heart catheterization. Several new methods, recognitions and concepts followed, especially the indirect Fick-method for determination of splanchnic blood flow. Five years passed before pressure measurements were performed and routine HVCs were done in liver patients. Later came splanchnic kinetics of test substances, dyes, metabolites, hormones and bioactive material and counter current wedged and balloon occlusion pressure. HVC has been a prerequisite for our understanding of the pathogenesis of portal hypertension and variceal bleeding leading to serial measurements, stratification, quantification and treatment of portal hypertension, and transvenous liver biopsy and portosystemic stent insertion (TIPS) followed. Measurements and pathophysiology of formation and amelioration of ascites advanced with HVC, likewise pathophysiology of known and new diseases in other organs, secondary to liver disease (kidney, heart, lung, systemic circulation). The hepatic venous pressure gradient (HVPG, i.e., wedged-to-free hepatic venous pressure) is today considered the gold standard for portal pressure measurement in intrasinusoidal and postsinusoidal portal hypertension. In spite of substantial developments in route, catheter type, pressure measurements and -registration, fluoroscopy, transvascular technique, etc. the basic concepts are the same today. New advanced technology, materials, imaging techniques and IT-power have together with the inborn dynamics of the catheterization given a progressive development, and there are potentials of further refinement and applications in science, clinical physiology, gastroenterology and hepatology.</p>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 9","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70827","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148754053","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":"Endotrophin Measured by PRO-C6 as a Prognostic Biomarker for Liver-Related Events in Patients With Advanced Chronic Liver Disease","authors":"Thomas Wiggers,&nbsp;Emilie Toft Skovgaard,&nbsp;Morten Karsdal,&nbsp;Jens Juul Holst,&nbsp;Frederik Christiansen,&nbsp;Andressa de Zawadzki,&nbsp;Diana Julie Leeming,&nbsp;Keyur Patel","doi":"10.1111/liv.70824","DOIUrl":"https://doi.org/10.1111/liv.70824","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background &amp; Aims</h3>\u0000 \u0000 <p>Prognostic non-invasive tests for liver-related events in compensated cirrhosis are needed. Endotrophin, a fragment of type VI alpha 3 collagen involved in fibrosis and inflammation, has been associated with adverse outcomes in several chronic diseases. This study examined the association between baseline endotrophin levels, measured by nordicPRO-C6 (PRO-C6), and liver-related events in advanced hepatitis C virus (HCV)-related liver disease.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>nordicPRO-C6 was assessed in baseline serum from 339 patients with advanced liver fibrosis from the Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis (HALT-C) trial. The prognostic value of PRO-C6 was evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Baseline serum levels of PRO-C6 were significantly higher in patients with cirrhosis and PRO-C6 was an independent prognostic marker for liver-related events. Each doubling of PRO-C6 was associated with increased hazard of liver-related events in all patients (hazard ratio (HR) = 2.22, 95% confidence interval (CI) 1.57–3.14, <i>p</i> &lt; 0.0001), and in patients with cirrhosis (HR = 1.71, 95% CI 1.14–2.58, <i>p</i> = 0.01).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Endotrophin assessed by PRO-C6 is an independent prognostic marker for liver-related events in patients with advanced liver fibrosis and ongoing inflammation due to HCV, particularly in those with cirrhosis, from the HALT-C trial. PRO-C6 may be useful for risk stratification in end-stage liver disease. However, validation in non–interferon-treated cohorts and across chronic liver diseases of varying etiologies is required to confirm its prognostic value for liver-related events.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 9","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70824","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148754178","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":"Readmission Requires Survival and Access: Reframing Global Quality Metrics in Cirrhosis","authors":"Yitong Shen,&nbsp;Juzheng Yuan","doi":"10.1111/liv.70840","DOIUrl":"10.1111/liv.70840","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 9","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148726649","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 Commentary on “Impact of Disease-Specific Treatment and NSBBs on Risk of PVT in Cirrhotic Patients With HCV or PBC”","authors":"Humberto C. Gonzalez,&nbsp;Stuart C. Gordon,&nbsp;Sheri Trudeau,&nbsp;Trueman Wu,&nbsp;Lora Rupp,&nbsp;Christina Melkonian,&nbsp;Mark A. Schmidt,&nbsp;Yihe Daida,&nbsp;Amandeep K. Sahota,&nbsp;Christopher L. Bowlus,&nbsp;Mei Lu","doi":"10.1111/liv.70839","DOIUrl":"10.1111/liv.70839","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 9","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148713058","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":"Disrupted Gut Viral-Bacterial Ecology of Patients With Liver Cirrhosis","authors":"Huanhuan Chang,&nbsp;Yan Yang,&nbsp;Pan Zhang,&nbsp;Zhixin Lei,&nbsp;Yuetong Zhang,&nbsp;Shenghui Li,&nbsp;Lumin Wang,&nbsp;Ying Wang,&nbsp;Jue Jiang,&nbsp;Lu Li,&nbsp;Haitao Shi,&nbsp;Ameng Shi","doi":"10.1111/liv.70836","DOIUrl":"10.1111/liv.70836","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The gut microbiota contributes to liver cirrhosis (LC), yet the gut virome and its cross-kingdom ecology with bacteria are less well defined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>To characterize LC-associated virome alterations and assess their clinical relevance, we reanalyzed publicly available faecal metagenomes from patients with LC and healthy controls. After quality control and removal of human reads, sequences were mapped to the Chinese Gut Viral Catalogue at 95% nucleotide similarity, viral operational taxonomic units (vOTUs) were annotated using the latest ICTV framework, and viral functions were inferred by KEGG annotation. Differential vOTUs and bacterial species, virus–bacteria networks and random forest classifiers were constructed with internal and external validation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>LC showed reduced viral richness and Shannon diversity, and a distinct Bray-Curtis separation from controls. Ten viral families and 473 vOTUs differed between groups (59 LC-enriched). KEGG-based profiling highlighted functional shifts in LC-enriched viruses, including increased K01185 (lysozyme) and K02172 (blaR1). Virus-bacteria networks were markedly sparser in LC than in controls (130 vs. 509 significant correlations). A virome-based random forest model distinguished patients from controls with high accuracy in internal (optimal AUC = 0.911) and external (optimal AUC = 0.773) validation cohorts, and the model combining viral and bacterial features achieved similarly robust performance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>LC is associated with disrupted gut viral–bacterial ecology, and virome features show promise as non-invasive biomarkers, warranting longitudinal and mechanistic follow-up.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 9","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70836","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148722916","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":"Liver Fat Changes in Patients With Type 2 Diabetes by Presence of Genetic Hepatic Steatosis: A Post Hoc Analysis of SURPASS-3 MRI","authors":"Kenneth Cusi,&nbsp;Amalia Gastaldelli,&nbsp;Laura Fernández Landó,&nbsp;Palash Sharma,&nbsp;Amelia Torcello-Gómez,&nbsp;Ángel Rodríguez","doi":"10.1111/liv.70837","DOIUrl":"10.1111/liv.70837","url":null,"abstract":"<p>The patatin-like phospholipase 3 (PNPLA3) I148M genetic variant is highly associated with steatotic liver disease. In the SURPASS-3 MRI substudy, tirzepatide significantly reduced liver fat content (LFC) versus insulin degludec in insulin-naïve patients with type 2 diabetes with metabolic dysfunction-associated steatotic liver disease. The influence of PNPLA3 I148M allele on changes in LFC in response to tirzepatide is unknown. This post hoc analysis evaluated changes in MRI-assessed LFC and cardiometabolic parameters by presence (genotypes GG and CG) or absence (genotype CC) of the PNPLA3 I148M allele after 52-week treatment. Tirzepatide-treated participants experienced significant reductions in LFC, weight, HbA_1c, and overall greater improvement in lipids and liver enzymes regardless of the presence of PNPLA3 I148M allele. Findings were consistent across genotype subgroups. In this exploratory analysis, the presence of PNPLA3 I148M allele did not seem to affect tirzepatide-induced improvement in LFC and several cardiometabolic parameters in patients with type 2 diabetes.</p><p><b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT03882970</p>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 9","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70837","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706894","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":"Barriers to Hepatitis B Treatment: A Multicentre Cross-Sectional Registry and Survey Study by the Canadian Hepatitis B Network","authors":"Hin Hin Ko,&nbsp;Jordyn Vienneau,&nbsp;Curtis L. Cooper,&nbsp;Pam Crotty,&nbsp;Stephen E. Congly,&nbsp;Mayur Brahmania,&nbsp;Alnoor Ramji,&nbsp;Erin Kelly,&nbsp;Angela M. Crawley,&nbsp;Karen Doucette,&nbsp;Vanessa Meier-Stephenson,&nbsp;Mang Ma,&nbsp;Scott K. Fung,&nbsp;David K. Wong,&nbsp;Jordan Feld,&nbsp;Nabiha Faisal,&nbsp;Kelly Kaita,&nbsp;Carla Osiowy,&nbsp;Magdy Elkhashab,&nbsp;Edward Tam,&nbsp;Alexander Wong,&nbsp;Robert Bailey,&nbsp;Philip Wong,&nbsp;Giada Sebastiani,&nbsp;Tianyan Chen,&nbsp;Brian Conway,&nbsp;David Truong,&nbsp;Keith Tsoi,&nbsp;Carmine Nudo,&nbsp;Julie Zhu,&nbsp;Sébastien Poulin,&nbsp;Abdel-Aziz Shaheen,&nbsp;Carla S. Coffin","doi":"10.1111/liv.70835","DOIUrl":"10.1111/liv.70835","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background &amp; Aims</h3>\u0000 \u0000 <p>Chronic hepatitis B (CHB) remains a leading cause of cirrhosis and hepatocellular carcinoma (HCC) worldwide, yet treatment uptake is suboptimal even in high-resource settings. This pan-Canadian study aimed to quantify treatment gaps within the Canadian Hepatitis B Network (CanHepB) Registry, compare characteristics of treatment-eligible but untreated patients to those receiving therapy, and assess patient and specialist perspectives on barriers to treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional, retrospective analysis of 1983 adults with CHB followed in 18 Canadian hepatitis B specialty clinics between January 2018 and November 2024. Treatment eligibility was determined using the 2018 Canadian Association for the Study of the Liver guidelines. An anonymous survey captured patient-reported barriers and perspectives (<i>n</i> = 191), while a separate survey evaluated specialist perceptions (<i>n</i> = 54).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 881 untreated patients, 46.4% (<i>n</i> = 409) were treatment eligible. Compared with the treatment group (<i>n</i> = 1087), the treatment-eligible but untreated patients were younger (median 47.3 vs. 54.5 years), more frequently female (54.2% vs. 39.7%), and more likely to be of Black/African/Caribbean origin (18.2% vs. 9.7%). They had a lower prevalence of cirrhosis (2.4% vs. 20.3%), HCC (0.7% vs. 9.3%), and hypertension (17.1% vs. 22.9%), but a higher prevalence of steatotic liver disease (36.4% vs. 24.6%) and dyslipidemia (14.7% vs. 10.8%). Among untreated respondents, concerns included side effects, the need for long-term therapy, and lack of curative options. Conversely, specialists identified cost as the primary barrier and side effects as the least concerning.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This nationwide study reveals a significant treatment gap in CHB care, driven by demographic disparities and a mismatch between patient concerns and clinician perceptions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"46 9","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70835","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706978","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}