Liver International最新文献

{"title":"MetALD: New Perspectives on an Old Overlooked Disease","authors":"Gustavo Ayares,&nbsp;Luis Antonio Diaz,&nbsp;Francisco Idalsoaga,&nbsp;Naim Alkhouri,&nbsp;Mazen Noureddin,&nbsp;Ramon Bataller,&nbsp;Rohit Loomba,&nbsp;Juan Pablo Arab,&nbsp;Marco Arrese","doi":"10.1111/liv.70017","DOIUrl":"https://doi.org/10.1111/liv.70017","url":null,"abstract":"<p>Metabolic dysfunction-associated steatotic liver disease (MASLD) and alcohol-associated liver disease (ALD) are the major contributors to the liver disease burden globally. The rise in these conditions is linked to obesity, type 2 diabetes, metabolic syndrome and increased alcohol consumption. MASLD and ALD share risk factors, pathophysiology and histological features but differ in their thresholds for alcohol use, and the ALD definition does not require the presence of metabolic dysfunction. A recent multi-society consensus overhauled the nomenclature of liver steatosis and introduced the term MetALD to describe patients with metabolic dysfunction who drink more than those with MASLD and less than those with ALD. This new terminology aims to enhance the understanding and management of liver disease but poses challenges, such as the need to accurately measure alcohol consumption in research and clinical practice settings. Recent studies show that MetALD has significant implications for patient management, as it is associated with increased mortality risks and more severe liver outcomes compared to MASLD alone. MetALD patients face increased risks of liver disease progression, cancer and cardiovascular disease. The diagnosis of MetALD involves the adequate quantification of alcohol use through standardised questionnaires and/or biomarkers as well as proper assessment of liver disease stage and progression risk using non-invasive tools including serologic markers, imaging, elastography techniques and genetic testing. Effective management requires addressing both metabolic and alcohol-related factors to improve outcomes. This review intends to provide a comprehensive overview of MetALD, covering pathogenesis, potential diagnostic approaches, management strategies and emerging therapies.</p>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 5","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143770230","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":"How Secondary Interventions Reduce the Burden of Alcohol Consumption at Risk of Cirrhosis: A Public Health Decision-Making Model","authors":"Claire Delacôte,&nbsp;Line Carolle Ntandja Wandji,&nbsp;Alexandre Louvet,&nbsp;Pierre Bauvin,&nbsp;Philippe Mathurin,&nbsp;Sylvie Deuffic-Burban","doi":"10.1111/liv.70086","DOIUrl":"https://doi.org/10.1111/liv.70086","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Better understanding of the kinetics of the consumption of alcohol at risk of cirrhosis (≥ 20 g/day) and the prediction of the burden of alcohol consumption are needed for public health decision-making.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Based on individual data from 45 054 individuals, collected from the French Health, Health Care and Insurance Survey between 2002 and 2014, a Markov model was developed to predict the future burden of alcohol consumption ≥ 20 g/day. This estimated the incidence of alcohol intake with an intermediate (20–50 g/day) or high (≥ 50 g/day) risk of cirrhosis. The impact of five primary or secondary interventions was evaluated between 2024 and 2030.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A 1 L increase in per capita alcohol consumption was associated with a 7% increase in the risk of progression to 20–50 g/day and to ≥ 50 g/day (HR = 1.07, 95% CI 1.06–1.07). Female gender was associated with a lower risk (HR = 0.47, 95% CI 0.43–0.51) and age &lt; 45 years with a higher risk (HR = 4.15, 95% CI 2.60–6.63) of consuming ≥ 50 g/day. In 2023, 2.5 million French individuals aged 15–74 years old drank ≥ 20 g/day (5.5%), and 435 000 of these drank ≥ 50 g/day. Based on the status quo (SQ), this prevalence would be 5.1% in 2030, and would not be influenced by primary prevention, but would be reduced by secondary interventions (from −2.0% to −13.7% compared to the SQ depending on the rate of implementation).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Primary interventions are important to reduce the overall impact of alcohol on health. The strategy of targeting individuals who already drink ≥ 20 g/day of alcohol is more effective in reducing the short-term burden of alcohol consumption at risk of cirrhosis than primary interventions. Thus, primary and secondary interventions need to be implemented jointly.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 5","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70086","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143749587","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":"Incidence and Predictors of Complications Following Percutaneous Liver Biopsy: A Large Italian Multicentre Study","authors":"Francesca Colapietro,&nbsp;Mauro Viganò,&nbsp;Federica Cerini,&nbsp;Riccardo Plebani,&nbsp;Alberto Savino,&nbsp;Maria Pia Calabrese,&nbsp;Paolo Marra,&nbsp;Kessy Djonis Martins de Mattos,&nbsp;Sara Taboni,&nbsp;Agostino Cosenza,&nbsp;Alessandro Loglio,&nbsp;Carmelo Selvaggio,&nbsp;Maria Grazia Lucà,&nbsp;Chiara Masellis,&nbsp;Benedetta Mori,&nbsp;Nicola Pugliese,&nbsp;Chiara Masetti,&nbsp;Elisa Farina,&nbsp;Stella De Nicola,&nbsp;Roberto Ceriani,&nbsp;Ana Lleo,&nbsp;Riccardo Muglia,&nbsp;Sandro Sironi,&nbsp;Stefano Fagiuoli,&nbsp;Alessio Aghemo","doi":"10.1111/liv.70078","DOIUrl":"https://doi.org/10.1111/liv.70078","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Management of ultrasound (US)-guided percutaneous liver biopsy (PLB) lacks standardisation. Despite the low risk of major complications (&lt; 1%), repeated blood counts and up to 4 h of in-hospital observation are typically recommended. We aimed to assess complication rates and predictors in a large cohort of patients undergoing US-PLB across three Italian tertiary centres. We included all patients undergoing US-PLB from January 2018 to December 2023. We collected clinical, biochemical and procedural features (needle type, insertions number, observation time and antiplatelet/anticoagulant regimens). Safety was assessed by the incidence of pain and major complications, including vasovagal reaction, bleeding, pneumothorax, shock, hospitalisation and death.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach and Results</h3>\u0000 \u0000 <p>Among 1838 patients (mean age 55.1 years, 46.1% females, mean BMI 25.1 kg/m², 74% parenchymal PLB), few were on anticoagulant/antiplatelet therapy (4.2%/16.2%); mean platelet count and PT INR were 209.7 × 10³/mm³ and 1.04; 17 patients (0.9%) received prophylactic therapy (blood components, thrombopoietin receptor agonists or vitamin K). Needle aspiration was predominant (92%). During a mean time of observation of 5.4 ± 2.0 h, 134/1838 patients reported pain (7.4%). Major complications were few (26, 1.4%), with 14 episodes of transient hypotension (0.8%); 10 bleeding events (0.5%); 1 pneumothorax; 1 abscess formation; 1 haemobilia; and 1 episode of chest pain. Hospitalisation was rare (12, 0.7%), primarily for bleeding management. No fatalities were recorded. Pain was the sole significant independent predictor of major complications (18/26, HR 30.6, <i>p</i> &lt; 0.05), particularly when reported within the first hour post-procedure (15/18, 83.3%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Major complications following US-PLB are few and strongly associated with early post-procedural pain. In the absence of pain within the first hour, extended monitoring may be unnecessary, allowing for earlier patient discharge.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 5","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.70078","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143749586","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":"Reassessing the Safety of Bulevirtide in Chronic Hepatitis Delta: A Critical Perspective","authors":"Tarik Asselah,&nbsp;Renee-Claude Mercier,&nbsp;Dmitry Manuilov,&nbsp;Heiner Wedemeyer","doi":"10.1111/liv.70079","DOIUrl":"https://doi.org/10.1111/liv.70079","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 5","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143726800","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: Precision in Diagnosis of Liver Fibrosis in MASLD: Machine Learning Based Scores May Be More Accurate Than Conventional NITs","authors":"Yasaman Vali,&nbsp;Quentin M. Anstee,&nbsp;Patrick M. Bossuyt","doi":"10.1111/liv.70077","DOIUrl":"https://doi.org/10.1111/liv.70077","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 5","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143726801","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":"Advancing FXR Research: Insights From a Novel Mouse Model and Bile Acid-Independent Mechanisms","authors":"Songjie Liao,&nbsp;Zongyu Yang,&nbsp;Fusong Liu,&nbsp;Yuanfu Lu","doi":"10.1111/liv.70084","DOIUrl":"https://doi.org/10.1111/liv.70084","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 5","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717308","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":"Gut-Vascular Barrier Disruption: The Missing Link Between MASLD and Bacterial Infection","authors":"Wojciech Marlicz,&nbsp;Karolina Skonieczna-Żydecka,&nbsp;Mariusz Kaczmarczyk,&nbsp;Igor Łoniewski","doi":"10.1111/liv.70082","DOIUrl":"https://doi.org/10.1111/liv.70082","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 4","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690179","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":"Genomic Integration of Hepatitis B Virus Into Human Hepatocytes in Early Childhood Cirrhosis","authors":"Ying Chen,&nbsp;Yi Dong,&nbsp;Shizhang Wei,&nbsp;Xue Gao,&nbsp;Weijie Li,&nbsp;Pan Zhao","doi":"10.1111/liv.70080","DOIUrl":"https://doi.org/10.1111/liv.70080","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aims</h3>\u0000 \u0000 <p>Hepatitis B virus (HBV) remains a major global health problem. HBV DNA can be integrated into the human chromosomes. The integration in young cirrhotic chronic hepatitis B children has not been explored. This study aims to investigate HBV DNA integration in early childhood cirrhosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Biopsy liver specimens from cirrhotic and matched non-cirrhotic chronic hepatitis B children were collected. HBV DNA integration was detected through targeted HBV DNA fragment capture sequencing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty cirrhotic and 20 non-cirrhotic children with chronic hepatitis B were included in the study. The cirrhotic group included 14 males and 6 females, and the non-cirrhotic group included 13 males and 7 females. Compared to non-cirrhotic children, cirrhotic children had lower serum HBsAg quantification (<i>p</i> = 0.001). The median number of HBV integrants in the cirrhotic group was 59 and that in the non-cirrhotic group was 98. No significant difference existed between the two groups (<i>p</i> = 0.529). In the multivariate linear regression analysis, serum HBV DNA level was correlated with the number of HBV integrants (<i>p</i> &lt; 0.001, <i>R</i>² = 0.322). Six differential intragenic high-frequency viral integration sites in cirrhotic children were revealed, all of which have protein-coding functions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Several frequently integrated genes were observed in early childhood cirrhosis. Detailed associations between genetic alterations induced by HBV integration and early childhood cirrhosis need further exploration.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 4","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689779","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":"Proton Pump Inhibitors and Alcohol-Related Cirrhosis","authors":"Shih-Wei Lai","doi":"10.1111/liv.70081","DOIUrl":"https://doi.org/10.1111/liv.70081","url":null,"abstract":"","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 4","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689780","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":"Increased IgG Levels at Diagnosis Are Associated With Worse Prognosis of Patients With Primary Biliary Cholangitis","authors":"Eirini I. Rigopoulou,&nbsp;Vassiliki Lygoura,&nbsp;Stella Gabeta,&nbsp;Nikolaos Gatselis,&nbsp;George Giannoulis,&nbsp;George N. Dalekos","doi":"10.1111/liv.70074","DOIUrl":"https://doi.org/10.1111/liv.70074","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background and Aim</h3>\u0000 \u0000 <p>A proportion of patients with primary biliary cholangitis (PBC) have increased IgG (I-IgG) levels at baseline, though not fulfilling the criteria of autoimmune hepatitis/PBC variant. Our aim was to evaluate whether I-IgG has prognostic significance in non-cirrhotic PBC patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Retrospective analysis of prospectively collected data from 675 PBC patients (592 non-cirrhotic) with available IgG levels at first evaluation was performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among non-cirrhotic patients, 97 with I-IgG were more frequently females (<i>p</i> &lt; 0.05), having a higher frequency of concurrent autoimmune diseases (<i>p</i> = 0.01) and a higher frequency of PBC-specific ANA (<i>p</i> &lt; 0.001), sp100 (<i>p</i> &lt; 0.001) and gp210 (<i>p</i> = 0.029) compared to 495 with normal IgG (N-IgG). Patients with I-IgG were older (<i>p</i> &lt; 0.001) and had lower albumin (<i>p</i> &lt; 0.001) and higher AST (<i>p</i> &lt; 0.001), ALT (<i>p</i> = 0.005), ALP (<i>p</i> = 0.006), γGT (<i>p</i> = 0.038) and IgM (<i>p</i> &lt; 0.001) compared to those with N-IgG. I-IgG patients had a higher probability of cirrhosis development (Breslow <i>p</i> &lt; 0.001; log-rank <i>p</i> = 0.05) and liver-related death (Breslow <i>p</i> = 0.034; log-rank <i>p</i> &lt; 0.05) compared to N-IgG patients. IgG &gt; 1.5xULN was the highest risk factor for cirrhosis development (HR = 9.507, 95% CI: 1.221–74.038, <i>p</i> = 0.032) and liver-related death (HR = 27.140, 95% CI: 3.111–236.783; <i>p</i> = 0.003); IgG normalisation after 1 year of UDCA treatment had a favourable effect on disease outcome. Ν-IgG was associated with a higher probability of liver stiffness regression (<i>p</i> = 0.025).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This long-term study demonstrates that I-IgG levels characterise a subgroup of non-cirrhotic PBC patients with faster disease progression and increased probability of liver-related death. Normalisation of IgG levels during UDCA treatment seems to improve prognosis and therefore, these patients could benefit from stricter follow-up and earlier add-on second-line treatments.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18101,"journal":{"name":"Liver International","volume":"45 4","pages":""},"PeriodicalIF":6.0,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690113","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}