World Journal of Hepatology最新文献

{"title":"Sex, racial, and ethnic disparities in United States liver transplantation clinical trials.","authors":"Saqr Alsakarneh, Ali Khalifa, Sharifeh Almasaid, Razan Aburumman, Yassine Kilani, Zeeshan Khalid, Laith Numan, Dushyant Singh Dahiya, Raffi Karagozian, John H Helzberg","doi":"10.4254/wjh.v17.i9.110384","DOIUrl":"10.4254/wjh.v17.i9.110384","url":null,"abstract":"<p><strong>Background: </strong>Regulatory agencies are increasingly recognizing that minority trial representation is inadequate, contributing to healthcare disparities. The scope of minority population disparities in clinical trial participation remains unclear, as previous studies have compiled enrollment data from published trials, which frequently do not report participant race and ethnicity.</p><p><strong>Aim: </strong>To evaluate sex, racial and ethnic inequities in liver transplantation (LT) trials participation in the United States.</p><p><strong>Methods: </strong>We used data from completed United States liver transplant clinical trials registered and reported on the National Institute of Health (NIH) website (clincaltrials.gov). Demographic data, including race, ethnicity, sex, and age were collected. To make inferences to a larger population, 95%CIs were computed for estimates in each demographic group using the Wilson method for binomial proportions. We also computed the simultaneous 95%CIs by applying a Bonferroni correction to reflect the multinomial distribution of race proportions. The numbers and percentages of racial/ethnic minority and female individuals compared with United States census data from 2010 and 2018. Secondary outcome measures were inclusion by trial funding source and year of completion.</p><p><strong>Results: </strong>A total of 69 United States based clinical trials involving 6990 participants were included in the analysis. Of these, 35 trials (51%) were randomized, and 26 (38%) were conducted across multiple United States regions. All trials reported sex, while 42 (61%) reported race and 27 (39%) reported ethnicity. Compared to United States census data, Asian individuals were overrepresented (9.3%; 95%CI: 8.1%-10.5%), whereas African American (7.8%; 95%CI: 6.7%-8.9%) and American Indian or Alaska Native individuals (0.4%; 95%CI: 0.1%-0.6%) were underrepresented. The proportion of White participants (75.9%; 95%CI: 74.1%-77.7%) was consistent with census estimates. Hispanic participants were underrepresented (13.3%; 95%CI: 12.2%-14.5%) regardless of the census year referenced. In industry-sponsored trials, Asian representation was three times higher than in the general population (15%). NIH funded trials showed overrepresentation of White participants (83.8%) and underrepresentation of Black participants (4.1%) relative to census data. Women comprised 31.1% of all participants (95%CI: 30.0%-32.2%), indicating underrepresentation. Among trials that reported racial data, 62 (90%) did not include participants of American Indian or Alaska Native, Native Hawaiian, or Pacific Islander descent.</p><p><strong>Conclusion: </strong>Our analysis indicates that women, African Americans, and Hispanic individuals are underrepresented in LT clinical trials compared to the general United States population. These results highlight the need for regulatory initiatives aimed at enhancing the inclusion of historically marginalized ","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 9","pages":"110384"},"PeriodicalIF":2.5,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathogenesis and clinical management of liver damage in porphyrias: Mechanisms and therapeutic approaches.","authors":"Tao Zeng, Shu-Ying Huang, Jian-Ning Chen, Jia-Hui Pang, Yu-Tian Chong, Xin-Hua Li","doi":"10.4254/wjh.v17.i9.107705","DOIUrl":"10.4254/wjh.v17.i9.107705","url":null,"abstract":"<p><p>Porphyria refers to a group of rare inherited metabolic disorders caused by enzymatic deficiencies in the heme biosynthesis pathway. These deficiencies lead to the pathological accumulation of neurotoxic porphyrin precursors, resulting in multisystem damage. Currently, there are no curative therapeutic interventions, and patients frequently experience severe morbidity or life-threatening complications. Among the most critical manifestations is protoporphyric liver disease, in which hepatotoxic porphyrins and their precursors drive progressive hepatic injury and cholestasis. Persistent elevation of these metabolites can lead to irreversible parenchymal damage, significantly affecting both quality of life and long-term prognosis. The clinical presentation of porphyria-associated liver injury is highly variable and often has an insidious onset. However, a subset of patients may experience rapid progression to acute liver failure or fulminant hepatic dysfunction. Diagnosis is based on clinical evaluation and is confirmed by genetic testing. Current treatment strategies are focused on symptom management while underlying disease mechanisms remain unaddressed, posing significant therapeutic challenges. This review summarizes the pathophysiology, clinical manifestations, and diagnostic approaches for porphyria-associated liver injury, highlighting emerging therapies with the potential to improve patient outcomes.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 9","pages":"107705"},"PeriodicalIF":2.5,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476770/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Explant-based prognostic models for hepatocellular carcinoma recurrence after liver transplantation: A systematic review and meta-analysis.","authors":"Iago Christofoli de Barros, Matheus Vanzin Fernandes, Santiago Rodríguez Villafuerte, Ajacio Bandeira de Mello Brandão","doi":"10.4254/wjh.v17.i9.111126","DOIUrl":"10.4254/wjh.v17.i9.111126","url":null,"abstract":"<p><strong>Background: </strong>Liver transplantation (LT) is the preferred curative treatment for early-stage hepatocellular carcinoma (HCC). However, approximately 17% of patients experience post-transplant recurrence. Extrahepatic recurrence and early recurrence (within one year after LT) are associated with poorer post-recurrence survival.</p><p><strong>Aim: </strong>To assess which explant-based prognostic model best predicts HCC recurrence after LT.</p><p><strong>Methods: </strong>A systematic search was performed in PubMed, EMBASE, Web of Science, and the Cochrane Library from inception to January 30, 2025. Nine retrospective studies comprising 5348 patients were included. Three explant-based prognostic models were analyzed: (1) Risk estimation of tumor recurrence after transplant (RETREAT); (2) Decaens; and (3) Predicting Cancer Recurrence Score (PCRS). Primary outcomes included: (1) HCC recurrence rate; and (2) Predictive accuracy of each score over a five-year follow-up.</p><p><strong>Results: </strong>All studies were retrospective and included validation cohorts from North America, Europe, and Asia. The overall recurrence rate was 7%. For high-risk thresholds, pooled sensitivity and specificity were Risk Estimation of Tumor Recurrence after Transplant (RETREAT) ≥ 5 (0.381/0.953), Decaens ≥ 4 (0.676/0.817), and PCRS ≥ 3 (0.217/0.987). Among high-risk patients, recurrence reached 45% (95%CI: 35.1-57.0). Area under the curve comparisons showed no statistically significant differences among models. Thus, no model demonstrated clear superiority.</p><p><strong>Conclusion: </strong>Although several explant-based models exist, their limited sensitivity suggests that many patients at risk of recurrence remain unidentified. The RETREAT score, developed in a large cohort, remains the most extensively validated. Future approaches should focus on developing improved prognostic tools using larger, preferably prospective datasets, and integrating artificial intelligence to enhance risk stratification and post-transplant surveillance.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 9","pages":"111126"},"PeriodicalIF":2.5,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Melatonin's anti-inflammatory and antioxidant effects in gallstone disease: A narrative review.","authors":"Umaimah Batool Mirza, Imteshal Sarfaraz, Zunaira Kiran, Daniyal Sohail, Rahim Khan, Ahmed Asad Raza, Abedin Samadi","doi":"10.4254/wjh.v17.i9.110964","DOIUrl":"10.4254/wjh.v17.i9.110964","url":null,"abstract":"<p><p>Gallstone disease (cholelithiasis) is a common gastrointestinal (GI) disorder characterized by the accumulation of hardened bile constituents, often leading to complications such as cholecystitis, cholangitis, and pancreatitis. Most gallstones are cholesterol-based and form due to bile supersaturation, gallbladder dysmotility, and inflammation. Current treatment options-such as ursodeoxycholic acid, laparoscopic cholecystectomy, and dietary modifications-have limitations including invasiveness, prolonged duration, side effects, and recurrence risk. Melatonin, a hormone secreted by the pineal gland, has gained attention for its antioxidant and anti-inflammatory properties, as well as its regulatory effects on lipid metabolism and gallbladder motility. Experimental studies suggest that melatonin reduces biliary cholesterol, suppresses oxidative stress, and restores gallbladder muscle function, thereby preventing gallstone formation. It is also present in bile and shown to enhance cholesterol conversion into bile acids and inhibit intestinal cholesterol absorption. Beyond gallstone prevention, melatonin demonstrates protective effects against GI malignancies, including hepatocellular carcinoma and cholangiocarcinoma, by regulating mitochondrial function, inhibiting glycolysis, and modulating apoptosis. With a strong safety profile and minimal side effects, melatonin may serve as a promising adjunct or alternative for gallstone management, particularly in patients unfit for surgery. Further clinical research is warranted to validate its therapeutic role.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 9","pages":"110964"},"PeriodicalIF":2.5,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476760/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Albumin-bilirubin score reflects the extent of liver fibrosis in chronic hepatitis C patients treated with direct-acting antivirals.","authors":"Mohammed Ewid, Hossam Sherif, Nazmus Saquib, Ammar Mohammed Alammari, Amro Abdelaziz Mohammed Ismail, Mohammed H Alkahlot, Ziyad T Ahmed, Faisal Zain Mohammed Al-Zabidi, Nawaf Al Mutiri","doi":"10.4254/wjh.v17.i9.110049","DOIUrl":"10.4254/wjh.v17.i9.110049","url":null,"abstract":"<p><strong>Background: </strong>The albumin-bilirubin (ALBI) score was developed as a prognostic tool for patients with hepatocellular carcinoma. However, its new role as an indicator of liver fibrosis in chronic hepatitis C virus (HCV) patients is under investigation.</p><p><strong>Aim: </strong>To investigate the ALBI score as a non-invasive means of assessing the extent of liver fibrosis in chronic HCV patients.</p><p><strong>Methods: </strong>We evaluated hospital records of 231 eligible chronic HCV patients from King Fahad Specialist Hospital in Buraydah, Saudi Arabia. Demographic/clinical data, liver function tests, non-invasive tests for liver fibrosis, and ALBI score/grades were evaluated before and two years after direct-acting antivirals (DAA) treatment.</p><p><strong>Results: </strong>The median ALBI score improved from -2.51 to -2.62 after DAA treatment (<i>P</i> < 0.05). Additionally, the ALBI score improved irrespective of the level of fibrosis, with improvement more evident in patients with advanced fibrosis (-2.26 to -2.41, <i>P</i> < 0.05). The ALBI score showed significant positive correlation with non-invasive tests for liver fibrosis (aspartate aminotransferase/alanine aminotransferase ratio, aspartate aminotransferase to platelet ratio index, and fibrosis-4 index) at baseline and after DAA treatment (<i>P</i> < 0.05). Moreover, the receiver operating characteristic curve demonstrated ALBI score's ability to predict advanced fibrosis (F3, F4) [area under the curve = 0.76, (95% confidence interval: 0.70-0.81), <i>P</i> < 0.001, best cut-off value = -2.38 (sensitivity 60% and specificity 83%)].</p><p><strong>Conclusion: </strong>The ALBI score appears to be a useful non-invasive marker for assessing liver fibrosis in chronic HCV patients and may serve as a valuable tool for monitoring hepatic function during and after DAA treatment.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 9","pages":"110049"},"PeriodicalIF":2.5,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Re-evaluating surgical strategies in Barcelona Clinic Liver Cancer-B hepatocellular carcinoma.","authors":"Ioannis Liapis, Ioannis A Ziogas, Charalampos Theocharopoulos, Dimitrios P Moris, Trevor L Nydam, Ana L Gleisner, Richard D Schulick, Georgios Tsoulfas","doi":"10.4254/wjh.v17.i9.108970","DOIUrl":"10.4254/wjh.v17.i9.108970","url":null,"abstract":"<p><p>The incidence of hepatocellular carcinoma (HCC) has been steadily rising, underscoring the need for a clear, stage-specific treatment approach. The Barcelona Clinic Liver Cancer (BCLC) staging system remains the most widely used framework for classifying HCC and guiding therapy. Among its classifications, the intermediate stage (BCLC-B) encompasses a highly heterogeneous patient population, with varying degrees of tumor burden and liver function. Traditionally, transarterial chemoembolization has been the standard treatment for this stage, based on earlier evidence. However, recent studies suggest that a subset of BCLC-B patients-particularly those with localized disease-may benefit more from liver resection. This review summarizes current treatment paradigms for BCLC-B HCC, explores emerging subclassifications within this group, and highlights evolving guidelines that support the selective use of surgery in appropriately chosen patients.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 9","pages":"108970"},"PeriodicalIF":2.5,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Silymarin-alpha lipoic acid and metabolic dysfunction-associated steatotic liver disease: Insights and methodological considerations.","authors":"Froylan David Martínez-Sánchez, Sophia Eugenia Martínez-Vázquez, Ricardo Gutiérrez-Monterrubio, Sergio Muñoz-Martínez, Ignacio Garcia-Juarez","doi":"10.4254/wjh.v17.i9.110162","DOIUrl":"10.4254/wjh.v17.i9.110162","url":null,"abstract":"<p><p>The trial by Cano Contreras <i>et al</i> examined a proprietary formulation containing <i>Silybum marianum</i> and alpha-lipoic acid (SM-ALA), combined with a Mediterranean diet, in patients with metabolic dysfunction-associated steatotic liver disease. While some metabolic benefits were observed, limitations such as the absence of an SM-ALA-only group, the lack of histological data, and a small sample size reduce the validity of the findings. Future research should follow clinical trial standards for pharmacological studies, including phase 1/2 testing, validated outcomes, and transparency.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 9","pages":"110162"},"PeriodicalIF":2.5,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145192986","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeting glypican-3 as a new frontier in liver cancer therapy.","authors":"Chen-Shiou Wu, Teng-Yu Lee, Hsu-Wen Chao","doi":"10.4254/wjh.v17.i9.107671","DOIUrl":"10.4254/wjh.v17.i9.107671","url":null,"abstract":"<p><p>Glypican-3 (GPC3) is a tumor-associated antigen that is specifically expressed in hepatocellular carcinoma (HCC) and having relatively low levels in normal tissues. This unique expression pattern positions GPC3 as a potential target for precision therapy and drug development in HCC. Recent studies have shown significant advancements in GPC3-targeted therapies and immunotherapies, particularly for patients with advanced or treatment-resistant HCC. Although certain clinical trials have yielded suboptimal results, numerous ongoing studies continue to explore its therapeutic efficacy. This mini-review focuses on the latest research developments regarding GPC3 as a therapeutic target across various HCC treatment strategies, including monoclonal antibodies, bispecific antibodies, chimeric antigen receptor-T-cell therapies, and other innovative approaches. In addition, the limitations of GPC3-targeted therapies and their future application prospects in HCC treatment are discussed. The review particularly emphasizes the unmet need for future research directions, such as combination immunotherapy strategies and novel drug designs. Through the integration of innovative technologies and clinical validation, GPC3 holds strong potential as a promising breakthrough in the treatment of HCC, offering new opportunities for enhancing patient outcomes and improving therapeutic efficacy.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 9","pages":"107671"},"PeriodicalIF":2.5,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476774/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From gut to liver: Exploring the relationship between inflammatory bowel disease and metabolic dysfunction-associated steatotic liver disease.","authors":"Marina Amorim Lopes, Ellen Cristina Souza Oliveira, Ana Elisa Valencise Quaglio, Andrey Santos, Marcello Imbrizi, Leticia Evelyn Rocha Mendes, Rodrigo Fedatto Beraldo, Julio Pinheiro Baima, Amanda Luísa Spiller, Daniéla Oliveira Magro, Ligia Yukie Sassaki","doi":"10.4254/wjh.v17.i9.109035","DOIUrl":"10.4254/wjh.v17.i9.109035","url":null,"abstract":"<p><p>Inflammatory bowel disease (IBD), comprising Crohn's disease and ulcerative colitis, is a chronic condition marked by relapsing inflammation of the gastrointestinal tract. Metabolic dysfunction-associated steatotic liver disease (MASLD) emphasizes the interplay between metabolic alterations and modern lifestyle factors in its pathogenesis. Emerging evidence suggests that individuals with IBD are at increased risk for MASLD, driven by shared mechanisms, including gut dysbiosis, chronic systemic inflammation, and compromised intestinal barrier function. However, MASLD frequently remains underdiagnosed in this population. The gut microbiota plays a central role in modulating these interactions, influencing both intestinal permeability and metabolic regulation. Key pathophysiological mechanisms include alterations in short-chain fatty acid production, particularly reduced butyrate synthesis; disruption of bile acid signaling pathways <i>via</i> farnesoid X receptor and Takeda G protein-coupled receptor 5 receptors; and activation of pro-inflammatory cascades through toll-like receptor 4 in the liver. These events lead to increased intestinal permeability, translocation of microbial products, and amplification of hepatic inflammation. This review synthesizes current knowledge on the shared pathophysiological pathways linking IBD and MASLD-focusing on dysbiosis, barrier dysfunction, and inflammation-and underscores their clinical relevance. Understanding the gut-liver axis provides opportunities for early diagnosis and integrated management strategies, aiming to reduce disease burden and improve patient outcomes.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 9","pages":"109035"},"PeriodicalIF":2.5,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender disparities in hepatitis C treatment: A call for tailored approaches.","authors":"Eyad Gadour","doi":"10.4254/wjh.v17.i9.110128","DOIUrl":"10.4254/wjh.v17.i9.110128","url":null,"abstract":"<p><p>Considering the recent study by Dobrowolska <i>et al</i>, which investigated sex-related differences in treatment outcomes for chronic hepatitis C infection, this letter endorses the findings that highlight significant disparities between male and female patients. The study revealed that women, particularly those in the premenopausal and menopausal stages, exhibited higher sustained virologic response rates than men. However, postmenopausal women encounter unique challenges that merit attention. This letter emphasizes the necessity for healthcare providers to implement sex-sensitive approaches in the management of hepatitis C, acknowledging the impact of biological, hormonal, and psychosocial factors on treatment efficacy. By advocating tailored treatment strategies that address these disparities, we can improve patient outcomes and ensure equitable healthcare for all individuals affected by hepatitis C. Furthermore, this letter calls for additional research to explore the underlying mechanisms driving these differences, ultimately contributing to more effective and personalized care of patients across diverse demographics.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 9","pages":"110128"},"PeriodicalIF":2.5,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}