World Journal of Hepatology最新文献

{"title":"Trends in viral hepatitis-related mortality in the United States from 1999 to 2022: A retrospective study.","authors":"Lizette Ahlers, Benjamin Kash, Taylor Billion, Mohsin Mirza, Abubakar Tauseef","doi":"10.4254/wjh.v17.i5.106940","DOIUrl":"10.4254/wjh.v17.i5.106940","url":null,"abstract":"<p><strong>Background: </strong>Viral hepatitis is characterized by a group of hepatotropic viruses that contribute to high rates of liver disease and mortality. It is well-documented that viral hepatitis is the leading cause of liver cancer and liver failure, with Hepatitis B and Hepatitis C being the most common viruses associated with these outcomes.</p><p><strong>Aim: </strong>To study viral hepatitis-related mortality trends from 1999 to 2022, focusing on gender, race/ethnicity, age, region, and urban/rural classifications.</p><p><strong>Methods: </strong>We used the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research database to identify viral hepatitis-related deaths in the United States from 1999 to 2022. Data on demographic and regional information were analyzed and stratified by gender, race/ethnicity, age, regional, and urban rural classifications. Using the Joinpoint Regression Program (version 4.9.0.0 used, available from the National Cancer Institute, Bethesda, Maryland) the annual percentage change (APC) and average APC (AAPC) were calculated with 95%CI for extracted Age Adjusted Mortality Rates (AAMR).</p><p><strong>Results: </strong>From 1999 to 2022, there were 389916 viral hepatitis-related deaths in the United States. The overall AAMR increased from 1999 to 2013 (APC: 3.20%; 95%CI: 2.54-3.99; <i>P</i> < 0.001), then declined through 2022 (APC: -5.54%; 95%CI: -6.75 to -4.47; <i>P</i> < 0.001). Males accounted for 70.4% of deaths, with steeper declines in females (AAPC: -0.48%; 95%CI: -0.87 to -0.12; <i>P</i> < 0.05). The American Indian/Alaska Native population had the highest AAMR (AAPC: 2.90%; 95%CI: 2.30 to 3.68; <i>P</i> < 0.001). The population of 65-74 years had the largest increase in overall crude mortality rate (AAPC: 3.20%; 95%CI: 2.77 to 3.85; <i>P</i> < 0.001). Mortality was highest in the West (AAPC: -0.78%; 95%CI -1.28 to -0.29; <i>P</i> < 0.05). Rural AAMR exceeded urban rates after 2015.</p><p><strong>Conclusion: </strong>This study found significant racial, ethnic, and geographical disparities in viral hepatitis AAMR. Key factors for mortality reduction include patient education, screening, and access to hepatitis vaccination and treatment.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 5","pages":"106940"},"PeriodicalIF":2.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275987","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":"Association between weight fluctuation and the risk of metabolic dysfunction-associated steatotic liver disease.","authors":"Jin-Ping Wang, Jia-Yang Wang, Pei-Qi Sun, Xue-Wei Wang, Ze-Ting Yuan, Qin Cao, Shu-Ming Pan, Yuan-Ye Jiang","doi":"10.4254/wjh.v17.i5.103852","DOIUrl":"10.4254/wjh.v17.i5.103852","url":null,"abstract":"<p><strong>Background: </strong>The global incidence of metabolic dysfunction-associated steatotic liver disease (MASLD) has increased in recent years. It has already been demonstrated that exercise and weight change are associated with the occurrence of MASLD; however, the association between weight fluctuation caused by different exercise intensities and the risk of MASLD remains to be studied.</p><p><strong>Aim: </strong>To investigate the impact of weight fluctuation and physical activity intensity on the risk of MASLD prevalence.</p><p><strong>Methods: </strong>Data from the National Health and Nutrition Examination Survey database including five cycles from 2009 to 2018 were analyzed. The model included variables such as age, sex, and poverty income ratio. Weighted multivariate logistic regression was used to examine the influence of different weight fluctuation patterns within the two time intervals on the prevalence of MASLD. Nonparametric restricted cubic spline curves were used to analyze the non-linear relationship between net weight change and MASLD prevalence.</p><p><strong>Results: </strong>Among 3183 MASLD cases, the risk of MASLD increased with age for individuals transitioning from non-obese to obese or maintaining obesity, with odds ratio (OR) changing from 8.91 (95%CI: 7.40-10.88) and 11.87 (95%CI: 9.65-14.60) at 10 years before baseline to 9.58 (95%CI: 8.08-11.37) and 12.51 (95%CI: 9.33-16.78) at 25 years. Stable obesity correlated with age-dependent MASLD prevalence escalation, whereas increased physical activity attenuated MASLD risk in this group, with an OR changing from 13.64 (95%CI: 10.59-17.57) to 6.42 (95%CI: 4.24-9.72). Further analysis of the net weight changes revealed a paradoxical risk elevation with intensified physical activity during different time periods.</p><p><strong>Conclusion: </strong>The risk of MASLD increases in individuals transitioning from non-obese to obese or maintaining obesity. High-intensity physical activity is beneficial for MASLD among individuals with stable obesity.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 5","pages":"103852"},"PeriodicalIF":2.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149894/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276043","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":"Cardiovascular implications of metabolic dysfunction-associated fatty liver disease and type 2 diabetes mellitus: A meta-analysis.","authors":"Sahana Shetty, Renuka Suvarna, Vanessa Ambrose Fistus, Shivam Modi, Joseph M Pappachan","doi":"10.4254/wjh.v17.i5.105706","DOIUrl":"10.4254/wjh.v17.i5.105706","url":null,"abstract":"<p><strong>Background: </strong>Metabolic dysfunction-associated fatty liver disease (MAFLD) and type 2 diabetes mellitus (T2DM) are independent risk factors for the development of cardiovascular disease (CVD) and an exaggerated CVD risk is expected when both diseases co-exist. Therefore, thorough risk stratification is important to inform better clinical practice decisions based on good quality evidence for patient with MAFLD and T2DM.</p><p><strong>Aim: </strong>To identify the CVD and cardiovascular event (CVE) risk in a systematic review when MAFLD and T2DM co-exist to inform better clinical practice decisions.</p><p><strong>Methods: </strong>A systematic review was performed by compiling data by searching PubMed, EMBASE and Cochrane Library databases. Quality appraisal of retrieved studies and the meta-analysis were performed using Joanna Briggs Institute (JBI) tool and RevMan 5.4 software respectively. The effect indicators for CVE and CVD risk were expressed as odds ratios (OR) and 95%CI with <i>P</i>-values < 0.05 as significant.</p><p><strong>Results: </strong>Fourteen (5 cohort and 9 cross-sectional) studies with 370013 participants were included in this review. The meta-analysis of CVE showed that the risk of CVE in T2DM was higher in the MAFLD group when compared to the non-MAFLD group [OR 1.28 (95%CI, 1.04-1.56) <i>P</i> = 0.02] with follow up duration ranging between 5-6 years. The prevalence of CVD in the metanalysis of cross-sectional studies was found to be higher [OR 1.47 (95%CI, 1.21-1.78) <i>P</i> = 0.0001] in T2DM with MAFLD when compared to T2DM without MAFLD. Significant heterogeneity exists due to variations in study design, methodologies, and MAFLD diagnostic criteria, which may have influenced the study's findings.</p><p><strong>Conclusion: </strong>The presence of MAFLD in T2DM increased the risk of CVE. The prevalence of CVD is higher in T2DM with MAFLD as compared to T2DM without MAFLD. Large well-designed multicentric long-term prospective studies are necessary to appropriately risk stratify the cardiovascular effect of the MAFLD in T2DM patients.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 5","pages":"105706"},"PeriodicalIF":2.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149901/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276044","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":"Infection risk and management in patients with cirrhosis: A critical overview.","authors":"Miguel Suárez, Raquel Martínez, Raquel Gómez-Molina, Jorge Mateo","doi":"10.4254/wjh.v17.i5.104468","DOIUrl":"10.4254/wjh.v17.i5.104468","url":null,"abstract":"<p><p>In this paper, we analyze the article published by El Labban <i>et al</i>, which explores the impact of cirrhosis on patients with necrotizing fasciitis. The authors conclude that cirrhosis is a significant risk factor for increased in-hospital morbidity and mortality in this patient population. Building upon their final observation regarding the importance of understanding this association, we will delve into the topic of infections in patients with liver cirrhosis. These patients exhibit intrinsic characteristics that make them particularly susceptible to infections, both bacterial and fungal. This heightened risk not only increases the likelihood of severe infections but also makes them a common trigger for acute decompensations, including the development of acute-on-chronic liver failure, which markedly worsens prognosis and mortality. Infections in patients with cirrhosis often require a more aggressive and rapid diagnostic and therapeutic approach due to the higher risk of nosocomial infections, multidrug-resistant organisms, and atypical clinical presentations. Delayed or inadequate management can lead to unfavorable outcomes, further complicating the course of their underlying liver disease. The aim of this article is to emphasize the importance of early and appropriate management in patients with cirrhosis with infections. Evidence supports that timely and tailored interventions not only improve clinical outcomes but also reduce mortality. By raising awareness among clinicians about the complexity of these cases, we hope to contribute to optimizing the care of this high-risk population.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 5","pages":"104468"},"PeriodicalIF":2.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275978","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":"Progress in the application of fludeoxyglucose positron emission tomography computed tomography in biliary tract cancer.","authors":"Jia-Xin Yin, Xin Fan, Qiao-Liang Chen, Jing Chen, Jian He","doi":"10.4254/wjh.v17.i5.105446","DOIUrl":"10.4254/wjh.v17.i5.105446","url":null,"abstract":"<p><p>Biliary tract cancer (BTC) is a group of heterogeneous sporadic diseases, including intrahepatic, hilar, and distal cholangiocarcinoma, as well as gallbladder cancer. BTC is characterized by high invasiveness and extremely poor prognosis, with a global increased incidence due to intrahepatic cholangiocarcinoma (ICC). The 18F-fludeoxyglucose positron emission tomography (PET) computed tomography (18F-FDG PET/CT) combines glucose metabolic information (reflecting the glycolytic activity of tumor cells) with anatomical structure to assess tumor metabolic heterogeneity, systemic metastasis, and molecular characteristics noninvasively, overcoming the limitations of traditional imaging in the detection of micrometastases and recurrent lesions. 18F-FDG PET/CT offers critical insights in clinical staging, therapeutic evaluation, and prognostic prediction of BTC. This article reviews research progress in this field over the past decade, with a particular focus on the advances made in the last 3 years, which have not been adequately summarized and recognized. The research paradigm in this field is shifting from qualitative to quantitative studies, and there have been significant breakthroughs in using 18F-FDG PET/CT metabolic information to predict gene expression in ICC. Radiomics and deep learning techniques have been applied to ICC for prognostic prediction and differential diagnosis. Additionally, PET/magnetic resonance imaging is increasingly demonstrating its value in this field.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 5","pages":"105446"},"PeriodicalIF":2.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149906/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275983","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":"Transjugular intrahepatic portosystemic shunt creation using intravascular ultrasound <i>vs</i> fluoroscopic guidance: A dual-institution retrospective comparative study.","authors":"Matthew L Hung, Abhishek Jairam, Matthew Carr, Zachary T Berman, Michael Taddonio, Jeet Minocha, Hamed Aryafar, Jeffrey I Mondschein, Michael C Soulen, Gregory J Nadolski, Jonas Redmond","doi":"10.4254/wjh.v17.i5.106892","DOIUrl":"10.4254/wjh.v17.i5.106892","url":null,"abstract":"<p><strong>Background: </strong>The use of intravascular ultrasound (iUS) has been shown in multiple single-center retrospective studies to decrease procedure time, radiation exposure, and needle passes compared to conventional fluoroscopic guidance in the creation of a transjugular intrahepatic portosystemic shunt (TIPS). However, there are few data regarding the impact of imaging guidance modality choice on clinical outcomes.</p><p><strong>Aim: </strong>To determine the impact of iUS <i>vs</i> fluoroscopic guidance during creation of a TIPS on procedural metrics, liver injury, shunt patency and mortality.</p><p><strong>Methods: </strong>The retrospective study cohort consisted of 66 patients who underwent TIPS creation using iUS [\"iUS-guided TIPS (iTIPS) group\"] and 135 patients who underwent TIPS creation using fluoroscopic guidance [\"conventional fluoroscopic-guided TIPS (cTIPS) group\"] at 2 tertiary academic medical centers from 2015-2019. TIPS that required variceal embolization or portal vein recanalization were excluded.</p><p><strong>Results: </strong>The technical success rate was 100% in the iTIPS group and 96% in the cTIPS group (<i>P</i> = 0.17). The iTIPS group had an air kerma (266 ± 254 mGy <i>vs</i> 1235 ± 1049 mGy, <i>P</i> < 0.00001), dose area product (5728 ± 6518 uGy × m² <i>vs</i> 28969 ± 19067 uGy × m², <i>P</i> < 0.00001), fluoroscopy time (18.7 ± 9.6 minutes <i>vs</i> 32.3 ± 19.0 minutes, <i>P</i> < 0.00001), and total procedure time (93 ± 40 minutes <i>vs</i> 110 ± 51 minutes, <i>P</i> = 0.01) which were significantly lower than the cTIPS group. There was no significant difference in liver function test adverse event grade at 1 month. With a median follow-up of 26 months (inter quartile range: 6-61 months), there was no difference between the two groups in terms of thrombosis-free survival (<i>P</i> = 0.23), intervention-free survival (<i>P</i> = 0.29), or patient mortality (<i>P</i> = 0.61).</p><p><strong>Conclusion: </strong>The use of iUS in the creation of TIPS reduces radiation exposure and procedure time compared with fluoroscopic guidance. At midterm follow-up, the imaging guidance modality did not affect shunt patency or mortality.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 5","pages":"106892"},"PeriodicalIF":2.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275986","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":"What determines survival in autoimmune liver disease overlap syndromes: A critical commentary.","authors":"Jian-Guo Zhang, Yan-Wei Wang, Lan Li, Biao Wen","doi":"10.4254/wjh.v17.i5.104688","DOIUrl":"10.4254/wjh.v17.i5.104688","url":null,"abstract":"<p><p>Recently, Jayabalan <i>et al</i> published an important study. The authors defined the liver outcome score as a novel biomarker for predicting liver-related mortality in patients with autoimmune hepatitis-primary biliary cholangitis overlap syndrome. After thoroughly reviewing their work, we offer insights that primarily relate to their study design to enhance the medical community's understanding of this complex disease.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 5","pages":"104688"},"PeriodicalIF":2.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149903/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275989","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":"Comparative prognostic performance of staging systems for hepatocellular carcinoma: Evidence from a Vietnamese cohort study.","authors":"Tuong-Anh Mai-Phan, Trong-Kha Nguyen, Tri-Nhan Pham, Minh-Quang Tran, Kim-Long Le","doi":"10.4254/wjh.v17.i5.104041","DOIUrl":"10.4254/wjh.v17.i5.104041","url":null,"abstract":"<p><strong>Background: </strong>Hepatocellular carcinoma (HCC), the sixth most common cancer and fourth-leading cause of cancer-related mortality globally, imposes a significant burden in Vietnam due to endemic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. Accurate prognostication is crucial for optimizing treatment and outcomes. Numerous staging systems exist, including the Barcelona Clinic Liver Cancer (BCLC), Hong Kong Liver Cancer (HKLC), cancer of the liver Italian Program (CLIP), Italian Liver Cancer (ITA.LI.CA), Japan Integrated Staging (JIS), Tokyo Score, and model to estimate survival in ambulatory HCC patients (MESIAH). However, their comparative performance in Vietnamese patients remains underexplored.</p><p><strong>Aim: </strong>To compare the prognostic accuracy of seven HCC staging systems in predicting survival and identify the optimal model.</p><p><strong>Methods: </strong>This retrospective cohort study included 987 patients with HCC diagnosed at Nhan dan Gia Dinh Hospital, Vietnam, from January 2016 to December 2023. Patients were staged using BCLC, HKLC, CLIP, ITA.LI.CA, JIS, Tokyo score, and MESIAH. Overall survival was analyzed using Kaplan-Meier methods, and prognostic performance was evaluated <i>via</i> the area under the receiver operating characteristic (ROC) curve, Harrell's concordance index, and calibration plots.</p><p><strong>Results: </strong>The HKLC and BCLC systems demonstrated the highest discriminatory ability, with area under the ROC curves of 0.834 and 0.830, respectively, at 12 months and 0.859 for both systems at 36 months. CLIP and ITA.LI.CA exhibited superior calibration, particularly at 36 months. The JIS system consistently showed the poorest discriminatory performance. Subgroup analyses revealed that HKLC maintained strong performance across different viral etiologies (HBV, HCV, non-B-non-C) and treatment modalities (transarterial chemoembolization, surgery, ablation).</p><p><strong>Conclusion: </strong>The HKLC and BCLC systems showed superior prognostic performance for Vietnamese patients with HCC, supporting HKLC adoption in clinical practice.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 5","pages":"104041"},"PeriodicalIF":2.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275974","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":"Deep sequencing analysis of hepatitis B virus in patients with incomplete response to tenofovir alafenamide fumarate treatment.","authors":"Norie Yamada, Hitomi Igarashi, Asako Murayama, Michihiro Suzuki, Kiyomi Yasuda, Masumichi Saito, Masanori Isogawa, Takanobu Kato","doi":"10.4254/wjh.v17.i5.104519","DOIUrl":"10.4254/wjh.v17.i5.104519","url":null,"abstract":"<p><strong>Background: </strong>Tenofovir alafenamide fumarate (TAF) is one of the first-line treatments used to treat chronic hepatitis B patients; TAF has strong antiviral activity and a high barrier to resistance. Although virological breakthroughs in patients during TAF treatment are rare, patients with incomplete responses to TAF are occasionally observed.</p><p><strong>Aim: </strong>To investigate responsible mutations in the reverse transcriptase region of hepatitis B virus (HBV) for TAF-incomplete responses.</p><p><strong>Methods: </strong>Thirteen chronic hepatitis B patients who received TAF monotherapy were included. A TAF-incomplete responder was defined as one who was continuously positive for HBV DNA over 2 years after TAF treatment initiation. The emergences of mutations in TAF-incomplete responders were evaluated before, one year after, and two years after treatment by deep sequencing of HBV DNA and RNA.</p><p><strong>Results: </strong>Two patients were continuously positive for HBV DNA over two years. The rtL269I mutation, one of the CYEI mutations linked to tenofovir resistance, was detected in both patients by direct sequencing. The deep sequencing analysis revealed that a combination of rtT118A and rtL220I mutations and the rtL269I mutation were predominantly detected in HBV DNA even when these mutations were barely detected in HBV RNA. This suggests a superior replication capability of the HBV variants with these mutations under TAF treatment.</p><p><strong>Conclusion: </strong>The deep sequencing analysis of HBV DNA and RNA and comparing the detection rates of mutations were useful for estimating responsible mutations for TAF-incomplete responses. Such analysis is needed to evaluate the association between mutations that emerge during TAF treatment and incomplete responses to TAF.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 5","pages":"104519"},"PeriodicalIF":2.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149899/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275975","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":"Importance of comprehensive nutritional assessment in predicting survival in cirrhosis.","authors":"Shinichiro Kobayashi","doi":"10.4254/wjh.v17.i5.106606","DOIUrl":"10.4254/wjh.v17.i5.106606","url":null,"abstract":"<p><p>Carteri <i>et al</i> reaffirmed the value of the Child-Turcotte-Pugh score in predicting survival in patients with cirrhosis. However, the lack of association with nutritional markers warrants careful interpretation. In cirrhosis, complex conditions often lead to malnutrition and individual markers may not be fully captured. Comprehensive assessments such as Subjective Global Assessment, handgrip strength, muscle mass measurements, and bioelectrical impedance analysis can improve risk stratification and inform personalized nutritional management. This letter emphasizes the need for standardized nutritional assessments for patients with cirrhosis and further research to clarify their impact on long-term outcomes, potentially improving patient care.</p>","PeriodicalId":23687,"journal":{"name":"World Journal of Hepatology","volume":"17 5","pages":"106606"},"PeriodicalIF":2.5,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12149900/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275977","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}