Hepatology Forum最新文献

{"title":"Embolization of spontaneous portosystemic shunts for refractory hepatic encephalopathy in cirrhosis patients:A meta-analysis.","authors":"Parth Patel, Mohamad Ebrahim, Eli Zaher, Himsikhar Khataniar, Priyadarshini Loganathan, Douglas G Adler","doi":"10.14744/hf.2025.59487","DOIUrl":"10.14744/hf.2025.59487","url":null,"abstract":"<p><strong>Background and aim: </strong>Hepatic encephalopathy is an important cause of morbidity in cirrhosis patients. The presence of spontaneous portosystemic shunts (SPSS) is associated with an increased risk of recurrent/refractory hepatic encephalopathy (HE). Embolization of SPSS has been shown to improve HE symptoms, but it may worsen portal hypertension and related complications. The aim of this study was to determine the efficacy of SPSS embolization for recurrent/refractory HE.</p><p><strong>Materials and methods: </strong>Five databases were screened to identify studies assessing the efficacy of SPSS embolization for HE. The random-effects model was used to calculate the pooled rates, and I2% values were used to assess heterogeneity.</p><p><strong>Results: </strong>Twenty-one studies met the inclusion criteria, comprising a total of 331 patients with recurrent or refractory HE despite medical management. The etiology of cirrhosis included ethanol abuse, chronic viral hepatitis, MASH, and others. Following embolization, 82% of patients had HE-related clinical improvement, and 71% of patients became free from HE-related hospitalization. The mean difference in pre- and post-embolization serum ammonia levels was 104 [77-130], p<0.01. Worsening portal hypertension following embolization presented as gastrointestinal bleeding (10%), new or aggravated varices (15%), and new or aggravated ascites (15%).</p><p><strong>Conclusion: </strong>SPSS embolization demonstrated improvement in HE-related clinical symptoms with a decreased need for hospitalization, but it exacerbates portal hypertension, increasing the risks of ascites, varices, and gastrointestinal bleeding. Future randomized controlled trials are needed to evaluate the efficacy of SPSS embolization against standard medical management.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"7 2","pages":"91-100"},"PeriodicalIF":2.1,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13442353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686090","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":"Peritonitis due to brucellosis in a patient newly diagnosed with liver cirrhosis complicated by ascites: A case report and literature review.","authors":"Remzi Ekici, Mine Filiz, Sefa Onus, Ali Gokhan Akcay, Tolga Bakir, Galip Buyukturan, Emine Gul Aydin, Mustafa Ekici, Musa Aydinli, Cemal Nuri Ercin","doi":"10.14744/hf.2025.40823","DOIUrl":"10.14744/hf.2025.40823","url":null,"abstract":"<p><p><i>Brucellosis</i> is a common zoonotic disease with a wide variety of clinical manifestations. Spontaneous bacterial peritonitis (SBP) is a rare form among them. Here, we present the case of a 63-year-old woman with newly diagnosed liver cirrhosis complicated with ascites and diagnosed as spontaneous bacterial peritonitis with <i>Brucella</i> spp. growth in culture, and the literature is reviewed.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"7 2","pages":"167-170"},"PeriodicalIF":2.1,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13442724/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686208","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":"Evaluation of percutaneous endobiliary punch biopsy in suspected malignant biliary strictures: Five-year experience from a tertiary center.","authors":"Ufuk Avcioglu, Hakan Demiroz, Aysegul Idil Soylu, Fatih Uzunkaya, Huseyin Akkaya, Ibrahim Goren, Talat Ayyildiz, Muge Ustaoglu Dede, Ahmet Bektas","doi":"10.14744/hf.2026.06659","DOIUrl":"10.14744/hf.2026.06659","url":null,"abstract":"<p><strong>Background and aim: </strong>To evaluate the diagnostic performance, technical feasibility, and safety of percutaneous endobiliary punch biopsy (PEPB) in patients with suspected malignant biliary strictures, particularly when endoscopic approaches are not feasible.</p><p><strong>Materials and methods: </strong>This retrospective, single-center study included 23 patients with radiologically confirmed biliary strictures who underwent PEPB between January 2020 and January 2025. All procedures were conducted under fluoroscopic guidance following percutaneous biliary drainage. Clinical, laboratory, and procedural data were reviewed.</p><p><strong>Results: </strong>Biopsy samples were adequate for histopathological analysis in all cases. The technical success rate was 100%. Malignancy was detected by PEPB in 17 patients, while 3 cases were confirmed as benign and 3 were false-negative results later proven malignant. PEPB demonstrated a sensitivity of 85%, specificity of 100%, and an overall accuracy of 86.96%. Fisher's exact test showed a significant association between biopsy results and final diagnosis (p=0.011). Two minor complications (8.7%)-cholangitis and hemobilia-occurred and were managed conservatively.</p><p><strong>Conclusion: </strong>PEPB is a safe, technically viable, and diagnostically accurate method for tissue sampling in biliary strictures. It offers a valuable alternative when endoscopic biopsy fails or is not feasible.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"7 2","pages":"133-138"},"PeriodicalIF":2.1,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13442725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686197","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":"Methylprednisolone for <i>Swietenia macrophylla</i> seeds-induced liver injury: A report of two cases.","authors":"Ze-Yu Huang, Xiu-Jun Zhang, Xue-Cheng Tong, Yuan Xue","doi":"10.14744/hf.2025.18282","DOIUrl":"10.14744/hf.2025.18282","url":null,"abstract":"<p><p><i>Swietenia macrophylla</i> seeds (SMS), as a traditional medicine, are widely used against diabetes, hypertension, and malaria. To date, knowledge about the safety of human consumption remains limited. We herein reported two cases of drug-induced liver injury (DILI) caused by SMS. Both patients had positive antinuclear antibodies. Hepatotoxicity of SMS is characterized by elevated alanine aminotransferase and obvious autoimmune-like hepatitis. Furthermore, the 2^nd biopsy at the 3^rd year of methylprednisolone treatment showed normal liver tissue, and then methylprednisolone was withdrawn. No recurrence occurred during one-year follow-up after methylprednisolone withdrawal. SMS may increase the risk of liver damage for patients with potential immune disorders, and patients with SMS-related DILI may benefit from methylprednisolone.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"7 2","pages":"163-166"},"PeriodicalIF":2.1,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13442719/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686205","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":"Empagliflozin versus dapagliflozin in patients with liver cirrhosis: A comparative real-world study on hepatic decompensation.","authors":"Hatem Ahmed, Imad Alabdul Razzak, Eyad Abdulrazzak, Sameh Gomaa, Joelle Lauchner","doi":"10.14744/hf.2026.11444","DOIUrl":"10.14744/hf.2026.11444","url":null,"abstract":"<p><strong>Background and aim: </strong>Sodium-glucose cotransporter-2 inhibitors may improve outcomes in liver cirrhosis, but comparative evidence between individual agents is limited. We compared real-world outcomes of empagliflozin versus dapagliflozin in adults with liver cirrhosis.</p><p><strong>Materials and methods: </strong>We conducted a multicenter retrospective cohort study using the TriNetX US Collaborative Network (69 healthcare organizations). Adults with cirrhosis who were newly prescribed empagliflozin or dapagliflozin after the diagnosis of cirrhosis between March 1, 2013 and January 1, 2025, were included. Propensity score matching (1:1) was used to balance baseline characteristics. Outcomes were assessed from day 1 after the index prescription through 5 years. Primary outcomes were all-cause mortality and all-cause hospitalization. Secondary outcomes included hepatic decompensation events. Tertiary outcomes included prognostic hepatic and renal biomarkers. Safety outcomes included the incidence of acute kidney injury, urinary tract infection, and diabetic ketoacidosis.</p><p><strong>Results: </strong>Before matching, 17,700 empagliflozin users and 8,619 dapagliflozin users were identified; 7,852 patients remained in each cohort after matching. Five-year mortality was similar between groups (12.7% vs. 12.6%; odds ratio [OR]: 1.012, 95% confidence interval [CI]: 0.921-1.112; p=0.8075), as was the risk of hospitalization (14.7% vs. 13.4%; OR: 1.105, 95% CI: 0.94-1.30; p=0.216). Empagliflozin was associated with lower rates of hepatic encephalopathy (4.0% vs. 4.7%; OR: 0.84; p=0.0295), hepatorenal syndrome (1.0% vs. 1.6%; OR: 0.614; p=0.0007), and paracentesis (2.9% vs. 3.7%; OR: 0.785; p=0.0083). Albumin levels were higher and bilirubin levels were lower with empagliflozin (p<0.01 for both). Safety outcomes were similar between groups.</p><p><strong>Conclusion: </strong>In matched adults with cirrhosis, empagliflozin and dapagliflozin demonstrated comparable five-year mortality and hospitalization rates. However, empagliflozin was associated with fewer selected decompensation events without an increase in adverse events.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"7 2","pages":"139-145"},"PeriodicalIF":2.1,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13442726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686168","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":"Occult hepatitis B infection.","authors":"Mikha Eliana Wati, Yusra","doi":"10.14744/hf.2025.12670","DOIUrl":"10.14744/hf.2025.12670","url":null,"abstract":"<p><p>Occult Hepatitis B Infection (OBI) is a condition in which HBsAg tests are negative, but Hepatitis B virus (HBV) DNA is detectable in the liver, with or without low levels of HBV DNA in the blood (<200 IU/mL). The Hepatitis B surface antigen (HBsAg) negative status in OBI may result from the absence or low production of HBsAg due to immune system defense mechanisms or mutations in the S genome of HBV DNA, which make HBsAg undetectable. The gold standard for diagnosing OBI is testing for HBV DNA from liver tissue, with an alternative method being HBV DNA testing from serum. Patients with OBI may be at risk of transmitting HBV to others through blood transfusions or organ transplants. Reactivation may occur, especially in OBI patients who are immunocompromised or undergoing immunosuppressive therapy. Antiviral prophylaxis may be considered for OBI patients at risk of reactivation. Additionally, OBI patients also carry a risk of developing hepatocellular carcinoma (HCC), similar to those with non-occult hepatitis B infection. Antiviral therapy for OBI is generally not required unless the case represents false OBI due to HBsAg mutation.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"7 2","pages":"146-153"},"PeriodicalIF":2.1,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13442727/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686192","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":"The usefulness of a simultaneous immunoassay for hepatitis C virus antigen-antibody using the ELECSYS HCV Duo assay.","authors":"Keisuke Amano, Tomoya Sano, Tatsuya Ide, Dan Nakano, Shigemune Bekki, Teruko Arinaga-Hino, Takumi Kawaguchi","doi":"10.14744/hf.2025.27743","DOIUrl":"10.14744/hf.2025.27743","url":null,"abstract":"<p><strong>Background and aim: </strong>The World Health Organization has a goal to eliminate the hepatitis C virus (HCV) by 2030. To achieve this, effective screening for HCV is essential. We evaluated the utility of the ELECSYS® HCV Duo immunoassay (Duo assay) for HCV screening.</p><p><strong>Materials and methods: </strong>This single-center retrospective study included 184 HCV patients from 2014 to 2017. We measured HCV antibody (Duo/Ab) and HCV core antigen (Duo/cAg) using the Duo assay in HCV RNA-positive samples obtained before DAA therapy. We compared Duo/cAg positivity rates according to host and viral factors. We also performed logistic regression analysis and decision tree analysis to identify independent factors and profiles for Duo/cAg false-negative results, respectively.</p><p><strong>Results: </strong>Duo/Ab positivity rates were 100%, and Duo/cAg positivity rates were 78% in all subjects. Duo/cAg positivity rates were 40.0%, 78.6%, and 92.9% at HCV RNA levels ≤4.9, 5.0-5.9, and ≥6.0 log IU/mL, respectively (p<0.0001). There were no significant differences in Duo/cAg positivity rates by gender, age, body mass index, ALT >30 U/L, and HCV genotype. In multivariate analysis, the HCV RNA level (Unit -1.0 log IU/mL, OR 5.49, CI 3.12-10.56, p<0.0001) was the only independent factor associated with Duo/cAg false-negative results. Decision tree analysis revealed that HCV RNA ≥5.7 log IU/mL was the profile associated with the lowest false-negative rate (7.4%). In contrast, HCV RNA <4.4 log IU/mL was the profile associated with the highest false-negative rate (100%).</p><p><strong>Conclusion: </strong>The Duo assay identified approximately 80% of HCV carriers without HCV RNA measurement, regardless of patient background, providing substantial clinical, economic, and time-saving benefits. However, clinicians should be aware of limitations in patients with low HCV RNA levels.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"7 2","pages":"118-124"},"PeriodicalIF":2.1,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13442722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686325","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":"A fructose-intolerant patient with acute liver injury: Not only the active ingredient, but also excipients matter.","authors":"Eda Kaya, Aleko Zedginidze, Djawid Baraksei, Ali Canbay, Andrea Tannapfel, Oliver Goetze","doi":"10.14744/hf.2025.99427","DOIUrl":"https://doi.org/10.14744/hf.2025.99427","url":null,"abstract":"<p><p>We report the case of an 18-year-old female with cholestatic hepatopathy of unknown origin, presenting with therapy-resistant jaundice and pruritus following oral contraceptive use and gastrointestinal infections. In another hospital, drug-induced autoimmune hepatitis (DILI-AIH) was suspected, and corticosteroid therapy was initiated but remained unresponsive. Initiation of colestyramine led to a worsening of symptoms and increasing liver transaminases. After referral to our centre, a mini-laparoscopic liver biopsy was performed, and histopathology revealed cholestatic DILI and mild fibrosis, with no signs of AIH. After a repeated precise history from the mother, a hereditary fructose intolerance was highly suggestive, and genetic testing confirmed a homozygous mutation in the aldolase B gene (A149P). Additionally, no pathogenic mutations in genes encoding bile acid and phospholipid transporters were detected. The treatment was adjusted to sugar-free colestyramine, leading to complete resolution of symptoms. In the management of hereditary fructose intolerance, not only dietary ingredients but also the supplements and medications may contain fructose excipients that could exacerbate and aggravate liver injuries.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"7 3","pages":"292-295"},"PeriodicalIF":2.1,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13473243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761179","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":"High expression of USP15 affects tumor progression and immune infiltration in hepatocellular carcinoma.","authors":"Si-Peng Wu, Xue-Yuan Zhang, Hui-Dan Chen, Fu-Zhi Jin, Nan Jiang, Jia-Xing Zhang, Zhe-Long Liang","doi":"10.14744/hf.2026.39981","DOIUrl":"10.14744/hf.2026.39981","url":null,"abstract":"<p><strong>Background and aim: </strong>Ubiquitin-specific protease 15 (USP15) is closely associated with the occurrence and progression of hepatocellular carcinoma (HCC). However, its role in shaping the immune landscape of HCC remains unclear.</p><p><strong>Materials and methods: </strong>The expression levels, proportions, and spatial distributions of USP15 and specific immune cell subsets in HCC tissues were evaluated using multiplex immunohistochemistry (mIHC).</p><p><strong>Results: </strong>In the tumor parenchyma of HCC tissues, the infiltration of immune cells, particularly natural killer (NK) cells, was significantly reduced (p<0.05). Further analyses revealed that USP15 expression levels were significantly associated with clinical stage and other clinicopathological parameters (p<0.05). In particular, NK cell infiltration was significantly correlated with N stage, M stage, and overall tumor-node-metastasis (TNM) stage (p<0.05).</p><p><strong>Conclusion: </strong>USP15 contributes to the establishment of an immunosuppressive tumor microenvironment in HCC by inhibiting T cell and NK cell infiltration, facilitating programmed death-ligand 1 (PD-L1)-mediated immune evasion, and enhancing macrophage recruitment. These findings indicate that USP15 may serve as a potential therapeutic target for HCC.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"7 2","pages":"108-117"},"PeriodicalIF":2.1,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13442720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148686200","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":"A traditional herbal remedy in liver diseases: <i>Momordica charantia</i> L. (kudret narı/bitter melon).","authors":"Dudu Altintas Gunduz, Yasemin Balaban, Ufuk Koca Caliskan","doi":"10.14744/hf.2025.98035","DOIUrl":"10.14744/hf.2025.98035","url":null,"abstract":"<p><p>The liver is the central organ regulating the body's metabolism; therefore, liver diseases negatively affect metabolic activities as well as the immune system. <i>Momordica charantia</i> L. is one of the medicinal plants used in folk medicine to prevent or treat liver diseases. <i>M. charantia</i> contains compounds with antioxidant and anti-inflammatory properties that protect liver cells from free radical damage and reduce inflammation. In addition, the phytochemicals of <i>M. charantia</i> may help regulate blood sugar levels, thereby supporting metabolism and reducing fat accumulation in the liver. Previous studies indicate that <i>M. charantia</i> has the potential to enhance liver function while reducing the incidence of fatty liver disease. This study aimed to summarize data from <i>in vivo</i> studies investigating the hepatoprotective mechanisms of <i>M. charantia</i> at various application doses, highlighting its potential as a future dietary supplement candidate. However, due to insufficient evidence regarding its safety, the possibility of hepatotoxic effects should not be disregarded.</p>","PeriodicalId":29722,"journal":{"name":"Hepatology Forum","volume":"7 2","pages":"154-162"},"PeriodicalIF":2.1,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13442721/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148685844","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}