International Journal of Hepatology最新文献

{"title":"Impact of Renal Replacement Therapy on Outcomes of Living Donor Liver Transplantation for Acute Liver Failure: A Cohort Study.","authors":"Abu Bakar Hafeez Bhatti, Nauman Ul Haq, Nayyer Mehmood, Danyal Hassan, Arsalan Ahmed, Wasim Tariq Malik, Haseeb Haider Zia, Mohammad Salih, Nusrat Yar Khan, Abid Ilyas, Nasir Ayub Khan","doi":"10.1155/2024/8422308","DOIUrl":"https://doi.org/10.1155/2024/8422308","url":null,"abstract":"<p><p>Despite the promising role of renal replacement therapy (RRT) in acute liver failure (ALF), high-risk patients need liver transplantation and remain at risk for death due to cerebral complications. The objective of this study was to report outcomes of living donor liver transplantation (LDLT) for ALF with perioperative RRT. This was a single-center retrospective cohort study. Out of 1167 LDLTs, 24 patients had ALF and met the King's College criteria for transplantation. They were categorized into no-RRT (<i>n</i> = 13) and RRT (<i>n</i> = 11) groups. We looked at 1-year posttransplant survival in these patients. The median serum ammonia level at the time of transplant in the no-RRT and RRT groups was 259.5 mcg/dL (222.7-398) and 70.6 mcg/dL (58.1-92.6) (<i>p</i> = 0.005). In the RRT group, serum ammonia level < 100 mcg/dL was achieved in all patients. Seven (53.8%) patients in the no-RRT group and 11/11 (100%) in the RRT group were extubated and regained full consciousness after LDLT (<i>p</i> = 0.013). The 90-day mortality was 6/13 (46.1%) and 2/11 (18.1%) (<i>p</i> = 0.211). There was no brainstem herniation-related mortality in the RRT group, that is, 5/13 (38.4%) and 0/11 (0%) (<i>p</i> = 0.030). The 1-year posttransplant survival was also significantly higher in the RRT group (<i>p</i> = 0.031). The use of RRT lowers serum ammonia levels and might reduce posttransplant mortality due to brainstem herniation.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2024 ","pages":"8422308"},"PeriodicalIF":1.5,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11392576/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298288","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":"miRNA-221: A Potential Biomarker of Progressive Liver Injury in Chronic Liver Disease (CLD) due to Hepatitis B Virus (HBV) and Nonalcoholic Fatty Liver Disease (NAFLD).","authors":"Parthana Rani Sutradhar, Nahida Sultana, Afzalun Nessa","doi":"10.1155/2024/4221368","DOIUrl":"10.1155/2024/4221368","url":null,"abstract":"<p><p><b>Background:</b> Early detection of progressive liver damage in chronic liver disease (CLD) patients is crucial for better treatment response. Several studies have shown the association of microRNA (miRNA) in the progression of CLD in regulating cell proliferation, fibrosis, and apoptosis as well as in carcinogenesis. <b>Objectives:</b> The study was aimed at determining the expression of miRNA-221 among different stages of fibrosis in CLD patients due to hepatitis B virus (HBV) and nonalcoholic fatty liver disease (NAFLD) and thus evaluate its role as an early biomarker in CLD. <b>Methods:</b> A total of 100 participants (75 CLD patients and 25 healthy control) were recruited in this cross-sectional study and divided into four groups, of which 25 as healthy control, 25 in CLD without fibrosis, 25 were CLD with fibrosis, and 25 were CLD with cirrhosis. Total RNA was extracted from plasma followed by cDNA synthesis, and finally, the expression of miRNA-221 was analyzed for its diagnostic potential as a single biomarker using the qRT-PCR method. <b>Results:</b> The plasma level of miRNA-221 was significantly upregulated in different fibrosis stages of CLD (<i>p</i> < 0.05), and this upregulation was positively correlated with the progression of fibrosis (<i>p</i> < 0.05). Significantly increased expression of miRNA-221 was found in NAFLD patients compared to HBV patients in the CLD without fibrosis patient group (<i>p</i> < 0.05), while expression of miRNA-221 was significantly upregulated among HBV patients in the CLD with the fibrosis group. miRNA-221 showed high diagnostic accuracy in discriminating different stages of fibrosis from healthy control (<i>p</i> < 0.05). <b>Conclusion:</b> miRNA-221 may be used as a potential plasma biomarker for early prediction of fibrosis progression in CLD patients.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2024 ","pages":"4221368"},"PeriodicalIF":1.5,"publicationDate":"2024-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11343628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142056880","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":"Survival and Disease Progression in Older Adult Patients With Cirrhosis: A Retrospective Study.","authors":"Khaled Al-Smadi, Ammar Qureshi, Michelle Buitrago, Besher Ashouri, Zeid Kayali","doi":"10.1155/2024/5852680","DOIUrl":"10.1155/2024/5852680","url":null,"abstract":"<p><p><b>Background:</b> Cirrhosis incidence in older adult patients has been increasing with limited data on their survival. This study is aimed at investigating the survival and disease progression in older adult patients with cirrhosis compared to younger patients. <b>Methods:</b> This is a retrospective single-center study. Patients aged above 50 with a confirmed diagnosis of cirrhosis based on biopsy, FibroSure test, splenomegaly, and low platelets < 120 × 10⁹/L) or imaging findings including FibroScan were included. Patients with active substance abuse, transjugular intrahepatic portosystemic shunt (TIPS), prior spontaneous bacterial peritonitis (SBP), variceal hemorrhage, model for end-stage liver disease-Na (MELD - Na) ≥ 20, had liver transplantation, malignancy except for squamous cell carcinoma, and other comorbidities such as congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), and end-stage kidney disease with glomerular filtration rate (GFR) < 30 were excluded. Patients' records from the liver clinic were reviewed and demographics, laboratory, and compensation and decompensation status were collated. Patients were separated into two groups based on age 50-64 years and age ≥ 65. The primary endpoint was death, and the secondary endpoint was disease progression measured by the baseline to 12-month increase in MELD-Na score. The Kaplan-Meier analysis was conducted to compare the survival between the two groups. Cox regression analysis was performed to identify independent risk factors for poor survival. <b>Results:</b> A total of 191 patients diagnosed with cirrhosis met the inclusion and exclusion criteria. There were 80 patients aged 50-64 years and 111 patients aged ≥ 65 years. Significantly shorter survival times were seen among patients aged ≥ 65 years compared to those aged 50-64 years (73.3 ± 4.8 vs. 151.5 ± 22.7; <i>p</i> < .001). Age of diagnosis ≥ 65 years (<i>p</i> < 0.001), male gender (<i>p</i> = .013), body mass index (BMI) < 30 (<i>p</i> = 0.005), and decompensation (<i>p</i> = 0.008) were found to be independent risk factors for poor survival. MELD-Na scores increased significantly in 12 months of follow-up from baseline, but only in patients with decompensated cirrhosis (<i>p</i> = 0.013). <b>Conclusions:</b> Cirrhotic patients aged ≥ 65 years have significantly poor survival compared to younger patients. A prospective study is needed to further investigate the effect of age and obesity on survival and disease progression in older adult patients with cirrhosis.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2024 ","pages":"5852680"},"PeriodicalIF":1.5,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11326880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141989184","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":"Acyl-CoA Thioesterase 1 Contributes to Transition of Steatosis to Metabolic-Associated Steatohepatitis.","authors":"Elisa Pasini, Cristina Baciu, Marc Angeli, Bianca Arendt, Diogo Pellegrina, Jüri Reimand, Keyur Patel, George Tomlinson, Mohammad T Mazhab-Jafari, Lakshmi P Kotra, Sandra Fischer, Johane P Allard, Atul Humar, Mamatha Bhat","doi":"10.1155/2024/5560676","DOIUrl":"https://doi.org/10.1155/2024/5560676","url":null,"abstract":"<p><strong>Background: </strong>Metabolic dysfunction-associated steatohepatitis (MASH) has become the leading cause of chronic liver disease, but there has been no approved pharmacotherapy to date.</p><p><strong>Methods: </strong>We used a network analysis approach to delineate protein-protein interactions that contribute to the transition from steatosis to MASH, in order to identify and target this transition as a potential pharmacotherapeutic strategy. Acyl-CoA thioesterase 1 (ACOT1) was identified as a critical node in the protein-protein interaction (PPI) network of the transition from steatosis to MASH in patient samples. ACOT1 overexpression and silencing effects were tested <i>in vivo</i> on C57BL/6 mice exposed to high-fat diet (HFD) and inoculated with an adenoviral system to modulate <i>ACOT1</i> expression. Transcriptomic and untargeted lipidomic profiles were performed on the mouse livers.</p><p><strong>Results: </strong>ACOT1 expression was 3-fold higher in MASH as compared to steatosis. In patient samples, <i>ACOT1</i> was significantly correlated with the severity of MASH as reflected by the nonalcoholic fatty liver disease score. Experimental validation showed that downregulation of ACOT1 resulted in decreased lipid accumulation and prevention of MASH <i>in vivo</i>. Conversely, upregulation of ACOT1 via an adenoviral vector resulted in development of MASH, whereas control mice only developed steatosis. Lipidomic analysis revealed glycerophospholipids to be especially abundant in MASH accelerated by ACOT1 upregulation.</p><p><strong>Conclusion: </strong>These results suggest that ACOT1 contributes to the transition from steatosis to MASH through modulation of glycerophospholipid accumulation and its potential as a novel therapeutic target in MASH. This trial is registered with NCT02148471.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2024 ","pages":"5560676"},"PeriodicalIF":1.5,"publicationDate":"2024-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11611406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773494","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":"Macrophage-2-Binding Protein Glycosylation Isomer (M2BPGi) and AGAP Score as Markers of Noninvasive Test for Liver Fibrosis versus FibroScan in Chronic Hepatitis B Patients: A Retrospective Observational Study.","authors":"Laila Kurnia Pramono, Anna Tjandrawati, Dewi Kartika Turbawaty, Tiene Rostini, Muhammad Begawan Bestari, Haryono, Deny Budiman, Prapanca Nugraha","doi":"10.1155/2024/6635625","DOIUrl":"10.1155/2024/6635625","url":null,"abstract":"<p><strong>Background: </strong>Liver biopsy as the gold standard for assessing the degree and diagnosis of fibrosis still has significant drawbacks, which make the emergence of a much less invasive diagnostic marker possible. M2BPGi levels and the AGAP score, the two newest serological markers, are known to have good sensitivity for detecting liver fibrosis. This study is aimed at determining the validity of examining M2BPGi levels and AGAP scores on the Fibroscan examination as markers of noninvasive test for liver fibrosis in chronic hepatitis B patients.</p><p><strong>Methods: </strong>This is an observational, descriptive study with a retrospective design. This study used secondary data taken from medical records and blood specimen research materials of outpatients at the Hepatology Gastroenterology Polyclinic at a tertiary general hospital in West Java, Indonesia, with a diagnosis of chronic hepatitis B.</p><p><strong>Results: </strong>There were 109 research subjects included. There were 73 (66.9%) subjects with no- or low-grade fibrosis and 36 (33.1%) with advanced fibrosis. The sensitivity and specificity of the M2BPGi were 88.9% and 61.6% (PPV 55.3%; NPV 91.8%; AUC 0.753), while the AGAP score was 47.2% and 100% (PPV 100%; NPV 79.3%; AUC 0.736). The combined M2BPGi level and the AGAP score showed a sensitivity of 80.9% and a specificity of 100% (PPV 100%; NPV 91.8%; AUC 0.905).</p><p><strong>Conclusion: </strong>The AGAP score and M2BPGi levels together are a better way to measure the degree of liver fibrosis in people with chronic hepatitis B than either M2BPGi or the AGAP score alone.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2024 ","pages":"6635625"},"PeriodicalIF":1.8,"publicationDate":"2024-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11178412/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332206","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 Efficacy of On-Site Integration Screening and Microelimination Programs for Chronic Hepatitis C in a Detection Center: A Comparison of the Treatment Outcomes and Characteristics of Incarcerated Patients and Outpatients.","authors":"Hsuan-Yuan Chang, Su-Hung Wang, Hsing-Tao Kuo, Ming-Jen Sheu, I-Che Feng, Chung-Han Ho, Jui-Yi Chen, Chi-Shu Sun, Chi-Hsing Chen, Cheng-Yi Lin, Chun-Chi Yang","doi":"10.1155/2024/3184892","DOIUrl":"10.1155/2024/3184892","url":null,"abstract":"<p><p>We aimed to analyze the different patient characteristics and treatment outcomes (such as sustained viral response, SVR) between incarcerated patients with chronic hepatitis C (CHC) and those with CHC from the outpatient department through an on-site integrated screening and microelimination program in a detection center. In this retrospective study, which ran from May 2021 to April 2022, we included 32 consenting male prisoners aged at least 20 years who were willing to participate in the study. Members of the control group (who received DAAs in an outpatient setting) were selected from the treated CHC patient databank of individuals who received DAA regimens at Chi Mei Hospital between January 2021 and December 2022. The patients in the two groups did not differ significantly in terms of age, FIB-4 score, HCV RNA, HBV coinfection, hemogram findings, coagulation profiles, and renal function tests. However, the patients in the incarcerated group had a significantly different genotype distribution compared to the control group, significantly lower liver enzyme levels, and higher albumin and bilirubin levels compared to those in the control group. The rate of SVR to DAA treatment obtained among incarcerated patients did not differ significantly from that obtained among patients in the control group. Loss to follow-up (for several reasons) is a major reason for treatment discontinuation among these patients.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2024 ","pages":"3184892"},"PeriodicalIF":1.8,"publicationDate":"2024-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10954363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140178695","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":"Severe Hepatotoxicity in Mushroom Poisoning by <i>Lepiota brunneoincarnata</i> from Complete Recovery to Liver Transplantation: A Case Series with Review on Liver Function Tests and Liver Histopathology.","authors":"Mohammad Hossein Anbardar, Neda Soleimani, Kourosh Kazemi, Zahra Jafarpour, Mahsa Hasani, Sahand Mohammadzadeh, Parnia Torfehnezhad, Sedighe Jafarian, Mahsa Farhadi, Mina Salari Sardari","doi":"10.1155/2024/2797712","DOIUrl":"10.1155/2024/2797712","url":null,"abstract":"<p><strong>Background: </strong>In spite of the scientific evidence supporting health advantages of mushrooms, some of them are seriously poisonous. The clinical picture of mushroom intoxication ranges from minor gastrointestinal symptoms to organ failure, such as liver failure and death.</p><p><strong>Method: </strong>We provided demographics, clinicopathological characteristics, applied treatments, and outcomes of mushroom poisoning by Lepiota species in a series of 18 cases that were referred from Kermanshah and Lorestan provinces to Abu-Ali-Sina Hospital, Shiraz, Iran. Clinical and paraclinical data were collected by taking history and reviewing of medical documents. Pathologic findings were extracted through a review of hematoxylin and eosin pathologic slides.</p><p><strong>Results: </strong>The patients were between the ages of 18 and 67 years, composed of ten females and eight males. The most frequent clinical manifestations were nausea and vomiting followed by abdominal pain. Four cases presented decreased consciousness on admission. One of them passed away. Three other cases underwent liver transplantation, two of them died after transplantation, and one fully recovered without any major issues. All instances had elevated ALT levels, which ranged from 44 to 9,140 IU/L (mean: 3259 ± 2476), with most of them also having concurrent AST elevations (mean: 1,361 ± 1,532). Only few patients had modest elevations in alkaline phosphatase. Total and direct bilirubin elevations up to 47.6 and 24 mg/dL, respectively, were found in most cases. Decreased total protein and albumin concentrations and increased BUN and creatinine levels were observed in some patients. In addition, some instances revealed increased LDH, increased WBC, decreased hemoglobin, and decreased platelet count. Most patients had increased prothrombin time; hematuria and positive stool occult blood were observed in few patients. Histopathologic examination of three explanted livers revealed massive necrosis with moderate to severe macrovesicular steatosis, significant ductular reaction, and parenchymal inflammation. Other patients followed a recovery process with a considerable drop in liver enzymes, especially ALT, during hospitalization utilizing conservative treatment. They had no liver problems or relevant issues after a two-year follow-up.</p><p><strong>Conclusion: </strong>In our study, highly elevated liver enzymes with a significantly high ALT/AST ratio were observed in cases of mushroom poisoning by Lepiota species, leading to fulminant liver failure and death in some cases. These laboratory findings were correlated with liver necrosis and macrovesicular steatosis in explanted livers.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2024 ","pages":"2797712"},"PeriodicalIF":1.5,"publicationDate":"2024-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10824578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139576792","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 Use of Noninvasive Velacur® for Discriminating between Volunteers and Patients with Chronic Liver Disease: A Feasibility Study.","authors":"Michael P Curry, Edward Tam, Caitlin Schneider, Noha Abdelgelil, Tarek Hassanien, Nezam H Afdhal","doi":"10.1155/2024/8877130","DOIUrl":"10.1155/2024/8877130","url":null,"abstract":"<p><strong>Background and aims: </strong>Nonalcoholic fatty liver disease is the leading cause of chronic liver disease globally and can progress to cirrhosis, liver failure, and liver cancer. Current AASLD, AGA, and ADA guidelines recommend assessment for liver fibrosis in all patients with NAFLD. Serum biomarkers for fibrosis, while widely available, have notable limitations. Imaging-based noninvasive testing for liver fibrosis/cirrhosis is more accurate and is becoming more widespread.</p><p><strong>Methods: </strong>We evaluated the feasibility of a novel shear wave absolute vibroelastography (S-WAVE) modality called Velacur® for assessing liver stiffness measurement (LSM) for fibrosis and attenuation coefficient estimation (ACE) in differentiating patients with chronic liver disease from normal healthy controls.</p><p><strong>Results: </strong>Fifty-four healthy controls and 89 patients with NAFLD or cured HCV with a prior known LSM of >8 kPa were enrolled, and all subjects were evaluated with FibroScan® and Velacur®. Velacur® was able to discriminate patients with increased liver stiffness as determined by a FibroScan® score of >8 kPa from healthy controls with an AUC of 0.938 (0.88-0.96). For assessment of steatosis in NAFLD patients only, Velacur® could identify patients with steatosis from healthy controls with an AUC of 0.831 (0.777-0.880). The Velacur® scan quality assessment was superior in healthy controls, as compared to patients, and the scan quality, as assessed by the quality factor (QF) and interquartile range (IQR)/median, was affected by BMI. Velacur® was safe and well tolerated by patients, and there were no adverse events.</p><p><strong>Conclusion: </strong>Velacur® assessment of liver stiffness measurement and liver attenuation is comparable to results obtained by FibroScan® and is an alternative technology for monitoring liver fibrosis progression in patients with chronic liver disease. This trial is registered with NCT03957070.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2024 ","pages":"8877130"},"PeriodicalIF":1.5,"publicationDate":"2024-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10807935/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139565127","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":"Hepatitis C Prevalence on the Rise but Screening at Safety Net Institutions Lagging behind","authors":"Jarin Prasa, Syed S. Karim, Bobby Jacob, Paul Mustacchia","doi":"10.1155/2023/3650746","DOIUrl":"https://doi.org/10.1155/2023/3650746","url":null,"abstract":"Introduction. In the United States, the hepatitis C virus (HCV) is a leading contributor to liver-related illnesses and fatalities. Despite effective antiviral medications, acute infections have increased in recent years, likely due to IV drug use and the opioid epidemic. Previous guidelines recommended one-time screening for individuals born between 1945 and 1965. The CDC now recommends screening all adults over 18 unless there is a low prevalence in the area. Accurate measurement of HCV prevalence is essential for targeted prevention. In New York, over 100,000 individuals have HCV. We present data on HCV screening at a safety net hospital in Long Island, NY. Objective. To identify screening rates for hepatitis C and the exposure prevalence and specific demographics of a community in Long Island, NY. Methods. We performed a review of all patients seen in our hospital from 2012 to 2019. We identified patients born in the years 1945 to 1965 using our electronic medical record (EMR) system and subsequently analyzed those who were anti-HCV positive. We reviewed their demographics, including age, gender, and ethnicity, as well as their history of intravenous drug use and HIV coinfection status. Basic statistical analysis was used. Results. Our study identified 21,722 patients born between 1945 and 1965 and found that only 8.5% or 1,858 individuals were screened for hepatitis C. Among them, we found that 5.9% (109) tested positive for HCV antibody, with 3.0% (56) having an active infection. Demographic characteristics of those with HCV antibodies included 70.6% male, 53.2% Caucasian, 33.9% Black, and 15.6% persons who inject drugs (PWID). Conclusion. Our study findings suggest that a significant portion of patients in our community had missed opportunities for screening in our hospital. Our community had an estimated 5.9% prevalence, higher than the national and state averages. Caucasian men had higher prevalences. This study suggests the need for broader screening initiatives and more focused resource allocation, perhaps to safety net institutions, to decrease the burden of HCV.","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":" 13","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135341111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathology of Hepatocellular Carcinoma and Tumor-Bearing Liver Tissue in Association with <i>hTERT</i> Promoter Mutation.","authors":"Anne Kristin Fischer, Alexander Semaan, Anna-Lena Wulf, Christian Vokuhl, Diane Goltz, Hans-Peter Fischer","doi":"10.1155/2023/4313504","DOIUrl":"10.1155/2023/4313504","url":null,"abstract":"<p><strong>Background: </strong>The <i>hTERT</i> promoter mutation represents a common and early event in hepatocarcinogenesis, but its linkage to the morphological status of the underlying liver tissue is poorly understood. We analyzed the connection between the histopathological changes in tumor-bearing liver tissue and the occurrence of the <i>hTERT</i> promoter mutation in hepatocellular carcinoma (HCC), correlated with clinical data.</p><p><strong>Methods: </strong>The study cohort comprised 160 histologically confirmed HCC in patients with or without cirrhosis that were investigated for the <i>hTERT</i> promoter mutation. We evaluated the frequency of the <i>hTERT</i> promoter mutation in patients with HCC with or without cirrhosis and correlated it with potential clinical and histopathological drivers. In particular, we examined tumor-bearing noncirrhotic liver tissue regarding inflammation; the modified histological activity index (mHAI), fibrosis, and steatosis; and its correlation with the frequency of the <i>hTERT</i> promoter mutation in HCC. We evaluated overall survival with multivariate Cox regression. Furthermore, we compared hTERT antibody immunohistochemistry and molecular <i>hTERT</i> promoter mutation analysis of both HCC and background liver tissue.</p><p><strong>Results: </strong>The <i>hTERT</i> promoter mutation was especially related to HCC in cirrhotic compared with noncirrhotic liver (<i>p</i> < 0.001) and independently of cirrhosis in patients ≥ 60 years (<i>p</i> = 0.005). Furthermore, the <i>hTERT</i> promoter mutation was associated with cirrhosis caused by alcohol toxicity and hepatitis C virus infection. In noncirrhotic liver tissue, the frequency of <i>hTERT</i>-promoter-mutated HCC increased with the degree of inflammation and fibrosis. Nevertheless, 25% of the <i>hTERT</i>-promoter-mutated HCC developed in normal liver tissue without HCC risk factors. Multivariate Cox regression analysis did not reveal an influence of the <i>hTERT</i> promoter mutation in HCC on overall survival at 3, 5, and 16 years. Immunohistochemical analysis with the hTERT antibodies LS-B95 and 2D8 in <i>hTERT</i>-promoter-mutated HCC and <i>hTERT</i>-wildtype HCC showed a mildly stronger immunoreaction compared with the tumor-bearing liver tissue (LS-B95: <i>p</i> < 0.01, 2D8: <i>p</i> < 0.01).</p><p><strong>Conclusions: </strong>Our study reveals a connection between pathological changes in tumor-bearing liver tissue and the <i>hTERT</i> promoter mutation in most HCC, even in noncirrhotic liver tissue. Immunohistochemical hTERT antibodies do not discriminate between <i>hTERT</i>-promoter-mutated and wildtype HCC.</p>","PeriodicalId":46297,"journal":{"name":"International Journal of Hepatology","volume":"2023 ","pages":"4313504"},"PeriodicalIF":1.5,"publicationDate":"2023-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10432107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10044654","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}