Lancet Gastroenterology & Hepatology最新文献

{"title":"Let's break it down: combating hepatitis stigma and discrimination","authors":"Rachel Halford, Jessica Hicks, Md Reazul Islam, Cary James, Gamal Shiha, Thomas Tu","doi":"10.1016/s2468-1253(25)00229-8","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00229-8","url":null,"abstract":"No Abstract","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"122 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144694184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient and public health perspectives to inform expansion of hepatitis B treatment guidelines","authors":"Chari Cohen, Thomas Tu, Philippa C Matthews, Su Wang, Jessica Hicks, Manal H El-Sayed, John E Tavis","doi":"10.1016/s2468-1253(25)00052-4","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00052-4","url":null,"abstract":"Chronic hepatitis B is associated with considerable morbidity and mortality worldwide. People living with hepatitis B face physical, emotional, social, and professional impacts, reducing their quality of life. Treatment with nucleoside or nucleotide analogues reduces the risk of liver cirrhosis and liver cancer and improves quality of life. However, few people globally are offered and can access affordable and long-term antiviral treatment. Moreover, little progress has been made towards meeting WHO hepatitis B elimination targets. The global landscape has been shifting towards expanding treatment criteria, but discussion surrounding patient and community perspectives has been inadequate. We should view treatment eligibility for hepatitis B virus infection from a public health and patient-centred approach. Here, we discuss the potential benefits and risks of expansion, implementation considerations, public health questions, and data needs surrounding the expansion of treatment eligibility. We conclude that there is a strong public health and community rationale for expanding treatment eligibility for people living with chronic hepatitis B.","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"58 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144694052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Estimating the annual number of hepatitis C virus infections through vertical transmission at country, regional, and global levels: a data synthesis study","authors":"Adam Trickey, Adelina Artenie, Jordan J Feld, Peter Vickerman","doi":"10.1016/s2468-1253(25)00189-x","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00189-x","url":null,"abstract":"<h3>Background</h3>The burden of hepatitis C virus (HCV) among women of childbearing age remains high globally. Studies have estimated that 7–12% of children born to women with HCV infection will acquire HCV, although around two-thirds of children will then clear their HCV infection by 5 years of age. We aimed to estimate the annual number of vertically transmitted HCV infections and how many cases remain at 5 years of age at the country or territory, regional, and global levels.<h3>Methods</h3>In this data synthesis study, we produced estimates of vertical HCV transmission by combining data from several sources: data on the number of women, age-specific fertility rates, mortality rates among children aged 0–5 years, and HIV prevalence among women aged 15–49 years from the UN; modelled data on HCV prevalence among women aged 15–49 years; meta-analysis data on HCV–HIV co-infection prevalence; and recent estimates of the probabilities of vertical HCV transmission and subsequent clearance by age 5 years. The annual number of births with HCV was estimated by multiplying the number of women with HCV in 5-year age bands by age band-specific birth rates, separately by HIV status, and multiplying by HIV status-specific HCV vertical transmission probabilities. The number of births with HCV was multiplied by the probability of spontaneous clearance of HCV by 5 years of age, accounting for mortality. All estimates were sampled 1000 times from their uncertainty intervals (UIs) to produce 95% UIs.<h3>Findings</h3>The estimated annual global number of new HCV infections occurring through vertical transmission was 73 862 (95% UI 69 808–78 279). Southern Asia (21 245 [18 095–24 847]), western Africa (16 482 [14 873–18 283]), and eastern Africa (8182 [7479–9085]) were the regions with the most infections. Pakistan (16 350 [13 325–19 844]) and Nigeria (8483 [6944–10 184]) had the largest burden and together accounted for around a third of new infections. We estimated that 23 120 (20 596–25 813) of these children would be alive and still have HCV when aged 5 years.<h3>Interpretation</h3>Targeted screening policies that test and treat pregnant women with HCV could prevent substantial numbers of new HCV infections; however, data on the safety of HCV treatments in pregnant women are required.<h3>Funding</h3>None.","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"31 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144694090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scientific and medical evidence informing expansion of hepatitis B treatment guidelines","authors":"Patrick T Kennedy, Lena Allweiss, Antonio Bertoletti, Markus Cornberg, Adam J Gehring, Luca G Guidotti, Hélène A Kerth, Maud Lemoine, Massimo Levrero, Seng Gee Lim, John E Tavis, Barbara Testoni, Thomas Tu","doi":"10.1016/s2468-1253(25)00053-6","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00053-6","url":null,"abstract":"Chronic hepatitis B treatment relies on nucleoside or nucleotide analogue drugs that suppress hepatitis B virus (HBV) replication, normalise liver enzymes, and slow disease progression with excellent safety profiles. Treatment is not curative, and patients remain at risk of cirrhosis and hepatocellular carcinoma. Treatment guidelines have generally restricted antiviral therapy to individuals with high HBV DNA and elevated ALT or hepatic fibrosis, often requiring longitudinal testing that can be scarcely available in resource-limited settings. Consequently, fewer than 3% of people living with HBV infection are receiving antiviral therapy. Guidelines from China and WHO recently broadened access criteria to antiviral therapy, but there are people who fall outside these guidelines who could still benefit from treatment initiation. The pathological processes induced by HBV infection are still active in these patients. We present the benefits and risks of expanding treatment eligibility. We believe that the benefits of reduced hepatic damage and carcinogenic stimuli greatly outweigh the risks.","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"123 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144694095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Launching the Center for Operational Research on Hepatitis B","authors":"Gibril Ndow, Neil Gupta, Lindsey Hiebert-Suwondo, John W Ward","doi":"10.1016/s2468-1253(25)00227-4","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00227-4","url":null,"abstract":"No Abstract","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"52 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144694085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of gluten and wheat on symptoms and behaviours in adults with irritable bowel syndrome: a single-centre, randomised, double-blind, sham-controlled crossover trial","authors":"Caroline Larissa Seiler, Gaston Horacio Rueda, Pedro Miguel Miranda, Andrea Nardelli, Rajka Borojevic, Amber Hann, Sara Rahmani, Russell De Souza, Alberto Caminero, Valentina Curella, Manjusha Neerukonda, Stephen Vanner, Detlef Schuppan, Paul Moayyedi, Stephen Michael Collins, Elena Francisca Verdu, Maria Ines Pinto-Sanchez, Premysl Bercik","doi":"10.1016/s2468-1253(25)00090-1","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00090-1","url":null,"abstract":"&lt;h3&gt;Background&lt;/h3&gt;Many patients with irritable bowel syndrome (IBS) believe gluten or wheat triggers their symptoms. We compared symptomatic responses to wheat and gluten with gluten-free sham challenge in patients with IBS who previously perceived benefit from a gluten-free diet.&lt;h3&gt;Methods&lt;/h3&gt;We conducted this randomised, double-blind, sham-controlled crossover study at McMaster University Medical Centre, ON, Canada. Eligible participants were adults aged 18 years or older who met Rome IV criteria for IBS and had previously self-reported improvement on a gluten-free diet, which was implemented for at least 3 weeks before enrolment. Eligible participants were randomly assigned (1:1:1:1:1:1) to receive one of six sequences of wheat, gluten, and sham (containing gluten and wheat free flour) in three periods of 7 days, separated by 14-day washout periods. Randomisation was done using the randomizeBE package in R and the cereal bars were designed to have the same appearance, taste, and smell to maintain blinding. The primary outcome was worsening of IBS symptoms of at least 50 points on the IBS Symptom Severity Score (IBS-SSS) after dietary challenges. Outcome and safety analyses were done in all patients who completed all three challenges. This trial was registered with &lt;span&gt;&lt;span&gt;ClinicalTrials.gov&lt;/span&gt;&lt;svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"&gt;&lt;path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;, &lt;span&gt;&lt;span&gt;NCT03664531&lt;/span&gt;&lt;svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"&gt;&lt;path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;.&lt;h3&gt;Findings&lt;/h3&gt;Between Nov 15, 2018, and June 19, 2023, we assessed 101 people for eligibility. 72 people were excluded due to ineligibility (n=15), refusing screening (n=42), and refusing participation (n=15). 29 participants were enrolled and randomly assigned to wheat–gluten–sham (n=5), wheat–sham–gluten (n=5), gluten–wheat–sham (n=5), gluten–sham–wheat (n=5), sham–wheat–gluten (n=5), and sham–gluten–wheat (n=4). One participant in the wheat–sham–gluten group completed the first challenge but withdrew without providing a reason. In the 28 patients completing the study, there were no statistically significant differences in the proportion of participants with a worsening of IBS-SSS of at least 50 points after wheat (11 [39%] of 28 participants, risk difference &lt;em&gt;vs&lt;/em&gt; sham 0·11; 95% CI –0·16 to 0·35) or gluten (ten participants [36%], 0·07; –0·19 to 0·32) versus sham (eight participants [29%]). Adverse events were reported in 26 (93%) of 28 patients after wheat, 26 patients (93%) after gluten, and 26 patients (93%) after sham. Study emergent adverse events were similar between challenges (five [18%] of 28 participants after wheat, five [18%] after gluten, and seven [25%] after sham). No patients report","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"21 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144678274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unravelling the power of nocebo in symptom response to food challenge in irritable bowel syndrome","authors":"Sigrid Elsenbruch","doi":"10.1016/s2468-1253(25)00126-8","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00126-8","url":null,"abstract":"No Abstract","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"17 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144678293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-TL1A antibody, afimkibart, in moderately-to-severely active ulcerative colitis (TUSCANY-2): a multicentre, double-blind, treat-through, multi-dose, randomised, placebo-controlled, phase 2b trial","authors":"Silvio Danese, Jessica R Allegretti, Stefan Schreiber, Laurent Peyrin-Biroulet, Vipul Jairath, Geert D'Haens, Jarosław Kierkuś, Rupert W Leong, Andres J Yarur, Michael S Vincent, Anindita Banerjee, Deepa E Chandra, Elena Peeva, Srividya Neelakantan, Kenneth E Hung, Jacqueline M McBride, Daniela Bojic, Karen Lasch, Courtney Schiffman, Brian G Feagan","doi":"10.1016/s2468-1253(25)00129-3","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00129-3","url":null,"abstract":"&lt;h3&gt;Background&lt;/h3&gt;TNF-like ligand 1A (TL1A) is an emerging therapeutic target for inflammatory bowel disease. We evaluated the safety and efficacy of multiple doses of afimkibart, a TL1A-directed antibody, in patients with moderately-to-severely active ulcerative colitis.&lt;h3&gt;Methods&lt;/h3&gt;The multicentre, double-blind, treat-through, multi-dose, randomised, placebo-controlled, phase 2b, TUSCANY-2 trial was conducted at 114 centres in 23 countries across North America, Europe, Asia, Africa, Australia, and South America. Adults (aged 18–75 years) with moderately-to-severely active ulcerative colitis (total Mayo score [tMS] 6–12, endoscopic subscore ≥2) were randomly assigned (2:2:2:2:2:3:1:1:1) to one of nine treatment sequences to receive subcutaneous afimkibart 50 mg, 150 mg, 450 mg, or matched placebo every 4 weeks during the 12-week induction period, and subcutaneous afimkibart 50 mg, 150 mg, or 450 mg during the treat-through 40-week maintenance period. Investigators and patients were masked to treatment. Study drugs were administered by masked site personnel following preparation by an unmasked pharmacist at the investigational site. Efficacy was assessed at weeks 14 and 56 in the intent-to-treat populations. The primary efficacy endpoint of clinical remission at week 14 by tMS (defined as tMS ≤2, with no individual subscore &gt;1) was assessed in those who received at least one dose of drug or placebo during induction, excluding patients who had missing data due to complications resulting from COVID-19. Safety endpoints were also analysed in those who were randomly assigned and received at least one dose of assigned treatment. This study is registered with &lt;span&gt;&lt;span&gt;ClinicalTrials.gov&lt;/span&gt;&lt;svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"&gt;&lt;path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;, &lt;span&gt;&lt;span&gt;NCT04090411&lt;/span&gt;&lt;svg aria-label=\"Opens in new window\" focusable=\"false\" height=\"20\" viewbox=\"0 0 8 8\"&gt;&lt;path d=\"M1.12949 2.1072V1H7V6.85795H5.89111V2.90281L0.784057 8L0 7.21635L5.11902 2.1072H1.12949Z\"&gt;&lt;/path&gt;&lt;/svg&gt;&lt;/span&gt;.&lt;h3&gt;Findings&lt;/h3&gt;Between Dec 19, 2019, and Oct 25, 2022, 246 patients were randomly assigned treatment, of whom 245 were treated, 228 completed induction, and 178 completed maintenance. Median age was 39 years (IQR 30·0–51·0), 99 (40%) patients were female and 146 (60%) were male; median disease duration was 4·7 years (IQR 2·5–10·2). At week 14, the primary endpoint of clinical remission by tMS was reported in 12 (26%) of 47 patients in the afimkibart 50 mg group (risk difference &lt;em&gt;vs&lt;/em&gt; placebo [RD] 13·9% [90% CI –0·2 to 27·7]; p=0·0545), 14 (23%) of 60 patients in the afimkibart 150 mg group (RD 11·7% [–1·7 to 24·1]; p=0·0823), and 21 (24%) of 88 patients in the in the afimkibart 450 mg group (RD 12·2% [–0·6 to 22·9]; p=0·0642) versus five (12%) of 43 patients in the placebo group. In alignment with updated US Foo","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"673 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144678295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraoperative fluorescence angiography with indocyanine green to prevent anastomotic leak in rectal cancer surgery (IntAct): an unblinded randomised controlled trial","authors":"David Jayne, Julie Croft, Neil Corrigan, Philip Quirke, Ronan A Cahill, Gemma Ainsworth, David M Meads, Andrew Kirby, Damian Tolan, Katie Gordon, Roel Hompes, Antonino Spinelli, Caterina Foppa, Albert M Wolthuis, André D'Hoore, Andrea Vignali, Henry S Tilney, Catherine Moriarty, Armando Vargas-Palacios, Caroline Young, Albert Wolthuis","doi":"10.1016/s2468-1253(25)00101-3","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00101-3","url":null,"abstract":"&lt;h3&gt;Background&lt;/h3&gt;Data are mixed on whether indocyanine green (ICG) fluorescence angiography can reduce the high rate of anastomotic leaks in patients undergoing surgery for rectal cancer. Therefore, we aimed to investigate the safety and efficacy of ICG fluorescence angiography in reducing the rate of clinical anastomotic leaks in these patients.&lt;h3&gt;Methods&lt;/h3&gt;IntAct was an unblinded randomised controlled trial conducted at 28 specialist rectal cancer centres across eight European countries. Adults (≥18 years) with rectal cancer (lower margin of cancer ≤15 cm from the anal verge) medically fit for elective, curative, laparoscopic or robotic high or low anterior resection were eligible. Patients not undergoing colorectal or anal anastomosis and those with synchronous colonic tumours or recurrent or locally advanced rectal cancer requiring extended or multi-visceral excision were excluded. Eligible participants were randomly assigned (1:1) by use of minimisation with a random element to undergo surgery with or without ICG (standard care). Resections and anastomoses were done per surgeon preference. In the ICG group, surgeons first marked proximal transection levels via standard white-light laparoscopy and then administered an intravenous bolus of 0·1 mg/kg of ICG for perfusion assessment. A second 0·1 mg/kg ICG assessment was done following anastomosis. In the standard care group, only a white-light assessment of bowel perfusion was performed. The primary endpoint was the rate of clinical anastomotic leak (grades B or C, per the International Study Group of Rectal Cancer) within 90 postoperative days. Analyses were done in the intention-to-treat population for complete cases. This trial is registered with the ISRCTN registry (ISRCTN13334746) and is now complete.&lt;h3&gt;Findings&lt;/h3&gt;Between Oct 20, 2017, and Aug 15, 2023, 2534 patients were assessed for eligibility and 766 participants were randomly assigned (383 to the ICG group and 383 to the standard care group). 501 (65%) of 766 participants were male, 726 (95%) were of White ethnicity, and the median age was 64·0 years (IQR 56·0–72·0). 343 patients in the ICG group and 355 in the standard care group were included in the intention-to-treat analysis. The rates of anastomotic leak were 11 (3%) of 343 in the ICG group and 20 (6%) in the standard care group for grade A, 11 (3%) and 31 (9%) for grade B, and 25 (7%) and 23 (6%) for grade C. Within 90 days, a clinical anastomotic leak occurred in 90 (13%) of 698 participants: 36 (10%) of 343 in the ICG group and 54 (15%) of 355 in the standard care group (adjusted odds ratio 0·667 [95% CI 0·419–1·060]; p=0·087). There were no serious adverse events related to ICG.&lt;h3&gt;Interpretation&lt;/h3&gt;Although IntAct did not show a significant benefit for ICG fluorescence angiography, a signal towards a reduction in clinical anastomotic leak rate was observed. The benefit of ICG could be in preventing grade A or B leaks, given similar rates of grade C leaks between gro","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"109 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144664646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening for advanced steatotic liver disease","authors":"Stine Johansen, Fredrik Åberg, Emmanuel A Tsochatzis, Aleksander Krag","doi":"10.1016/s2468-1253(25)00097-4","DOIUrl":"https://doi.org/10.1016/s2468-1253(25)00097-4","url":null,"abstract":"Steatotic liver disease often progresses asymptomatically, with the risk of advancing to cirrhosis and liver cancer. Early detection of advanced liver disease through screening presents an opportunity to prevent severe outcomes, if said screening is linked to effective intervention. This Review evaluates the feasibility of screening for advanced steatotic liver disease through the lens of the Wilson and Jungner criteria. The assessment focuses on the presence of a presymptomatic stage as a target for screening, advances in diagnostic tests, cost-effectiveness, the availability of effective treatments, and the difficult task of balancing harms against benefits of screening. Additional criteria are proposed to address contemporary challenges, including ensuring equitable access, implementing long-term programme evaluation, and developing strategies to minimise psychosocial harm. The long-term benefits of screening—particularly in reducing liver-related morbidity and mortality remain unclear—highlighting the need for large-scale randomised trials with long-term follow-up.","PeriodicalId":56028,"journal":{"name":"Lancet Gastroenterology & Hepatology","volume":"10 1","pages":""},"PeriodicalIF":35.7,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144640466","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}