Annals of hepatology最新文献

{"title":"New steatotic liver disease criteria diagnostic performance in an agricultural population in Chile","authors":"Maria Spencer-Sandino ,&nbsp;Franco Godoy ,&nbsp;Laura Huidobro ,&nbsp;Danilo Alvares ,&nbsp;Francisco Cruz ,&nbsp;Claudia Marco ,&nbsp;Macarena Garrido ,&nbsp;Daniel Cabrera ,&nbsp;Juan Pablo Arab ,&nbsp;Marco Arrese ,&nbsp;Francisco Barrera ,&nbsp;Catterina Ferreccio","doi":"10.1016/j.aohep.2025.101919","DOIUrl":"10.1016/j.aohep.2025.101919","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>This study aims to assess the performance of Steatotic Liver Disease (SLD) criteria in identifying liver steatosis compared to the NAFLD and MAFLD definitions in an agricultural population in Chile.</div></div><div><h3>Patients and Methods</h3><div>We performed a cross-sectional analysis on the MAUCO cohort, composed of 9,013 individuals aged 38 to 74. Health conditions, socio-demographics, anthropometrics, hepatic ultrasonography, blood pressure, and biological samples were obtained. Participants were classified as NAFLD, MAFLD, or any of the five SLD categories: Metabolic dysfunction-associated steatosis liver disease (MASLD), Metabolic and Alcohol-Associated Liver Disease (MetALD), Alcohol-Associated Liver Disease (ALD), Specific aetiologies, and Cryptogenic. The Framingham cardiovascular risk score and BARD liver fibrosis score were used to assess clinical relevance.</div></div><div><h3>Results</h3><div>Liver steatosis was present in 4,082 participants (45%); SLD criteria captured an additional 176 individuals not classified under NAFLD and 103 not included under MAFLD definition. The main SLD subgroups were MASLD (95%), MetALD (1.9%) and ALD (1.3%). Individuals classified in the MetALD and ALD subgroups exhibited more severe liver steatosis and a higher cardiovascular risk. Notably, participants categorized under specific etiologies and cryptogenic subgroups were younger and had a higher risk for liver fibrosis.</div></div><div><h3>Conclusions</h3><div>The study reveals that SLD offers a more inclusive classification to identify high-risk individuals in the Chilean population, capturing cases that could be missed by NAFLD or MAFLD definitions by using the same resources.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 2","pages":"Article 101919"},"PeriodicalIF":3.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954239","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improvement in renal function after switching from entecavir to tenofovir alafenamide in chronic hepatitis B patients with low estimated glomerular filtration rates","authors":"Liang Wang ,&nbsp;Shipeng Ma ,&nbsp;Lajpat Rai Malhi ,&nbsp;Xiaoping Wu ,&nbsp;Liping Liu ,&nbsp;Xin Wan ,&nbsp;Yuliang Zhang ,&nbsp;Xiaopeng Li ,&nbsp;Shanfei Ge","doi":"10.1016/j.aohep.2025.101925","DOIUrl":"10.1016/j.aohep.2025.101925","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Tenofovir alafenamide (TAF) and entecavir (ETV) are both considered renal-friendly nucleoside/nucleotide analogs (NAs). However, the difference between ETV and TAF in terms of renal function remains unclear. This study aims to compare the renal safety profiles of two antiviral medications directly and evaluate the impact of switching from ETV to TAF treatment on renal function in chronic hepatitis B (CHB) patients with low estimated glomerular filtration rates (eGFR).</div></div><div><h3>Patients and Methods</h3><div>A total of 179 CHB patients who received TAF (n = 84) or ETV (n = 95) between 2019 and 2023 were included in the study. Changes in eGFR levels between two treatment groups from baseline to 72 weeks were compared to measure the influence of these NAs on renal function.</div></div><div><h3>Results</h3><div>At baseline, 84 patients were included in each treatment group after a 1:1 propensity score matching process. At week 48, a notable different changes in eGFR were observed between the two groups. Gender, baseline eGFR, and medication (TAF/ETV) were significantly correlated with eGFR abnormalities. Furthermore, eGFR abnormalities at week 48 led to the transition of 6 patients in the ETV group to TAF. eGFR significantly increased (83.60 ± 5.45 vs. 93.39 ± 9.88 mL/min/1.73 m²; <em>p</em> = 0.031) and serum creatinine significantly decreased (81.47 ± 11.36 vs. 74.9 ± 10.67 μmol/L; <em>p</em> = 0.046) from week 48 to 60. At week 48, the incidence of low-level viremia (LLV) was 19.0 % in the ETV group and 16.7 % in the TAF group, respectively (<em>p</em> &gt; 0.05). Pairwise comparisons revealed no significant difference in the percentage of LLV between the ETV continued group and the TAF continued group at week 48, 60, and 72. Additionally, there was also no significant difference in the proportion of LLV between the ETV + TAF combination group and the TAF + ETV combination group at week 48, 60, and 72.</div></div><div><h3>Conclusions</h3><div>There was a substantial difference in eGFR between ETV and TAF treatments at week 48. Gender, baseline eGFR, and medication (TAF/ETV) were all remarkably positive indicators of eGFR abnormalities. In patients receiving ETV, an early switch to TAF may result in the reversal of early-stage renal damage.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 2","pages":"Article 101925"},"PeriodicalIF":3.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeted albumin infusions in hospitalized patients with cirrhosis receiving terlipressin: A post-hoc analysis of ATTIRE.","authors":"Nikolaj Torp, Louise China, Mads Israelsen, Ewan Forrest, Nick Freemantle, Jonel Trebicka, Aleksander Krag, Alastair O'Brien","doi":"10.1016/j.aohep.2025.101941","DOIUrl":"https://doi.org/10.1016/j.aohep.2025.101941","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>The ATTIRE trial showed increased severe adverse events with targeted albumin therapy. Safety concerns exist regarding albumin-terlipressin use for hepatorenal syndrome-acute kidney injury (HRS-AKI), but terlipressin is also used for variceal bleeding and hypotension. We evaluated the safety of terlipressin and albumin for any indication using ATTIRE data.</p><p><strong>Materials and methods: </strong>In ATTIRE, hospitalized decompensated cirrhosis patients were randomized to daily 20% albumin (serum albumin ≥30 g/L) or standard care for up to 14 days post-randomization. Of 777 patients, 42 received terlipressin at randomization in the targeted albumin arm and 41 in standard care. We studied death and fluid-related complications from serious adverse event reporting during the 15-day trial period.</p><p><strong>Results: </strong>Indications for terlipressin were variceal bleeding (73%), HRS-AKI (23%) and sepsis-induced hypotension (3%). Median albumin dosing was higher with targeted albumin than standard care for variceal bleeding (200 g vs. 0 g) and sepsis-induced hypotension (180 g vs. 0 g), but similar for HRS-AKI (220 g vs. 230 g). A composite of death and fluid-related complications was more common with targeted albumin compared to standard care (log-rank: p = 0.011), where the increased risk persisted when adjusting for baseline MELD. This composite outcome occurred more often in variceal bleeding patients treated with targeted albumin (n=7) compared to standard care (n=2), although the difference was not statistically significant (p=0.064).</p><p><strong>Conclusions: </strong>In hospitalized cirrhosis patients, targeted albumin infusions with terlipressin may increase the risk of death and fluid-related complications, particularly in variceal bleeding. Caution is warranted when using albumin in this subgroup.</p><p><strong>Clinical trial number: </strong>EudraCT number: 2014-002300-24 and International Standard RCT Number: 14174793 Research Ethics Committee Number: 15/LO/0104.</p>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"101941"},"PeriodicalIF":3.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144558891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world efficacy of cabozantinib alone or in combination with ICIs in heavily pretreated hepatocellular carcinoma: potential role of AXL and MET expression","authors":"Kuan-Chang Lai ,&nbsp;Te-Lin Hsu ,&nbsp;Shih-Yao Lin ,&nbsp;Nai-Jung Chiang ,&nbsp;Ming‑Huang Chen ,&nbsp;Yee Chao ,&nbsp;Muh-Hwa Yang ,&nbsp;San-Chi Chen","doi":"10.1016/j.aohep.2025.101917","DOIUrl":"10.1016/j.aohep.2025.101917","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Cabozantinib, a multi-kinase inhibitor targeting AXL and MET, is approved for second-line treatment of hepatocellular carcinoma (HCC). However, the combination of cabozantinib with immune checkpoint inhibitors (ICIs) remains controversial after the COSMIC-312 study. The role of AXL and MET expression in predicting cabozantinib response is unclear. This study aims to evaluate cabozantinib's efficacy with ICIs and the predictive value of AXL and MET expression.</div></div><div><h3>Materials and Methods</h3><div>From January 2019 and December 2023, 50 advanced HCC patients treated with cabozantinib were retrospectively enrolled.</div></div><div><h3>Results</h3><div>Overall, 74% of patients received prior immunotherapy, 72% had been treated with more than two different multiple kinase inhibitors (MKIs), and 58% received cabozantinib as a fifth-line or later therapy. Cabozantinib was used alone (60%), with ICIs (12%), or with chemotherapy (28%). A majority (70%) received a dosage exceeding 40 mg/day. The ORR to cabozantinib was 0%, while the DCR was 42.2%. median PFS was 3.3 months, and OS was 6.1 months. There was no significant difference in PFS or OS between patients receiving five or more lines of treatment and those receiving fewer. Cabozantinib plus ICIs showed longer PFS (6.7 vs. 3.2 months, p = 0.04) and a trend toward improved OS compared to cabozantinib alone. AXL expression may predict better outcomes. Common adverse effects included palmar-plantar erythrodysesthesia (24.2%) and hypertension.</div></div><div><h3>Conclusions</h3><div>This study highlights the potential of cabozantinib combined with immunotherapy in heavily pretreated HCC, with AXL expression as a possible predictive biomarker.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 2","pages":"Article 101917"},"PeriodicalIF":3.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143963054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Latin American Association for the Study of the Liver (ALEH) guidance of preoperative care in liver transplantation: referral criteria, patient assessment, and waiting list management.","authors":"Victoria Mainardi, Josefina Pages, Josemaría Menendez, Rodrigo Zapata, Luis Antonio Díaz, Sebastian Marciano, Fernando Cairo, Martin Padilla-Machaca, Laura Tenorio, Alvaro Urzua, Lucia Navarro, Nicolas Dominguez, Pablo Coste, Manuel Mendizabal, Jorge Martinez, Sergio Lopez, Adriana Varon, Alfeu de Medeiros Fleck, Jhon Abad Gonzalez, Juan Carlos Restrepo, Liana Codes, Paulo Lisboa Bittencourt, Norma Marlene Pérez Figueroa, Graciela Castro-Narro, Débora Raquel B Terrabuio, Mário Guimarães Pessoa, Marcos Girala, Leonardo Lucca Schiavon, Edgard Aguilera, Kenia Valenzuela Aguilera, Marcia Samada, Solange Gerona, Alejandra Villamil","doi":"10.1016/j.aohep.2025.101939","DOIUrl":"https://doi.org/10.1016/j.aohep.2025.101939","url":null,"abstract":"<p><p>Liver transplantation (LT) is the standard of care therapy for patients with decompensated cirrhosis, early-stage hepatocellular carcinoma, acute liver failure, and other expanding indications. Latin America is a highly heterogeneous region characterized by an uneven distribution of socio-economic conditions and irregular access to health resources, and consequently LT activity varies across it. This current guidance of preoperative care in LT represents a collaborative effort to assess and standardize preoperative evaluation of liver transplant candidates in Latin America. It is the first position paper of the special interest group on LT of the Latin American Association for the Study of the Liver (ALEH), which draws evidence-based comprehensive recommendations regarding who to refer, the LT assessment and how to manage the patient on the waiting list, taking into consideration their applicability in Latin America.</p>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"101939"},"PeriodicalIF":3.7,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Critical commentary on camrelizumab-based triple therapy for unresectable hepatocellular carcinoma.","authors":"Ibrahim Nagmeldin Hassa","doi":"10.1016/j.aohep.2025.101940","DOIUrl":"https://doi.org/10.1016/j.aohep.2025.101940","url":null,"abstract":"","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"101940"},"PeriodicalIF":3.7,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Chronic hepatitis B virus persistence: Mechanisms, consequences and implications for achieving cure.","authors":"Christopher Georgi, Simmone D'souza, Carla Osiowy, Carla S Coffin, Curtis L Cooper","doi":"10.1016/j.aohep.2025.101938","DOIUrl":"10.1016/j.aohep.2025.101938","url":null,"abstract":"<p><p>HBV persists within the hepatocyte due to the presence of intranuclear covalently closed circular DNA (cccDNA) and double-stranded linear DNA (dslDNA) integration. These bodies pose formidable challenges for achieving HBV functional and sterilizing cure. In this virology-focused review we provide an overview of HBV persistence with consideration of the negative implications for chronic infection. We also discuss advancements in HBV therapies that aim to disrupt these targets.</p>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"101938"},"PeriodicalIF":3.7,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144526197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to: MAFLD treatment: emphasizing the concept of \"homology of medicine and food\".","authors":"Jianyu Lv, Mi Zhou, Yujie Shi, Shuo Zhang","doi":"10.1016/j.aohep.2025.101936","DOIUrl":"10.1016/j.aohep.2025.101936","url":null,"abstract":"","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"101936"},"PeriodicalIF":3.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MAFLD treatment: Emphasizing the concept of \"homology in medicine and food\".","authors":"Yuqing Zhang, Chengchou Pa, Hongqiang Gao","doi":"10.1016/j.aohep.2025.101937","DOIUrl":"10.1016/j.aohep.2025.101937","url":null,"abstract":"","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"101937"},"PeriodicalIF":3.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144511382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Hepatocellular carcinoma surveillance: Current challenges in Latin America\".","authors":"Josefina Pages, Manuel Mendizabal, Graciela Elia Castro-Narro, Jose María Menéndez, Oscar Beltran, Leonardo Gomes Da Fonseca, Jaime Poniachik Teller, Marcos Girala, Daniel Fabricio Alarcon Cano, Federico Piñero","doi":"10.1016/j.aohep.2025.101935","DOIUrl":"10.1016/j.aohep.2025.101935","url":null,"abstract":"<p><p>Hepatocellular carcinoma (HCC) is the most common primary liver cancer, predominantly linked with cirrhosis and chronic hepatitis B. In Latin America, disparities in healthcare access complicate HCC management. A recent expert meeting emphasized the importance of identifying at-risk populations for effective screening and surveillance, underlining the need for structured routine programs. Early detection of HCC improves outcomes and increases survival rates. Surveillance programs are essential, yet access to healthcare and treatment varies significantly across Latin America, making timely diagnosis and intervention challenging. Additionally, recent shifts in disease etiology, notably the rising prevalence of MASLD, further complicate HCC detection. Effective HCC surveillance relies on cost-efficient diagnostic tools. Ultrasound is the main screening method, though it has moderate sensitivity. In obese patients, achieving adequate visualization is particularly difficult. Combining ultrasound with alpha-fetoprotein (AFP) improves diagnostic accuracy. Biomarkers such as AFP are commonly used to diagnose and monitor HCC, but their predictive value remains limited. Integrating biomarkers with ultrasound or other novel markers may enhance detection; however, further research is necessary to validate these strategies. In conclusion, HCC surveillance remains a significant challenge in our region. A comprehensive, multifaceted approach is needed to improve early detection and clinical outcomes.</p>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"101935"},"PeriodicalIF":3.7,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}