Annals of hepatology最新文献

{"title":"A multinational survey of physician knowledge about management of chronic hepatitis C.","authors":"Mohamed El-Kassas, Yusuf Yilmaz, Chun-Jen Liu, Marlen I Castellanos Fernández, Yuichiro Eguchi, Khalid Al-Naamani, Doaa Abdeltawab, Mohammed A Medhat, Wah-Kheong Chan, Stuart Gordon, Vasily Isakov, Ming Lung Yu, Maria Buti, George V Papatheodoridis, Fatema Nader, Andrei Racila, Linda Henry, Maria Stepanova, Zobair M Younossi","doi":"10.1016/j.aohep.2025.102134","DOIUrl":"https://doi.org/10.1016/j.aohep.2025.102134","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Up-to-date knowledge of hepatitis C virus (HCV) management among healthcare providers is crucial for improving patient outcomes. This study evaluates physicians' awareness, attitudes, self-efficacy, perceptions, and barriers related to current HCV management guidelines and post-treatment follow-up.</p><p><strong>Materials and methods: </strong>We invited healthcare providers treating HCV patients to complete a 48-question survey regarding their practices, guideline familiarity, and related attitudes.</p><p><strong>Results: </strong>The survey was completed by 183 physicians from 8 countries, including hepatologists (32%), gastroenterologists (39%), internal medicine specialists (12%), and infectious disease specialists (16%). The majority (95%) were aware of at least one treatment guideline, with the EASL guideline cited by 84% and the AASLD guideline by 72%. Most (94%) believed post-HCV treatment follow-up was effective for detecting complications, and 93% recommended continued follow-up. Although 90% felt well-informed about guidelines, 39% reported encountering inconsistencies. Sixty-one percent recognized that HCV elimination reduces the rate of decompensation but does not abolish the risk of hepatocellular carcinoma (HCC). Overall, 86% acknowledged the need for follow-up in patients who achieved sustained virological response (SVR), with the most commonly recommended intervals being six months for non-cirrhotic patients and three months for cirrhotic patients. Minimal barriers to follow-up were reported, with only 1.6% to 4.4% not discussing its benefits due to time or resource constraints.</p><p><strong>Conclusions: </strong>The surveyed physicians demonstrated a strong awareness of the current HCV guidelines but indicated potential gaps in knowledge and inconsistencies. Continuous education and support are essential to enhance adherence to HCV management protocols.</p>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"102134"},"PeriodicalIF":4.4,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228317","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":"Piloting eLearning initiatives: Computer-based training and telementoring for viral hepatitis care in public primary care setting.","authors":"Janus P Ong, Geohari Hamoy, Eric David B Ornos, Vanessa Co-Tanco, Joy Gillera, Jhunnel Macalanda, Jae-Ann Sumalo","doi":"10.1016/j.aohep.2025.102133","DOIUrl":"https://doi.org/10.1016/j.aohep.2025.102133","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Chronic viral hepatitis remains a major global public health challenge. The WHO launched the Global Health Sector Strategy on Viral Hepatitis in 2016, emphasizing health equity. Digital learning offers a promising solution to barriers in achieving hepatitis elimination. This study describes a digital learning initiative to strengthen primary care capacity for viral hepatitis management in the Philippines.</p><p><strong>Materials and methods: </strong>The initiative utilized asynchronous computer-based training (CBT) on the HepLearn platform and synchronous telementoring via HepTalks. The CBT was developed collaboratively with the Department of Health, WHO, Hepatology Society of the Philippines, and University of the Philippines Manila. The course addressed essential hepatitis B and C topics. Telementoring paired primary care physicians with specialists from the Hepatology Society of the Philippines using Zoom for interactive case discussions. Eight one-hour sessions were conducted, each starting with expert-led didactic lectures followed by case discussions.</p><p><strong>Results: </strong>Evaluation included quantitative and qualitative methods: surveys, pre- and post-test assessments, and feedback forms. Among 189 enrollees, 111 (58.7%) completed HepLearn. Mean pre-test score was 2.63 ± 0.29, rising to 7.09 ± 1.90 post-test (p<0.001), demonstrating significant knowledge gain. Participant feedback indicated high satisfaction (72% to 98%) with course content. Thirteen physicians participated in HepTalks. Confidence in viral hepatitis care increased significantly, with 67% expressing strong agreement that the sessions helped them provide better care.</p><p><strong>Conclusions: </strong>This integrated eLearning approach demonstrates potential for scalable digital education to enhance hepatitis care in primary and remote communities. eLearning should be a strategy for eliminating viral hepatitis by 2030.</p>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"102133"},"PeriodicalIF":4.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145224829","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":"Comment on \"Burden of disease and risk factors for primary liver cancer by etiology in the United States, 1990-2021: Results from the Global Burden of Disease study, 2021\".","authors":"Haoran Zhang, Shuai Liu, Nan Zhang","doi":"10.1016/j.aohep.2025.102128","DOIUrl":"https://doi.org/10.1016/j.aohep.2025.102128","url":null,"abstract":"","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"102128"},"PeriodicalIF":4.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211444","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":"Fenofibrate in managing cholestatic pruritus in paediatric patients.","authors":"Jesús Quintero-Bernabeu, Javier Juamperez-Goñi, Cristina Padrós-Fornieles, Mauricio Larrarte-King, Simone Mameli, Lis Vidal-Valdivia, Susana Clemente-Bautista, Aurora Fernández-Polo, José Andrés Molino-Gahete, Maria Mercadal-Hally","doi":"10.1016/j.aohep.2025.102132","DOIUrl":"https://doi.org/10.1016/j.aohep.2025.102132","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Cholestatic pruritus is a difficult-to-manage symptom in cholestatic disorders. This study presents our experience with fenofibrate for treating refractory cholestatic pruritus in paediatric patients.</p><p><strong>Materials and methods: </strong>We conducted a retrospective review involving patients under 18 with moderate to severe pruritus (5D Itch score >15), unresponsive to conventional treatments. Fenofibrate was administered at 100 mg/20 kg daily, with a maximum dose of 100 mg for those under 20 kg. A good response was defined as a >50% reduction in the 5D Itch score, with partial relief as a 25-50% reduction.</p><p><strong>Results: </strong>Between May 2017 and May 2023, 25 patients were treated, with a median treatment duration of 24.2 months. Pruritus reduction at 2 weeks, 1, 3, 6, and 12 months was 36.8%, 52.2%, 53.6%, 57.1%, and 60.8%, respectively. After 12 months, 64% (16/25) achieved >50% improvement, and 16% (4/25) showed partial relief. Fenofibrate significantly reduced serum bile acids, AST, ALT, bilirubin, cholesterol, and triglycerides, without affecting elastography. No serious adverse events occurred.</p><p><strong>Conclusions: </strong>Fenofibrate shows potential in managing pruritus in paediatric patients with cholestatic diseases, warranting further investigation through randomized clinical trials to assess its efficacy and safety.</p>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"102132"},"PeriodicalIF":4.4,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145211389","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":"Letter to the editor: enhancing the clinical utility of a ten-gene prognostic signature for HCC.","authors":"Weiyi Jiang, Jinkai Feng, Shuqun Cheng","doi":"10.1016/j.aohep.2025.102130","DOIUrl":"https://doi.org/10.1016/j.aohep.2025.102130","url":null,"abstract":"","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"102130"},"PeriodicalIF":4.4,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190776","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":"Re-evaluating the survival benefit of adding camrelizumab to TACE plus tyrosine-kinase inhibitors in unresectable hepatocellular carcinoma: the undervalued influence of TACE frequency.","authors":"Longshuang Wang, Jian Zhang, Jianfei Liu","doi":"10.1016/j.aohep.2025.102126","DOIUrl":"10.1016/j.aohep.2025.102126","url":null,"abstract":"","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"102126"},"PeriodicalIF":4.4,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184535","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":"Epidemiology and etiologic trends of hepatocellular carcinoma in cirrhotic patients in Mexico: a multicenter retrospective study (2018-2024).","authors":"Nahum Méndez-Sánchez, Mariana M Ramírez-Mejía, Carlos Cortez-Hernández, Elianee M Tovar-Bojorquez, Raúl Contreras-Omaña, Juan D Monsiváis-Morales, Jacqueline Cordova-Gallardo, Mauricio Castillo-Barradas, Nubia Guzmán-Rodríguez, María S González-Huezo, Adrian Sandez-Araiza, Eira Cerda-Reyes, Stefanny Cornejo-Hernandez, Beatriz Barranco-Fragoso, Ana D Cano-Contreras, José M Remes-Troche, Fatima Higuera-de-la-Tijera, José L Pérez-Hernández, Norberto Chávez-Tapia, Francisco J Valentin-Cortez, Iaarah Montalvo-Gordon, Rubén R Lozano-Salazar, Montserrat Sabanes-Hernández, Itziar Borbolla-Schega, Heriberto Rodríguez-Hernández","doi":"10.1016/j.aohep.2025.102131","DOIUrl":"10.1016/j.aohep.2025.102131","url":null,"abstract":"<p><strong>Introduction and objectives: </strong>Hepatocellular carcinoma (HCC) represents a major complication of chronic liver disease and an emerging public health challenge in Mexico. As the prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD) continues to increase, a comprehensive understanding of the current epidemiological landscape of HCC has become increasingly important. This study aims to describe the epidemiologic features and etiologic distribution of HCC in patients with cirrhosis in Mexico using multicenter data collected from 2018 to 2024.</p><p><strong>Materials and methods: </strong>We conducted a multicenter retrospective study of 2182 patients with cirrhosis diagnosed between 2018 and 2024 across 13 tertiary care hospitals in northern, central, and southern Mexico. HCC was identified using standardized imaging and/or histological criteria. Data on demographics, cirrhosis etiology and clinical characteristics were collected.</p><p><strong>Results: </strong>Among 2182 patients with cirrhosis (mean age 61 ± 12 years; 53.8 % female), 8.8 % (n = 194) developed HCC. Prevalence was higher in women (55.1 %) and in older adults, with 78.3 % of HCC cases occurring in individuals aged ≥60 years. In women, HCC peaked between ages 70-79, while in men it peaked between 60 and 69 years. Regional differences were observed, with the highest prevalence in central Mexico (10.4 %) and the lowest in the south (3.8 %) (p < 0.001). MASLD was the leading etiology (39.1 %), followed by HCV (33.0 %) and ALD (18.6 %).</p><p><strong>Conclusions: </strong>These findings highlight the growing impact of MASLD as the leading cause of HCC in patients with cirrhosis in Mexico, with notable age, sex and regional disparities. Understanding these patterns is essential to inform targeted prevention and early detection strategies.</p>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"102131"},"PeriodicalIF":4.4,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181875","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":"Comment on \"Liver stiffness measurement trajectory analysis for prognosis in patients with chronic hepatitis B and compensated advanced chronic liver disease\".","authors":"Cunkai Wang, Pingping Li, Yun Bai","doi":"10.1016/j.aohep.2025.102129","DOIUrl":"10.1016/j.aohep.2025.102129","url":null,"abstract":"","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"102129"},"PeriodicalIF":4.4,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172286","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":"Refining fibrosis risk stratification in CHB-MASLD: methodological considerations.","authors":"Chao Wan, Mingjie Xie, Ying Zhu","doi":"10.1016/j.aohep.2025.102121","DOIUrl":"10.1016/j.aohep.2025.102121","url":null,"abstract":"","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"102121"},"PeriodicalIF":4.4,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172295","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":"Comment on \"Camrelizumab combined with transcatheter arterial chemoembolization and sorafenib or lenvatinib for unresectable hepatocellular carcinoma: A multicenter, retrospective study\".","authors":"Qing Chen, Meng Meng, Chunhui Yuan","doi":"10.1016/j.aohep.2025.102127","DOIUrl":"10.1016/j.aohep.2025.102127","url":null,"abstract":"","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"102127"},"PeriodicalIF":4.4,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145172319","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}