Annals of hepatology最新文献

{"title":"DATA OMISSION IN COMPULSORY NOTIFICATION FORMS RELATED TO HEPATITIS A, B AND C AND HIV CO-INFECTION","authors":"Isabelle Cristine de Jesus Macedo ,&nbsp;João Vitor da Mota Silva ,&nbsp;Ana Paula Maciel Gurski ,&nbsp;Mário Peribanez Gonzalez ,&nbsp;Elton Carlos de Almeida ,&nbsp;Aline Alves da Silva ,&nbsp;Ana Monica de Mello ,&nbsp;Carla Francisca dos Santos Cruz ,&nbsp;Nathália da Silva Cruz ,&nbsp;Jose Nilton Neris Gomes ,&nbsp;Leonardo Carrara Matsuura","doi":"10.1016/j.aohep.2025.102042","DOIUrl":"10.1016/j.aohep.2025.102042","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Co-infection with Human Immunodeficiency Virus (HIV) and hepatitis C virus (HCV) represents a significant public health challenge in Brazil, as it is associated with worsening clinical outcomes, such as accelerated progression of liver disease and increased morbidity and mortality.</div><div>To describe the rate of incomplete reporting related to HCV and HIV co-infection among individuals notified between 2013 and 2023 in the North region of Brazil.</div></div><div><h3>Materials and Methods</h3><div>This is a descriptive, cross-sectional study conducted using data from the Notifiable Diseases Information System (Sinan) database for the period from 2013 to 2023. The variables used were viral hepatitis classification and co-infection with HIV. Subsequently, a descriptive analysis was performed to identify omissions in the HIV co-infection variable in viral hepatitis notifications.</div></div><div><h3>Results</h3><div>A high number (18.6%) of data omissions was observed regarding HIV and viral hepatitis co-infection. Among the types, the highest omission rate was observed in hepatitis A notifications (21.7%), followed by hepatitis C (20.3%) and hepatitis B (17%). Among the states, Roraima showed the highest percentage of omission of information on HIV diagnosis (23.2%).</div></div><div><h3>Conclusions</h3><div>The data reveal a significant percentage of omissions regarding the investigation of HIV co-infection in viral hepatitis notifications, especially for hepatitis A (21.7%), C (20.3%), and B (17%). This weakness in the completeness of information compromises epidemiological surveillance and health action planning.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 102042"},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154334","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":"VISCERAL FAT AS A KEY DRIVER OF LIVER FIBROSIS IN MASLD: A DXA-BASED ANALYSIS","authors":"Jenaine Rosa Emiliano Godinho ,&nbsp;Raul Donizetti Moraes Silva ,&nbsp;Lívia Manéa Petri ,&nbsp;Ana Cecilia Sartori Ferruzzi ,&nbsp;Jordanna de Paula Torres ,&nbsp;Henrique Pezzin Sario ,&nbsp;João Marcello de Araújo-Neto ,&nbsp;Maria Auxiliadora Nogueira Saad ,&nbsp;Priscila Pollo-Flores ,&nbsp;Débora Vieira Soares","doi":"10.1016/j.aohep.2025.102017","DOIUrl":"10.1016/j.aohep.2025.102017","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Adiposity is associated with an increased risk of developing metabolic dysfunction-associated steatotic liver disease (MASLD).</div><div>Verify the association between liver fibrosis and visceral adiposity in MASLD by Dual-energy X-ray absorptiometry (DXA) method.</div></div><div><h3>Materials and Methods</h3><div>In a cross-sectional study, assessment of MASLD and significant fibrosis (F≥2) were performed by ultrassonography and transient elastography, respectively. Dual-energy X-ray absorptiometry (DXA) were performed to assess fat mass index (FMI), visceral adipose tissue (VAT)and android-to-gynoid (A/G) ratio. Data are reported as median (IQR) or n (%); p &lt; 0.05 was considered significant</div></div><div><h3>Results</h3><div>141 participants were enrolled, 32(22.7%) had hepatic fibrosis. Age was 62.0(55.0–68.0) years, and 118(83.7%) were women. Adiposity parameters were waist-to-height ratio (WHtR) 0.66 (0.59–0.71); abdominal circumference (AC) 105.0(94.4–114.1) cm; fat mass index (FMI) 13.94 (10.50–17.20) kg/m²; VAT 1784 (1203–2430) cm³; and A/G 1.13 (1.04–1.23). The prevalence of obesity (BMI ≥ 30 kg/m²), high FMI (&gt; 14 kg/m²), and A/G &gt; 1 was 45(31.9%), 52(36.9%), and 130(92.2%) respectively. The groups with and without fibrosis were compared. Age and sex were similar between groups. Those with fibrosis had significantly higher WHtR, AC, VAT, trunk fat mass, android fat mass, and total fat mass. (Table 1).</div></div><div><h3>Conclusions</h3><div>This study shows that central and visceral adiposity are significantly linked to liver fibrosis. These findings are measured by DXA, an accurate method, and are supported by simple and cost-effective clinical measures such as WHtR and AC.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 102017"},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154574","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":"INR-PLATELET RATIO AS A PREDICTOR OF ESOPHAGEAL VARICES IN MEXICAN CIRRHOTIC PATIENTS","authors":"Cinthya Yatzel Mulato Briones ,&nbsp;Raúl Ramírez Marcial ,&nbsp;Maria del Rosario Herrero Maceda ,&nbsp;Scherezada María Isabel Mejía Loza ,&nbsp;Rodrigo Vázquez Pérez ,&nbsp;María Isabel Astudillo Delgado ,&nbsp;Alejandra Díaz García","doi":"10.1016/j.aohep.2025.102003","DOIUrl":"10.1016/j.aohep.2025.102003","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>High mortality from esophageal variceal bleeding necessitates primary prophylaxis in cirrhosis. Mexico's endoscopy-limited settings require biochemical predictors like the INR-Platelet Ratio (INPR) for variceal detection.The present work proposes that the INPR retains predictive validity for esophageal varices in Mexican cirrhotic patients.Consequently, validation of this hypothesis constitutes the primary objective of this investigation.</div></div><div><h3>Patients and Methods</h3><div>An observational, single-center study was conducted in the Gastroenterology Department of Hospital Juárez de México between 2023 and 2024.Inclusion criteria:Patients aged over 18 years with a diagnosis of cirrhosis confirmed by FIB-4 or hepatic ultrasound,and no prior endoscopic screening.A total of 139 patients were included: 71 women (51.1%) and 68 men (48.9%). Statistical analyses were performed using IBM SPSS Statistics software. Descriptive population analyses utilized frequencies and medians.Group comparisons were conducted using the chi-square test and Student’s t-test,with a p-value &lt;0.05 considered statistically significant.ROC curves and the Youden index were employed to identify optimal cutoff values for sensitivity and specificity.</div></div><div><h3>Results</h3><div>Using an INPR cut-off of ≥0.9463 for detecting esophageal varices (irrespective of size), the following performance metrics were achieved: sensitivity 83%, specificity 71%, PPV 85%, NPV 66%. +LR 2.87, -LR 0.24.</div></div><div><h3>Conclusions</h3><div>The INR-Platelet Ratio is an efficient tool for healthcare providers to initiate screening and prioritize early endoscopy, particularly in patients with other risk markers such as thrombocytopenia or Child-Pugh B/C cirrhosis.Future studies should evaluate its cutoff points to reduce unnecessary endoscopies and improve timely complication detection.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 102003"},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154755","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":"Granulomatous liver disease in a referral center in Mexico city.","authors":"Jesús Ruiz-Manríquez, Sandra M Feria-Agudelo, Antonio Olivas-Martinez, Froylan D Martínez-Sánchez, Daniel Azamar-Llamas, Miriam Bobadilla-Del-Valle, Orlando Emmanuel Falcón-Antonio, Braulio Martínez-Benítez, María José Mulas-Torres, Roberto Calderón, David Kershenobich-Stalnikowitz, José Sifuentes-Osornio, Alfredo Ponce-de-León, Edgar Ortiz-Brizuela","doi":"10.1016/j.aohep.2025.102108","DOIUrl":"10.1016/j.aohep.2025.102108","url":null,"abstract":"<p><strong>Background: </strong>Up to 15 % of liver biopsies may reveal granulomas. The underlying causes vary geographically, with marked differences between high- and low-middle-income countries. No studies have examined the etiology of granulomatous liver disease (GLD) in Mexico.</p><p><strong>Aims: </strong>To describe the etiologic profile and clinical outcomes of patients diagnosed with GLD at a tertiary care center in Mexico.</p><p><strong>Methods: </strong>Retrospective cohort study of patients diagnosed with GLD by liver biopsy between 2001 and 2017.</p><p><strong>Results: </strong>We identified 133 patients with GLD. The most common causes were infectious diseases (36.1 %, n = 48; including 22 mycobacterial infections), foreign body reactions (21.1 %, n = 28), and autoimmune disorders (15.0 %, n = 20). The overall 6-month survival probability was 90.9 % (95 % confidence interval [CI], 86-95 %), declining to 87.5 % (95 % CI, 82-93 %) at 12 months. Patients with autoimmune etiologies had the best prognosis (100 % survival at 6 and 12 months). In contrast, patients with neoplastic GLD had the poorest outcomes, with survival probabilities of 72.7 % (95 % CI, 50.6-100 %) at 6 months and 63.6 % (95 % CI, 40.7-99.5 %) at 12 months. Patients with idiopathic GLD had a favorable short-term prognosis, with a 12-month survival probability of 92 %.</p><p><strong>Conclusions: </strong>In this cohort, infectious diseases were the most common cause of GLD. Prognosis varied by etiology, with idiopathic cases showing favorable short-term outcomes and neoplastic cases exhibiting poor survival rates.</p>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":" ","pages":"102108"},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144939678","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":"LIVER TRANSPLANTATION FOR HEPATOCELLULAR CARCINOMA: IMPLICATIONS OF EXPANDING AGE LIMITS IN LOW-DONATION SETTINGS IN LATIN AMERICA","authors":"Maria Fernanda Lynch-Mejía ,&nbsp;Francisco Vargas-Navarro ,&nbsp;Wagner Ramírez-Quesada ,&nbsp;Maria José Soto-Echeverri ,&nbsp;Andrés Solera-Vega ,&nbsp;Alejandra Ochoa-Palominos ,&nbsp;Pablo Coste","doi":"10.1016/j.aohep.2025.102028","DOIUrl":"10.1016/j.aohep.2025.102028","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>In Costa Rica, liver transplantation (LT) for hepatocellular carcinoma (HCC) is legally restricted to patients under 65 years. This limits curative options and may favor patients receiving exception MELD points. The country’s average liver donation rate remains low, at 5.4 donors per million population per year, further limiting access.</div></div><div><h3>Materials and Methods</h3><div>We assessed transplant eligibility, bridging therapies, and outcomes in HCC patients at a tertiary center. Eligibility was defined as age &lt;65, meeting UCSF criteria, and having no contraindications. We modeled the impact of raising the age limit to &lt;70 years.</div></div><div><h3>Results</h3><div>Of 260 patients, 52 (20%) met transplant criteria; 86.5% received bridging therapy (TACE 27, ablation 18, resection 2). One additional patient was downstaged to eligibility. Among 53 total candidates, 30.2% progressed or died before listing, 11.3% remained stable on alternative treatments, 45% were transplanted, and 9.4% died or dropped out while on the waitlist. Mean wait time was 148.1 days (SD 93.5). Expanding the age limit to &lt;70 years would increase eligibility by 49%, adding 27 candidates. However, this may disadvantage other patients with high functional MELD scores, as those with HCC receive exception points after three months of evaluation.</div></div><div><h3>Conclusions</h3><div>Raising the age threshold for LT would expand access for older HCC patients but may exacerbate inequities in organ allocation due to low donation rates and MELD exception prioritization. Policy reform must be accompanied by increased organ procurement efforts and ethical safeguards to ensure equitable access in low-donation settings such as Costa Rica.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 102028"},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154259","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":"ENCEPHALAPP STROOP TO DETECT COVERT HEPATIC ENCEPHALOPATHY IN PATIENTS WITH COMPENSATED CIRRHOSIS","authors":"Oscar Suazo ,&nbsp;Kemo Sayon ,&nbsp;Yusimik Román ,&nbsp;Sila M. Gonzales ,&nbsp;Mirtha Infante Velasquez ,&nbsp;Marlén Castellanos ,&nbsp;Danay Guerrero ,&nbsp;Susana Borges","doi":"10.1016/j.aohep.2025.102026","DOIUrl":"10.1016/j.aohep.2025.102026","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Covert hepatic encephalopathy (CHE) is a common complication in patients with compensated cirrhosis, associated with subtle cognitive impairment and a worse prognosis. The EncephalApp Stroop is a digital tool that facilitates its identification.</div><div>To evaluate the diagnostic capacity of the EncephalApp Stroop to identify CHE in patients with compensated cirrhosis</div></div><div><h3>Materials and Methods</h3><div>A diagnostic evaluation study was conducted in patients with compensated cirrhosis treated at the Institute of Gastroenterology in Havana, Cuba, between March 2023 and December 2024. All participants completed the EncephalApp Stroop and the Psychometric Hepatic Encephalopathy Score (PHES). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were determined. The discriminatory capacity of the test was assessed using ROC curve analysis, considering a cutoff point of &gt;190 seconds in the “on” time metric plus “off” time, and the PHES result as the gold standard.</div></div><div><h3>Results</h3><div>Seventy patients of both sexes were included, with a predominance of viral etiology (74.3%). The prevalence of EHE was 38.6%. The EncephalApp Stroop showed a sensitivity of 95.2% (95% CI: 77.3% to 99.2%) and specificity of 85.7% (95% CI: 73.3% to 92.9%), PPV of 74.1% (95% CI: 55.3% to 86.8%) and NPV of 97.7% (95% CI: 87.9% to 99.6%) for the detection of HSE, with an area under the ROC curve of 0.905 (95% CI: 0.826-0.984).</div></div><div><h3>Conclusions</h3><div>The EncephalApp Stroop is a valid, accessible, and efficient diagnostic test for identifying EHE in compensated cirrhosis, with high performance compared to PHES as the gold standard. Its implementation can optimize early detection and clinical management.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 102026"},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154257","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":"GUT MYCOBIOME IN THE SPECTRUM OF METABOLIC-DYSFUNCTION ASSOCIATED STEATOTIC LIVER DISEASE (MASLD): FROM MASH TO HEPATOCELLULAR CARCINOMA","authors":"Cassio Marques Perlin ,&nbsp;Melina Keingeski Belén ,&nbsp;Bruno de Souza Basso ,&nbsp;Beatriz Mendes Borba ,&nbsp;Julliane Dutra Medeiros ,&nbsp;Francis Moreira Borges ,&nbsp;Bernd Schnabl ,&nbsp;Mario Reis Alvares-da-Silva","doi":"10.1016/j.aohep.2025.102044","DOIUrl":"10.1016/j.aohep.2025.102044","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Gut microbiome (GM) dysbiosis is associated with the development and progression of metabolic-dysfunction associated steatotic liver disease (MASLD) and steatohepatitis (MASH). There is still very limited data on the gut mycobiome (GMyco). This study aims to evaluate the composition of the GMyco at different stages of MASLD.</div></div><div><h3>Patients and Methods</h3><div>28 patients were included: controls (CON), n=6; MASH, n=6; cirrhosis (CIR), n=7; and hepatocellular carcinoma (HCC), n=5. Stool samples were collected and stored in a -80°C freezer for DNA extraction and sequencing (18S region). The single sequence variants (ASVs) obtained were compared to the SILVA database.</div></div><div><h3>Results</h3><div>77.93% women, average BMI of 31.4 kg/m2, use of antibiotics in the last 6 months (30.4%), and concurrent lipid-lowering drugs in 26.1%. MASH patients had a greater alpha-diversity (p&lt;0,05) than CON. CON had a higher abundance of Ascomycota phylum, and MASH higher Basidiomycota. CON had higher Aspergillaceae family, while there was a higher abundance of Malasseziaceae and Sporidiobolaceae in CIR and Saccharomycetacea in HCC. Only one ASV (genus Naganishia, previously reported as Cryptococcus) was homogeneously distributed in MASLD and absent in CON.</div></div><div><h3>Conclusions</h3><div>This study shows in an unprecedented way GMyco profile in the different strata of MASLD. Basidiomycetes, higher in MASH, were previously described in obese patients. For the first time, the genus Naganishia was described in this population. Our findings suggest that fungi could be a potential biological marker in the MASLD spectrum in the future.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 102044"},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154336","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":"ACCELERATED PROGRESSION TO CIRRHOSIS AND HEPATIC DECOMPENSATION IN METALD AND ALD COMPARED TO MASLD: A GLOBAL STUDY","authors":"Luis Antonio Díaz Piga ,&nbsp;Xiao-Dong Zhou ,&nbsp;Natalia Baeza ,&nbsp;Francisco Idalsoaga ,&nbsp;Gustavo Ayares ,&nbsp;Terry Cheuk-Fung Yip ,&nbsp;Vincent Wai-Sun Wong ,&nbsp;Grace Lai-Hung Wong ,&nbsp;Jimmy Che-To Lai ,&nbsp;Rakhi Maiwall ,&nbsp;Shiv K. Sarin ,&nbsp;Yu Jun Wong ,&nbsp;Xin En Goh ,&nbsp;May Xuan Goh ,&nbsp;David Marti-Aguado ,&nbsp;Cristiane Villela-Nogueira ,&nbsp;Ana Carolina Cardoso ,&nbsp;Natalia Balassiano Wajsbrot ,&nbsp;Nathalie Leite ,&nbsp;Gil Fernando Salles ,&nbsp;Juan Pablo Arab","doi":"10.1016/j.aohep.2025.101952","DOIUrl":"10.1016/j.aohep.2025.101952","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>The natural history of MetALD remains poorly characterized. In a large global cohort, we compared the natural history of the main steatotic liver disease (SLD) subtypes in terms of liver fibrosis progression and hepatic decompensation.</div></div><div><h3>Materials and Methods</h3><div>Retrospective cohort study of adult participants with SLD (2003–2025), including MASLD, MetALD, and ALD according to the 2023 SLD criteria. Sociodemographic and clinical data, vibration-controlled transient elastography (VCTE) parameters, and liver biopsy (when available) were recorded. Other causes of liver disease were excluded. The primary outcome was progression to cirrhosis in those without cirrhosis at baseline (defined by 1. liver biopsy, or 2. VCTE ≥13.6 kPa, or Fibrosis-4 [FIB-4] &gt;3.25 if other techniques were missing). Secondary outcomes included incidence of hepatic decompensation (ascites, hepatic encephalopathy, variceal bleeding, or hepatorenal syndrome). A multivariable Cox regression adjusted by age, sex, race, body mass index, diabetes, hypertension, hyperlipidemia, and smoking (for HCC) was performed.</div></div><div><h3>Results</h3><div>The total cohort included 150,306 participants from 15 countries; 87.5% MASLD, 7.9% MetALD, and 4.6% ALD. Overall, the median age was 61 years [IQR 51–70]; 52.8% men, and 97.6% Asian. At baseline, 12.2% of the cohort had a liver biopsy with F4 or a VCTE/FIB-4 suggestive of cirrhosis. During a median follow-up of 2.1 years [IQR 0.6–4.7], 0.9% of participants progressed to cirrhosis and 0.4% had hepatic decompensations. Individuals with MetALD and ALD exhibited a higher risk of progression to cirrhosis (MetALD aHR 1.34, 95%CI: 1.06–1.68, p=0.013; ALD aHR 1.82, 95%CI: 1.41–2.35, p&lt;0.0001; MASLD: reference) and of hepatic decompensation (MetALD aHR 9.33, 95%CI: 6.32–13.75, p&lt;0.0001; ALD aHR 20.56, 95%CI: 13.86–30.48, p&lt;0.0001).</div></div><div><h3>Conclusions</h3><div>In this multi-ethnic global cohort, MetALD and ALD were associated with more rapid cirrhosis progression and greater decompensation rates than MASLD, independent of cardiometabolic factors.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101952"},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154561","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":"PRESENTATION AND FOLLOW-UP OF POST-TRANSPLANT LYMPHOPROLIFERATIVE DISORDER THROUGH 2005-2022 AT A LIVER TRANSPLANT UNIT IN BOGOTA, COLOMBIA","authors":"Lina Dorado Delgado ,&nbsp;Daniel Valery Rojas Kozhakin ,&nbsp;Aura Blanco ,&nbsp;Geovanny Hernandez ,&nbsp;Carolina Salinas ,&nbsp;Cristina Torres ,&nbsp;Oscar Beltran ,&nbsp;Martin Garzón ,&nbsp;Adriana Varon","doi":"10.1016/j.aohep.2025.102022","DOIUrl":"10.1016/j.aohep.2025.102022","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Post- transplant lymphoproliferative disorders (PTLD) are a group of neoplasms developed after transplantation, associated with increased mortality. The incidence of PTLD in liver transplant is 1-5.5%. Risk factors include immunosuppression, Epstein Barr Virus (EBV) mismatch and acute rejection. Clinical presentation is diverse. Treatment options include reduction of immunosuppression (RIS), rituximab and chemotherapy. The objective is to evaluate the incidence and clinical-pathological characteristics of patients with PTLD in our center.</div></div><div><h3>Materials and Methods</h3><div>Retrospective analysis of orthotopic liver transplant (OLT) patients over 18 years old in La Cardio from January 2005 to December 2022 was collected to identify PTLD patients. After identifying PTLD patients, demographic details, indication for liver transplant, induction and maintenance immunosuppressive regimen, EBV status, acute rejection episodes, histopathological classification of PTLD, chemotherapy used, and outcome were analysed in each case.</div></div><div><h3>Results</h3><div>Of a total of 617 OLT patients 4 developed PTLD representing a prevalence of 0.6% during a 17-year period of follow-up. Of the patients, 3 (75%) were female. Chronic hepatitis C, chronic hepatitis B, alcoholic hepatitis and autoimmune hepatitis was the etiology of cirrhosis in each of the patients. Median age of the cohort was 44 years. Median time of presentation for PTLD was 52,7 months since liver transplant. More detailed information is in table 1.</div></div><div><h3>Conclusions</h3><div>This study showed a low prevalence of PTLD among OLT recipients. Most of the patients responded well to RIS and chemotherapy. Further and multi-center studies are needed to provide a better understanding of PTLD in our population.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 102022"},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154492","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":"HIGH WAITING LIST MORTALITY AMONG LIVER TRANSPLANT CANDIDATES WITH ALCOHOL-RELATED LIVER DISEASE: A 10-YEAR COHORT FROM A BRAZILIAN TERTIARY CENTER","authors":"Guilherme Fontanini Massote ,&nbsp;Roberta Araújo Chaves ,&nbsp;Verena da Silva Ayub ,&nbsp;Fernanda Souza Fernandes ,&nbsp;Ajith Sankarankutty Kumar","doi":"10.1016/j.aohep.2025.102025","DOIUrl":"10.1016/j.aohep.2025.102025","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Alcohol-related liver disease (ALD) is a leading cause of cirrhosis-related mortality and a common indication for liver transplantation. This study aimed to assess the impact and characteristics of ALD in liver transplant candidates at a tertiary center in Brazil.</div></div><div><h3>Patients and Methods</h3><div>This retrospective study included the medical records of patients listed for liver transplantation between 2009 and 2019 at a tertiary hospital. We evaluated the proportion of ALD as an indication, clinical and epidemiological profiles, waiting list mortality, and patterns of alcohol consumption and abstinence in patients with ALD.</div></div><div><h3>Results</h3><div>Among the 583 patients, 243 (41.7%) had ALD. This etiology was the most frequent among both non-transplanted (45.5%) and transplanted (38.4%) patients. In the transplanted group, ALD patients were predominantly male and smokers (p&lt;0.001). The overall waiting list mortality rate was 70.2%, with ALD accounting for 43% of the deaths. Among the 118 transplanted patients with an alcohol-related component, data on alcohol consumption were available for 92. The mean daily alcohol intake was 133.1 g, with a mean abstinence duration of 4.9 years before transplantation.</div></div><div><h3>Conclusions</h3><div>ALD was the most frequent indication for liver transplantation in this cohort and was associated with high mortality on the waiting list. These findings highlight the need for the early identification and management of patients with harmful alcohol use.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 102025"},"PeriodicalIF":4.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154498","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}