Annals of hepatology最新文献

{"title":"Liver alterations found in patients with inflammatory bowel disease in a tertiary care center.","authors":"Kenia M. Bastida-Guadarrama ,&nbsp;Jorge Luis De-León-Rendón ,&nbsp;Viridiana López-Ladrón-de-Guevara ,&nbsp;Santiago Camacho-Hernandez ,&nbsp;Fátima Higuera-de-la-Tijera","doi":"10.1016/j.aohep.2025.101799","DOIUrl":"10.1016/j.aohep.2025.101799","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Inflammatory bowel disease (IBD) encompasses two main conditions: Crohn's disease (CD) and ulcerative colitis (UC); the association between these diseases and liver diseases has been described. The objective of this work is to report the frequency of these alterations in a tertiary hospital.</div></div><div><h3>Material and Patients</h3><div>Observational, retrospective, descriptive, case series type. Patients with a diagnosis of IBD were included, including its two variants, CD and UC. An intentional search was carried out for alterations in the liver biochemical profile, findings in imaging methods and their clinical correlation, primary biliary cholangitis (PBC), primary sclerosing cholangitis (PSC), autoimmune hepatitis (AIH), among other anatomical alterations. Qualitative data are expressed in percentages and quantitative data in mean±SD.</div></div><div><h3>Results</h3><div>62 patients were included, of which 31 were men and 31 were women, with a mean age of 42.74±15.47 years. Within this universe, there were 22 patients with CD (35.4%), 40 patients with UC (64.5%) who, according to the Montreal classification, were classified as E1=4 patients (10%), E2=12 patients (30%), E3=24 patients (60%). There were 16 patients (25.8%) who had some reported liver alteration, of which 8 (12.9%) with autoimmune liver diseases, 5 with PSC (8.06%), 2 with PBC (3.22%), 1 with HAI (1.61%). When intentionally searching for liver morphological alterations and as an incidental finding, they were found 3 (4.83%) simple hepatic cysts, 1 (1.61.%) hepatic hemangioma, and finally, 2 (3.22%) hepatitis C virus (HCV) infections.</div></div><div><h3>Conclusions</h3><div>IBD is commonly associated with autoimmune liver disorders. Likewise, the CUCI-PBC and CUCI-HAI relationship was found, which agrees with the international literature and is extrapolated with the population studied. Other incidental findings are also frequent, especially the high frequency of HCV compared to the general population.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101799"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896074","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":"Atypical migratory reactive arthritis related to Hepatitis C Virus","authors":"Clara C. Sánchez-Rodríguez ,&nbsp;Ana M. Mendoza-Martínez ,&nbsp;Héctor R. Sánchez-Nuncio ,&nbsp;Jorge H. Luna-Domínguez","doi":"10.1016/j.aohep.2025.101801","DOIUrl":"10.1016/j.aohep.2025.101801","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Reactive arthritis (RA) occurs after bacterial infections and is sporadically associated with enterovirus and hepatitis B virus (HBV) and hepatitis C virus (HCV). Clinically, we observe the characteristic triad of arthritis, uveitis and urethritis or diarrhea. We present a patient with RA associated with HCV.</div></div><div><h3>Materials and Patients</h3><div>Fifty-three-year-old man with a history of cannabis use as a youth, suspended 15 years ago. He begins with conjunctival injection, ocular pruritus, increased conjunctival secretion with ocular foreign body sensation, dysuria, and foamy urine. After 24 hours, there was pain, redness, increased volume and significant limitation of the left glenohumeral joint. He received non-steroidal anti-inflammatory drugs (NSAID) with a poor response. Seventy-two hours later, he presented pain in the right coxofemoral joint and 48 hours later in the right knee with increased volume. heat and redness with expansion of the edema to the right lower extremity, highlighting the pain in the ankle, knee and hip joints, which is why he went to the emergency room with suspicion of thrombosis (Image 1).</div></div><div><h3>Results</h3><div>During his hospitalization, a Doppler ultrasound of the lower extremity was performed, ruling out venous thrombosis. The left knee was punctured, obtaining transparent liquid with characteristics of transudate, acellular without bacteria in the biochemical analysis. Serum analysis, general urine analysis, urine culture, VDRL, antibodies against human immunodeficiency virus (HIV), antibodies against hepatitis C virus (Ac vs. HCV), hepatitis B surface antigen (HBVAg) and acute phase reactants (Image 2). Active bacterial infection was excluded, and he received 0.9% saline solution and 150 mg intravenous methylprednisolone every 12 hours, with improvement of symptoms and resolution of uveitis. Active infection with HCV was detected and the patient was discharged with 14 more days on prednisone 10 mg every 24 hours. As an outpatient, he received sofosbuvir/velpatasvir for 12 weeks with sustained viral response at week 12 (SVR12).</div></div><div><h3>Conclusions</h3><div>HCV can induce systemic inflammatory conditions and simulate other infections, such as, in this case, those associated with sexually transmitted bacteria, so it is important to request the Ac vs HCV and, if they are reactive, verify viral replication to administer specific treatment with direct-acting antivirals.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101801"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896076","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":"Association between autoimmune hepatitis and leukocytoclastic vasculitis, a case report","authors":"Yajzeel Estevez-Lopez ,&nbsp;Sury Z. Palma-Motte ,&nbsp;Mary C. Jimenez-Prieto ,&nbsp;Raquel Ramirez-Carrillo ,&nbsp;Maria F. Reyes-Romero ,&nbsp;Felipe de J. Duarte-Grajales","doi":"10.1016/j.aohep.2025.101877","DOIUrl":"10.1016/j.aohep.2025.101877","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction and Objectives&lt;/h3&gt;&lt;div&gt;Autoimmune hepatitis has an incidence that ranges from 0.9-2%. It is usually associated with other liver diseases and other autoimmune disorders, however, there are few cases associated with leukocytoclastic vasculitis. Now we present the case of an association between autoimmune hepatitis and leukocytoclastic vasculitis.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Patients&lt;/h3&gt;&lt;div&gt;This is a female patient who presented constant pain in the right hypochondrium since 2019, intermittent fever with nocturnal presentation.&lt;/div&gt;&lt;div&gt;In the Personal pathological history, she reported that was healthy, had an uncomplicated pregnancy, had no history of traveling outside the country or visiting caves, had no family history of autoimmune, genetic, or infectious diseases, had no history of exposure to chemical substances or people with a diagnosis of tuberculosis. During the years 2019 to 2024, in addition to pain in the hypochondrium and fever, they presented myalgia, arthralgia, morning stiffness that improves with activity with signs of inflammatory pain, facial erythema, and maculopapular skin rashes on the hands and legs on sun exposure. She presented Eye with foreign body sensation, and we referred to rheumatology, considering the possibility of systemic lupus erythematosus and Sjögren's syndrome, complementary studies were performed, and she was sent to ophthalmology where a normal tear breakup time of less than 5 seconds was concluded. and Sjögren's Syndrome is ruled out. Antibodies are performed to rule out systemic lupus erythematosus, such as Anti DNA and Anti SM, being negative.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;We performed a diagnostic approach in a patient with constitutional symptoms, skin rashes and constant pain in the right upper quadrant. Complementary imaging studies were requested such as USG of the liver and CT scan of the abdomen, both of which showed signs of cirrhosis, so autoimmune hepatitis began to be suspected. Within the liver studies, the transaminases are normal, alkaline phosphatase elevated, and hyperglobulinemia. Protein electrophoresis with immunofixation was performed, being positive for HyperGammaglobulinemia, subsequently, biopsies of the lip, liver and skin lesions were taken. Amylodosis and Sjögren's syndrome were ruled out with these studies, however the skin lesions demonstrated leukocytoclastic vasculitis and the antibody studies showed positive ANA, with AMA, ANCA, DNA, SM negative, and the liver biopsy showed findings related to autoimmune hepatitis. Therefore, by ruling out connective tissue and associated oncological diseases, the diagnosis of autoimmune hepatitis was established, since when using the simplified diagnostic criteria of the International Autoimmune Hepatitis Group, 8 points were met, thus confirming the diagnosis of this entity. Due to hypergammaglobulinemia, hematological diseases were ruled out when bone marrow aspiration and biopsy were performed.&lt;/di","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101877"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895769","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":"Characterization of the inflammatory profile in patients with compensated and decompensated liver cirrhosis through cytosines determined by spectroscopy.","authors":"Carlos E. Coronel-Castillo ,&nbsp;Gustavo J. Vázquez-Zapien ,&nbsp;Mónica M. Mata-Miranda ,&nbsp;Eira Cerda-Reyes ,&nbsp;Adriana Martínez-Cuazitl","doi":"10.1016/j.aohep.2025.101882","DOIUrl":"10.1016/j.aohep.2025.101882","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction and Objectives&lt;/h3&gt;&lt;div&gt;Inflammatory cytokines influence the progression of cirrhosis and decompensation. The study aims to characterize the inflammatory response of patients with compensated and decompensated liver cirrhosis through inflammatory cytokines and evaluate the state of the disease, type of decompensation, severity and the development of acute on chronic liver failure.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Patients&lt;/h3&gt;&lt;div&gt;Hospitalized patients with a diagnosis of compensated and decompensated liver cirrhosis were included. Upon admission, saliva samples were collected in microcentrifuge tubes to measure cytosines (IL-6, IL-1β, IL-10, ILF-γ and TNF), lipids and immunoglobulins: A, M and G using Fourier transform infrared spectroscopy (FTIR). Clinical and biochemical variables (complete blood count, blood chemistry, liver biochemistry, serum electrolytes, lipid profile and C-reactive protein), MELD 3.0 and Child Pugh scales were included. The statistical analysis was used the SPSS V24 program for continuous quantitative variables expressed in measures of central tendency and dispersion according to the normality of the data, the ordinal quantitative variables were expressed in frequencies and percentages, Spearman correlation analysis and a linear regression analysis were performed, from which a ROC curve and the Youden's J statistic and its sensitivity and specificity were determined, with a statistically significant p &lt;0.05.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;It was included 40 patients: 19 compensated and 21 decompensated. The most common decompensation was hepatic encephalopathy. (20%) (MELD 3.0 12.5 ± 3.59 vs 21.61 ±7.47, p&lt;0.000). Statistical significance was found in leukocytes, neutrophils and INR as well as differences in the levels of IgG, IgM, IL-6, IL1β, IFN-γ and IL-10 between the causes of decompensation (Figure 1) and decreased IgM levels. And IFN-γ in decompensated patients compared to compensated patients. A negative correlation was found between neutrophil levels and IgM, IL6, IL1β, IL10 and IFN-γ levels. The linear regression analysis gave the following formula m= 2.648+ (-0.267*infection) + (-0.926*abs1) + (0.084*abs2) + (0.442*abs3) + (-0.051*abs12) + (0.005*IgM) + (-0.064*IFNγ) + (-0.2*Leukocytes) + (0.223*Neutrophils) + (0.006*Urea), R=0.623. With the same formula, AUROC: 0.877 and p value &lt;0.0001, Youden's J statistic cutoff of 1.3913, obtaining sensitivity of 92.1%, and specificity of 78.9%. The correlation with Child-Pugh is negative with IgM levels, while it was no association between the presence of infection and decompensation (X&lt;sup&gt;2&lt;/sup&gt;= 0.053, p= 0.818), an association was indeed observed between Child-Pugh and the presence of infection (X&lt;sup&gt;2&lt;/sup&gt;= 15.126, p= 0.001).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;No correlation was found between levels of IgG, IL-6, IL1β, IFN-γ and IL-10 and the MELD 3.0 and Child Pugh scales, there is only a correlation between the Child P","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101882"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895785","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":"Cholestatic Injury Induced by Naproxen: A Rare Cause of NSAID-Induced Hepatotoxicity. Case Report.","authors":"Héctor M. Herrera-Martínez ,&nbsp;Erika G. Salgado-Parra ,&nbsp;Brenda N. Loza-Hernandez ,&nbsp;Arturo Rodriguez-Guajardo ,&nbsp;Byron I. Argoti-Mosquera","doi":"10.1016/j.aohep.2025.101828","DOIUrl":"10.1016/j.aohep.2025.101828","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction and Objectives&lt;/h3&gt;&lt;div&gt;Naproxen-induced liver injury is very rare (1-3 cases per 100,000 exposed individuals), typically occurring 1-6 weeks after ingestion¹. The damage can manifest with or without immunoallergic features and varying degrees of hepatocellular injury and cholestasis². We illustrate a case of a patient who developed cholestatic injury.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Patients&lt;/h3&gt;&lt;div&gt;A 51-year-old man, with the only relevant history being self-prescribed ingestion of 220 mg gel capsules of naproxen sodium two weeks prior for post-exercise muscle pain, presented on 04/05/24 with asthenia, vague abdominal pain in the right hypochondrium, jaundice, acholia, and dark urine. He sought medical emergency services two days later, where pronounced mucocutaneous jaundice, hepatomegaly, and hepatodynia were observed. Paraclinical tests showed hyperbilirubinemia: total bilirubin (TB) elevated due to direct bilirubin (DB), marked elevation of alkaline phosphatase (AP) and gamma-glutamyl transferase (GGT), and slight elevation of aspartate aminotransferase (AST) and alanine aminotransferase (ALT) (R factor = 2 mixed). Hepatic and biliary tract ultrasound reported diffuse increased hepatic echogenicity, ruling out biliary tract obstruction. Serological testing for hepatotropic viruses and TORCH screen were negative, as was the serological profile for autoantibodies. A percutaneous ultrasound-guided liver biopsy was performed; biopsies demonstrated intrahepatic cholestasis, minimal and focal lobular and portal interface hepatitis, macrovesicular steatosis; special stains negative for hemosiderin and glycogen deposits, fibrosis and copper-bound proteins; suggested of drug induced liver damage &lt;strong&gt;(Figure 1)&lt;/strong&gt;.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Drug-induced liver injury is a diagnosis of exclusion, only to be suspected when major causes of liver damage have been ruled out. Naproxen, a non-steroidal anti-inflammatory drug (NSAID) derived from propionic acid, has been reported to cause hepatotoxicity phenotypes of hepatocellular injury (acute hepatitis) and cholestasis through metabolic, immunoallergic and idiosyncratic mechanisms³. In this patient, the toxicity was non-dose-dependent, with an acute presentation characterized by a predominant elevation of cholestatic markers. Only supportive measures were provided, with close clinical and biochemical monitoring to identify early signs of liver dysfunction. The patient showed favorable evolution towards remission, characterized by symptomatic improvement and a progressive decrease in cholestatic markers within the first few days &lt;strong&gt;(Figure 2)&lt;/strong&gt;. After nine days of hospitalization, discharge was decided due to improvement, with a follow-up appointment for continued monitoring.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;In suspected naproxen-induced cholestatic injury, a liver biopsy is not required for diagnosis⁴ but is useful for understanding etiology","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101828"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896141","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":"Oxidative damage to lipids improves with Omega-5 fatty acid supplementation treatment in patients with severe alcoholic hepatitis","authors":"Moisés Martínez-Castillo ,&nbsp;Jacqueline Cordova-Gallardo ,&nbsp;Abigail Hernandez-Barragan ,&nbsp;Marisela Hernández-Santillán ,&nbsp;Diana Mungía-Ramos ,&nbsp;Froylan Martínez-Sánchez ,&nbsp;Daniel Santana-Vargas ,&nbsp;Gabriela Gutiérrez-Reyes","doi":"10.1016/j.aohep.2025.101829","DOIUrl":"10.1016/j.aohep.2025.101829","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Chronic and excessive alcohol consumption causes alcoholic liver disease (ALD). Alcoholic hepatitis (AH) is a severe clinical event that develops in patients with ALD and active alcohol consumption, and it has a high mortality rate within 30 days. Inflammation and redox imbalance play a crucial role in promoting the dysfunction of hepatocytes and reducing patient survival. Glucocorticoids have a transient beneficial effect in AH; however, it is necessary to understand the effect of antioxidant therapy in this pathology. To evaluate oxidative stress of lipids in patients with alcoholic hepatitis whose treatment included Omega-5</div></div><div><h3>Materials and Patients</h3><div>The randomized, double-blind clinical study included two groups of patients (men and women) with severe alcoholic hepatitis: 1) Patients treated with Prednisone (40 mg/day) + oral administration of Omega-5 (0.64 g/day) (n=20; 10% women and 90% men), and 2) Prednisone + Placebo group (n=20; 15% women, 85% men). Both groups received treatment for 28 days. Alcohol consumption was calculated in g/day. Biochemical and hematological laboratory test were performed. The MELD, Glasgow, ABIC, and Lille scales were evaluated, as well as serum levels of lipid oxidation through malondialdehyde (MDA) at 7, 14, and 28 days. The data was analyzed by Kruskal-Wallis, Mann-Whitney U and ANOVA statistical tests by SPSS v.22, significance of p&lt;0.05.</div></div><div><h3>Results</h3><div>Both groups had similar characteristics; there was no difference in severity and alcohol consumption. After 7 days of treatment, both groups of patients showed similar levels of MDA, with the highest determination of MDA observed at this point. However, a reduction in serum MDA levels was observed at 14 days (5%) in the Omega-5 group; similarly, a 22% reduction in MDA was observed at 28 days. In contrast, the placebo group showed a continuous increase in MDA levels: 19.6% and 35% at 14 and 28 days, respectively. However, there were no statistical differences, indicating the need for further studies to evaluate changes in MDA levels over six months, as well as the effects of different doses and Omega-5supplementation time.</div></div><div><h3>Conclusions</h3><div>The oral administration of Omega-5 fatty acid in combination with prednisone can reduce oxidative stress of lipids at the systemic level. The use of antioxidant therapy as an adjuvant may improve the redox state and inflammation, which could decrease infectious events and, consequently, mortality in alcoholic hepatitis.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101829"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896142","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":"Lactate/albumin ratio as an indicator of mortality in patients hospitalized with ACLF at the Juárez Hospital in Mexico.","authors":"G. Bretón-Arroy,&nbsp;LA. Robles-Casanova,&nbsp;M. Coutiño-Flores,&nbsp;MR. Herrero-Maceda,&nbsp;SMI. Mejia-Loza","doi":"10.1016/j.aohep.2025.101890","DOIUrl":"10.1016/j.aohep.2025.101890","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Albumin and lactate are markers of systemic inflammation, which are altered by their hepatic metabolism; however, they can be useful indicators of mortality in patients with cirrhosis. To determine the association between lactate/albumin ratio levels and mortality in patients with ACLF.</div></div><div><h3>Materials and Patients</h3><div>A retrospective and observational cohort study was conducted. Eighty-five patients diagnosed with ACLF according to the EASL-CLIF criteria were included from February 2022 to May 2024. Patients with hepatocellular carcinoma were excluded. Data analysis was performed using GraphPad Prism version 10.2.3 and Microsoft Excel software. An ROC curve was performed to establish the cutoff point of the lactate/albumin ratio, as well as determine the sensitivity and specificity of the model to predict 28-day mortality.</div></div><div><h3>Results</h3><div>Eighty-five patients were included, 68 (80%) men and 17 (20%) women; average age 52.4 years (39 -80). Alcohol consumption was the main cause of cirrhosis in 74 (87.05%), autoimmune diseases in 7 (8.23%), and MASLD in 4 (4.70%) <strong>(Table 1)</strong>. 12 patients (14.11%) had ACLF grade 1, 29 (34.11%) grade 2 and 44 (51.76%) grade 3. With failure: kidney 61 (71.76%), liver 57 (67.05%), brain 49 (57.64%), coagulation 37 (43.52%), respiratory 15 (17.64%) and circulatory 5 (5.88%) <strong>(Table 1)</strong>. 37 (43.52%) died within the first 28 days. The cutoff point of the lactate/albumin ratio was 1.74 (AUC 0.87), with a p value &lt;0.0001, sensitivity 71.7% and specificity 58.8% (95% CI) <strong>(Figure 1)</strong>.</div></div><div><h3>Conclusions</h3><div>The cutoff point of the lactate/albumin ratio of 1.74 allows for the objective prediction of mortality in patients with ACLF using easily accessible laboratory tests.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101890"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896157","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":"Correlation between Connective Tissue Growth Factor and the degree of fibrosis in patients with cholestasis.","authors":"Cristian Y. Sánchez-Sánchez ,&nbsp;Diego F. Abendaño-Rivera ,&nbsp;Viridiana López-Ladrón de Guevara ,&nbsp;María A. Diaz-Castro ,&nbsp;Fátima Higuera-De La Tijera ,&nbsp;Carolina Guzmán-Arriaga ,&nbsp;Ángel D. Santana-Vargas ,&nbsp;José L. Pérez-Hernández","doi":"10.1016/j.aohep.2025.101807","DOIUrl":"10.1016/j.aohep.2025.101807","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>The Connective Tissue Growth Factor (CTGF) is a multifunctional protein recognized as an important mediator in fibrogenic pathways in liver diseases. We aimed to establish the correlation between serum CTGF levels using Enzyme-Linked ImmunoSorbent Assay (ELISA) and the degree of hepatic fibrosis measured by transient elastography in patients with cholestasis diagnosed with Primary Biliary Cholangitis (PBC).</div></div><div><h3>Materials and Patients</h3><div>Prospective, analytical, experimental study. Three groups were recruited: the first group comprised patients with cholestasis, the second group comprised patients with cirrhosis due to Hepatitis C Virus (HCV), and the third group comprised healthy subjects. Anthropometric and biochemical data were collected. A blood sample was collected to quantify serum levels of CTGF using ELISA. The degree of fibrosis was determined by transient elastography. Statistical analysis: Data are presented as Mean±SD or Median (IQR 25-75). They were analyzed by one-way ANOVA with Tukey's post-hoc test or Kruskal-Wallis with Dunn's post-hoc test. The following parameters were calculated: Sensitivity (S), Specificity (E), Positive Predictive Values (PPV), Negative Predictive Values (NPV), and the area under the ROC curve (AUROC). A p-value &lt;0.05 was considered significant.</div></div><div><h3>Results</h3><div>Thirty patients with cholestasis diagnosed with PBC were included, along with a group of subjects with cirrhosis due to Hepatitis C Virus (VHC-F4, n=6), and a control group without liver disease (C, n=17). It was observed that there is a positive correlation between CTGF levels and the degree of fibrosis in patients with cholestasis (PBC), but not in patients with cirrhosis due to HCV. Using a cutoff point of 630 pg/mL, a sensitivity (S) of 0.93, specificity (E) of 0.91, positive predictive value (PPV) of 0.93, negative predictive value (NPV) of 0.91, and an area under the ROC curve (AUROC) of 0.97 with a Youden index of 0.85 were obtained (Figure 1). With a serum CTGF value of 520 pg/mL in patients with PBC without fibrosis or with moderate fibrosis compared to controls and HCV-F4, a sensitivity (S) of 0.75, specificity (E) of 0.87, and AUROC of 0.88 for F0, and a sensitivity (S) of 0.91, specificity (E) of 0.87, and AUROC of 0.94 for F2 were identified (Figure 1). Regarding the degree of fibrosis, CTGF was significantly higher in F4 compared to F0 in patients with PBC. In the case of the VHC-F4 group, there were no differences compared to the group without liver disease, suggesting a specificity of CTGF for fibrosis due to cholestatic disease (Figure 2).</div></div><div><h3>Conclusions</h3><div>There is a direct correlation between serum levels of CTGF in patients with cholestasis and the degrees of fibrosis measured by transient elastography, as well as specific cutoff points for discrimination with and without fibrosis for PBC.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101807"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895997","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":"Seroprevalence of hepatitis b and c viruses in blood donors in a third level hospital from 2019 to 2023.","authors":"Karina Cazarin-Chávez ,&nbsp;Yadira L. Béjar-Ramírez ,&nbsp;José A. Pérez-González ,&nbsp;Claudia G. Solís-Hernández ,&nbsp;María F. Higuera-De la Tijera ,&nbsp;José L. Pérez-Hernández","doi":"10.1016/j.aohep.2025.101824","DOIUrl":"10.1016/j.aohep.2025.101824","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Hepatitis B virus (HBV) and C virus (HCV) infection are public health problems and risks for transfusion medicine, which have been reduced by routine serological screening. The aim of this work is to describe the prevalence of these infections in blood donors in a tertiary hospital.</div></div><div><h3>Materials and Patients</h3><div>An observational, descriptive, retrospective and analytical study was conducted from 2019 to 2023 in blood donors in a third-level hospital, a total of 99,393 donors; only the complete records of the donors who resulted with reactivity and later confirmation for HBV and HCV were reviewed, The data were analyzed using the Statistical Program SPSS. Qualitative variables are expressed as percentages and quantitative variables as mean±SD, as appropriate.</div></div><div><h3>Results</h3><div>A total of 370 donors who tested positive for some virus were included, despite having been classified as suitable to donate blood products following an official questionnaire with no relevant history and laboratory tests with no alterations. The mean age was 42.02±11.88 years; 54% were men; 135 patients were reactive for HBV and 235 for HCV; however, the true seropositivity found was 2 (1.4%) cases with HBV and 11 (4.6%) cases for HCV (figure 1); the rest of the donors with reactive serology had negative confirmatory studies. The overall seroprevalence observed in our population was 0.002% for HBV, 100% for men and, 0.011% for HCV, 45.4% for women and 54.4% for men. The frequency was 5.5 times higher for HCV than for HBV.</div></div><div><h3>Conclusions</h3><div>In people with no apparent risk factors, the prevalence of HBV and HCV infection is very low, with HCV being more frequent. However, if the “fit” is infected, it is necessary to optimize the health system to offer universal screening that includes those with risk factors.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101824"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895847","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 Administration of DEN and 2-AAF for 13 and 18 weeks in Wistar Rats Leads to Progress of Hepatocarcinogenesis","authors":"Jaime Sánchez-Meza ,&nbsp;Marina Campos-Valdez ,&nbsp;José A. Domíngez-Rosales ,&nbsp;Juliana M. Godínez-Rubí ,&nbsp;Sarai C. Rodríguez-Reyes ,&nbsp;Erika Matínez-López ,&nbsp;Adriana M. Salazar-Montes ,&nbsp;Carmen M. Gurrola Díaz ,&nbsp;Manuel A. Castro-García ,&nbsp;Guillermo M. Zúñiga-González ,&nbsp;Laura V. Sánchez Orozco","doi":"10.1016/j.aohep.2025.101870","DOIUrl":"10.1016/j.aohep.2025.101870","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Induction of hepatocellular carcinoma by administration of the agents diethylnitrosamine (DEN) and N-(2-Fluorenyl) acetamide (2-AAF) in murine animals, is a model to study liver cancer. The objective was to evaluate the alterations triggered by the chronic administration of DEN and 2-AAF during 13 and 18 weeks (wks.) in Wistar rats.</div></div><div><h3>Materials and Patients</h3><div>Male Wistar rats (180-200 g) were organized in groups: a) Control 18 wks. (18-wk Ctl; n=6); b) Damage 18 wks. (18-wk Dmg; n=8), c) Control 13 weeks. (13-wk Ctl; n=5), and d) Damage 13 wks. (13-wk Dmg; n=6). The 13- and 18-wk Dmg groups were weekly treated with i.p DEN (50 mg/Kg) on day one and with i.g. 2-AAF (25 mg/Kg) on day three; the treatment (Tx) was maintained over 13 and 18 weeks, respectively. Then, livers and serum were collected for histological, serum biochemistry, and gene expression analyses. Statistical test Student's t-tests or Kruskal-Wallis and Mann-Whitney U were performed using the software GraphPad Prism version 8. A p value &lt; 0.05 was considered significant.</div></div><div><h3>Results</h3><div>The rat's survival decreased to 62.5% with the Dmg Tx for the 18-wk Dmg group at the tenth week, but when the 13-wk Dmg group was included, the survival increased to 78.5% (n= 14) until the thirteenth week. Dmg Tx tended to decrease the animal's weight and induced changes in the liver tissue (paler coloration, differentiated nodules, and hepatomegaly; to a lesser degree in the 13-wk Dmg group). Heterogeneity in the damage severity was detected among the animals of both groups, which was also found at the histological level, where there were clear signals of loss of normal hepatocyte architecture, lobular structure disorder, atypical cell enhancement, and accumulation of collagen. Probable lung metastasis was recognized in the 18-wk Dmg group (indicated by macroscopic and histological alterations). In the Dmg groups, the levels of ALT, AST, ALKP, GGT, and total proteins in serum were significantly altered; as well as <em>CAT, SOD, COL1A</em>, and <em>TGFB1</em> expression were significantly different. In addition, <em>IL6</em> was also increased in the 18-wk Dmg group.</div></div><div><h3>Conclusions</h3><div>Dmg Tx during 13 wks. is sufficient to induce significant alterations and the 18-wk Tx exhibited possible lung metastasis. The heterogeneity in this model may be seen as a disadvantage; yet, this may be taken as a depiction of the heterogeneity found in liver cancer patients in real life.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101870"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895935","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}