Annals of hepatology最新文献

{"title":"Success of a second treatment of direct-acting antiviral therapy in patients with chronic Hepatitis C Virus infection.","authors":"Daniela L. Andrade-González,&nbsp;Aleida Bautista-Santos,&nbsp;Rosalba Moreno-Alcántar","doi":"10.1016/j.aohep.2025.101850","DOIUrl":"10.1016/j.aohep.2025.101850","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Direct-acting antivirals (DAAs) are associated with a high sustained viral response (&gt;95%) at 12 weeks (SVR12) in patients with chronic hepatitis C virus (HCV) infection.</div><div>There is a low percentage of patients who have treatment failure or reinfection in the presence of persistent risk factors. The indicated treatment is a scheme with voxilaprevir but in Mexico we do not have this option so sofosbuvir-velpatasvir and glecaprevir-pibrentasvir are used. The objective is to report the success of a second-line therapy with DAA in patients with chronic HCV infection.</div></div><div><h3>Materials and Patients</h3><div>Study: retrospective, descriptive, cross-sectional, single center. Study period: April 2017 to December 2023. Patients over 18 years of age in follow-up at the hepatitis clinic of the Hospital de Especialidades del Centro Médico Nacional Siglo XXI were included, before starting treatment, genotyping and new HCV viral load, laboratory and imaging studies were performed to rule out hepatocellular carcinoma and the cases were discussed by a group of experts at the national level as part of the National Hepatitis C Program of the Mexican Social Security Institute to define the treatment: sofosbuvir- velpatasvir or glecaprevir-pibrentasvir. Descriptive statistics were used to analyze the variables with frequencies and percentages and a table was prepared to show the characteristics of the patients.</div></div><div><h3>Results</h3><div>900 patients were treated in the study period with reported SVR12 97%; 5 patients with treatment failure were included, total patients received treatment based on sofosbuvir-velpatasvir + ribavirin for 24 weeks, 3 women and 2 men, mean age was 52 years. 3 patients with genotype 1, 1 patient with genotype 3 and only in one patient the genotype was not determined. Forty percent (2) had cirrhosis of the liver. The percentage of adherence to initial treatment was &gt;80% in all patients and none had used a proton pump inhibitor (PPI). The SVR12 percentage was 100%.</div><div>(Table 1)</div></div><div><h3>Conclusions</h3><div>Sofosbuvir-velpatasvir + ribavirin-based treatment is highly effective as a second treatment in patients with a history of first treatment failure, with SVR 12 of 100%.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101850"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896089","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":"Clinical outcomes in patients with hepatitis A virus infection in a tertiary center: retrospective cohort 2022-2024.","authors":"Norma N. Parra-Holguín,&nbsp;Yenni J. Cruz Ramírez,&nbsp;Reina S. Velez Ramírez,&nbsp;Francisco I. García-Juárez","doi":"10.1016/j.aohep.2025.101854","DOIUrl":"10.1016/j.aohep.2025.101854","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>In Mexico, the incidence rate of hepatitis A virus (HAV) infection is 3.11/100,000 person/year. 70% of adults develop symptoms, representing 3% of cases of acute liver failure (ALF). This study aimed to evaluate the clinical outcomes obtained in our institution.</div></div><div><h3>Materials and Patients</h3><div>It is a retrospective, observational cohort study, which included all patients over 18 years of age hospitalized from March 2022 to April 2024. 16 patients with a confirmed diagnosis of HAV infection (IGM) who required hospital management in the Centro Medico Nacional 20 de Noviembre ISSSTE were included. All patients who did not have a confirmatory serological test were excluded. The SPSS v.24 program was used for statistical analysis, using frequencies and percentages for reporting the data.</div></div><div><h3>Results</h3><div>Of the total of 16 cases included, 31.3% (5) patients were women, and 68.8% (11) were men, with an average age of 35 years old (19-47). The comorbidities they presented were: type 2 diabetes in 18.8% (3), systemic arterial hypertension in 6.3% (1), rheumatoid arthritis in 6.3% (1). Among the clinical manifestations they presented during the evolution were the following: hepatic encephalopathy 31.3% (5), abdominal pain 62.5% (10), fever 3.1% (8), vomiting 3.5% (9), diarrhea 1.6% (4). Of our studied population, 25.0% (4) patients developed acute liver failure requiring attention in the intensive care unit, where they received adjuvant treatment based on n-acetylcysteine ​​and renal replacement therapy. The remaining patients presented alarm symptoms 75.0% (12) without developing liver failure. The mortality reported in our population was 18.8% (3).</div></div><div><h3>Conclusions</h3><div>The observed mortality was 18.8% (3) of the total included, higher than that reported worldwide. In recent years, an epidemiological transition has been seen in patients with FHA. Among the factors that increased mortality were serious infections, hydroelectrolytic alterations, and limiting the transplant protocol.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101854"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896093","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":"Autoinmne hepatitis associated with hepatitis A virus infection, a case report","authors":"J. Ugalde-Zanella,&nbsp;L. Martínez-Martinez,&nbsp;M. Saldaña-Barnard,&nbsp;L. Beltran-Rascon","doi":"10.1016/j.aohep.2025.101840","DOIUrl":"10.1016/j.aohep.2025.101840","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Hepatitis due to Hepatitis A Virus (HAV) is an entity that has been described as a causal factor of HAI, the prevalence and course of which is reported to be 1% - 3%. The diagnosis is associated with AIH is usually made in the acute event; a time criterion is not well defined.</div></div><div><h3>Materials and Patients</h3><div>41-year-old male, with a history of DM2, systemic arterial hypertension and rheumatoid arthritis, onset in June 2023 with fever and gastrointestinal symptoms (vomiting, nausea and stools with reduced consistency), associated with jaundice of 1 week after his symptoms. Diagnosis of Acute Liver Injury due to HAV is confirmed on 06/22/23, with Ac. IgM VHA (8.7 +), Transaminases &gt;2000U/L and INR 2.4; support therapy and symptom control began with partial resolution on 09/2023. He subsequently re-entered the emergency area 11/2023 with jaundice, abdominal pain, and excessive fatigue. Acute Hepatitis was again determined with transaminases &gt;2000 U/L, a 3F CT scan was performed and was normal, and the approach for autism was complemented with the following panel: negative ANAS and positive ASMAs 1:100, IgG 2780. Liver biopsy confirmed AIH. morphological changes compatible with autoimmune hepatitis. Treatment was started with Prednisone 0.5mg/kg, with subsequent maintenance based on Azathioprine, achieving biochemical remission 04/2024</div></div><div><h3>Results</h3><div>It has been postulated that HAV infection, as occurs with other viral infections, may be a triggering factor for latent AIH in susceptible individuals, considering multiple pathways of inflammation and immunotolerance defects. Most of the reported cases are diagnosed 5 months after the acute event HAV; in the case of our patient, it was 6 months after the acute event, completing a score of 7 points by the simplified system. In case reports of OAB-associated AIH, treatment has been initially established with oral Prednisone 0.5 to 1 mg/kg day, with maintenance of Azathioprine or Mycophenolate Mofetil with comparable response rates. The goal of treatment is biochemical and histological remission with the goal of avoiding progression of liver damage and mortality.</div></div><div><h3>Conclusions</h3><div>Viral infections have been associated with the development of autoimmune hepatitis, HAV in up to 3% based on case reports due to the rarity of the presentation. The pathophysiology of presentation triggered by OAB is poorly defined. Biopsy and differential diagnoses are the mainstay in the approach to these patients.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101840"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896105","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":"Hepatic histologic findings in a murine model of diet induced-steatotic liver disease and acute alcohol intake","authors":"Gabriela Sarahi Martínez-Mejia,&nbsp;Miriam G. Bautista-Ubaldo,&nbsp;Gabriela Gutiérrez-Reyes,&nbsp;Carolina Guzmán","doi":"10.1016/j.aohep.2025.101885","DOIUrl":"10.1016/j.aohep.2025.101885","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Steatotic liver disease is produced by a range of etiologic agents, among them metabolic and alcoholic. Our aim was to identify the histologic findings produced in the liver after the interaction of steatosis induced by the methione-choline deficient (MCD) diet and the acute ethanol consumption in a murine model.</div></div><div><h3>Materials and Patients</h3><div>46 male, 10 week-old, C57BL/6 mice were randomly assigned to the following groups: Control, fed LabDiet 5010; MCD, fed the steatogenic diet MCD for 6 weeks; OHa, fed LabDiet, this group received 8 doses i.p. of ethanol (2.5g/Kg), within a scheme of 2 days of administration followed by 1 day rest; MCDOHa, fed MCD for 6 weeks, this group receive 8 ethanol doses during weeks 5 and 6, as described earlier; a group receiving vehicle with the same scheme as the ethanol was included. After treatments, livers were collected. Paraffin sections were stained with hematoxylin-eosin and Masson's thrichrome. Samples were analyzed. Representative histologic findings were considered when present in at least 50% of the samples per group.</div></div><div><h3>Results</h3><div>Control and vehicle livers did not show alterations. MCD livers showed macrovesicular steatosis (range 33-66%) in portal and central areas, with few or non ballooning, inflammation was observed, as well as portal fibrosis (F1C). OHa group did not showed steatosis, 57% of samples showed sinusoidal dilation in portal areas; necrosis and inflammation were also observed in the portal triad. Fibrosis was observed in 50% of livers. Interaction of both stimulus (MCDOHa) produced macrovesicular diffused steatosis ranging from 50-90% of liver area. 56% of samples showed few ballooning. Increased inflammatory foci were observed compared with MCD. Regarding fibrosis, 56% showed F0. No signs of necrosis were observed compared with OHa.</div></div><div><h3>Conclusions</h3><div>Interaction among steatosis induced by MCD diet and OHa increases steatosis, at broader areas of the hepatic parenchyma with increased number of inflammatory foci, but no increase in ballooning, and a lower number of liver showed fibrosis compared to MCD.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101885"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896152","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":"Degrees of Liver Stiffness and Steatosis as Predictors of Preeclampsia Complications","authors":"Andrés T. Flores-y-Flores ,&nbsp;Orestes de J. Cobos-Quevedo ,&nbsp;José L. Perez-Hernández ,&nbsp;Jesús C. Briones-Garduño ,&nbsp;Daniel Santana-Vargas","doi":"10.1016/j.aohep.2025.101809","DOIUrl":"10.1016/j.aohep.2025.101809","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Liver damage in preeclampsia is caused by antiangiogenic factors such as soluble tyrosine kinase, placental growth factor, and soluble endoglin. These induce endothelial injury and fibrin deposits in the hepatic microcirculation, thus modifying the physical characteristics of the liver parenchyma and its stiffness. This study aims to evaluate the correlation between the degree of liver stiffness and the severity of patients with preeclampsia.</div></div><div><h3>Materials and Patients</h3><div>An observational, analytical, cross-sectional, and prospective study. Pregnant women from week 20 of gestation were included, and divided into 3 groups: normal pregnancy, pre-eclampsia, and pre-eclampsia with severity features; They were recruited from February 2023 to August 2023 in Mexico´s City General Hospital, Obstetrics department. Transient elastography was performed on all of them. Pregnant women with chronic systemic arterial hypertension and pre-existing liver diseases were excluded. Descriptive statistics measures of central tendency were performed, and univariate analysis was carried out considering kilopascals (kPa) as a dependent univariable and the group (without preeclampsia, preeclampsia, and preeclampsia with severity criteria) as fixed factors and BMI as a covariate.</div></div><div><h3>Results</h3><div>34 patients were included, 9 in the control group, 12 in the preeclampsia group and 13 in the preeclampsia with severity features group. The mean gestational age was 32 ± 5.8 weeks. The mean age was 27.26 ± 7.73 years. The mean BMI was 28.88 ± 4.83. The mean kPa in the control group was 4.35 ± 0.98, in the preeclampsia without severity features group 5.05 ± 0.87, and in the preeclampsia with severity features group 6.67 ± 1.84. The mean control group CAP was 202.82 ± 21.26 db/m2, in the preeclampsia without severity features group was 227.81 ± 47.81 db/m2, and in the preeclampsia with severity features group was 215.28 ± 37.41 db/m2. Univariate contrasts were significant for preeclampsia with severity criteria features versus preeclampsia F (2 of 23) = 7.679, p = 0.011. Preeclampsia with severity features versus control F (2 of 22) = 11.134, p = 0.003</div></div><div><h3>Conclusions</h3><div>Liver stiffness significantly increases in patients with preeclampsia and preeclampsia with severity features measured by transient elastography. This increase is due to intrahepatic fibrin deposition, but not by fibrosis (collagen) itself. Transient elastography could be useful as a predictor of severity in patients with preeclampsia.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101809"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895999","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":"Serum Immunoglobulin M levels and neutrophil/lymphocyte index as predictors of treatment response in patients with primary biliary cholangitis","authors":"Anel Y. Avila-Franco,&nbsp;Rodrigo Guirao-Perez,&nbsp;Eumir I. Juárez-Valdes,&nbsp;Scherezada MI. Mejía-Loza","doi":"10.1016/j.aohep.2025.101817","DOIUrl":"10.1016/j.aohep.2025.101817","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Primary biliary cholangitis (PBC) involves chronic inflammation of the bile ducts, with a high risk of progression to cirrhosis in non-responders to treatment. Identifying the relationship between immunoglobulin M (IgM) levels and neutrophil/lymphocyte index as predictors of response to treatment could optimize clinical outcomes.</div></div><div><h3>Materials and Methods</h3><div>A retrospective, longitudinal, analytical, and observational study was conducted that included the review of 71 records of patients diagnosed with PBC. Baseline serum IgM levels were recorded, and the neutrophil/lymphocyte index (NLI) was calculated. Response to treatment with ursodeoxycholic acid (UDCA) at doses of 13-15mg/kg was assessed after one year of follow-up, according to the Barcelona criteria. Subsequently, Pearson's correlation coefficient was determined to identify the relationship between the variables.</div></div><div><h3>Results</h3><div>A total of 67 patients diagnosed with PBC were included. The mean age reported was 55.5 years and the highest frequency was recorded in females, representing 91% of cases. The main comorbidities reported were hypothyroidism (20.8%), systemic sclerosis (11.9%) and Sjögren's syndrome (7.4%). Clinical portal hypertension was identified at diagnosis in 22 patients (32.8%). An adequate response to treatment was observed in 35 patients (52.2%), while 32 (47.8%) did not show a satisfactory response. The mean neutrophil/lymphocyte index value in the response group was 2.3 (range: 0.7-8.6), while in the non-response group, it was 2.5 (range: 0.8-18.5). Additionally, 42 patients (62%) were identified with IgM levels &gt;240mg/dl. Subsequently, a Pearson correlation analysis was performed between IgM and NLI levels with treatment response, yielding a value of 0.04 (p&gt;0.05) and -0.18 (p&gt;0.5), respectively.</div></div><div><h3>Conclusions</h3><div>A considerable percentage of patients presented failure to treatment with UDCA and according to the results, there was no significant association between IGM levels and NLI and therapeutic response.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101817"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895929","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":"IGFBPs in chronic liver diseases: Are they potential biomarkers?","authors":"Marisela Hernandez-Santillan ,&nbsp;Moisés Martínez-Castillo ,&nbsp;Wendolyne Ruíz-Benítez ,&nbsp;Adrián Flores-Sánchez ,&nbsp;Abigail Hernandez-Barragán ,&nbsp;José Luis Pérez-Hernández ,&nbsp;Fátima Higuera-De la Tijera ,&nbsp;Aldo Torre-Delgadillo ,&nbsp;Jacqueline Córdova-Gallardo ,&nbsp;Gabriela Gutiérrez-Reyes","doi":"10.1016/j.aohep.2025.101868","DOIUrl":"10.1016/j.aohep.2025.101868","url":null,"abstract":"<div><h3>Introduction and objectives</h3><div>Liver diseases are caused by alcohol consumption, Hepatitis C virus, and metabolic dysfunction. There are few studies on insulin-like growth factor binding proteins (IGFBPs), also IGFBP-1 being involved in regulating glucose and lipid metabolism but its relation with liver diseases has not been fully clarified yet. To evaluate serum levels of IGFBPs 1,2,3 and 7 in subjects with alcoholic liver cirrhosis, alcoholic hepatitis, chronic hepatitis C, and Metabolic Dysfunction-Associated Steatotic Liver Disease.</div></div><div><h3>Materials and patients</h3><div>Prospective, cross-sectional, and multicenter study; approved by the research and ethics commission at UNAM, and the Hospital General de México, which included subjects with clinical and biochemical data of alcohol-related liver damage, defining two groups: alcoholic liver cirrhosis (OHCi) and alcoholic hepatitis (AH). Another group with Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD). The last group was defined with a diagnosis of chronic hepatitis C (HepC). FibroScan Testing, and/or Fibrotest were realized. All study groups were compared with healthy subjects called the control group (CT). IGFBPs were quantified in serum using a multiplex suspension array. The data were analyzed and compared between groups. For statistical analysis, Kruskal-Wallis and Mann-Whitney U tests were used.</div></div><div><h3>Results</h3><div>The serum concentrations of IGFBPs 1, 2, and 7 in Hepatitis C were elevated compared to all groups. In the case of HA, IGFBP-2, 3, and 7 decreased compared to the CT group, while IGFBP-1 was higher compared to CT. For IGFBP-3, all groups were decreased compared to the CT group. In the MASLD and CiOH groups, low concentrations of IGFBPs 1, 2, 3, and 7 were observed when compared with HepC, AH, and CT groups.</div></div><div><h3>Conclusions</h3><div>The serum levels of IGFBPs highlight have the relevance in the diverse liver diseases, it's evident in Hepatitis C are synthesized in higher concentration, while in MASLD and alcohol-related liver disease the concentration is lower, these proteins can be used as differential serum markers in liver diseases. It's necessary to conduct studies that would allow us to find new mechanisms involved in lipid metabolism and its relationship with liver disease.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101868"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143895933","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":"Importance of the profile of inflammatory and anti-inflammatory cytokines in patients with Hepatitis C according to degrees of fibrosis.","authors":"Abigail Hernandez-Barragan ,&nbsp;Moisés Martínez-Castillo ,&nbsp;Adrián Flores-Sánchez ,&nbsp;Jesús Dorantes-Alvarez ,&nbsp;Isabel Villagómez-López ,&nbsp;Marisela Hernandez-Santillan ,&nbsp;Andrea Garcia-Avalos ,&nbsp;José Luis Pérez-Hernández ,&nbsp;Fátima Higuera-De la Tijera ,&nbsp;Paula Cordero-Pérez ,&nbsp;Linda Muñoz-Espinosa ,&nbsp;Gabriela Gutierrez-Reyes","doi":"10.1016/j.aohep.2025.101858","DOIUrl":"10.1016/j.aohep.2025.101858","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>The cure for chronic Hepatitis C (HCV) is a milestone for humanity, however, patients could still progress toward hepatocellular carcinoma even after receiving direct-acting antiviral treatment [1]. Therefore, determining the inflammatory (IFN-γ, TNF-α), and anti-inflammatory (IL-10- IL-1RA) profiles in patients with different degree of liver fibrosis are the important aim in researching of new biomarkers.</div></div><div><h3>Materials and Methods</h3><div>Prospective, cross-sectional and multicenter study; approved through the ethics committee of the UNAM, and the Hospital General de Mexico, patients with chronic Hepatitis C (CHC), and healthy subjects (control group) were included. A personalized survey of chronic and recent pathologies, as well as alcohol consumption, was performed in all the subjects. Biochemical and hematological laboratory test were performed, including Fibroscan and/or Fibrotest to determinate the degree of fibrosis. In addition, the cytokine profile (IFN-γ, TNF-α, IL-10 and IL-1RA) was quantified in the serum by multiple suspension array. The data was analyzed by Kruskal-Wallis, Mann-Whitney U and ANOVA statistical tests by SPSS v.22 software, considering p &gt; 0.05</div></div><div><h3>Results</h3><div>A total of 180 CT subjects were included; whereas 90 patients with CHC with different grades of fibrosis: F0=20, F1=15, F2=15, F3=16 and F4=24, were enrolled. As has been studied, Hepatitis C Virus inhibits the activity of IFN-γ, despite of this, its concentration has been controversial in different populations. In our population, the levels were low with the exception for F2 (p&lt;0.01). Another important factor of inflammation is TNF-α, which was found increased in all stages: F0-F4 and in F2 up to 6 times more than the CT and F4 groups (p&lt;0.001). When analyzing the results of anti-inflammatory cytokines; the highest concentration of IL-10 was observed in F2 (increased up to 7 times) (p&lt;0.001), while for IL-1RA in F2 it was found to be increased up to 10 times more than in F1 and F3 (p&lt;0.05); what it shows that in F2 the inflammatory/anti-inflammatory microenvironment at the peripheral level has more activity. On the other hand, the highest concentration of IL-1RA was observed in F4, which may be actively participating in the repair due to decreased mediators of inflammation.</div></div><div><h3>Conclusions</h3><div>The F2 stage is an important turning point, indicating a shift in the microenvironment due to the accumulation of the extracellular matrix, making it clear the importance of measuring inflammation at intermediate stages of fibrosis, which would allow for impacting the limitation of the hepatic fibrogenic process.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101858"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896017","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":"Pirfenidone limits the progression of malignancy and slows the development of fibrosis in experimental hepatocarcinoma.","authors":"Scarlet Arceo-Orozco ,&nbsp;Fernando Caloca-Camarena ,&nbsp;Roberto Flores-Peña ,&nbsp;Marina Galicia-Moreno ,&nbsp;Hugo Christian Monroy-Ramírez ,&nbsp;Juan Armendáriz-Borunda","doi":"10.1016/j.aohep.2025.101797","DOIUrl":"10.1016/j.aohep.2025.101797","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction and Objectives&lt;/h3&gt;&lt;div&gt;Hepatocarcinoma (HCC) is the fourth cause of cancer death in Mexico, derived from fibrotic, metabolic and inflammatory alterations, modifiable by pirfenidone (PFD), which has shown beneficial effects at these levels. Our aim is to demonstrate the hepatoprotection of PFD in a model of HCC progression.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Materials and Patients&lt;/h3&gt;&lt;div&gt;To evaluate the effect of PFD in a setting similar to that of patients at risk for HCC, we developed an experimental model of neoplastic progression, with damage induction for 9 weeks, followed by free progression of the disease. Male Fischer-344 strain rats (n=18) were divided into three groups: CTL: untreated control; HCCp: damage progression group (generated by administration of diethylnitrosamine (DEN) 50 mg/kg and 2-Acetaminofluorene (2AAF) 25 mg/kg weekly for 9 weeks and damage progression); and HCCp/PFD: damage progression group plus administration of PFD 300 mg/kg daily starting from week 9. The weight of the animals in the different study groups was recorded, and morphological and histopathological analyses of the liver were performed. H&amp;E, Masson's Trichrome (MCT) and Sirius Red (SR) staining were performed, and GPC-3 and Ki-67 proteins were analyzed by immunohistochemistry. This was done in order to evaluate the presence and severity of fibrosis, malignancy and proliferation markers. Data were analyzed by ANOVA followed by Tukey's post-hoc tests to identify differences between study groups. Comparisons with p values ≤0.05 were considered significant.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Treatment with PFD did not produce a difference in weight between the groups. However, it caused a tendency to decrease in body weight, net weight and relative liver weight. The morphological analysis of the liver of the HCCp/PFD group showed surface characteristics, coloration and consistency similar to the control, in addition to the evident attenuation in the progression of cancerous nodules, with a 34.02% reduction in the total tumor incidence. At the tissue level, PFD decreased the accumulation of extracellular matrix and collagen I and III deposition. The fibrotic bridges present in the HCCp/PFD group are incipient and of interstitial disposition, contrary to the intensity and tissue restriction shown in the HCCp group. In addition, dysplastic changes were limited after PFD treatment, with a decrease in hyperchromasia and nuclear pleomorphism, fewer cells with loss of polarity and nucleus/cytoplasm ratio, together with a decrease in necrotic cells, as well as a decrease in ductal reaction and destruction of portal triads compared to the damage group. Finally, in the HCCp/PFD group, the expression of both GPC-3 and Ki-67 was reduced, slowing tumor progression.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;PFD administration had a hepatoprotective effect on tumor progression and slowing of fibrosis in our experimental model based on our results, we can concl","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101797"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896072","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":"Lymphopenia as a risk factor for mortality in patients with liver cirrhosis.","authors":"Carlos F. Fajardo–Felix,&nbsp;Aleida Bautista-Santos,&nbsp;Hector H. Gonzalez-Anchondo,&nbsp;Daniela Lilian Andrade-Gonzalez,&nbsp;Rosalba Moreno-Alcántar","doi":"10.1016/j.aohep.2025.101849","DOIUrl":"10.1016/j.aohep.2025.101849","url":null,"abstract":"<div><h3>Introduction and Objectives</h3><div>Patients with cirrhosis develop immune dysfunction where a decrease in CD4 lymphocytes has been described in up to 65% of patients. The aim of this study is to evaluate if lymphopenia is a risk factor for mortality in patients with liver cirrhosis during hospitalization</div></div><div><h3>Materials and Patients</h3><div>A retrospective, observational, cross-sectional, and single-center study was carried out in a period from October 2023 to May 2024, which included patients &gt;18 years of age with diagnosis of liver cirrhosis who were admitted to the Gastroenterology service due to some acute decompensation and who died in that hospitalization, who had absolute lymphocyte determination on admission. Descriptive statistics were performed with frequencies and percentages and the variables were analyzed according to their free or normal distribution with Mann-Whitney U or Student's t, respectively. Chi-square was used to assess the risk of mortality associated with lymphopenia.</div></div><div><h3>Results</h3><div>67 patients were included females predominated 39 (58.2%), with a mean age of 58±10 years, the most frequent admission diagnoses were variceal hemorrhage in 29 (43%) patients, followed by the diagnosis of acute over chronic liver disease (ACLF) 13 (19%) and in third place hepatic encephalopathy and acute kidney injury 8 (11%) respectively. The mean MELD 3.0 was 21±9 and most patients were in Child Pugh B 32 (47.8%). Patients with ascites were 48 (71.6%), hepatic encephalopathy 33 (49.3%), acute renal injury 25 (37.3%), and spontaneous bacterial peritonitis 8 (11.9%). 52.2% (35) of the patients had absolute lymphocytes &lt;1000 on admission.</div><div>The OR for lymphocytes &lt;500 at admission was 4.1 95% CI (1.04-16.18) for the outcome and mortality.</div><div>Mortality in this group of patients was 17.9% (12), with ACLF being the main cause in 11 patients, which is equivalent to 91%, 75% of patients had lymphopenia (9).</div></div><div><h3>Conclusions</h3><div>The absolute lymphocyte count &lt; 500 at admission is a risk factor for mortality in patients admitted to hospitalization due to an acute decompensation event.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"30 ","pages":"Article 101849"},"PeriodicalIF":3.7,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143896080","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}