Annals of hepatology最新文献

{"title":"P-46 IMMUNOSUPPRESSION IN POST LIVER TRANSPLANTATION: REVIEW OF THE EXPERIENCE IN A CHILEAN UNIVERSITY HOSPITAL","authors":"Richard Esteban Martinez Ruiz ,&nbsp;Renato Francisco Palma Fernandez ,&nbsp;Rodrigo Mauricio Wolff Rojas","doi":"10.1016/j.aohep.2024.101660","DOIUrl":"10.1016/j.aohep.2024.101660","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>Liver transplantation is currently a cost-effective therapy for the treatment of advanced liver diseases. Immunosuppression plays a key role in the prevention of organ rejection. Corticosteroids and anti-CD-25 antibodies are used in the induction phase, while calcineurin inhibitors, mycophenolate, corticosteroids and mTOR inhibitors are used in the maintenance phase. <em>Objectives:</em> To describe the type of immunosuppression regimen used in the management of liver transplant patients during the first post-transplant year.</div></div><div><h3>Patients / Materials and Methods</h3><div>Observational, retrospective cohort study of adult patients undergoing liver transplantation at the Hospital Clínico UC (Santiago, Chile), between January 2020 and June 2023. Demographic and clinical data were included. Immunosuppression regimens used in four periods during the first year of follow-up (at discharge, third, sixth and twelfth month) were evaluated. Pediatric patients, combined transplants and cases with post-transplant follow-up in centers not associated with our hospital were excluded.</div></div><div><h3>Results and Discussion</h3><div>A total of 160 patients were analyzed, of whom 149 (93.1%) were cirrhotic. The predominant etiology was MASLD (34.3%). The average age was 54 years, with a predominance of females (53.7%). The active immunosuppression regimen at discharge and at the third month of follow-up was the combination of tacrolimus, mycophenolate, and prednisone, representing 68% and 56%, respectively. The dual tacrolimus-mycophenolate mofetil regimen was the most prevalent at month 6 (26%), while at one year of follow-up, tacrolimus monotherapy was the most commonly used (27%). Only 34% of cases were able to maintain monotherapy at one year after transplant (43 pacients with tacrolimus, 6 with cyclosporine and 6 with everolimus).</div></div><div><h3>Conclusions</h3><div>Tacrolimus is the most frequently used immunosuppressant in the maintenance phase. The use of mycofenate mofetil and prednisone decreases as time progresses post-transplant. Only one third of cases achieved monotherapy at one year of follow-up.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101660"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P-76 MANIFESTATIONS OF PORTAL HYPERTENSION IN PATIENTS WITH COMMON VARIABLE IMMUNODEFICIENCY: PRELIMINARY DATA","authors":"VERONICA GUIDO ,&nbsp;Belen Russo ,&nbsp;Daniela Chiodi ,&nbsp;Nelia Hernandez","doi":"10.1016/j.aohep.2024.101690","DOIUrl":"10.1016/j.aohep.2024.101690","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>Liver involvement in common variable immunodeficiency (CVID) can be found in 9% to 79% of cases and may lead to reduced survival. Anicteric cholestasis and portal hypertension (PH) were the main hepatic manifestations. We aimed to establish the prevalence and characteristics of PH in patients with CVID under treatment at a primary immunodeficiency clinic of a tertiary-level hospital.</div></div><div><h3>Patients / Materials and Methods</h3><div>A retrospective and descriptive study examined the medical records of patients with confirmed CVID.</div></div><div><h3>Results and Discussion</h3><div>out of the eleven patients with CVID, eight were women, and the median age was 34 years (range 23-72). PH was suspected in five (45.4%), with three patients experiencing clinically significant PH and one case complicated by variceal bleeding. Table 1 compares both groups (with and without PH). Thrombocytopenia was found in most patients, consistent with the higher incidence of splenomegaly. Liver biopsies performed only in two patients with suspected PH excluded cirrhosis but identified regenerative nodular hyperplasia in one case. Both cases had liver stiffness measurements by shear wave elastography, showing a median of 14.2 kPa. No association was identified with other non-infectious complications of CVID (gastrointestinal and pulmonary disease).</div></div><div><h3>Conclusions</h3><div>Liver disease is often underdiagnosed in patients with CVID, with portal hypertension appearing to be frequent. Early screening is essential to avoid severe complications.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101690"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P-34 ALBUMIN-BILIRUBIN GRADE ANALYSIS OF OVERALL SURVIVAL WITH ATEZOLIZUMAB PLUS BEVACIZUMAB IN PATIENTS WITH UNRESECTABLE HEPATOCELLULAR CARCINOMA","authors":"Cristina Cheinquer Coelho Borges ,&nbsp;Alexandre de Araújo ,&nbsp;Mario Alvares-da-Silva Reis ,&nbsp;Rui Weschenfelder ,&nbsp;Hugo Cheinquer","doi":"10.1016/j.aohep.2024.101648","DOIUrl":"10.1016/j.aohep.2024.101648","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>Atezolizumab-bevacizumab (atezo-bev) is currently recommended as first-line therapy for patients with unresectable hepatocellular carcinoma (uHCC). However, its effectiveness in patients with albumin-bilirrubin (ALBI) grade 2 has been questioned in a recent post-hoc analysis of the Phase III IMbrave 150 study, which showed that atezo-bev had a similar overall survival (OS) compared to sorafenibe in that population. To evaluate the impact of ALBI grade on OS in patients with uHCC treated as first-line systemic therapy with atezo-bev.</div></div><div><h3>Patients / Materials and Methods</h3><div>This prospective cohort study was conducted in Hospital de Clinicas de Porto Alegre and Hospital Moinhos de Vento, two tertiary healthcare centers in the city of Porto Alegre, Brazil. It comprised all Child A patients with uHCC that started atezo-bev as first line therapy between August 2020 and May 2023. ALBI grade within 30 days of treatment initiation was calculated using MDCalc, available online free of charge. Mean OS was established for patients with ALBI-1 versus ALBI-2 and 3.</div></div><div><h3>Results and Discussion</h3><div>A total of 20 Child A patients with uHCC were included, 1 classified as Barcelona Clinic Liver Cancer B (BCLC-B) and 19 as BCLC-C. Mean age was 65 years, 75.6% were males and all were cirrhotic. According to ALBI grade, 10 patients were classified as ALBI-1 and 10 as ALBI non-1 (9 grade 2 and 1 grade 3). Mean OS among those with ALBI-1 was 56.3 weeks and among those with ALBI non-1 was 32 weeks (P&lt;0.05). Macrovascular invasion (MVI) was similar in ALBI-1 vs non-1 (40% vs 50%, respectively). However, variceal bleeding during atezo-bev was remarkably different among ALBI-1 vs non-1 patients (0 vs 50%, respectively).</div></div><div><h3>Conclusions</h3><div>Overall, the findings of this study showed that the baseline ALBI grade was superior to Child score in predicting the prognosis of patients with uHCC treated with atezo-bev.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101648"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143094739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P-38 EVALUATION OF THE GENETIC AND VIROLOGICAL PROFILE OF PREGNANT WOMEN INFECTED WITH HEPATITIS B AND C VIRUSES IN A REFERENCE CENTER IN RIO DE JANEIRO, BETWEEN 2016 AND 2022","authors":"Kaio Ferreira Callebe Pedro ,&nbsp;Vinicius Mello Motta ,&nbsp;Giovana Nascimento Guimarães Santos ,&nbsp;Giovana Angelice Paula ,&nbsp;Paulo Sergio Sousa Fonseca ,&nbsp;Aryele Raíra Pereira da Silva ,&nbsp;Nathalia Balassiano ,&nbsp;Caroline Baldin ,&nbsp;Poliana Fernandes ,&nbsp;Girleide Oliveira Pereira ,&nbsp;Livia Villar Melo ,&nbsp;Barbara Lago Vieira ,&nbsp;Lia Laura Lewis-Ximenez","doi":"10.1016/j.aohep.2024.101652","DOIUrl":"10.1016/j.aohep.2024.101652","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>It is estimated that there are around 400 million people living with hepatitis B (HBV) and/or C virus (HCV) infections worldwide. This situation is relevant because both viruses can be transmitted vertically (VT). Despite efforts to prevent VT, many measures still need to be reinforced, especially regarding the spread of clinically relevant viral variants. Therefore, this study aimed to demonstrate the clinical/laboratory profile of pregnant women identified as positive for HBV and HCV during prenatal care, and referred to a specialized viral hepatitis unit in Rio de Janeiro between 2016-2022, and to identify those with clinically relevant mutations that can be transmitted vertically.</div></div><div><h3>Patients / Materials and Methods</h3><div>To this end, all pregnant women with positive rapid tests were retested by eletrochemioluminescence using commercial tests for HBV antigens and antibodies against HBV and HCV. In addition, molecular tests were carried out to quantify HBV DNA and/or HCV RNA. Liver enzyme tests were also carried out in order to classify pregnant women according to HBV clinical phase.</div></div><div><h3>Results and Discussion</h3><div>Two hundred and thirty-two pregnants women with HBV and HCV infection were analyzed. Among the 138 pregnant women with HBV, 95% had HBeAg-negative chronic infection and the mean viral load was 3.70 log IU/ml. Up to now, 6 samples were sequenced, Genotypes A1 (n=5/6,83%) and D3 (n=1/6,16%) were identified and the mutation Y100C was found. In 94 pregnant women with HCV, 75.7% had HCV RNA successfully amplified, with subtypes 1a (n=12/33; 36,4%), 1b (n=17/33; 51,5%) and 3a (n=3/33; 9,1%) detected. Clinically relevant mutations were found V321L, V321IV, C316N.</div></div><div><h3>Conclusions</h3><div>Identifying mutations in HBV and HCV infections is crucial for epidemiological surveillance and postpartum treatment. Our findings highlight the importance of monitoring drug-resistant mutations in pregnant women with these infections.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101652"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143094743","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P-31 ACUTE LIVER FAILURE DUE TO WILSON'S DISEASE IN COSTA RICA: A LOOK AT GENETICS","authors":"Jorge Andres Herrera Corrales ,&nbsp;Francisco Hevia Urrutia ,&nbsp;Danny Alvarado ,&nbsp;Fernanda Vasquez Carit ,&nbsp;Francisco Vargas Navarro ,&nbsp;Jorge Eduardo Vargas Madrigal ,&nbsp;Karina Hidalgo ,&nbsp;Mildred Jimenez","doi":"10.1016/j.aohep.2024.101645","DOIUrl":"10.1016/j.aohep.2024.101645","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>Acute liver failure (ALF) can be defined as a complex clinical syndrome characterized by coagulopathy, alteration in liver biochemistry and encephalopathy in a patient without underlying chronic liver disease. An exception occurs in patients with Wilson's Disease (WD) manifested precisely by ALF. Costa Rica is known as a country with a high incidence of WD, a pioneer in the study of the genetics of this disease, documenting more than 1,161 pathogenic variants. Taking advantage of the work of the genetics laboratory of the National Children's Hospital, we undertook the task of assessing the genetic spectrum of patients with FHA due to Wilson in the last 2 years in our country. <em>Objective</em>: To analyze and describe the genetic spectrum of acute liver failure due to WD in Costa Rica during the last two years.</div></div><div><h3>Patients / Materials and Methods</h3><div>Molecular Sequencing (Sanger NGS) for molecular confirmation, as well as MLPA techniques and Copy Number Variation Analysis (CNVs).</div></div><div><h3>Results and Discussion</h3><div>During the period (2022-2023), 86 patients with WD variants were identified, of which 30 had confirmatory genetics of the disease. 4 of them presented as having FHA, being managed with a liver transplant, and to this day all of them are alive. It was evident that 100% of the patients presented the c.3809A&gt;G variant, with half of the patients being homozygous and the other half being c.3207C&gt;A / c.3809A&gt;G compound heterozygotes.</div></div><div><h3>Conclusions</h3><div>The c.3809A&gt;G variant was found in all patients who presented ALF due to Wilson's disease in Costa Rica in the last 2 years. There is a lack of studies that assess the association between this variant and more aggressive presentations of the disease, however these results allow us to open a debate about the study of genetics as a predictor of ALF due to WD.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101645"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143094832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"OP- 4 EPIDEMIOLOGY OF PRIMARY BILIARY CHOLANGITIS IN LATIN AMERICA: PRELIMINARY RESULTS FROM ALLATIN COHORT","authors":"Guilherme Grossi Lopes Cançado ,&nbsp;Rafael Theodoro ,&nbsp;Ezequiel Ridruejo ,&nbsp;Lorena Castro Solari ,&nbsp;Cristiane Alves Villela-Nogueira ,&nbsp;Pablo Andres Coste Murillo ,&nbsp;Harlim Rodríguez ,&nbsp;Carlos Benítez Gajardo ,&nbsp;Álvaro Urzúa ,&nbsp;Eira Cerda Reyes ,&nbsp;Paulo Lisboa Bittencourt ,&nbsp;Alejandro Sosa ,&nbsp;Emilia Vera ,&nbsp;Luciana Costa Faria ,&nbsp;Maria Lucia Ferraz ,&nbsp;Mario Guimarães Pessoa ,&nbsp;Debora Raquel Benedita Terrabuio ,&nbsp;Eduardo Luiz Rachid Cançado ,&nbsp;Claudia Alves Couto","doi":"10.1016/j.aohep.2024.101602","DOIUrl":"10.1016/j.aohep.2024.101602","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>Primary biliary cholangitis (PBC) may present differently depending on various factors such as ethnicity and genetic background. Latin America has a highly admixed population with a unique genetic diversity compared to other regions of the world. However, there is limited information available on the presentation and epidemiology of PBC in this region. This study aims to address the epidemiology of PBC in Latin America.</div></div><div><h3>Patients / Materials and Methods</h3><div>Ongoing retrospective, international, multicentric cohort study sponsored by ALEH that enrolls PBC patients from different countries in Latin America.</div></div><div><h3>Results and Discussion</h3><div>Data were accrued on 231 patients [Brazil (52%), Argentina (27.4%), Chile (10.8%), Costa Rica (4.5%), Cuba (3.6%), and Mexico (0.9%)], 92.1% female (mean age at diagnosis 50.5 years), 25.6% with cirrhosis at baseline. Overlap with autoimmune hepatitis was reported in 16.0% of cases. Most patients were symptomatic (67.9%) at diagnosis, with fatigue (41.9%) and pruritus (40.5%) being the main symptoms. Anti-mitochondrial antibodies (AMA) were positive in 70.8% and antinuclear antibodies (ANA) in 60.6%. Hashimoto thyroiditis (23.7%) and Sjogren syndrome (9.1%) were the most common extrahepatic autoimmune diseases associated with PBC. Mean baseline alkaline phosphatase, alanine aminotransferase, aspartate aminotransferase, and bilirubin levels were 445.9 (± 407), 89.8 (± 137.2), 37.6 (± 8.9) U/L, and 1.6 (± 3.1) mg/dL, respectively. Almost all patients (99.1%) were treated with ursodeoxycholic acid (UDCA). 67.4% achieved adequate response to UDCA according to the Toronto criteria and 32% normalized alkaline phosphatase at 12 months. Only 19.9% received second-line therapy, all with fibrates (89.1% bezafibrate, 8.7% ciprofibrate, 4.3% fenofibrate). Of the patients, 9% died, with 33% of deaths being liver-related, while 6% underwent liver transplantation. Hepatocellular carcinoma was diagnosed in 1.7% of patients.</div></div><div><h3>Conclusions</h3><div>In this unprecedented study, the epidemiology of PBC in Latin America appears similar to that in other parts of the world. However, lower rates of AMA positivity were observed, and most patients were still diagnosed with symptomatic disease. Second-line therapy options were limited to the availability of fibrates only.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101602"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143093987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P-48 COMPARISON OF THE ALBI MODEL (ALBUMIN/BILIRUBIN INDEX) WITH ESTABLISHED SCALES AS PREDICTOR OF RESPONSE TO STEROID TREATMENT IN PATIENTS WITH SEVERE ALCOHOLIC HEPATITIS","authors":"CLAUDIA LETICIA DORANTES NAVA ,&nbsp;Maria de Fatima Higuera de la Tijera ,&nbsp;Juan Carlos Silis Cravioto ,&nbsp;Julio Cesar Zavala Castillo ,&nbsp;Miguel Yael Carmona Castillo ,&nbsp;Ernesto Javier Medina Avalos ,&nbsp;Sandra Teutli Carrion ,&nbsp;Raquel Yazmin Lopez Perez","doi":"10.1016/j.aohep.2024.101662","DOIUrl":"10.1016/j.aohep.2024.101662","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>Alcoholic hepatitis (AH) is acute liver inflammation associated with excessive alcohol consumption. Due to its high mortality rate, various predictive models have been studied. The ALBI model (serum albumin/bilirubin index) predicts patient mortality without the need for subjective data in patients with chronic liver disease, achieving significantly better performance than Child Pugh and MELD models.</div><div>Evaluate the prognostic utility of the ALBI model for determining the response to steroid treatment in patients diagnosed with severe alcoholic hepatitis.</div></div><div><h3>Patients / Materials and Methods</h3><div>Retrospective cohort study from October 2019 to September 2023. We evaluated severity criteria, demographic characteristics, and endoscopic features. Maddrey, MELD, MELDNa, ABIC, Glasgow, and ALBI models were compared at the time of admission, and the Lille score was calculated 7 days after steroid treatment. Statistical analysis was performed using SPSS 26 software, with a p-value of &lt;0.005 considered statistically significant.</div></div><div><h3>Results and Discussion</h3><div>We included 170 patients, 21 women (12.4%) and 149 men(87.6%), average age of 45 ± 13.5 years. Of these, 30.6% were classified as Child-Pugh B and 69.4% as Child-Pugh C. Concomitant infection was documented in 15.3%, with urinary tract infections being the most prevalent, and the most frequent endoscopic finding was portal hypertensive gastropathy in 98% of patients, of which 65.5% were mild and 34.4% were severe. The 90-day follow-up mortality rate was reported at 34.7%. Comparing the different scales, we found good diagnostic accuracy for ALBI(AUC:0.64[95%CI:0.57–0.73];p=0.002),MELD 3.0(AUC:0.62[95%CI:0.53–0.70];p=0.009),MELDNa(AUC:0.61[95%CI:0.52–0.69];p=0.01),and ABIC(AUC:0.60[95%CI:0.51–0.69];p=0.02).</div></div><div><h3>Conclusions</h3><div>The ALBI model, due to its objective and straightforward nature, is increasingly employed in the evaluation of hepatic dysfunction. It provided prognostic assessment comparable to MELD, MELDNa, and MELD3.0 for predicting the response to steroid treatment in patients with severe alcoholic hepatitis.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101662"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143094037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P-50 CLINICAL AND DEMOGRAPHIC CHARACTERISTICS OF PATIENTS WITH ACUTE HEPATITIS B VIRUS IN A PUBLICAL HOSPITAL IN CHILE FROM 2015 TO 2022.","authors":"Herman Aguirre Barahona ,&nbsp;Marisol Arratia Pinto ,&nbsp;Javier Perez Valenzuela ,&nbsp;Belen Soler Masferrer ,&nbsp;Camila Lazcano Jorquera ,&nbsp;Joaquin Thomas Pozo ,&nbsp;Lilian Isla Montoya ,&nbsp;Gabriel Mezzano Puentes","doi":"10.1016/j.aohep.2024.101664","DOIUrl":"10.1016/j.aohep.2024.101664","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>Since Chile is a low endemic Hepatitis B virus (HBV) country, most cases present as acute infection that resolves spontaneously (95%). There is scarce literature describing the demographic characteristics and serological follow-up of patients with acute HBV infection in Chile.</div><div>The objective is to describe demographic, clinical, laboratory and serological characteristics of patients evaluated in the viral hepatitis polyclinic of a Chilean public hospital. To evaluate indication criteria, received treatments, and surrogate markers of therapeutic objectives.</div></div><div><h3>Patients / Materials and Methods</h3><div>Observational, retrospective study including adults with acute HBV infection, without immunodeficiency, controlled in hepatology policlinic between 2015 and 2022 at Hospital del Salvador. Descriptive statistics were used to determine the demographic characteristics of this population, criteria for indication of antiviral therapy and surrogate markers of therapeutic targets.</div></div><div><h3>Results and Discussion</h3><div>180 clinical records were reviewed. 147 were excluded: poor treatment adherence and follow-up (30), deceased (59), chronic HBV infection (39) and immunodeficiency (19). 33 patients were included in the analysis, with mean age of 32.3 years and 69.6% being men. Sexual transmission was the most frequent transmission mechanism (48%). There were no cases with cirrhosis at the time of diagnosis. 6 patients (18.1%) required antiviral treatment due to severity, being entecavir the antiviral most frequently prescribed. 36.3% achieved ALT normal levels, most of them at the third month. 39.3% achieved loss of the HBV surface antigen (HBsAg).</div></div><div><h3>Conclusions</h3><div>Most patients achieved loss of HBsAg, however, many had no follow-up HBsAg studies or did not adhere to medical controls. Only 1 patient was diagnosed as chronic infection during follow-up. Follow-up and adherence to medical controls in patients with acute HBV infection need to be improved.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101664"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143094039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P-11 REAL-WORLD DATA WITH PANGENOTYPIC DIRECT-ACTING ANTIVIRALS IN LATINAMERICA: PRELIMINARY RESULTS OF THE SVR10K STUDY","authors":"Mario Alvares da Silva ,&nbsp;Fatima Higuera de la Tijera ,&nbsp;Miguel Castruita Garcia ,&nbsp;Oscar Beltran Galvis ,&nbsp;Ming Lung Yu ,&nbsp;Soo Aleman ,&nbsp;Grace Lai-Hung Wong ,&nbsp;Javier Garcia Samaniego ,&nbsp;Joaquin Cabezas Gonzalez ,&nbsp;Marta Casado Martin ,&nbsp;Mohamed Alzaabi ,&nbsp;Aastha Chandak ,&nbsp;Marta Martinez ,&nbsp;Artak Khachatryan ,&nbsp;Linda Chen ,&nbsp;Candido Hernandez Lopez ,&nbsp;Yu Jun Wong","doi":"10.1016/j.aohep.2024.101625","DOIUrl":"10.1016/j.aohep.2024.101625","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>Yes, Gilead-sponsored research</div></div><div><h3>Introduction and Objectives</h3><div>A previous real-world data (RWD) analysis demonstrated high effectiveness of sofosbuvir/velpatasvir (SOF/VEL) without ribavirin in &gt; 6,000 HCV patients from 12 clinical cohorts across Australia, Canada, Europe &amp; USA. Expand this research initiative with the ongoing SVR10K study, to include even more patients from additional geographical areas, which will allow to show SOF/VEL effectiveness across multiple diverse populations, including Latin-American (LATAM) region.</div></div><div><h3>Patients / Materials and Methods</h3><div>This RWD analysis includes patients ≥ 18 years treated with SOF/VEL without RBV for 12 weeks, as decided by the treating HCP, from 13 sites across Brazil, Colombia, Hong Kong, Mexico, Singapore, Sweden, Spain, Taiwan, and the United Arab Emirates. Age, sex, treatment experienced (TE), cirrhosis stage (no decompensated included), genotype, coinfections, time to treatment initiation (TTI) from HCV diagnosis, and SVR were analyzed for LATAM region.</div></div><div><h3>Results and Discussion</h3><div>Overall, 7,027 patients have been included up to now, 13% (n=890) of them from four sites in the LATAM region (Table). There, median age was 54.5 [IQR 43.2-63.5], where males 51%, and age &gt; 50 years in 62%. Genotype 3 was present in 14%, cirrhotic (CC) 34%, TE 8%, while HIV, HBV and HDV coinfection was reported in 7.2%, 0.3%, and 0.0%, respectively. The TTI was available in 94%, with 28% having ≤30 days (In Brazil 57%). In terms of effectiveness, SVR was achieved in 99.6% of the treated population (n=788); being 98.2% in GT3 patients (n=112), 99.6% in CC patients (n=279), and 97.4% in GT3 CC patients (n=38).</div></div><div><h3>Conclusions</h3><div>Results on treatment effectiveness in LATAM region did not differ from RWD studies of patients in the North-Western countries, reinforcing that HCV treatment guidelines are globally applicable, and supporting the efficacy of panfibrotic, pangenotypic, and pangeographic DAA therapy. Although with positive signs, there is still a significant room for improvement in the time to treatment initiation in the LATAM region.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101625"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143094730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"P-61 CLINICAL APPLICATION OF NAFLD FIBROSIS SCORE AND HEPAMET FIBROSIS SCORE IN CORONARY ARTERY DISEASE AND MASLD: A CROSS-SECTIONAL STUDY IN WESTERN MEXICAN POPULATION","authors":"José Antonio Velarde Chávez ,&nbsp;Francisco Alejandro Félix Téllez ,&nbsp;Jorge Alberto Martínez Ortiz ,&nbsp;Neisser Morales Victorino ,&nbsp;Claudia Ximena Vásquez Veloza ,&nbsp;Diana Karen Tapia Calderón ,&nbsp;José Roberto Barrientos Avalos ,&nbsp;José Antonio Velarde Ruiz Velasco","doi":"10.1016/j.aohep.2024.101675","DOIUrl":"10.1016/j.aohep.2024.101675","url":null,"abstract":"<div><h3>Conflict of interest</h3><div>No</div></div><div><h3>Introduction and Objectives</h3><div>Coronary artery disease (CAD) is a leading cause of morbidity and mortality worldwide. Reliable knowledge of the prevalence of occult CAD, particularly anatomically confirmed CAD is limited and cardiovascular risk (CVR) models only predict the risk of an acute coronary event within a set period. It has been described that a FIB-4 score is associated with a higher CVR. <em>Objective:</em> to determine the utility of noninvasive markers of liver fibrosis in CAD.</div></div><div><h3>Patients / Materials and Methods</h3><div>A cross-sectional study in western Mexican population was conducted in two tertiary centers in central and western Mexico from March 2019 to April 2023. Patients with MASLD according to the latest recommendations (hepatic steatosis demonstrated by imaging study and at least one cardiometabolic criteria) who required percutaneous coronary angiography were included, demographic data and coronary angiographic were recorded. Noninvasive fibrosis indexes were calculated. Continuous variables were subjected to a distribution analysis and equality of variances to subsequently perform a mean comparison analysis with U-Mann-Whitney test between patients with monovascular, bivascular and trivascular involvement. A correlation analysis was also performed between the invasive markers and the Syntax index.</div></div><div><h3>Results and Discussion</h3><div>A total of 168 patients were included with a mean age of 66 ± 12 years with a predominance of male sex with 75.6% (n= 127). Angiographic findings included 37.5%, monovascular, 32.7%, bivascular and 29.8% trivascular involvement. Comparison of means of noninvasive markers of fibrosis demonstrated a significant difference in HFS between patients with monovascular (0.17 ± 0.18), bivascular (0.27 ± 0.18) and trivascular (0.30 ± 0.25) coronary artery disease, p≤ 0.001. A correlation was also demonstrated between non-invasive markers and Syntax score: FIB-4 (r=: 820, p≤0.001), APRI (r=: 766, p≤0.001), HFS (r= 869, p≤0.001), (r= 820, p≤0.001), NFS (r= 807 p≤0.001).</div></div><div><h3>Conclusions</h3><div>The score of noninvasive tools to assess liver fibrosis correlates positively with the complexity of CAD and could be considered as noninvasive tools to be used in the CVR assessment in MASLD patients.</div></div>","PeriodicalId":7979,"journal":{"name":"Annals of hepatology","volume":"29 ","pages":"Article 101675"},"PeriodicalIF":3.7,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143095206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}