International Hepatology

Portal hypertension is a severe complication of chronic liver disease, directly associated with clinical outcomes such as ascites and variceal bleeding. Transjugular intrahepatic portosystemic shunt (TIPS) is an effective treatment that significantly reduces portal pressure. Portal pressure gradient (PPG) is commonly used to assess portal pressure in patients undergoing TIPS. Recently, a study led by Dr. Guohong Han's team from Xi'an International Medical Center Hospital, published in the Journal of Hepatology, explored the optimal timing and hemodynamic target for measuring PPG in cirrhotic patients with variceal bleeding after undergoing TIPS with covered stents.

Interventional therapy is an emerging clinical discipline and an important part of minimally invasive medicine. It stands as the third major clinical discipline, distinct from traditional internal medicine and surgery. Interventional therapy allows the treatment of various diseases through tiny channels a few millimeters in diameter created in the skin, using advanced imaging technologies such as DSA, ultrasound, and CT, without the need for large incisions to expose the lesion. Special needles, catheters, drugs, or stents are employed to treat the affected organs and tissues. To provide cutting-edge advancements in interventional hepatology, Hepatology Digest has partnered with Dr. Xuefeng Luo from West China Hospital of Sichuan University to create the "Interventional Therapy in Hepatobiliary Diseases" column. This monthly column aims to share the latest research, convey standardized treatment concepts, and track the latest developments in interventional therapy, with the goal of benefiting experts, researchers, and frontline medical workers in the field.

A recent clinical study conducted by Dr. Jean-Charles Nault and his team at the Cordeliers Research Center of Sorbonne University, France, was published in Gut journal. This study reveals the dynamic changes in circulating tumor DNA (ctDNA) in patients with hepatocellular carcinoma (HCC) and its clinical significance. The findings provide new perspectives and tools for the clinical management of HCC, highlighting the potential of ctDNA monitoring as an important adjunct in the diagnosis and treatment of HCC.

According to estimates from the Polaris Observatory, the prevalence of inactive hepatitis B surface antigen (HBsAg) carriers in the general population in China was 6.1% in 2016, with approximately 86 million people chronically infected with HBV. This suggests that around 36.08% of these individuals are inactive HBsAg carriers (IHC), equating to about 30.96 million people. The definitions and treatment recommendations for IHC vary across national or regional chronic hepatitis B (CHB) guidelines. As research into the natural history of CHB deepens and antiviral treatment strategies evolve, the management of HBV infection is gradually changing. At a recent Beijing Hepatology Academic Annual Meeting, Dr. Sujun Zheng from Beijing You An Hospital, Capital Medical University, presented an insightful report on "Advances in the Diagnosis and Treatment of Inactive HBsAg Carriers." Here, we summarize the key points.

The liver is a powerful organ with complex physiological structures and functions. Liver fibrosis is a dynamic pathological process associated with various chronic liver diseases, ultimately leading to cirrhosis. In cirrhosis, the liver not only becomes harder but also shrinks in size, with imaging showing changes in the liver's appearance accompanied by alterations in hepatic hemodynamics. Recently, at the 10th Beijing Hepatology Academic Annual Conference in 2024, Hepatology Digest invited Dr. Dong Ji from the Fifth Medical Center of the Chinese PLA General Hospital to discuss the latest insights and strategies on liver fibrosis reversal. The interview has been compiled into this article for readers to reference.

HBV infection is a major cause of chronic hepatitis B (CHB), cirrhosis, liver failure, and hepatocellular carcinoma. Despite the development of new drugs and advancements in antiviral therapy, a complete cure for CHB remains a clinical challenge. The burden of liver disease in China is still heavy, and the implementation of high-quality liver disease management is urgently needed. This involves a comprehensive approach that includes enhanced public education, convenient screening and monitoring, empowerment of primary healthcare, optimization of doctor incentives, refined data management, and scientifically sound prevention and treatment strategies. Recently, Dr. Sujun Zheng from Beijing You An Hospital, Capital Medical University, provided a systematic overview of the exploration and progress in comprehensive liver disease management during an academic exchange. The following is a summary of the key points shared.