International Hepatology

Most patients with acute-on-chronic liver failure (ACLF) exhibit varying degrees of cholestasis. Previous studies have shown that compared to standard medical treatment alone, the artificial liver support system (ALSS) can improve prognosis and extend survival time in ACLF patients. Additionally, research has confirmed gut microbiota dysbiosis in ACLF patients. However, the specific impact of ALSS on the gut microbiota composition in these patients remains unclear. Considering the complex interactions between gut microbiota, bile acids (BAs), and the liver, researchers conducted a study to elucidate the unique effects of ALSS on gut microbiota and serum BAs in ACLF patients. Furthermore, the study visualized the relationships between gut microbiota, serum BAs, and clinical outcomes in ACLF patients using correlation heatmaps, providing insights into potential therapeutic targets for ACLF. The study was recently published in Hepatology International.

July 28, 2024, marks the 14th World Hepatitis Day. Despite significant progress in combating viral hepatitis, it remains the most prevalent infectious disease in China. Hepatitis E (HEV) is particularly challenging, as China is a high-endemic region for the virus. To address the need for more standardized in-hospital screening procedures, accurate assessments, and a reduction in disease burden, the Chinese Consortium for the Study of Hepatitis E (CCSHE), in collaboration with the Chinese Physician Association for Infectious Disease and the National Clinical Research Center for Infectious Diseases, has developed the "Expert Consensus on the Process of In-Hospital Screening Management of Viral Hepatitis E in China (2023)" (referred to as the Consensus). During a recent academic exchange on hepatitis E prevention and control, Dr. Jian Wu, from the Affiliated Suzhou Hospital of Nanjing Medical University. Hepatology Digest invited Dr. Jian Wu to share his insights and experiences on hepatitis E prevention, diagnosis, and treatment, aiming to further raise public awareness and encourage proactive measures to curb the spread of the virus.

July 28 is "World Hepatitis Day," and this year's theme in China is "Eliminate Hepatitis: Act Now." While the focus remains on viral hepatitis, the prevention and treatment of Metabolic Associated Fatty Liver Disease (MAFLD) should not be overlooked. In honor of World Hepatitis Day, Hepatology Digest invited Dr. Yuemin Nan from the Hebei Medical University Third Hospital to share valuable insights on MAFLD.

July 28, 2024, marks the 14th World Hepatitis Day. Recently, the National Disease Control and Prevention Administration released a report on the national legal infectious disease situation for May 2024, revealing that viral hepatitis remains the most prevalent category B infectious disease. In light of this, Hepatology Digest interviewed Dr. Jidong Jia from Beijing Friendship Hospital, Capital Medical University, to discuss the transmission routes of hepatitis, prevention measures, and more. Below is the transcript of the interview.

The Journal of Hepatology (JOH) recently published an online systematic review and individual patient data meta-analysis conducted by Cedars-Sinai Medical Center in Los Angeles. The study investigates the impact of using immune checkpoint inhibitors (ICIs) for hepatocellular carcinoma (HCC) before liver transplantation on various key clinical outcomes post-transplantation. The findings reveal that while ICIs treatment may increase the risk of post-transplant rejection, the overall risk remains manageable, with patient age and ICI clearance time being closely related to rejection risk. This study provides valuable clinical data to support the use of ICIs before liver transplantation, offering new insights and directions for research and clinical practice in this area.

HBV infection is a global public health issue, with its chronic progression leading to severe liver diseases such as chronic hepatitis B (CHB), cirrhosis, and hepatocellular carcinoma (HCC). In recent years, the phenomenon of HBV DNA integrating into the host genome has garnered widespread attention as it unveils new mechanisms of HBV pathogenesis and significantly impacts the diagnosis, treatment, and prognosis of HBV-related diseases. Recently, Dr. Fabien Zoulim from Lyon Hepatology Institute, France, published a comprehensive review article in the Journal of Hepatology (JOH), detailing the mechanisms of HBV DNA integration, its impact on liver disease progression, and its implications for the functional cure of CHB. This review aims to provide new perspectives and methods for the prevention and treatment of CHB

Portal hypertension can lead to complications such as variceal bleeding and ascites. Transjugular intrahepatic portosystemic shunt (TIPS) creates an artificial channel between the hepatic vein and portal vein to reduce portal pressure. TIPS is the only minimally invasive method that can reduce or even normalize portal pressure and is effective in controlling variceal bleeding and refractory ascites. However, American, Chinese, and European guidelines recommend endoscopic treatment, non-selective beta-blockers, and paracentesis as the first-line treatments for variceal bleeding and ascites related to portal hypertension, with TIPS recommended as an alternative treatment. One of the main reasons is that TIPS can induce overt hepatic encephalopathy (HE), with an incidence rate of 10% to 50%, negatively affecting patients' quality of life and increasing mortality. Even with multiple treatments, the recurrence rate of HE remains high. These factors make predicting the risk of overt HE crucial for determining patient eligibility for TIPS. Recently, a study by Dr. Ligong Lu from Zhuhai People's Hospital, published in Hepatology International, explored the feasibility of using liver vascular assessments to predict HE, providing evidence to support the selection of suitable patients for TIPS treatment.

It is estimated that 25% of adults worldwide are affected by metabolic dysfunction-associated steatotic liver disease (MASLD). MASLD is characterized by at least 5% liver fat content in individuals who do not consume alcohol or consume very little. MASLD represents the liver manifestation of metabolic syndrome and is closely associated with obesity, insulin resistance, and type 2 diabetes (T2DM). About 20% to 30% of MASLD patients progress to metabolic dysfunction-associated steatohepatitis (MASH), characterized by steatosis, inflammation, and hepatocellular ballooning, with or without fibrosis. It is estimated that 20% of MASH patients will further develop end-stage liver disease. A weight loss of 3% to 5% can improve MASLD, while a weight loss of ≥10% is associated with MASH regression and fibrosis regression, indicating the critical role of obesity in the progression of these diseases. Recently, a study published in the Journal of Hepatology suggests that a GLP-1R/GCGR dual agonist may provide an effective treatment for MASLD and obesity.

As of 2022, there are 257.5 million people worldwide who are HBsAg positive. Decompensated cirrhosis and hepatocellular carcinoma (HCC) are the leading causes of death among chronic HBV patients. Liver biopsy is the "gold standard" for diagnosing fibrosis stages, but its invasive nature makes many patients reluctant to undergo the procedure. Recently, a study published in Hepatology International explored the value of serum N-glycan markers in diagnosing liver fibrosis.

Recently, a study by Italian scholar Dr. Silvia Nardelli, published in the Journal of Hepatology, found that even if cirrhotic patients develop overt hepatic encephalopathy (OHE) after undergoing transjugular intrahepatic portosystemic shunt (TIPS) surgery, their mortality rate does not significantly increase. This conclusion challenges previous perceptions of the negative impact of OHE in non-TIPS contexts, offering new hope and management strategies for cirrhotic patients.