International Hepatology

Complications related to portal hypertension are the main cause of death in patients with advanced chronic liver disease (ACLD). Even after the underlying cause is controlled, clinical events during the progression of portal hypertension, such as esophageal variceal bleeding, ascites, overt hepatic encephalopathy, and acute-on-chronic liver failure, are the most critical factors leading to high mortality in chronic liver disease. The hepatic venous pressure gradient is the "gold standard" for assessing portal hypertension, and upper gastrointestinal endoscopy is an essential tool for screening and evaluating esophagogastric varices and their severity. However, both are invasive procedures, making them unsuitable for screening and monitoring portal hypertension. Non-invasive diagnostic methods based on spleen stiffness measurement (SSM) using vibration-controlled transient elastography can be used for screening, stratifying diagnosis, and monitoring portal hypertension and esophageal varices. At the recent 2024 Jinling Liver Disease Conference, Professor Jinjun Chen from Nanfang Hospital, shared advances in the non-invasive diagnosis of portal hypertension and esophagogastric varices in ACLD patients using spleen stiffness. The content is summarized as follows for the readers.

To help clinicians and researchers in the field of hepatology stay updated with academic knowledge and research trends, Hepatology Digest and the Journal of Clinical and Translational Hepatology (JCTH) jointly launched the "Journal Club" column. Every two weeks (Tuesday), one selected article is highlighted, focusing on key points or insights to improve clinical practice, inspire research thinking, and enhance writing skills.

Since the advent of immune checkpoint inhibitors (ICI) for the treatment of malignant tumors, the exploration of their use in hepatocellular carcinoma (HCC) has been relentless. In 2017 and 2018, nivolumab and pembrolizumab were respectively granted accelerated approval by the FDA for second-line treatment of HCC following progression on sorafenib. However, both agents failed to meet primary endpoints in phase III clinical trials (CheckMate-459 for nivolumab and Keynote-240 for pembrolizumab) as first-line and second-line treatments respectively, which prevented them from securing a standalone role in HCC treatment. Conversely, a phase III trial in an Asian population (Keynote-394), which tested pembrolizumab as a second-line treatment compared to a placebo, reported positive results, and pembrolizumab continues to be conditionally used post-sorafenib progression. Subsequent extensive clinical research has continued to explore the role of ICIs across the entire spectrum of HCC treatment, including neoadjuvant and adjuvant therapies around curative resection, first-line therapy combining with TACE for intermediate-stage HCC, and first and second-line treatments for advanced-stage HCC. Professor Ming Zhao from the Sun Yat-sen University Cancer Center provides a comprehensive review of the recent applications of immunotherapy in HCC.

Since the advent of immune checkpoint inhibitors (ICI) for the treatment of malignant tumors, the exploration of their use in hepatocellular carcinoma (HCC) has been relentless. In 2017 and 2018, nivolumab and pembrolizumab were respectively granted accelerated approval by the FDA for second-line treatment of HCC following progression on sorafenib. However, both agents failed to meet primary endpoints in phase III clinical trials (CheckMate-459 for nivolumab and Keynote-240 for pembrolizumab) as first-line and second-line treatments respectively, which prevented them from securing a standalone role in HCC treatment. Conversely, a phase III trial in an Asian population (Keynote-394), which tested pembrolizumab as a second-line treatment compared to a placebo, reported positive results, and pembrolizumab continues to be conditionally used post-sorafenib progression. Subsequent extensive clinical research has continued to explore the role of ICIs across the entire spectrum of HCC treatment, including neoadjuvant and adjuvant therapies around curative resection, first-line therapy combining with TACE for intermediate-stage HCC, and first and second-line treatments for advanced-stage HCC. Professor Ming Zhao from the Sun Yat-sen University Cancer Center provides a comprehensive review of the recent applications of immunotherapy in HCC.

Drug-induced liver injury (DILI) is liver damage caused by prescription or over-the-counter chemical medicines, biological products, traditional Chinese medicines, herbal and natural medicines, health products, dietary supplements, or their metabolites, additives, contaminants, and impurities. It is one of the most concerning drug-related diseases globally. At the inaugural 2024 Jinling Liver Disease Conference, Professor Dong Ji from the Fifth Medical Center of the Chinese PLA General Hospital delivered a keynote report on the prognosis of DILI, discussing the histological and biochemical characteristics of chronic DILI and their relationship to its prognosis, and introducing a new non-invasive predictive model for forecasting the prognosis of chronic DILI.

The "Acute-on-Chronic Liver Failure (ACLF) Monthly Review" is a scholarly column produced by the Chinese Acute-on-Chronic Liver Failure Consortium at the invitation of the editorial department of the journal Liver International. Each month, the column focuses on a specific area of ACLF to disseminate knowledge about the concept and significance of ACLF and to help readers stay updated on recent developments in the field. The aim is to benefit both liver disease specialists and researchers interested in field hotspots, as well as frontline clinical practitioners in need of practical knowledge.

Editor's Note:HBV infection remains a significant public health issue worldwide, with about 1.5 million new infections annually. As of 2019, there were 46.5 million children and adolescents globally suffering from…

Non-hepatotropic viruses are significant pathogens in viral hepatitis. With advancements in diagnostic techniques, cases of hepatitis caused by non-hepatotropic viral infections are increasingly recognized in clinical settings. These viruses can manifest solely as hepatitis or in conjunction with other organ disorders. While most infections cause only mild liver damage, viruses such as HHV-6, Coxsackievirus, and adenovirus can lead to acute liver failure in immunocompromised patients, necessitating vigilant monitoring. At the recent 2024 First Jinling Hepatology Conference, Professor Jinghang Xu from Peking University First Hospital delivered a keynote lecture on "Fever with Hepatic Damage," systematically introducing the etiological characteristics, clinical manifestations, and diagnosis of non-hepatotropic viral hepatitis, and shared relevant clinical cases.

Liquid biopsy is a cutting-edge technology that utilizes molecular biomarkers in human body fluids for analysis, thereby obtaining relevant disease information. In the era of precision medicine, liquid biopsy has become an indispensable tool in the field of tumor diagnosis and treatment. It has received extensive attention and research for its applications in early tumor screening, treatment plan selection, disease recurrence monitoring, and biopharmaceuticals. Notably, plasma free DNA fragmentomics, as an emerging technology in the field of liquid biopsy, is increasingly applied in the diagnosis of various cancers.