Journal of Hepatology

BACKGROUND & AIMS: Non-alcoholic fatty liver disease (NAFLD) is a growing public health problem worldwide and has become an important field of biomedical inquiry. We aimed to determine whether European countries have mounted an adequate public health response to NAFLD and non-alcoholic steatohepatitis (NASH). METHODS: In 2018 and 2019, NAFLD experts in 29 European countries completed an English-language survey on policies, guidelines, awareness, monitoring, diagnosis and clinical assessment in their country...

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BACKGROUND AND AIMS: Systemic corticosteroid may cause hepatitis B virus (HBV) reactivation, but the impact on patients with previous HBV exposure is poorly defined. We aimed to study the risk of hepatitis B surface antigen (HBsAg) seroreversion and hepatitis flare in patients with previous HBV exposure. METHODS: Patients who were negative for HBsAg and received corticosteroid in 2001-2010 were included. Patients who were positive for antibody to HBsAg (anti-HBs) and/or to hepatitis B core antigen (anti-HBc) was defined to have previous HBV exposure...

BACKGROUND & AIMS: Treatment allocation of patients with hepatocellular carcinoma (HCC) on Child-Pugh B (CP-B) cirrhosis is controversial. Liver resection has been proposed by small series with acceptable outcomes, but data are limited. The aim of this study was to evaluate the outcomes of patients undergoing liver resection for HCC in CP-B cirrhosis focusing on the surgical risks and survivals. METHODS: Patients were retrospectively pooled from 14 international referral centers from 2002 to 2017...

BACKGROUND & AIMS: The role of Hepatitis B virus (HBV)-specific CD4 T cells in chronic HBV infection patients is not clear. METHODS: Through intracellular IFN-γ and TNF-α staining, HBV-specific CD4 T cells were analyzed in 68 chronic HBV infection patients with alanine aminotransferase (ALT) < 2×upper limit of normal (ULN) and 28 hepatitis B flare patients. HBV-specific HLA-DRB1*0803/HLA-DRB1*1202-restricted CD4 T-cell epitopes were identified. RESULTS: TNF-α producing cells were the dominant population in patients' HBV-specific CD4 T cells...

BACKGROUND & AIMS: Microenvironment regulates hepatoma stem cells behaviors. The contributions of lymphatic endothelial cells in hepatoma stem cells niche remain largely unknown. METHODS: The association between lymphatic endothelial cells and CD133+ hepatoma stem cells was analyzed using immunofluorescence and adhesion assays. The effects of the interaction between lymphatic endothelial cells and hepatoma stem cells on IL-17A expression were examined using western blot, qRT-PCR and luciferase reporter assay...

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The case of a 34-year-old woman with primary biliary cholangitis (PBC) before, during and after pregnancy is described. The use of ursodeoxycholic acid during and after pregnancy is discussed. UDCA has not been approved by the drug regulatory authorities as a pregnancy-safe drug; therefore, reluctance of clinicians to prescribe UDCA during pregnancy is comprehendible. This Grand Round aims to provide a detailed analysis of the current evidence, safety data and clinical experience with ursodeoxycholic acid (and alternative drugs) during pregnancy and lactation...

BACKGROUND: &Aims: Cancer is a major cause of death in nonalcoholic fatty liver disease (NAFLD). Obesity is a risk factor for cancers; however, the role of NAFLD in this association is unknown. We investigated the effect of NAFLD versus obesity on incident cancers. METHODS: We identified all incident cases of NAFLD in a US population between 1997-2016. Subjects with NAFLD were matched by age and sex to referent individuals from the same population (1:3) on the index diagnosis date...

BACKGROUND & AIMS: Nonalcoholic fatty liver disease (NAFLD) and alcoholic liver disease (ALD) pose an important challenge to current clinical healthcare pathways due to a large number of at-risk patients. Therefore, we aimed to explore the cost-effectiveness of transient elastography (TE) as a screening method to detect liver fibrosis in a primary care pathway. METHODS: Cost-effectiveness analysis using real-life individual patient data from six independent prospective cohorts (five from Europe and one from Asia)...

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BACKGROUND &AIMS: Sorafenib is associated with multiple adverse events (AEs), potentially causing its permanent interruption. The impact of the physicians experience on the management of these AEs and the relative implications on clinical outcomes are unknown. We verified if the AEs management changed over time and if these modifications impacted on treatment duration and overall survival (OS). METHODS: We analysed the prospectively collected data of 338 consecutive patients who started sorafenib between January 2008 and December 2017 in three tertiary care centres in Italy...

Basic and clinical studies have demonstrated the efficacy of immunotherapy, a technical and conceptual breakthrough that has revolutionized cancer treatment. Hepatocellular carcinoma (HCC), a deadly malignancy with etiologic diversity and a chronic course, is strongly influenced by the immune system, and was recently found to partially benefit from immune checkpoint inhibitor therapy. Notably, HCC onco-immunology depends on diverse genetic and environmental factors that together shape cancer-promoting inflammation as well as immune dysfunction, critical processes that control HCC malignant progression and response to therapy...