Diagnosed Patients With Chronic Hepatitis B and Delta Virus in Italy in 2024: An Estimation From a National Real-World Database.

Background And Aims: Hepatitis B (HBV) and Hepatitis Delta virus (HDV) infection have undergone significant changes in Italy over the past few decades, but reliable and updated prevalence of chronic hepatitis B (CHB) and Delta (CHD) data are lacking. The aim of the study was to describe the epidemiology of CHB and CHD in Italy in 2024, based on real-world data.

Methods: The number of patients with a healthcare expenditure exemption for CHB (016.

Autobrewery Syndrome and Endogenous Ethanol Production in Patients with MASLD: A Perspective from Chronic Liver Disease.

Autobrewery syndrome is a rare condition characterized by the endogenous fermentation of carbohydrates by gut microbiota, which exceeds the liver's detoxification capacity and leads to signs and symptoms of acute alcohol intoxication. This condition has significant clinical, social, and legal implications. Beyond the acute effects, the role of excessive endogenous ethanol production in the progression of chronic diseases-particularly liver disease-is still under investigation.

The Medical Impact of Hepatitis D Virus Infection in Natives and Immigrants: The Italian Paradigm.

Background And Aim: Ongoing migratory flows are reconstituting the hepatitis D virus (HDV) reservoir in Italy. We aimed to characterise the current clinical and virologic features of HDV infection in both native Italians and migrants.

Methods: We enrolled 515 hepatitis B surface antigen (HBsAg)-positive patients with detectable anti-HDV antibodies from 32 Italian centres between August 2022 and July 2024; all patients underwent centralised virologic assessment.

Outcome of hepatic resection for HCC in ideal and non-ideal candidates.

Background: The Barcelona Clinic Liver Cancer staging system considers, among patients with HCC, "ideal candidates" (ICs) for hepatic resection (HR) those with a single lesion, normal bilirubin, and without clinically significant portal hypertension (CSPH). We compared the outcome of HR between ICs and non-ICs.

Methods: Retrospective analysis was conducted on Child-Pugh A patients.

Role of Vascular Liver Diseases in Hepatocellular Carcinoma Development.

Hepatocellular carcinoma (HCC) is a frequent complication of various liver diseases, occurring with or without underlying cirrhosis. While cirrhosis and chronic liver inflammation are well-established major drivers of hepatocarcinogenesis, HCC can also develop in patients with vascular liver diseases (VLDs), highlighting an alternative pathway of disease progression. Alterations in liver perfusion appear to underlie the process of carcinogenesis.

Recurrence rate, features, and outcome after hepatocellular carcinoma curative resection or ablation according to the IMbrave050 criteria: a real-world study.

Background/aims: Adjuvant systemic therapy has been proposed in patients at high-risk of hepatocellular carcinoma (HCC) recurrence. This study assessed the outcomes of a real-world cohort treated with either resection or ablation, stratified according to the IMbrave050 trial criteria.

Methods: We selected, from the Italian Liver Cancer database, 1150 patients with HCC treated with upfront resection (n = 483, 64.

Cancer Vaccines: A Promising Therapeutic Strategy in Advanced Solid Tumors.

Recent advancements in understanding how cancer cells evade immune recognition have led to significant progress in cancer immunotherapy. Therapeutic cancer vaccines hold great promise due to their safety, specificity, and ability to establish lasting immune memory, serving as an effective immunotherapy either alone or in combination with other treatments in clinical research. Cancer vaccines aim to restore the host's innate and adaptive anti-cancer immune responses by stimulating antigen-presenting processes and reversing the immunosuppressive environment that facilitates tumor immune evasion and metastasis.

Etiology of Hepatocellular Carcinoma May Influence the Pattern of Progression under Atezolizumab-Bevacizumab.

Background: Preclinical models have shown that metabolic dysfunction-associated steatotic liver disease (MASLD)-related hepatocellular carcinoma (HCC) may exhibit reduced responsiveness to immunotherapy, especially for intrahepatic lesions due to liver tumor microenvironment. Radiological pattern of progression has been validated in clinical studies as a useful tool for predicting outcomes in HCC undergoing systemic treatments.

Aims: The aim of this study was to determine whether MASLD influences the pattern of progression in patients treated with atezolizumab-bevacizumab.

The Concept of "Converse Therapeutic Hierarchy" for Patients with Hepatocellular Carcinoma.

Background: The clinical complexity of patients with hepatocellular carcinoma (HCC), the availability of multiple therapeutic options, and clinical therapeutic intents could make it challenging to identify an unequivocal limit between conversion, downstaging/downsizing, and neoadjuvant therapies and curative or palliative intent treatments and to dimension the most proper sequential therapeutic strategy for each patient.

Summary: The concept of converse therapeutic hierarchy could rationally embrace all the different sequential treatment options (e.g.

Biopsy in chronic liver disease: proposal for a shared path between clinicians and pathologists.

Introduction: Liver biopsy is fundamental for characterizing chronic liver disease. Effective communication between specialists during the diagnostic process is crucial. This project aims to outline a diagnostic path shared by clinicians and pathologists, and to propose practical solutions at different stages of the diagnostic work-up, from clinical suspicion to the histology report in patients with chronic liver diseases.

Local and Systemic Endothelial Damage in Patients with CEAP C2 Chronic Venous Insufficiency: Role of Mesoglycan.

Chronic venous disease (CVD) involves complex pathophysiological mechanisms, particularly an imbalance between matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMPs), contributing to venous remodeling and varicosities. Elevated MMP-2 and MMP-9 levels are commonly found in tissues affected by venous ulcers. Inflammation plays a central role in CVD, with higher levels of pro-inflammatory markers present in varicose veins compared to healthy ones.

Characteristics and Outcomes of Hepatocellular Carcinoma in Patients with Autoimmune Hepatitis.

Background: The incidence of HCC in patients with autoimmune hepatitis (AIH) is low and, due to the paucity of data in the literature, a thorough characterization of these patients is missing.

Aim: To describe the main characteristics and outcome of patients with AIH and HCC.

Methods: Among patients with HCC included in the Italian Liver Cancer (ITA.

Safety of Anticoagulant Treatment in Patients With Splanchnic Vein Thrombosis and History of Portal Hypertension-Related Bleeding.

Splanchnic vein thrombosis (SVT) can be associated with liver cirrhosis or prothrombotic conditions, including myeloproliferative disorders, intra-abdominal inflammation, solid cancers or surgery. While anticoagulation therapy improves outcomes in noncirrhotic patients and reduces all-cause mortality in cirrhotic populations, its safety in patients with a history of portal hypertension (PH)-related bleeding is less clear. This systematic review examines the impact of anticoagulant therapy on rebleeding risk in SVT patients with a history of PH-related bleeding.

A Real-World Analysis of the Population with Hepatitis C Virus Infection Affected by Type 2 Diabetes in Italy: Patients' Characteristics, Comorbidity Profiles and Treatment Patterns.

: HCV infection represents a main risk factor for type 2 diabetes (T2D). This real-world analysis investigated the HCV-positive (HCV+) population with a T2D co-diagnosis in Italy. : From 2017 to 2021, HCV+ patients were identified from administrative databases and stratified into T2D-HCV+ and HCV+-only cohorts in the presence/absence of a T2D diagnosis.

Prognostic Role of Endoscopic Ultrasound Guided Direct Portal Pressure Gradient Measurement in Porto-Sinusoidal Vascular Disorder.

Background & Aims: HVPG is the gold standard for the diagnosis of clinically significant portal hypertension (CSPH), a condition associated with the risk of developing hepatic decompensation events. However, HVPG is an indirect method to measure portal pressure, and its application in the pre-sinusoidal form of portal hypertension (PH), as in porto-sinusoidal vascular disorder (PSVD), is hindered by low accuracy. Recently, endoscopic ultrasound-guided portal pressure gradient (EUS-PPG) measurement, which allows direct measurement of portal pressure, is emerging as a safe method and may overcome the limitation of HVPG.

Evolution of focal nodular hyperplasia during long-term ultrasound follow-up: results from a single-center study.

Purpose: To examine the natural history of focal nodular hyperplasia (FNH) lesions through long-term ultrasound (US) follow-up and assess the relationship between clinical characteristics and size changes.

Methods: We retrospectively enrolled 55 patients diagnosed with FNH who were followed with ultrasound for at least 24 months. A total of 94 FNH nodules were included in the final analysis.

Liver transplantation for HBV-related liver disease: Impact of prophylaxis for HBV on HCC recurrence.

Background & Aims: Conflicting data exist regarding optimal prophylaxis for HBV recurrence (HBV-R) after liver transplantation (LT), particularly in patients with hepatocellular carcinoma (HCC). We assessed current practices for HBV-R prophylaxis in Italy, evaluating rates, risk factors, and the clinical impact of HBV-R and HCC-R.

Methods: We performed a multicentric, retrospective study involving 20 Italian LT centers.

Liver Decompensation in Patients With Hepatocellular Carcinoma Treated With Atezolizumab Plus Bevacizumab: A Real-life Study.

Background & Aims: Atezolizumab plus bevacizumab (atezobeva) has changed the treatment landscape of advanced hepatocellular carcinoma, but its efficacy and safety in patients with impaired liver function are still debated. This study aimed to evaluate the prognostic impact of baseline liver function and liver decompensation during treatment on clinical outcomes.

Methods: In this multicenter study, we included 247 patients with advanced or unresectable hepatocellular carcinoma treated with atezobeva.

N-Ammonia PET-CT for Evaluating Response to Antiangiogenic Therapy and Prognosis in Patients with Advanced Hepatocellular Carcinoma: A Pilot Study.

Purpose: To prospectively investigate dynamic N-ammonia PET-CT for evaluating early treatment response and predicting prognosis in advanced hepatocellular carcinoma (HCC) patients who have undergone antiangiogenic therapy.

Methods: Dynamic N-ammonia PET-CT was performed in 23 advanced HCC patients before antiangiogenic therapy (baseline) and in 18/23 patients after 8-10 weeks of treatment (post-therapy). At kinetic PET-CT analysis, mean, maximum, and peak values of (mL/cm/min) and (min) were estimated in HCC lesions and non-neoplastic liver using cardiologic N-ammonia PET-CT in 15 patients without any liver diseases as normal controls.

Meta-Analysis: Inverse Association Between Helicobacter pylori Infection and Eosinophilic Oesophagitis.

Background: Exposure to Helicobacter pylori (H. pylori) has been associated with a decreased risk of eosinophilic oesophagitis (EoE).

Aim: The aim of this study is to determine the association between H.

Absence of Viral Replication Is Associated With Improved Outcome in Anti-HCV-Positive Patients With Hepatocellular Carcinoma.

Background And Aims: Presence of active hepatitis C virus (HCV) infection may influence the outcome of patients treated for hepatocellular carcinoma (HCC), although this issue has never been adequately assessed in a large series of patients. The aim of this study was to evaluate whether the presence of active HCV affects the survival of patients treated for HCC.

Methods: This study assessed the outcome of 3123 anti-HCV-positive patients with HCC, subdivided according to the presence of active HCV infection or previous sustained virological response (SVR).

"Pleiotropic" Effects of Antibiotics: New Modulators in Human Diseases.

Antibiotics, widely used medications that have significantly increased life expectancy, possess a broad range of effects beyond their primary antibacterial activity. While some are recognized as adverse events, others have demonstrated unexpected benefits. These adjunctive effects, which have been defined as "pleiotropic" in the case of other pharmacological classes, include immunomodulatory properties and the modulation of the microbiota.

Endothelial Dysfunction and Liver Cirrhosis: Unraveling of a Complex Relationship.

Endothelial dysfunction (ED) is the in the background of multiple metabolic diseases and a key process in liver disease progression and cirrhosis decompensation. ED affects liver sinusoidal endothelial cells (LSECs) in response to different damaging agents, causing their progressive dedifferentiation, unavoidably associated with an increase in intrahepatic resistance that leads to portal hypertension and hyperdynamic circulation with increased cardiac output and low peripheral artery resistance. These changes are driven by a continuous interplay between different hepatic cell types, invariably leading to increased reactive oxygen species (ROS) formation, increased release of pro-inflammatory cytokines and chemokines, and reduced nitric oxide (NO) bioavailability, with a subsequent loss of proper vascular tone regulation and fibrosis development.

International consensus statement on microbiome testing in clinical practice.

There is growing interest in the potential exploitation of the gut microbiome as a diagnostic tool in medicine, but evidence supporting its clinical usefulness is scarce. An increasing number of commercial providers offer direct-to-consumer microbiome diagnostic tests without any consensus on their regulation or any proven value in clinical practice, which could result in considerable waste of individual and health-care resources and potential drawbacks in the clinical management of patients. We convened an international multidisciplinary expert panel to standardise best practices of microbiome testing for clinical implementation, including recommendations on general principles and minimum requirements for their provision, indications, pre-testing protocols, method of analyses, reporting of results, and potential clinical value.

Perioperative administration of albumin in adult patients undergoing liver transplantation: A systematic review.

Hypoalbuminemia is a risk factor for mortality in patients with end-stage liver disease (ESLD) and in those undergoing orthotopic liver transplantation (OLT), since it represents a biomarker of post-operative delayed functional recovery of the graft. Despite albumin infusion during and after OLT is frequently adopted in recipients with hypoalbuminemia, it remains unclear whether this procedure could improve post OLT clinical outcomes. Observational studies indicated that treatment with albumin after OLT might be beneficial in reducing ascites and acute kidney injury (AKI) development.