Engineered monoclonal antibody tobevibart enhances HBsAg capture by Fc receptor-positive cells and activates HBV-specific T cells.

Background & Aims: Effective immune targeting is likely essential for achieving functional cure of chronic hepatitis B (CHB). Tobevibart, a human monoclonal antibody against hepatitis B virus (HBV) surface antigen (HBsAg), neutralizes HBV and hepatitis delta virus (HDV). This study aimed to characterize effects of the engineered GAALIE Fc of tobevibart on HBV immune responses.

Plasma Ammonia Levels Predict Hepatic Encephalopathy After Transjugular Intrahepatic Portosystemic Shunt Placement.

Background: Placement of a transjugular intrahepatic portosystemic shunt (TIPS) is an effective treatment for portal hypertension. Overt hepatic encephalopathy (oHE) is a complication after TIPS associated with increased morbidity. Elevated ratio of plasma ammonia (AMM) levels compared to the local upper limit of normal (ULN) has been associated with oHE, hepatic complications and increased mortality in patients with cirrhosis without TIPS.

Impact of Frailty on the Prognosis of Patients With Liver Cirrhosis Undergoing Insertion of a TIPS.

Background And Aims: Frailty is associated with a poorer prognosis of patients awaiting liver transplantation. Data on the impact of frailty on prognosis after transjugular intrahepatic portosystemic shunt (TIPS)-insertion in patients with cirrhosis and the influence of TIPS on longitudinal changes in frailty are lacking.

Methods: We retrospectively analysed data of 123 prospectively recruited patients with cirrhosis in Mainz and Hannover prior to elective TIPS insertion and monitored them for death/liver transplantation or post-TIPS overt hepatic encephalopathy (OHE).

[Innovations in transplantation medicine].

More than 70 years after the first successful organ transplant between identical twins, transplantation medicine still faces significant challenges today: How can the large number of people waiting for a new kidney, liver, lung, or heart receive a suitable organ more quickly? How can survival on the waiting list be extended? How can long-term graft survival with high quality of life be ensured after transplantation? The various disciplines of transplantation medicine are working daily to address these challenges. The goal of this overview article is to provide practicing physicians with an overview of the current state and medium-term perspectives of transplantation medicine. For this purpose, an interdisciplinary team of transplantation experts from the largest transplant center in Germany has come together to summarize the current innovations and future perspectives of transplantation medicine in a compact and organ-overarching format.

Molecular signatures discriminating different types of rejection in human liver transplants.

Background & Aims: The role of antibody-mediated rejection (AMR) after liver transplantation (LT) remains controversial. Chronic AMR (cAMR) is often subclinical and may be missed without surveillance biopsies (svLbx). Transcriptome analyses have previously characterized molecular changes in T cell-mediated rejection (TCMR) after solid organ transplantation.

Sex Disparities in Treatment Trajectories of Inflammatory Bowel Disease Are Associated With Diagnostic Delay.

Background: Diagnostic delay (DD) is a common finding in inflammatory bowel diseases (IBD). The reasons and effects of this delay are frequently underestimated, particularly in the context of sex. Our aims were to examine the impact of delayed diagnosis in IBD, with a particular focus on sex disparities.

Caffeine Intoxication: An Analysis of Published Case Reports, 1883–2023.

Background: Many case reports of acute caffeine intoxication have been published, but there have been hardly any systematic data analyses, nor have there been any prospective studies, representative epidemiologic studies, or guideline recommendations. In this review, we aim to describe the clinical entity of acute caffeine intoxication and its treatments to date on the basis of published case reports.

Methods: This review is based on pertinent case reports retrieved by a search in the PubMed, Google Scholar, and Semantic Scholar databases covering the period 1851-2023 and employing the keywords "caffeine intoxication," "caffeine poisoning," and "caffeine overdose.

Exploring the patient experience of chronic hepatitis D (CHD) and assessment of content validity of the Hepatitis Quality of Life Questionnaire and (HQLQv2) and the Fatigue Severity Scale (FSS).

Background: Chronic hepatitis D (CHD) is the most severe form of viral hepatitis, which results in accelerated progression to cirrhosis and poor prognosis compared with other hepatitis infections, impacting patients' health-related quality of life (HRQoL). To adequately capture patient perspectives of new hepatitis D virus (HDV) treatments in clinical trials, patient-reported outcome (PRO) measures that are valid and assess key concepts relevant to the patient are needed. This study aimed to explore the patient experience of CHD and evaluate the content validity of the Hepatitis Quality of Life Questionnaire (HQLQv2) and the Fatigue Severity Scale (FSS) for use in an HDV population.

Extrahepatic Replication and Genomic Signatures of the Hepatitis E Virus in the Kidney.

Introduction: The hepatitis E virus (HEV; species Paslahepevirus balayani) is a common human pathogenic and zoonotic virus that can cause both acute fulminant and chronic hepatitis. Despite its reputation as a hepatotropic virus, HEV infection is also associated with a number of extrahepatic diseases, including kidney disorders. However, the extent to which HEV replicates in kidney cells remains unclear.

Differences in the incidence of cirrhosis-associated complications between MASLD, MetALD and ALD among patients with decompensated liver cirrhosis.

Background: Recently, the new definition of steatotic liver disease (SLD) has been introduced, which not only differentiates MASLD (Metabolic Dysfunction-Associated steatotic liver disease) from alcohol-related steatotic liver disease (ALD), but also introduces the concept of metabolic and alcohol-related SLD (MetALD). However, potential differences of the new etiologies regarding the clinical phenotype of patients with advanced liver cirrhosis still remain undetermined. Therefore, we analyzed survival and the incidence of cirrhosis-related complications in SLD-patients with advanced liver cirrhosis.

Accurate quantification using the new RoboGene HDV RNA Quantification Kit 3.0: A European multicenter study.

Background: The management of chronic hepatitis delta requires reliable test systems for the detection and quantification of hepatitis delta virus (HDV) RNA. The aim of this study was to obtain comparable results between seven European laboratories using the new RoboGene HDV RNA Quantification Kit 3.0 (Roboscreen GmbH) in combination with different test systems consisting of different nucleic acid extraction and amplification/detection platforms.

Hepatitis D Virus Infection: Pathophysiology, Epidemiology and Treatment. Report From the Third Delta Cure Meeting 2024.

Chronic infection with hepatitis delta virus (HDV) leads to rapid progression of liver disease, cirrhosis and complications such as end-stage liver disease and hepatocellular carcinoma. In recent years, understanding of the HDV life cycle has increased significantly; however, much remains unknown about the pathogenesis, host-virus interactions and the role of the immune system in HDV persistence and control. Challenges remain in the diagnosis of HDV, not only because of the lack of standardised assays, but also because of limited access and availability in resource-limited countries.

Minimal residual ascites 3 months after TIPS implantation implicates worse clinical outcomes in patients with cirrhosis.

Background & Aims: Transjugular intrahepatic portosystemic shunt (TIPS) implantation is indicated for recurrent/refractory ascites in patients with cirrhosis. The prognostic impact of residual minimal ascites after TIPS implantation has not yet been investigated.

Methods: We included patients with cirrhosis undergoing covered TIPS implantation for refractory ascites in Vienna (2000-2022) and Hannover (2009-2021) with available abdominal ultrasound 3 months after TIPS insertion (3M).

Assessing Highly Processed Food Consumption in Patients with Inflammatory Bowel Disease: Application of the German Screening Questionnaire (sQ-HPF).

The consumption of highly processed foods (HPFs) is increasing on a global scale, and these foods have been associated with non-communicable diseases (NCDs). In particular, the consumption of HPFs has been associated with the intensification of inflammatory responses, with these foods being implicated in the exacerbation of chronic inflammatory conditions. Conversely, ultra-processed foods (UPFs) have been indicated as a possible factor in the pathogenesis of inflammatory bowel disease (IBD), particularly Crohn's disease (CD).

Origin of Hypofunctional CD103 NK Cells in Cirrhosis-Associated Ascites.

The occurrence of ascites is a frequent complication associated with the decompensation of liver cirrhosis. While it is known that cirrhosis leads to altered immune responses in the periphery, the immunological milieu of ascites remains poorly understood. In this study, we investigate the role and origin of natural killer (NK) cells in cirrhosis-associated ascites.

Distinct Inflammatory Imprint in Non-Cirrhotic and Cirrhotic Patients Before and After Direct-Acting Antiviral Therapy.

Background/aims: Hepatitis C virus (HCV) infection remains a global health challenge, leading to chronic liver disease, cirrhosis, and hepatocellular carcinoma (HCC). Despite the high efficacy of direct-acting antiviral (DAA) therapy in achieving sustained virologic response (SVR), concerns persist regarding long-term immune alterations and residual risks, particularly in cirrhotic patients.

Methods: This study investigates 75 soluble immune mediator (SIM) profiles in 102 chronic HCV patients, stratified by cirrhosis status, at therapy initiation, end of treatment, and long-term follow-up (median 96 weeks).

Evaluating Resmetirom Eligibility Among Patients with MASH: Insights from the German Steatotic Liver Disease-Registry.

The THR-β agonist resmetirom is the first treatment approved for metabolic dysfunction-associated steatohepatitis (MASH) in the US so far. It can be prescribed given MASH and F2/F3-fibrosis ("at-risk MASH").We analyzed how many patients qualify for resmetirom in a recently recruited Steatotic Liver Disease-cohort involving both tertiary and secondary care centers, the German SLD-Registry.

Impact of distinct antiviral treatment regimens on the long-term outcome after HCV cure - Data from the German Hepatitis C-Registry (DHC-R).

Direct-acting antiviral (DAA) regimens for the treatment of hepatitis C virus (HCV) infection are endowed with sustained virological response (SVR) rates >95%. However, HCV cure does not completely eliminate the risk of hepatocellular carcinoma (HCC) development and liver decompensation. The present study investigated the impact of the administered DAA regimen on clinical long-time outcomes after SVR.

Food-related Quality of Life in patients with Inflammatory Bowel Disease: Translation and Validation of the German version of FR-QoL-29.

The psychosocial effects of eating and drinking - summarized as food-related quality of life (FR-QoL) - are underexplored in inflammatory bowel disease (IBD). Currently, there is no German instrument to assess FR-QoL in IBD patients. This study aimed to translate the validated English FR-QoL-29 questionnaire into German and evaluate its validity and reliability.

Bacterial Infections in Patients With Severe Alcohol-Associated Hepatitis: Drivers of Organ Failure and Mortality.

Background: Severe alcohol-associated hepatitis (sAH) is a life-threatening condition with limited treatment options. Although corticosteroids offer some benefit in short-term survival, their use remains controversial due to concerns about increased infection risk. Infections are a major cause of mortality in sAH; however, the reasons for this remain unclear.

Updated recommendations for the management of hepatitis B, C, and E virus infections in patients with haematological malignancies and those undergoing haematopoietic cell transplantation: recommendations from the 9th European Conference on Infections in Leukaemia (ECIL-9).

Viral hepatitis remains a global health challenge and immune status affects outcomes. In patients with haematological malignancies, including haematopoietic stem-cell transplantation recipients, viral hepatitis can be life-threatening due to the direct effects of the virus or the need to modify or delay chemotherapy. Additionally, haematopoietic stem-cell donors with past or current viral hepatitis infections might transmit the virus to recipients.

[Evidence-based guidelines in gastroenterological medical care: a survey among members of the German Society for Gastroenterology, Digestive and Metabolic Diseases (DGVS) on acceptance, application and optimization].

Evidence-based guidelines are an important basis for medical action. The methodological effort to develop guidelines is high. Nevertheless, a high methodological effort in the development of guidelines does not automatically guarantee the success of a guideline, but it must be ensured that guidelines are also accepted and thus applied.