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.

Hepatitis B Immunoglobulins Withdrawal in Hepatitis B Virus Mono-Infected Liver Transplant Recipients: An Italian Multicentre Prospective Study.

Background & Aims: Despite recommendations from scientific societies that hepatitis B immunoglobulin (HBIG) can be safely discontinued, centres across Europe continue to use the combination nucleoside analogues (NAs) plus HBIG for long-term prophylaxis against hepatitis B virus (HBV) recurrence after liver transplant (LT). The aim of this study was to evaluate the safety of HBIG withdrawal in a cohort of LT recipients on long-term HBIG+NAs.

Methods: All patients under third-generation NAs + HBIG and who adhered to the INSIGHT-B protocol were followed up after HBIG withdrawal, in a multicentre, prospective, Italian cohort study, to evaluate the risk of HBV reactivation.

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.

Long-term effectiveness, safety, and liver stiffness dynamics of PBC treatment with obeticholic acid in real-world.

Background & Aims: Several studies have assessed the short-term effectiveness and safety of obeticholic acid (OCA) in the real-world setting. We aimed to extend knowledge on the real-world effectiveness and safety of OCA treatment by expanding sample size and follow-up, and by exploring changes in liver stiffness measurement (LSM) over time.

Methods: The RECAPITULATE project involves centres belonging to the "Italian PBC registry" and/or the "Club Epatologi Ospedalieri" PBC working group.

Risk Factors of Metabolic Dysfunction-associated Steatotic Liver Disease in a Cohort of Patients With Chronic Hepatitis B.

Background & Aims: Chronic hepatitis B (CHB) and metabolic dysfunction-associated steatotic liver disease (MASLD) commonly co-exist, with conflicting data in prevalence and disease severity. We aimed to investigate these discrepancies.

Methods: This multicenter study included consecutive patients with CHB from 19 European centers.

Impact of first and further decompensation in patients with compensated ACLD due to MASLD.

Background & Aims: First and further decompensation events mark key transitions in the natural history of cirrhosis and significantly influence mortality risk. We assessed the cumulative incidence of first and further (acute and non-acute) decompensation and evaluated their impact on liver-related death (LR-D) in patients with compensated advanced chronic liver disease (cACLD) due to metabolic dysfunction-associated steatotic liver disease (MASLD).

Methods: We conducted an international, multicenter (17 centers), retrospective study involving 6,061 consecutive patients with cACLD due to MASLD, diagnosed either clinically (liver stiffness measurement >10 kPa) or histologically (F3-F4 fibrosis).

Key Predictors of Relevant Weight Loss in Patients With Metabolic Dysfunction-Associated Steatotic Liver Disease.

Background And Aims: Weight loss is an effective therapeutic strategy for patients with metabolic dysfunction-associated steatotic liver disease (MASLD). This study aimed to identify factors that predict relevant weight loss, defined as at least 7% of initial body weight, in MASLD outpatients.

Method: We retrospectively included all MASLD patients referred to four Italian tertiary centers between January 2019 and December 2021.

COVID-19 Vaccine Perception in Liver Transplant Recipients: Patient-Reported Outcomes and Real-Life Experience from the Bergamo Center.

Background: Bergamo was the most severely affected Italian province at the onset of the 2020 COVID-19 pandemic. The liver transplant (LT) patient population should be among the more sensitized to the concept of health prevention. Long-term data on both perception and outcomes of SARS-CoV-2 vaccination in LT recipients since the COVID-19 vaccine became available in Italy are still lacking.

Dosimetric optimization and evaluation of hepatocellular carcinoma treatment effect prediction in Y-90 radioembolization.

Background: Liver transarterial radioembolization (TARE) with Y microspheres is a common treatment for hepatocellular carcinoma (HCC). A pre-treatment SPECT/CT dosimetric study is performed using Tc macroaggregated albumin, followed by PET-based dosimetry to assess dose distribution of Y. Recent studies show a significant correlation between absorbed doses and treatment outcomes in terms of radiological response, adverse events and overall survival.

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.

Ricomprendo: an assessment test for fine-graded alterations of syntactic processing.

Introduction: RiComprendo was designed as a comprehensive tool to evaluate comprehension of various syntactic structures with a sentence-to-picture matching-task. The study sets normative data and investigates the influence of demographic characteristics and sentence types.

Methods: Two-hundred-ten right-handed healthy Italian native speakers were included.

The Italian Adaptation of the Treatment of Underlying Forms for Object Relatives in Agrammatic Aphasia: Training Efficacy, Generalization Patterns, and Cross-Linguistic Implications.

Purpose: Treatment of Underlying Forms (TUF) is a training program grounded in linguistic theory and aiming to boost complex sentences production in people with agrammatism. Language treatment studies in aphasia confirmed TUF efficacy and led to the formulation of the Complexity Account of Treatment Efficacy (CATE). According to CATE, which relies on the primitive distinction between A- and A'-structures, training complex sentences induces an improvement on simpler structures, but no generalization occurs between different types of syntactic movement.

Incidence and Predictors of Complications Following Percutaneous Liver Biopsy: A Large Italian Multicentre Study.

Background And Aims: Management of ultrasound (US)-guided percutaneous liver biopsy (PLB) lacks standardisation. Despite the low risk of major complications (< 1%), repeated blood counts and up to 4 h of in-hospital observation are typically recommended. We aimed to assess complication rates and predictors in a large cohort of patients undergoing US-PLB across three Italian tertiary centres.

Liver transplantation for hepatitis D virus/hepatitis B virus coinfection in Italy: An intention-to-treat analysis of long-term outcomes.

Patients with hepatitis D virus (HDV)/hepatitis B virus (HBV)-related end-stage liver disease candidates for liver transplantation (LT) have traditionally been regarded as a special population, although their outcomes are controversial. An intention-to-treat (ITT) analysis of long-term outcomes of HDV/HBV-coinfected patients waitlisted for LT in Italy, between 2011 and 2020, was performed and compared with HBV-monoinfected LT candidates. Of 1731 HBV-infected LT candidates, 1237 (71.

Long-term outcomes of Yttrium-90 transarterial radioembolization for patients with hepatocellular carcinoma.

Aims: We retrospectively assessed the long-term outcomes of Yttrium-90 (Y) transarterial radioembolization (TARE) for hepatocellular carcinoma (HCC), focusing on overall survival (OS), radiological response, and safety.

Methods: We included patients with HCC treated with Y TARE at a single center between January 2012 and December 2021 with measurable lesions and a minimum of 2 years of follow-up. Only the former was analyzed for patients with multiple TARE.

Assessment of Response and Safety of Bulevirtide Treatment in Patients with Chronic Delta Virus Infection: The ARISTOTLE Pilot Observational Study.

Introduction: Hepatitis D virus (HDV) infection remains a significant global health challenge due to its severity and high risk of progression to cirrhosis and hepatocellular carcinoma (HCC). Bulevirtide, a novel HDV entry inhibitor, has shown promise in managing chronic hepatitis D by blocking viral entry into hepatocytes. This study evaluated the efficacy and safety of bulevirtide in reducing HDV RNA levels and improving liver function in a real-life cohort of Italian patients with HDV infection.

Deep learning helps discriminate between autoimmune hepatitis and primary biliary cholangitis.

Background & Aims: Biliary abnormalities in autoimmune hepatitis (AIH) and interface hepatitis in primary biliary cholangitis (PBC) occur frequently, and misinterpretation may lead to therapeutic mistakes with a negative impact on patients. This study investigates the use of a deep learning (DL)-based pipeline for the diagnosis of AIH and PBC to aid differential diagnosis.

Methods: We conducted a multicenter study across six European referral centers, and built a library of digitized liver biopsy slides dating from 1997 to 2023.

Hepatotoxicity in Cancer Immunotherapy: Diagnosis, Management, and Future Perspectives.

Cancer immunotherapy, particularly immune checkpoint inhibitors, has positively impacted oncological treatments. Despite its effectiveness, immunotherapy is associated with immune-related adverse events (irAEs) that can affect any organ, including the liver. Hepatotoxicity primarily manifests as immune-related hepatitis and, less frequently, cholangitis.

Real-world effectiveness and safety of bulevirtide monotherapy for up to 96 weeks in patients with HDV-related cirrhosis.

Background & Aims: Bulevirtide (BLV) 2 mg/day is EMA approved for the treatment of compensated chronic HDV infection; however, real-world data in large cohorts of patients with cirrhosis are lacking.

Methods: Consecutive HDV-infected patients with cirrhosis starting BLV 2 mg/day from September 2019 were included in a European retrospective multicenter real-world study (SAVE-D). Patient characteristics before and during BLV treatment were collected.

Antibiotic Stewardship Based on Colonization with Multi-Drug-Resistant Bacteria in Liver Transplantation: A Narrative Review.

In solid organs post-transplant, bacterial infections can complicate the course of recovery with devastating consequences, such as graft loss and death. We provide an expert review on early post-liver transplant bacterial infections, with a focus on infections with multi-drug-resistant organism (MDRO) etiologies. Best practice recommendations are derived from a combination of available evidence and expert consensus.

Noninvasive Assessment of Portal Hypertension in Patients With Primary Biliary Cholangitis Is Affected by Severity of Cholestasis.

Background & Aims: Noninvasive tests (NITs) for ruling-out clinical significant portal hypertension (CSPH) and high-risk varices (HRVs) in patients with primary biliary cholangitis (PBC) and compensated advanced chronic liver disease (cACLD) are lacking. We evaluated NITs in these patients and the influence of cholestasis on their performance.

Methods: Consecutive patients from the "Italian PBC registry" and 2 United Kingdom large-volume PBC referral centers with upper endoscopy within 6 months from biochemical evaluation and transient elastography were included.

Percutaneous management of chronic total occlusion of the portal vein: a retrospective analysis of technical aspects and outcomes.

Background: Chronic total occlusion (CTO) of the portal vein is one of the main causes of portal hypertension, which may result in life-threatening complications often managed by interventional radiology (IR). The aim of this study is to report the innovative experience with percutaneous revascularization therapy in the management of portal vein CTO in paediatric and adult patients.

Materials And Methods: From January 2020 to December 2023 consecutive paediatric and adult patients with severe portal hypertension resulting from portal vein CTO who underwent attempts at percutaneous recanalization were retrospectively reviewed.

Link between persistent, unexplained gamma-glutamyltransferase elevation and porto-sinusoidal vascular disorder.

Background & Aims: Porto-sinusoidal vascular disorder (PSVD) is a group of vascular disorders characterized by lesions involving portal venules and sinusoids, irrespective of the presence of portal hypertension. Liver biopsy is essential for diagnosis. In a single-center study, we demonstrated high rates of PSVD in patients with persistently elevated gamma-glutamyltransferase (GGT).