Publications by authors named "Victor de Ledinghen"
Background & Aims: Hypertension is common in metabolic dysfunction-associated steatotic liver disease (MASLD), but its impact on long-term clinical outcomes and disease progression remains unclear. This study investigated the association of hypertension and risk of adverse clinical outcomes and progression of liver stiffness/fibrosis in MASLD.
Methods: Three multicenter prospective cohorts were analyzed: the UK BioBank (UKBB) cohort to assess the risk of adverse clinical outcomes, the VCTE-Prognosis cohort to assess liver stiffness/fibrosis progression, and the Paired Liver Biopsy cohort to assess histologic liver fibrosis progression.
Deep learning radiomics of elastography for diagnosing compensated advanced chronic liver disease: an international multicenter study.
Vis Comput Ind Biomed Art
August 2025
Accurate, noninvasive diagnosis of compensated advanced chronic liver disease (cACLD) is essential for effective clinical management but remains challenging. This study aimed to develop a deep learning-based radiomics model using international multicenter data and to evaluate its performance by comparing it to the two-dimensional shear wave elastography (2D-SWE) cut-off method covering multiple countries or regions, etiologies, and ultrasound device manufacturers. This retrospective study included 1937 adult patients with chronic liver disease due to hepatitis B, hepatitis C, or metabolic dysfunction-associated steatotic liver disease.
View Article and Find Full Text PDFLongitudinal Changes in Fibrosis Markers: Monitoring Stiffness/Fibrosis Progression and Prognostic Outcomes in MASLD.
Clin Gastroenterol Hepatol
July 2025
Background & Aims: Fibrosis-4 Index (FIB-4) is a noninvasive tool for assessing liver fibrosis in metabolic dysfunction-associated steatotic liver disease (MASLD). However, its role of dynamic FIB-4 for assessing fibrosis progression and predicting clinical outcomes remains unclear. The aim of this study was to examine the association between changes in FIB-4 and changes in liver stiffness, fibrosis progression, and outcomes in MASLD.
View Article and Find Full Text PDFA Novel Risk Prediction Model for Hepatocellular Carcinoma in MASLD: A Multinational, Multicenter Cohort Study.
Clin Gastroenterol Hepatol
July 2025
Background And Aims: It is unclear that which cardiometabolic risk factors (CMRFs) are significantly associated with hepatocellular carcinoma (HCC) development in metabolic dysfunction-associated steatotic liver disease (MASLD). We aimed to develop and validate a novel CMRF-based HCC risk prediction model in MASLD.
Methods: This multicenter cohort study recruited 77,677 MASLD patients from 20 medical centers in Korea and other Asian and Western countries (2004-2023).
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).
Background: Metabolic dysfunction-associated steatotic liver disease (MASLD) affects over 30% of the general population and is the fastest growing cause of hepatocellular carcinoma (HCC). Current guidelines recommend HCC surveillance in patients with cirrhosis when annual HCC incidence exceeds 1% without specifying the role of non-invasive tests in patient selection.
Objective: To define non-invasive test thresholds to select patients with MASLD for HCC surveillance.
Aims: Central venous pressure (CVP) is an important variable in assessing heart failure (HF) patients. However, invasive CVP measurement using right heart catheterization is associated with potential complications, and accurate measurement requires careful attention to technique. In this multicentre pilot study, we aimed to evaluate whether non-invasively measured liver stiffness can be used to assess CVP in patients with HF.
View Article and Find Full Text PDFEffect of Antidiabetic Drug Classes on the Risk of Liver-Related Events in Individuals With T2D and MASLD.
Clin Gastroenterol Hepatol
June 2025
Background: We investigated the use of type 2 diabetes (T2D) medications, including pioglitazone, glucagon-like peptide-1 receptor agonists (GLP-1RAs), and sodium-glucose cotransporter-2 (SGLT-2) inhibitors, in individuals with T2D and metabolic dysfunction-associated steatotic liver disease (MASLD), and explored the effect of these medications on long-term risk of liver-related events (LREs) and progression of liver stiffness in a retrospective cohort study.
Methods: We enrolled 7867 individuals with T2D and MASLD from 16 tertiary referral centers between February 2004 and January 2023. We recorded the use of pioglitazone, GLP-1RAs, and SGLT-2 inhibitors and analyzed the effects of these antihyperglycemic medications on the risk of developing incident LREs and the progression of liver stiffness over a median of 5.
Background & Aims: The absence of hepatic fat in advanced fibrosis has been documented in metabolic dysfunction-associated steatotic liver disease ("burnt-out" MASLD). However, whether hepatic fat loss occurs continuously with fibrosis progression is controversial. We proposed a "burning-out" concept to describe this process and analyze the long-term outcomes of "burnt-out" and "burning-out" MASLD.
View Article and Find Full Text PDFIntestinal failure-associated liver disease in adult patients with chronic intestinal failure receiving home parenteral nutrition: A descriptive cohort study.
JPEN J Parenter Enteral Nutr
May 2025
Background: Intestinal failure-associated liver disease (IFALD) is a major complication of chronic intestinal failure. Few data exist about hepatic monitoring of IFALD using the liver stiffness measurement. The aim of this study was to provide a descriptive analysis of IFALD and its prevalence in a tertiary center and to determine the IFALD risk factors and high liver stiffness measurement values using FibroScan.
View Article and Find Full Text PDFBackground & Aims: Whether the dynamics of non-invasive tests (NITs) correlate with hepatocellular carcinoma (HCC) risk in patients with cirrhosis following sustained virological response (SVR) remains unknown. Thus, we aimed to describe NIT dynamics and assess their correlation with HCC risk.
Methods: The dynamics of NITs (fibrosis-4 index [FIB-4], aspartate aminotransferase-to-platelet ratio index [APRI] and liver stiffness measurement) were described in patients with cirrhosis after SVR included in two prospective French multicenter cohorts (ANRS CO22 Hepather and CO12 CirVir) between 2006 and 2015.
Background & Aims: Current guidelines recommend a two-step approach for risk stratification in patients with metabolic dysfunction-associated steatotic liver disease (MASLD) involving Fibrosis-4 index (FIB-4) followed by liver stiffness measurement (LSM) by vibration-controlled transient elastography (VCTE) or similar second-line tests. This study aimed to examine the prognostic performance of this approach.
Methods: The VCTE-Prognosis study was a longitudinal study of patients with MASLD who had undergone VCTE examinations at 16 centres from the US, Europe and Asia with subsequent follow-up for clinical events.
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.
Background & Aims: The accuracy of non-invasive tests (NITs) should be ≥80% (EASL recommendation). We aimed to compare the accuracies of the recommended NITs for advanced fibrosis in metabolic dysfunction-associated steatotic liver disease (MASLD) and to develop NITs with improved accuracy.
Methods: A total of 1,051 patients with MASLD were allocated to derivation (n = 637) and validation (n = 414) sets.
Background: Patients with advanced chronic liver disease (ACLD) are at high risk of developing hepatocellular carcinoma (HCC). Therefore, biannual surveillance is recommended. This large-scale multicenter study aimed to stratify the risk of HCC development in ACLD.
View Article and Find Full Text PDFacFibroMASH Index for the Diagnosis of Fibrotic MASH and Prediction of Liver-related Events: An International Multicenter Study.
Clin Gastroenterol Hepatol
April 2025
Article Synopsis
- Scientists studied a health problem called MASH, which affects people's livers, and worked on two tests to help doctors tell if someone has it.
- They looked at data from over 3,000 people to make sure their first test, called acMASH, worked well, and then created a new test called acFibroMASH to find more severe cases.
- The new acFibroMASH test was better at predicting who might have future liver problems compared to another test, showing it's a useful tool for doctors to keep patients healthy.
Ultraportable Quantitative Ultrasound for Hepatic Steatosis Assessment.
Ultrasound Med Biol
December 2024
Article Synopsis
- * The study found that specific QUS parameters demonstrated high reliability and correlation with controlled attenuation parameter (CAP), indicating accurate assessment of liver fat levels.
- * The research concludes that QUS can be effectively used on portable devices, offering a convenient method for large-scale screening and monitoring of liver fat.
Article Synopsis
- Direct-acting antivirals (DAAs) have improved treatment for chronic hepatitis C (HCV), but there is a lack of focus on the risk of liver-related events (LREs) after achieving sustained virological response (SVR), which this study aims to address with the AI-Safe-C score.
- The AI-Safe-C score, developed using data from 913 non-cirrhotic HCV patients, assesses the risk of LREs by considering factors like liver stiffness measurement (LSM), age, and sex, showing high prediction accuracy in validation cohorts from Korea, Hong Kong, and France.
- This score is essential for identifying non-cirrhotic patients at risk of developing LREs
Article Synopsis
- * Out of 230 patients evaluated, TE showed strong diagnostic accuracy for detecting cirrhosis and advanced fibrosis, with area under the receiver operating characteristic curves of 0.88 and 0.86, outperforming other non-invasive tests.
- * The findings suggest that LSM values above 10 kPa indicate a high probability of advanced fibrosis, while values below 6 kPa almost completely rule out significant fibrosis, necessitating further discussion for values between 6 and 10 kPa.
Article Synopsis
- Bulevirtide is a new antiviral therapy specifically designed to treat chronic hepatitis D, and researchers aimed to understand its effectiveness alone and in combination with pegylated-interferon (Peg-IFN).
- Mathematical modeling of data from 183 patients showed that bulevirtide effectively blocks cell infection by 90.3%, while Peg-IFN blocks viral production at 92.4%, leading to enhanced outcomes when combined.
- Results indicated that combining bulevirtide with Peg-IFN resulted in a higher rate of viral decline and a better chance of achieving a cure, suggesting the need for further randomized clinical trials to assess treatment effectiveness.
Article Synopsis
- Statins provide multiple benefits for patients with metabolic-associated steatotic liver disease (MASLD), particularly in reducing long-term risks of all-cause mortality and liver-related clinical events (LREs).
- A study followed 7988 patients for nearly 4.6 years, revealing that statin users had significantly lower risks of mortality (HR=0.233) and LREs (HR=0.380), as well as slower liver stiffness progression rates.
- While statin usage is linked to a decrease in the progression of liver stiffness, it did not significantly correlate with liver stiffness regression, suggesting a complex relationship in liver health management.
Background & Aims: In France, bulevirtide (BLV) became available in September 2019 through an early access program to treat patients with HDV. The aim of this analysis was to evaluate the efficacy and safety of BLV in patients with HIV and HDV coinfection.
Methods: Patients received BLV 2 mg ± pegylated interferon-α (pegIFNα) according to the physician's decision.
Dynamics of Liver Stiffness Measurement and Clinical Course of Primary Biliary Cholangitis.
Clin Gastroenterol Hepatol
December 2024
Article Synopsis
- The study investigates the prognostic value of changes in liver stiffness measurement (LSM) over time in patients with primary biliary cholangitis (PBC) who are being treated with ursodeoxycholic acid.
- It utilizes data from 3,078 patients over a 19-year period, finding that 59% of participants had an increase in LSM, which is linked to a higher risk of serious clinical events such as cirrhosis complications and liver transplants.
- The research concludes that monitoring LSM changes provides essential prognostic information, suggesting its potential as a valuable endpoint in clinical trials for PBC treatment.