Medison.Sang Bong Ahn has received grants from Hanwha, Samjin, Ildong, and Hanmi.Dae Won Jun has served as an advisory committee member of Sysmax, J2H, and Future medicine. He is a speaker for Gilead Sciences,
Antiplatelet therapy reduces the risk of HCC in chronic hepatitis B patients whose hepatitis B virus is effectively suppressed. However, antiplatelet therapy containing clopidogrel may increase the risk of bleeding. (Hepatology 2017;66:1556-1569).
In patients without HCC, rifaximin treatment was significantly associated with prolonged overall survival and reduced risks of spontaneous bacterial peritonitis, variceal bleeding and recurrent hepatic encephalopathy.
Nonalcoholic fatty liver disease (NAFLD), together with metabolic syndrome and obesity, has shown a rapid increase in prevalence worldwide and is emerging as a major cause of chronic liver disease and liver transplantation. Among the various phenotypes of NAFLD, nonalcoholic steatohepatitis (NASH) is highly likely to progress to development of end-stage liver disease and cardiometabolic disease, resulting in liver-related and non-liver-related mortality. Nonetheless, there is no standardized pharmacotherapy against NASH and many drugs are under development in ongoing clinical trials. To develop a successful anti-NASH drug, it is necessary to select an appropriate target population and treatment outcomes depending on whether the mode of action is anti-metabolic, anti-inflammatory or anti-fibrotic. Recently, innovative surrogate markers have been investigated to replace hard outcomes such as liver histology and mortality and reduce the clinical trial duration. Currently, several drugs with fast track designation are being tested in phase III clinical trials, and many other drugs have moved into phase II clinical trials. Both lean NAFLD and typical obese NAFLD have been extensively studied and genetic variants such as PNPLA3 and TM6SF2 have been identified as significant risk factors for lean NAFLD. In the near future, noninvasive biomarkers and effective targeted therapies for NASH and associated fibrosis are required to develop precision medicine and tailored therapy according to various phenotypes of NAFLD.
The increasing prevalence of Klebsiella pneumoniae liver abscess in Asian countries is attributable to virulent strains of the K1 serotype. We investigated the risk factors for the K1 serotype K. pneumoniae liver abscess. A case-control study was performed using the database of a nationwide study of liver abscess in Korea. Multivariate logistic regression analysis was performed for 78 cases of the K1 serotype K. pneumoniae liver abscess and 81 controls with non-Klebsiella. Diabetes mellitus was the significant risk factor (OR 2.13; 95% CI 1.026 approximately 4.428; P = 0.042) for the K1 serotype K. pneumoniae liver abscess. Biliary disorders had a strong negative association (OR 0.18; 95% CI 0.078 approximately 0.410; P < 0.001). This study suggests that diabetes mellitus is a more significant risk factor for the K1 serotype K. pneumoniae liver abscess than for the non-Klebsiella liver abscess.
CLIF-SOFA enables more accurate prediction of short-term mortality in patients with acutely decompensated alcoholic cirrhosis than other available scoring systems and is useful in predicting both 12-week mortality and the need for mechanical support after liver transplantation.
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