In conclusion, we submit that H. pylori infection might, in fact, play a role in increasing the circulating levels of ammonia and endotoxins in cirrhotic patients, thus facilitating the onset of HE.

Background: Liver fibrosis is one of the chronic hepatitis B (CHB) indications for treatment. Objectives: We aimed to assess the fibrosis index, FIB-4, King's fibrosis score, albumin-bilirubin (ALBI) score, gamma-glutamyl transferase-platelets (GPR), and gamma-glutamyl transferase-albumin (GAR) ratios as diagnostic models of liver fibrosis in CHB patients. Methods: The study enrolled 217 patients. Liver fibrosis was assessed by transient elastography, which showed 20.3% of the patients had F4 fibrosis. Treatment was given for 33.20 ± 20.94 months. Results: F4 fibrosis patients had higher values (P = 0.001) of Fibrosis index score, FIB-4 score, King's fibrosis score, ALBI score, GPR, and GAR than non-F4 fibrosis patients. All patients had improved values after treatment. The mean treatment-induced changes were comparable in patients with and without virological response. The Fibrosis index of >-32.66 showed 63.64% sensitivity and 91.33% specificity. The FIB-4 score of > 1.88 had 72.73% sensitivity and 91.33% specificity. The King's fibrosis score of > 7.93 demonstrated 90.91% sensitivity and 73.99% specificity. The ALBI score of >-2.7 had 70.45% sensitivity and 86.13% specificity. The GPR value of > 0.69 revealed 70.5% sensitivity and 94.2% specificity. The GAR value of > 1.28 showed 72.73% sensitivity and 46.4% specificity. The GAR was inferior to FIB-4 and GPR (P < 0.05). Conclusions: GPR, fibrosis index, King's fibrosis score, ALBI, and FIB-4 are useful diagnostic models of liver fibrosis in CHB patients.

Background Hepatocellular carcinoma (HCC) remains a major health problem despite the emergence of several preventive and therapeutic modalities. HCC has heterogeneous and wide morpho-molecular patterns, resulting in unique clinical and prognostic criteria. Therefore, we aimed to study the clinical and pathological criteria of HCC to update the morpho-molecular classifications and provide a guide to the diagnosis of this disease. Methods Five hundred thirty pathologically analyzed HCC cases were included in this study. The clinical and survival data of these cases were collected. Results Hepatitis C virus is still the dominant cause of HCC in Egypt. Post-direct-acting antiviral agent HCC showed an aggressive course compared to interferon-related HCC. Old age, male gender, elevated alpha-fetoprotein level, tumor size, and background liver were important prognostic parameters. Special HCC variants have characteristic clinical, laboratory, radiological, prognostic, and survival data. Tumor-infiltrating lymphocytes rather than neutrophil-rich HCC have an excellent prognosis. Conclusions HCC is a heterogenous tumor with diverse clinical, pathological, and prognostic parameters. Incorporating the clinicopathological profile per specific subtype is essential in the treatment decision of patients with HCC. Trial registration This was a retrospective study that included 530 HCC cases eligible for analysis. The cases were obtained from the archives of the Pathology Department, during the period between January 2010 and December 2019. Clinical and survival data were collected from the patients’ medical records after approval by the institutional review board (IRB No. 246/2021) of Liver National Institute, Menoufia University. The research followed the guidelines outlined in the Declaration of Helsinki and registered on ClinicalTrials.gov (NCT05047146).

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