MAFLD considerations as a part of the global hepatitis C elimination effort: an international perspective

Fouad, Yasser; Lazarus, Jeffrey V.; Negro, Francesco; Peck‐Radosavljevic, Markus; Sarin, Shiv Kumar; Ferenci, Péter; Esmat, Gamal; Ghazinian, Hasmik; Nakajima, Atsushi; Silva, Marcelo; Lee, Samuel; Colombo, Massimo

doi:10.1111/apt.16346

Cited by 26 publications

(9 citation statements)

References 110 publications

(210 reference statements)

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“…Notably, those with concurrent MAFLD and CHC had more severe liver injury than those with either disease alone [68,69]. Therefore, experts have noted the importance of considering the management of MAFLD in the ongoing effort to eliminate HCV [70].…”

Section: Impact On Identification Of Coexistence Of Fatty Liver Disea...mentioning

confidence: 99%

Metabolic dysfunction-associated fatty liver disease: a year in review

Alharthi

Gastaldelli

Homer

et al. 2022

Current Opinion in Gastroenterology

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Purpose of reviewIn 2020, a novel comprehensive redefinition of fatty liver disease was proposed by an international panel of experts. This review aims to explore current evidence regarding the impact of this new definition on the current understanding of the epidemiology, pathogenesis, diagnosis, and clinical trials for fatty liver disease. Recent findingsThe effectiveness of metabolic dysfunction-associated fatty liver disease (MAFLD) was compared to the existing criteria for nonalcoholic fatty liver disease (NAFLD). Recent data robustly suggest the superior utility of MAFLD in identifying patients at high risk for metabolic dysfunction, the hepatic and extra-hepatic complications, as well as those who would benefit from genetic testing, including patients with concomitant liver diseases. This change in name and criteria also appears to have improved disease awareness among patients and physicians.

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Section: Impact On Identification Of Coexistence Of Fatty Liver Disea...mentioning

confidence: 99%

Metabolic dysfunction-associated fatty liver disease: a year in review

Alharthi

Gastaldelli

Homer

et al. 2022

Current Opinion in Gastroenterology

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“…As a result, a recent appeal for the MAFLD to be taken into account as part of the worldwide drive to eradicate HCV has been made by an international group of specialists on viral hepatitis. 17 18 19 20 21 Third, despite the fact that HBV-HCC accounts for a lesser percentage of cases of diagnosed HCC, which is likely primarily due to the implementation of a universal program for pediatric hepatitis B vaccination, the sharp rise in these instances over the research period is concerning. This pattern indicates the need for a free catch-up HBV vaccination program, more active case detection of HBV patients, and viral load management.…”

Section: Discussionmentioning

confidence: 99%

Changes in the Etiologies of Liver Cancer in Upper Egypt over a Decade from 2010 to 2020: A Single Tertiary Care Center Study

Fouad

Gaber

Alem

et al. 2023

South Asian J Cancer

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The profile of liver diseases in Egypt is changing dramatically and viral hepatitis is declining, while the fatty liver disease is increasing dramatically. However, the impact of these changes on the profile of hepatocellular carcinoma (HCC) remains uncertain. Therefore, we determined the temporal trends in the etiologies of HCC in Egypt over a decade. We retrospectively analyzed data from consecutive patients who were diagnosed with HCC over 10 years (2010–2020) in a large center in Upper Egypt. Standard tests were utilized to diagnose hepatitis C virus (HCV) and hepatitis B virus. In the absence of other liver disorders, the presence of obesity, or diabetes in the absence of other risk factors, metabolic dysfunction-associated fatty liver disease (MAFLD) was diagnosed. A total of 1,368 HCC patients were included, in which 985 (72%) had HCV, 58 (4%) had hepatitis B virus, and 143 (10.5%) had MAFLD, 1 patient had hemochromatosis, 1 had autoimmune liver disease, and 180 (13%) patients were with unknown cause. The annual proportions of MAFLD-related HCC were increased significantly between 8.3% in 2010 and 20.6% in 2020 (p = 0.001), while HCV-related HCC declined from 84.8 to 66.7% (p = 0.001). Throughout the study period, there were significant increases in the age at diagnosis of HCC, the proportion of female patients, obesity, diabetes, and less severe liver dysfunction at diagnosis (p < 0.05 for all). With the decline of HCV, MAFLD is becoming a major cause of HCC in Egypt, which has increased substantially over the past 10 years. This study urges the creation of comprehensive action strategies to address this growing burden.

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“…A recent meta-analysis estimated the pooled incidence of HCC development post-SVR amongst patients with cirrhosis and F3 fibrosis to be 2.1 and 0.5 per 100 patient years, respectively [ 48 ]. Application of MAFLD criteria has been proposed as one strategy which may be useful to inform surveillance strategies [ 49 ], however, studies to assess HCC incidence rates post-SVR in MAFLD vs non-MAFLD cohorts, both in cirrhosis and F3 fibrosis are waiting to be done.…”

Section: Combined Aetiology Hccmentioning

confidence: 99%

MAFLD: an optimal framework for understanding liver cancer phenotypes

et al. 2023

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Hepatocellular carcinoma has a substantial global mortality burden which is rising despite advancements in tackling the traditional viral risk factors. Metabolic (dysfunction) associated fatty liver disease (MAFLD) is the most prevalent liver disease, increasing in parallel with the epidemics of obesity, diabetes and systemic metabolic dysregulation. MAFLD is a major factor behind this sustained rise in HCC incidence, both as a single disease entity and often via synergistic interactions with other liver diseases. Mechanisms behind MAFLD-related HCC are complex but is crucially underpinned by systemic metabolic dysregulation with variable contributions from interacting disease modifiers related to environment, genetics, dysbiosis and immune dysregulation. MAFLD-related HCC has a distinct clinical presentation, most notably its common occurrence in non-cirrhotic liver disease. This is just one of several major challenges to effective surveillance programmes. The response of MAFLD-related HCC to immune-checkpoint therapy is currently controversial, and is further complicated by the high prevalence of MAFLD in individuals with HCC from viral aetiologies. In this review, we highlight the current data on epidemiology, clinical characteristics, outcomes and screening controversies. In addition, concepts that have arisen because of the MAFLD paradigm such as HCC in MAFLD/NAFLD non-overlapping groups, dual aetiology tumours and MAFLD sub-phenotypes is reviewed.

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MAFLD considerations as a part of the global hepatitis C elimination effort: an international perspective

Cited by 26 publications

References 110 publications

Metabolic dysfunction-associated fatty liver disease: a year in review

Metabolic dysfunction-associated fatty liver disease: a year in review

Changes in the Etiologies of Liver Cancer in Upper Egypt over a Decade from 2010 to 2020: A Single Tertiary Care Center Study

MAFLD: an optimal framework for understanding liver cancer phenotypes

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