Liver international: official journal of the International Association for the Study of the Liver (Liver Int)

Publisher: International Association for the Study of the Liver, Wiley

Journal description

The general aim of Liver International is to promote all aspects of the science of hepatology from basic research to applied clinical studies. It is an international Journal providing a forum for the publication of high quality original research in hepatology. It provides an essential resource for all professionals concerned with normal and abnormal structure and function in the liver and its constituent cells and is intended for clinicians and basic scientists involved in the multi-disciplinary field of hepatology. It includes studies of pathobiology from experimental models and human material. Liver International welcomes articles from all fields of hepatology, which may be published as original articles, rapid communications, reviews, and letters to the Editor. Case reports will be accepted if the clinical problem is studied in detail and of sufficient interest in a wider context. Papers are normally evaluated by a peer review process involving at least two independent reviewers. Within the scope of the Journal, articles will be accepted on the basis of scientific quality, originality and up-to-date relevance.

Current impact factor: 4.41

Impact Factor Rankings

2015 Impact Factor Available summer 2015
2013 / 2014 Impact Factor 4.412
2012 Impact Factor 3.87
2011 Impact Factor 3.824
2010 Impact Factor 3.84
2009 Impact Factor 2.987
2008 Impact Factor 2.908
2003 Impact Factor

Impact factor over time

Impact factor
Year

Additional details

5-year impact 3.54
Cited half-life 3.70
Immediacy index 1.35
Eigenfactor 0.02
Article influence 1.04
Website Liver International website
Other titles Liver international (Online)
ISSN 1478-3231
OCLC 52034063
Material type Document, Periodical, Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Wiley

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    • 12 months embargo
  • Conditions
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    • On author's personal website, institutional repositories, arXiv, AgEcon, PhilPapers, PubMed Central, RePEc or Social Science Research Network
    • Author's pre-print may not be updated with Publisher's Version/PDF
    • Author's pre-print must acknowledge acceptance for publication
    • On a non-profit server
    • Publisher's version/PDF cannot be used
    • Publisher source must be acknowledged with citation
    • Must link to publisher version with set statement (see policy)
    • If OnlineOpen is available, BBSRC, EPSRC, MRC, NERC and STFC authors, may self-archive after 12 months
    • If OnlineOpen is available, AHRC and ESRC authors, may self-archive after 24 months
    • Publisher last contacted on 07/08/2014
    • This policy is an exception to the default policies of 'Wiley'
  • Classification
    ​ yellow

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Background & Aims: Hepatocellular carcinoma (HCC) has become a major cause of liver related death and indication to liver transplantation (LT) in patients with chronic hepatitis B virus (HBV) infection following the widespread adoption of antiviral therapy with nucleos(t)ide analogs (NUCs). Yet, the long-term outcome of patients undergoing liver transplantation for an HCC developed during effective NUC treatment is unknown. Methods: We evaluated 101 patients with persistently compensated cirrhosis who were consecutively transplanted for HCC in two centers in Milan. At LT, 91 (90%) patients had undetectable serum HBV DNA (<12 IU/mL) and 90 (89%) were within Milan criteria(MC).All patients received post transplant HBV prophylaxis with specific immunoglobulins (HBIgs) and NUCs. End-points were long-term patient survival and recurrence of HCC and HBV. Results: During 106 (range 3-165) months following LT, HCC recurred in 11 (11%) patients (9 beyond MC at explant, 2 within MC with HBV recurrence). Age (HR 1.1, 95%CI 1.0-1.2, p=0.04) and exceeding MC (HR 9.6, 95%CI 2.9-32, p<0.0001) were the only independent pretransplant predictors of tumor recurrence. The 10-year cumulative rate of HCC recurrence was 7% among patients transplanted within MC compared to 45% among those beyond MC al LT (p=0.004). Overall, 18 patients (18%, 9 HCC, 9 non liver-related events) died with a 10-year cumulative probability of overall and liver-related survival of 79% and 89%, respectively. Conclusions: Extended survival of HBV cirrhotics transplanted for HCC can be achieved by coupling MC at listing with persistent pharmacological suppression of HBV.
    Liver international: official journal of the International Association for the Study of the Liver 05/2015; DOI:10.1111/liv.12835
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    ABSTRACT: Background & AimsSteatosis accentuates the severity of hepatic ischemia-reperfusion injury (IRI); “statins” (HMG-CoA reductase inhibitors) protect the heart and brain against post-ischemic injury. We tested whether short-term administration of atorvastatin protects fatty livers in obese mice against IRI.Methods Mice with dietary or genetic simple steatosis (SS) or non-alcoholic steatohepatitis (NASH) were subjected to 60min partial hepatic ischemia/24hr reperfusion. Atorvastatin was injected intravenously (5mg/kg) 1hour (hr) before IRI. Liver injury, Toll-like receptor-4 (TLR4), cytokines/chemokines, iNOS/eNOS expression, eNOS activity and thromboxane B2 (TXB2) production were determined.ResultsIRI was exaggerated by 2-5-fold in SS and NASH compared to lean liver. Atorvastatin pre-treatment conferred 70-90% hepatic protection in all animals. Atorvastatin increased post-ischemic eNOS mRNA/protein and strikingly enhanced eNOS activity (by phospho-eNOS). It also attenuated microparticle (MP) production, NF-κB activation, significantly dampened post-ischemic thromboxane B2 production, induction of TNF-α, IL-6, MIP-1a, MCP-1, GM-CSF and vascular cell adhesion molecule-1 (VCAM), with a resultant reduction on macrophage and polymorphonuclear neutrophil recruitment. Upregulation of HMGB1 and TLR4 after IRI was marked in fatty livers; 1hr pre-treatment with atorvastatin reduced HMGB1 and TLR4 expression in all livers.Conclusions Acute (1hr) atorvastatin administration is highly hepatoprotective against IRI in NASH, fatty and lean livers. Key mechanisms include suppression of inflammation by prevention of NF-κB activation, microvascular protection via eNOS activation and suppression of TXB2 and MP release. Short-term intravenous statin treatment is a readily available and effective preventive agent against hepatic IRI, irrespective of obesity and fatty liver disease, and merits clinical trials in at-risk patients.This article is protected by copyright. All rights reserved.
    Liver international: official journal of the International Association for the Study of the Liver 03/2015; DOI:10.1111/liv.12827
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    ABSTRACT: We read with interest the article by Sato et al., in which serum fetuin-A level was found to be associated with liver fibrosis-related markers and proposed as an useful biomarker for predicting liver fibrosis progression in ultrasound diagnosed nonalcoholic fatty liver disease (NAFLD) patients (1). We would like to share our thoughts and contributions to the original study. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Liver international: official journal of the International Association for the Study of the Liver 03/2015; DOI:10.1111/liv.12826
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    ABSTRACT: I read with interest the wide long-term one centre experience on liver transplant (LT) for Budd-Chiari Syndrome (BCS) recently published in Liver International (1). Together with other previous data, the paper confirms that myeloproliferative neoplasms are not a contraindication for LT in BCS, since they do not seem to significantly affect the outcome after LT. However, as often happening with rare diseases, the experiences published are hardly sufficiently powered to reach adequate statistically significance. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Liver international: official journal of the International Association for the Study of the Liver 03/2015; DOI:10.1111/liv.12828
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    ABSTRACT: There is no doubt that resin and glass (90) Y-loaded microspheres have different specific activities (Bq per sphere) and, hence, the total amount of spheres needed to ensure an adequate radiobiological effect is different. Therefore, we may agree to the semantic issue put forward by Dr. Garin et al. However, we disagree with the argument that the use of the term radioembolization would generate a misinterpretation of the substantial (clinical) message we provided by comparing selective internal radiation therapy (SIRT) with systemic therapy based on sorafenib administration. Indeed, to the best of our knowledge, there is no evidence that one type of microspheres (glass or resin) is superior to the other one for the outcomes we considered, i.e. tumor response, toxicity and patient survival. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Liver international: official journal of the International Association for the Study of the Liver 03/2015; DOI:10.1111/liv.12823
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    ABSTRACT: We welcome the response from Fernandes et al regarding our recently published study (1). We fully agree that the ELF test is a good non-invasive marker for advanced fibrosis. In our study we utilized the manufacturer's recommended cut-off of ≥9.8 for severe fibrosis (2) since we believe this single cut-off value enables comparison of results across studies and facilitates development of a universal algorithm to guide clinical practice, in the absence of liver biopsy. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Liver international: official journal of the International Association for the Study of the Liver 03/2015; DOI:10.1111/liv.12822
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    ABSTRACT: We appreciate the comments of Zhao et al. (1) on the topic of the current use of technetium-99m-labeled macroaggregated albumin (MAA) lung scan for detecting intrapulmonary vascular dilations (IPVDs) as a criterion for detecting hepatopulmonary syndrome (HPS). As mentioned in our review (2), the presence of IPVDs is documented either on microbubble transthoracic echocardiography (MTTE) or MAA scan. Clinical recommendations on screening for HPS were mainly based on the European Respiratory Society Task Force guideline (3). MTTE has always been considered the gold standard for detecting HPS based on clinical studies. Important advantages include (1) its high sensitivity to detect IPVDs, (2) its possibility to distinguish intrapulmonary from intracardiac shunting and (3) the additional possibility of screening for portopulmonary hypertension (2-4). On the other hand, HPS can be diagnosed and the degree of shunting can even be quantified on MAA scan (2-4). This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Liver international: official journal of the International Association for the Study of the Liver 03/2015; DOI:10.1111/liv.12821
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    ABSTRACT: We read with great interest the study by Graupera et al (1). The authors prospectively assessed adrenal function in 36 cirrhotic patients with severe acute variceal bleeding (AVB) and 26 non-cirrhotic patients with peptic ulcer bleeding, using the standard-dose short synacthen test (SST) according to a consensus from an international task force of Critical Care (2). The prevalence of relative adrenal insufficiency (RAI) was similar between groups (22% vs. 24%). The major finding of this study was that the probability of survival without further bleeding at 45 days was significantly lower in patients with acute variceal bleeding and RAI than in patients without RAI (25% vs. 68%); however, in the group of patients with ulcer bleeding, RAI was not associated with bleeding outcomes. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Liver international: official journal of the International Association for the Study of the Liver 03/2015; DOI:10.1111/liv.12820
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    ABSTRACT: Current clinical assays for total 25-hydroxy(OH) vitamin D measure vitamin D bound to vitamin D binding protein (DBP) and albumin plus unbound ("free") D. We investigated the relationship between total and free 25(OH)D with bone metabolism markers in normal(>3.5g/dL) versus low(≤3.5g/dL) albumin cirrhotics. 82 cirrhotics underwent measurement of free and total 25(OH)D by immunoassay, DBP, and markers of bone metabolism (intact parathyroid hormone(iPTH), C-telopeptide(CTX), bone-specific alkaline phosphatase(BSAP), osteocalcin, amino-terminal pro-peptide of type 1-collagen(P1NP)). Pearson coefficients assessed relevant associations. Cirrhotics with low(n=54) vs. normal(n=28) albumin had lower total 25(OH)D(12.1vs.21.7ng/mL), free 25(OH)D(6.2vs.8.6pg/mL), and DBP(91.4vs.140.3ug/mL) [p<0.01 for each]. iPTH was similar in low and normal albumin groups(33vs.28pg/mL; p=0.38), although serum CTX(0.46vs.0.28ng/mL) and BSAP(31.7vs.24.8ug/L) were increased (p<0.01). An inverse relationship was observed between total 25(OH)D and iPTH in normal(r=-0.47, p=0.01) but not low albumin cirrhotics(r=0.07, p=0.62). Similar associations were seen between free 25(OH)D and iPTH(Normal: r=-0.46, p=0.01; Low: r=-0.03, p=0.84). BSAP, osteocalcin, and P1NP were elevated above the normal range in all cirrhotics but not consistently associated with total or free 25(OH)D. Cirrhotics with low versus normal albumin have lower levels of DBP, total and free 25(OH)D. The expected relationship between total or free 25(OH)D with iPTH was observed in normal but not low albumin cirrhotics, demonstrating that total 25(OH)D is not an accurate marker of bioactive vitamin D status in cirrhotics with synthetic dysfunction. Additional investigation into the role of vitamin D supplementation and its impact on bone mineral homeostasis in this population is needed. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Liver international: official journal of the International Association for the Study of the Liver 03/2015; DOI:10.1111/liv.12819
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    ABSTRACT: Thrombocytosis is associated with metastasis in many human cancers. Most hepatocellular carcinomas (HCC) develop in cirrhotic livers, which are characterized by thrombocytopenia. We aimed to elucidate the pretreatment platelet count in prediction of extrahepatic metastasis of HCC during the follow-up. Three cohorts containing 1660, 480, and 965 HCC patients enrolled from three hospitals were used for discovery and validation, respectively. Pretreatment clinical factors associated with extrahepatic metastasis during follow-up up to 5 years were identified using multivariate Cox regression model. In early-stage HCC (BCLC stage 0-A), pretreatment platelet count (hazard ratio [HR], 1.04 per 10,000/μL; 95% CI, 1.01-1.07; P = 0.010) and serum alpha-fetoprotein (AFP) > 100 ng/mL (HR, 1.70; 95% CI, 1.04-2.78; P = 0.033) were the only two independent factors associated with extrahepatic metastasis. Receiver operating characteristic evidenced that pretreatment platelet count predicted metastasis better than AFP did. Survival tree analysis identified platelet counts < 118,000/μL (HR, 0.49; 95% CI, 0.38-0.63; P < 0.001) or > 212,000/μL (HR, 2.12; 95% CI, 1.67-2.70; P < 0.001) to categorize patients into low and high risk of metastasis subgroups, which were verified using both validation cohorts. Pretreatment platelet count is a reliable marker to predict extrahepatic metastasis of early-stage HCC following curative treatment. Cirrhotic thrombocytopenia contributes to relatively low metastasis incidence of HCC than many other cancers. High platelet count identifies a subgroup of HCC patients at high risk of metastasis, who might benefit from adjuvant therapies following initial curative treatment. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Liver international: official journal of the International Association for the Study of the Liver 03/2015; DOI:10.1111/liv.12817
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    ABSTRACT: Background & AimsHepatitis C virus (HCV) is associated with development of B-cell non-Hodgkin lymphoma (HCV-NHL). Antiviral therapy (AVT) is prioritized in HCV-infected patients with significant fibrosis/cirrhosis. It is unknown whether current recommendations based on liver parameters cover the risk of HCV-NHL development. We aimed to evaluate the liver disease stages of patients with HCV-NHL.MethodsHCV-NHL patients seen at MD Anderson Cancer Center between 2008-2014 were evaluated for underlying liver disease within a year of HCV-NHL diagnosis by non-invasive fibrosis markers, radiology or liver biopsy. Included patients were observed retrospectively (2008 – 2012) or prospectively (2012 – 2014).ResultsEighty nine patients with HCV-NHL were evaluated. Most patients had genotype 1 (62%) infection, had diffuse large B cell lymphomas (62%), and detectable HCV RNA (90%) at NHL diagnosis. Notably, advanced liver disease (Metavir stage ≥ 3) was present in only 18% of the patients at the time of HCV-NHL diagnosis. All 53 patients with chronic HCV infection documented before lymphoma diagnosis were seen by HCV-treating physicians. Providers did not recommend AVT in almost one half of cases (44%), mostly because of the lack of advanced liver disease at HCV diagnosis (38%).Conclusions Most patients with HCV-NHL have mild liver disease at cancer diagnosis. Our findings suggest the need for early initiation of AVT in infected patients to eradicate HCV infection and its extra-hepatic manifestations. Treatment prioritization and cost must be weighed against the potential benefits of preventing NHL.This article is protected by copyright. All rights reserved.
    Liver international: official journal of the International Association for the Study of the Liver 03/2015; DOI:10.1111/liv.12825
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    ABSTRACT: We appreciated the article by Seo et al (1) that evaluated the accuracy of transient elastography (TE) in assessing liver fibrosis in patients with chronic hepatitis B (CHB) and chronic hepatitis C. In this article, the area under receiver operating characteristics curve in CHB patients was 0.774 for Metavir fibrosis ≥F2, 0.849 for ≥F3 and 0.902 for F4, respectively. These results were similar to previous studies. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Liver international: official journal of the International Association for the Study of the Liver 03/2015; DOI:10.1111/liv.12824
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    ABSTRACT: Background & aimMechanisms of non-responsiveness to peginterferon alfa-2a are not completely understood. Inadequate plasma levels may contribute to reduced response. The aim of this prospective, multicentre, crossover phase 1 study was to evaluate the pharmacokinetics and viral kinetics of intravenous versus subcutaneous peginterferon alfa-2a in patients with genotype 1 chronic hepatitis C infection who showed null-response to previous peginterferon/ribavirin.Methods Patients were randomized in 4 treatment arms to subcutaneous or intravenous peginterferon alfa-2a 180μg, once or twice weekly for two weeks. After a wash-out phase of 6 weeks patients first receiving intravenous administration switched to subcutaneous or vice versa for additional two weeks.ResultsIntravenous administration resulted in a stronger and faster decline in HCV RNA with a maximum decline of 1.17 log10 vs. 0.41 log10 after application of pegylated interferon once weekly and 1.32 log10 vs. 0.54 log10 and twice weekly. Pharmacokinetic studies revealed significantly higher maximum concentration (Cmax) 0-12 h and Cmax 0-7 d following intravenous administration, irrespective of dosing frequency A rapid rebound in HCV RNA was observed in all treatment arms. Adverse events occurred more frequently following intravenous administration.Conclusion Intravenous administration of peginterferon alfa-2a results in considerably higher plasma concentration and a stronger decline in HCV RNA and offers an interesting approach in order to overcome interferon non-responsive-state in patients with full null-response to previous peginterferon/ribavirin combination therapy.
    Liver international: official journal of the International Association for the Study of the Liver 03/2015; DOI:10.1111/liv.12832
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    ABSTRACT: Background & AimsHepatocellular carcinoma (HCC) is the second most common cause of cancer deaths worldwide. The global HCC BRIDGE study was a multi-regional, large-scale, longitudinal cohort study undertaken to improve understanding of real-life management of patients with HCC, from diagnosis to death.Methods Data were collected retrospectively from January 2005 to September 2012 by chart reviews of eligible patients newly diagnosed with HCC at participating institutions.ResultsForty-two sites in 14 countries contributed final data for 18,031 patients. Asia accounted for 67% of patients, Europe for 20%, and North America for 13%. As expected, the most common risk factor was hepatitis C virus in North America, Europe and Japan, and hepatitis B virus in China, South Korea and Taiwan. The most common Barcelona Clinic Liver Cancer stage at diagnosis was C in North America, Europe, China and South Korea, and A in Taiwan and Japan. Across all stages, first HCC treatment was most frequently transarterial chemoembolization in North America, Europe, China and South Korea, percutaneous ethanol injection or radiofrequency ablation in Japan and resection in Taiwan. Survival from first HCC treatment varied significantly by region, with median overall survival not reached for Taiwan and 60, 33, 31, 24 and 23 months for Japan, North America, South Korea, Europe and China, respectively (P<0.0001).Conclusions Initial results from the BRIDGE study confirm previously reported regional trends in patient demographic characteristics and HCC risk factors, document the heterogeneity of treatment approaches across regions/countries and underscore the need for earlier HCC diagnosis worldwide.This article is protected by copyright. All rights reserved.
    Liver international: official journal of the International Association for the Study of the Liver 03/2015; DOI:10.1111/liv.12818
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    ABSTRACT: Background Chronic hepatitis C virus (HCV) infection of the liver with either genotype 1 or genotype 3 gives rise to distinct pathologies and the two viral genotypes respond differently to antiviral therapy.Methods To understand these clinical differences, we compared gene transcription profiles in liver biopsies from patients infected with either gt1 or gt3, and uninfected controls.ResultsGt1-infected biopsies displayed elevated levels of transcripts regulated by Type I and Type III interferons (IFN), including genes that predict response to IFNα therapy. In contrast, genes controlled by IFNγ were induced in gt3-infected biopsies. Moreover, IFNγ levels were higher in gt3 infected biopsies. Analysis of hepatocyte-derived cell lines confirmed that the genes up-regulated in gt3 infection were preferentially induced by IFNγ. The transcriptional profile of gt3 infection was unaffected by IFNL4 polymorphisms, providing a rationale for the reduced predictive power of IFNL genotyping in gt3-infected patients.Conclusions The interactions between HCV genotypes 1 and 3 and hepatocytes are distinct. These unique interactions provide avenues to explore the biological mechanisms that drive viral genotype-specific differences in disease progression and treatment response. A greater understanding of the distinct host-pathogen interactions of the different HCV genotypes is required to facilitate optimal management of HCV infection.
    Liver international: official journal of the International Association for the Study of the Liver 03/2015; DOI:10.1111/liv.12830
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    ABSTRACT: A considerable proportion of patients receiving liver transplants for Budd-Chiari syndrome (BCS) suffer from myeloproliferative neoplasms (MPN). This study evaluated the long-term prognosis of liver-transplanted patients with BCS secondary to MPN and the effect of immunosuppression on MPN progression. A total of 78 patients with BCS were evaluated between 1982 and 2013. Of those, 40 patients suffered from polycythaemia vera (PV) and essential thrombocythaemia (ET). One patient had primary myelofibrosis (PMF). All patients received the standard immunosuppressive regimen. We retrospectively evaluated the long-term survival, clinical course and laboratory parameters of patients with MPN. 29/41 patients (71%) with MPN survived ≥ 3 years (mean age 36 ± 11 years; females n=27 [93%]). Mean follow-up after OLT was 12.4 ± 7.3 years (range 3-28 years). Five- and 10-year survival rates were not significantly different in patients with and without MPN (p=0.81 and p=0.66, resp.) or in patients with PV and ET (p=0.29 and p=0.55, respectively). Thrombosis and bleeding developed in 7/29 (24%) long-term MPN survivors with no significant difference between ET and PV (p=0.18). In the long-term follow-up there was no evidence of progression to overt myelofibrosis or acute myeloid leukaemia (AML). In the uni- and multivariate Cox -regression analyses, MPN did not influence survival after OLT. BCS patients with and without underlying MPN had similar long-term survival rates after OLT. There was no evidence of enhanced progression of MPN after OLT secondary to immunosuppressive therapy. However, major haemorrhage and recurrent thrombosis contributed to morbidity and mortality after OLT in those patients. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Liver international: official journal of the International Association for the Study of the Liver 03/2015; DOI:10.1111/liv.12816
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    ABSTRACT: First of all, from a semantic point of view, the use of the term "90Y radioembolization" is not entirely suitable. It is now well known that resin and glass 90Y-loaded microspheres possess different radiobiological properties (2) due to their highly different specific activities, namely with 50 Bq for resin microspheres versus 2500 Bq for glass microspheres, as well as the different amounts of spheres injected. Thus, just as for the drug used the product used for radioembolization must therefore be precisely defined, especially in the title or abstract, in order to avoid misinterpretation. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Liver international: official journal of the International Association for the Study of the Liver 02/2015; DOI:10.1111/liv.12811
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    ABSTRACT: Although a high viral load is an independent risk factor for recurrence of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after surgery, the prognostic impact of viral load on advanced HCC is unclear. This study investigated the impact of baseline HBV load and antiviral therapy on survival of patients with advanced HCC treated with sorafenib. 130 patients with advanced HBV-related HCC received first-line sorafenib therapy were evaluated in a multicenter, retrospective study. No patients experienced severe hepatic impairment due to HBV reactivation during sorafenib therapy. The median progression-free survival (PFS) and overall survival (OS) of all patients were 5.7 and 9.6 months, respectively. Patients with a baseline HBV DNA ≤10(4) copies/mL had significantly better OS than those with >10(4) copies/mL (10.4 vs 6.6 months; P = 0.002), but PFS showed an increasing trend (5.8 vs 4.8 months; P = 0.068). Patients who received antiviral therapy had a better trend in OS than those who didn't (12.0 vs 8.3 months; P=0.058), but there was no difference in PFS (6.4 vs 4.1 months; P = 0.280). In a multivariate analysis, the baseline HBV DNA level >10(4) copies/mL (P = 0.001; hazard ration [HR] = 2.294; 95% CI 1.429-3.676) and antiviral therapy (P = 0.038; HR 0.617; 95% CI 0.390-0.975) were independent predictors of OS. In patients with advanced HBV-related HCC treated with sorafenib, a high baseline HBV load was an adverse prognostic factor for survival. However, survival was significantly improved with the use of antiviral therapy. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Liver international: official journal of the International Association for the Study of the Liver 02/2015; DOI:10.1111/liv.12805