Smoking and Hepatitis B Virus–Related Hepatocellular Carcinoma Risk: The Mediating Roles of Viral Load and Alanine Aminotransferase

Ya‐Hui Wang, Ya‐Hui Chuang, Chih‐Feng Wu, Meng‐Chin Jan, Wan‐Jung Wu, Chih‐Lin Lin, Chun‐Jen Liu, Ya‐Chien Yang, Pei‐Jer Chen, Shi‐Ming Lin, Mong‐Hsun Tsai, Yi‐Wen Huang, Ming‐Whei Yu – 1 November 2018 – Smoking interacts with hepatitis B virus (HBV) to increase the risk of hepatocellular carcinoma (HCC), which might be explained by its role in antiviral immunity. We evaluated the potential mediating role of viral load and/or alanine aminotransferase (ALT) in the relation of smoking with HBV‐associated HCC risk.

Frailty, Psychoactive Medications, and Cognitive Dysfunction Are Associated With Poor Patient‐Reported Outcomes in Cirrhosis

Elliot B. Tapper, Jad Baki, Neehar D. Parikh, Anna S. Lok – 1 November 2018 – Cirrhosis is associated with disabling symptoms and diminished health‐related quality of life (HRQOL). However, for patients with compensated disease, data are limited regarding associations with poor patient‐reported outcomes (PROs). We prospectively enrolled 300 patients with cirrhosis and portal hypertension without a history of hepatic encephalopathy (HE) and reviewed medical and pharmacy records.

Challenges and Opportunities in the Clinical Development of Immune Checkpoint Inhibitors for Hepatocellular Carcinoma

Michael J. Flynn, Anwar A. Sayed, Rohini Sharma, Abdul Siddique, David J. Pinato – 1 November 2018 – After a decade of stagnation in drug development, therapeutic reversal of immune‐exhaustion with immune checkpoint inhibitors (ICPIs) has been shown to be effective in advanced hepatocellular carcinoma (HCC). The clinical development of novel ICPIs continues at a rapid pace, with more than 50 clinical trials of immunotherapeutic agents registered as of May 2018 for this indication.

Challenges and Opportunities in the Clinical Development of Immune Checkpoint Inhibitors for Hepatocellular Carcinoma

Michael J. Flynn, Anwar A. Sayed, Rohini Sharma, Abdul Siddique, David J. Pinato – 1 November 2018 – After a decade of stagnation in drug development, therapeutic reversal of immune‐exhaustion with immune checkpoint inhibitors (ICPIs) has been shown to be effective in advanced hepatocellular carcinoma (HCC). The clinical development of novel ICPIs continues at a rapid pace, with more than 50 clinical trials of immunotherapeutic agents registered as of May 2018 for this indication.

A Pathophysiologic Approach Combining Genetics and Insulin Resistance to Predict the Severity of Nonalcoholic Fatty Liver Disease

Christopher J. Danford, Margery A. Connelly, Irina Shalaurova, Misung Kim, Mark A. Herman, Imad Nasser, James D. Otvos, Nezam H. Afdhal, Z. Gordon Jiang, Michelle Lai – 1 November 2018 – Nonalcoholic fatty liver disease (NAFLD) is a complex disease dictated by both genetic and environmental factors. While insulin resistance (IR) is a key pathogenic driver, two common genetic variants in patatin‐like phospholipase domain containing 3 (PNPLA3) and transmembrane 6 superfamily member 2 (TM6SF2) also impart significant risk for disease progression.

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