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11 results on '"Hasmik Ghazinyan"'

1. Global burden of metabolic dysfunction-associated steatotic liver disease, 2010 to 2021

Author

Gong Feng, Giovanni Targher, Christopher D. Byrne, Yusuf Yilmaz, Vincent Wai-Sun Wong, Cosmas Rinaldi Adithya Lesmana, Leon A. Adams, Jerome Boursier, George Papatheodoridis, Mohamed El-Kassas, Nahum Méndez-Sánchez, Silvia Sookoian, Laurent Castera, Wah-Kheong Chan, Feng Ye, Sombat Treeprasertsuk, Helena Cortez-Pinto, Hon Ho Yu, Won Kim, Manuel Romero-Gómez, Atsushi Nakajima, Khin Maung Win, Seung Up Kim, Adriaan G. Holleboom, Giada Sebastiani, Ponsiano Ocama, John D. Ryan, Monica Lupșor-Platon, Hasmik Ghazinyan, Mamun Al-Mahtab, Saeed Hamid, Nilanka Perera, Khalid A. Alswat, Qiuwei Pan, Michelle T. Long, Vasily Isakov, Man Mi, Marco Arrese, Arun J. Sanyal, Shiv Kumar Sarin, Nathalie Carvalho Leite, Luca Valenti, Philip N. Newsome, Hannes Hagström, Salvatore Petta, Hannele Yki-Järvinen, Jörn M. Schattenberg, Marlen I. Castellanos Fernández, Isabelle A. Leclercq, Gulnara Aghayeva, Abdel-Naser Elzouki, Ali Tumi, Ala I. Sharara, Asma Labidi, Faisal M. Sanai, Khaled Matar, Maen Al-Mattooq, Maisam Waid Akroush, Mustapha Benazzouz, Nabil Debzi, Maryam Alkhatry, Salma Barakat, Said A. Al-Busafi, John Rwegasha, Wah Yang, Agyei Adwoa, Christopher Kenneth Opio, Mohammadjavad Sotoudeheian, Yu Jun Wong, Jacob George, and Ming-Hua Zheng

Subjects
Metabolic dysfunction-associated fatty liver disease, Non-alcoholic fatty liver disease, Metabolic dysfunction-associated steatotic liver disease, Epidemiology, Diseases of the digestive system. Gastroenterology, RC799-869
Abstract

Background & Aims: This study used the Global Burden of Disease data (2010–2021) to analyze the rates and trends of point prevalence, annual incidence, and years lived with disability (YLDs) for metabolic dysfunction-associated steatotic liver disease (MASLD) in 204 countries. Methods: Total numbers and age-standardized rates per 100,000 population for MASLD prevalence, annual incidence, and YLDs were compared across regions and countries by age, sex, and sociodemographic index (SDI). Smoothing spline models were used to evaluate the relationship between the burden of MASLD and SDI. Estimates were reported with uncertainty intervals (UI). Results: Globally, in 2021, the age-standardized rates per 100,000 population of point prevalence of MASLD were 15,018.1 cases (95% UI 13,756.5–16,361.4), annual incidence rates were 608.5 cases (598.8–617.7), and YLDs were 0.5 (0.3–0.8) years. MASLD point prevalence was higher in men than women (15,731.4 vs. 14,310.6 cases per 100,000 population). Prevalence peaked at ages 45–49 for men and 50–54 for women. Kuwait (32,312.2 cases per 100,000 people; 95% UI: 29,947.1–34,839.0), Egypt (31,668.8 cases per 100,000 people; 95% UI: 29,272.5–34,224.7), and Qatar (31,327.5 cases per 100,000 people; 95% UI: 29,078.5–33,790.9) had the highest prevalence rates in 2021. The largest increases in age-standardized point prevalence estimates from 2010 to 2021 were in China (16.9%, 95% UI 14.7%–18.9%), Sudan (13.3%, 95% UI 9.8%–16.7%) and India (13.2%, 95% UI 12.0%–14.4%). MASLD incidence varied with SDI, peaking at moderate SDI levels. Conclusions: MASLD is a global health concern, with the highest prevalence reported in Kuwait, Egypt, and Qatar. Raising awareness about risk factors and prevention is essential in every country, especially in China, Sudan and India, where disease incidence and prevalence are rapidly increasing. Impact and implications: This research provides a comprehensive analysis of the global burden of MASLD, highlighting its rising prevalence and incidence, particularly in countries with varying sociodemographic indices. The findings are significant for both clinicians and policymakers, as they offer critical insights into the regional disparities in MASLD burden, which can inform targeted prevention and intervention strategies. However, the study’s reliance on modeling and available data suggests cautious interpretation, and further research is needed to validate these findings in clinical and real-world settings.

Published
2025
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2. Global multi-societies endorsement of the MAFLD definition

Author

Mohamed Alboraie, Tawesak Tanwandee, Xiaoyuan Xu, Dafina Nikolova, Enrique Carrera Estupiñan, Hasmik Ghazinyan, Sameer Alawadhi, Ponsiano Ocama, Gulnara Aghayeva, Alejandro Piscoya, Taghreed Farahat, Pramendra Prasad, Cosmas Rinaldi Adithya Lesmana, Shashank R Joshi, Said Al-Busafi, Vladimir Milivojevic, Violet Kayamba, Yeong Yeh Lee, Shahinul Alam, Chengwei Tang, Wei-Fen Xie, Moutaz Derbala, Yuemin Nan, Dennis Ndububa, Hongting Zheng, Jiajun Zhao, Nawal Alkhalidi, Yahya Ghanem, Phunchai Charatcharoenwitthaya, Mamun Mahtab, Nagwa N. Hegazy, Edford Sinkala, Cecil Kwaku Dovia, Moussa Ali Mahamat, Mortada El-Shabrawi, Dao Viet Hang, Shlomo Vinker, Bilal Hotayt, Mohammed Tahiri, Pavel Bogomolov, Nawal Afredj, Inass Shaltout, Reda Elwakil, Abd Elkhalek Hamed, Lubna Kamani, Maheeba Abdulla, Constant Assi, Oidov Baatarkhuu, Munira Al Tarrah, Yousef Ajlouni, Bounena Abidine, Christopher Muñoz, Mohammad Ali, Emad Salama, Abdelaziz Elamin, Iqbal Ahmad Memon, Aram Mirijanyan, Sajjad Jamil, Alexander V. Nersesov, Nseabasi Ekanem, Waseem Hamoudi, Bisi Bright, Teresa Casanovas, Ewaoche Itodo, Esther A Torres, Maja Karin, Enver Zerem, Svetlana Turcan, Audrius Dulskas, Iulianna Lupasco, Alina Jucov, Christian Tzeuton, Roger Sombie, Kateryna Lapshyna, Andrriy Dorofeyev, Yaw A Awuku, Hilal Ünalmış Duda, Rijimra Ande, Nehal El Koofy, Naglaa Kamal, Ziyan Pan, Angela Peltec, Liang Qiao, Andry Lalaina Rinà Rakotozafindrabe, Ahmed Salama, Reham Soliman, Badre Wafaa, Marinela Debu, Eileen A Micah, Gamal Shiha, Mohammed Eslam, and Yasser Fouad

Subjects
Specialties of internal medicine, RC581-951
Published
2024
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3. Ammonia is associated with liver-related complications and predicts mortality in acute-on-chronic liver failure patients

Author

Kessarin Thanapirom, Sombat Treeprasertsuk, Ashok Choudhury, Nipun Verma, Radha Krishan Dhiman, Mamun Al Mahtab, Harshad Devarbhavi, Akash Shukla, Saeed Sadiq Hamid, Wasim Jafri, Soek Siam Tan, Guan H. Lee, Hasmik Ghazinyan, Ajit Sood, Dong Joon Kim, C. E. Eapen, Han Tao, Nan Yuemin, A. Kadir Dokmeci, Manoj Sahu, Anil Arora, Ashish Kumar, Ramesh Kumar, V. G. Mohan Prasad, Ananta Shresta, Jose Sollano, Diana Alcantara Payawal, George Lau, and Shiv Kumar Sarin

Subjects
Medicine, Science
Abstract

Abstract The relationship between ammonia and liver-related complications (LRCs) in acute-on-chronic liver failure (ACLF) patients is not clearly established. This study aimed to evaluate the association between ammonia levels and LRCs in patients with ACLF. The study also evaluated the ability of ammonia in predicting mortality and progression of LRCs. The study prospectively recruited ACLF patients based on the APASL definition from the ACLF Research Consortium (AARC) from 2009 to 2019. LRCs were a composite endpoint of bacterial infection, overt hepatic encephalopathy (HE), and ascites. A total of 3871 cases were screened. Of these, 701 ACLF patients were enrolled. Patients with LRCs had significantly higher ammonia levels than those without. Ammonia was significantly higher in patients with overt HE and ascites, but not in those with bacterial infection. Multivariate analysis found that ammonia was associated with LRCs. Additionally, baseline arterial ammonia was an independent predictor of 30-day mortality, but it was not associated with the development of new LRCs within 30 days. In summary, baseline arterial ammonia levels are associated with 30-day mortality and LRCs, mainly overt HE and ascites in ACLF patients.

Published
2024
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4. An international multidisciplinary consensus statement on MAFLD and the risk of CVD

Author

Xiao-Dong Zhou, Giovanni Targher, Christopher D. Byrne, Virend Somers, Seung Up Kim, C. Anwar A. Chahal, Vincent Wai-Sun Wong, Jingjing Cai, Michael D. Shapiro, Mohammed Eslam, Philippe Gabriel Steg, Ki-Chul Sung, Anoop Misra, Jian-Jun Li, Carlos Brotons, Yuli Huang, George V. Papatheodoridis, Aijun Sun, Yusuf Yilmaz, Wah Kheong Chan, Hui Huang, Nahum Méndez-Sánchez, Saleh A. Alqahtani, Helena Cortez-Pinto, Gregory Y. H. Lip, Robert J. de Knegt, Ponsiano Ocama, Manuel Romero-Gomez, Marat Fudim, Giada Sebastiani, Jang Won Son, John D. Ryan, Ignatios Ikonomidis, Sombat Treeprasertsuk, Daniele Pastori, Monica Lupsor-Platon, Herbert Tilg, Hasmik Ghazinyan, Jerome Boursier, Masahide Hamaguchi, Mindie H. Nguyen, Jian-Gao Fan, George Boon-Bee Goh, Mamun Al Mahtab, Saeed Hamid, Nilanka Perera, Jacob George, Ming-Hua Zheng, Repositório da Universidade de Lisboa, Zhou X., Targher G., Byrne C. D., Somers V., Kim S. U., Chahal C. A. A., Wong V. W., Cai J., Shapiro M. D., Eslam M., et al., and Gastroenterology & Hepatology

Subjects
Internal Diseases, Consensus, MAFLD, Gastroenterology and Hepatology, Sağlık Bilimleri, İç Hastalıkları, Clinical Medicine (MED), Metabolic (dysfunction)-associated fatty liver disease, Gastroenteroloji-(Hepatoloji), SDG 3 - Good Health and Well-being, Metabolic (dysfunction), Health Sciences, associated fatty liver disease, Klinik Tıp (MED), Internal Medicine Sciences, Klinik Tıp, Hepatology, GASTROENTEROLOGY & HEPATOLOGY, Dahili Tıp Bilimleri, CLINICAL MEDICINE, Cardiovascular disease, GASTROENTEROLOJİ VE HEPATOLOJİ, Tıp, Hepatoloji, Medicine, Delphi survey, Non-alcoholic fatty liver disease
Abstract

© Asian Pacific Association for the Study of the Liver 2023, Background: Fatty liver disease in the absence of excessive alcohol consumption is an increasingly common condition with a global prevalence of ~ 25-30% and is also associated with cardiovascular disease (CVD). Since systemic metabolic dysfunction underlies its pathogenesis, the term metabolic (dysfunction)-associated fatty liver disease (MAFLD) has been proposed for this condition. MAFLD is closely intertwined with obesity, type 2 diabetes mellitus and atherogenic dyslipidemia, which are established cardiovascular risk factors. Unlike CVD, which has received attention in the literature on fatty liver disease, the CVD risk associated with MAFLD is often underestimated, especially among Cardiologists. Methods and results: A multidisciplinary panel of fifty-two international experts comprising Hepatologists, Endocrinologists, Diabetologists, Cardiologists and Family Physicians from six continents (Asia, Europe, North America, South America, Africa and Oceania) participated in a formal Delphi survey and developed consensus statements on the association between MAFLD and the risk of CVD. Statements were developed on different aspects of CVD risk, ranging from epidemiology to mechanisms, screening, and management. Conculsions: The expert panel identified important clinical associations between MAFLD and the risk of CVD that could serve to increase awareness of the adverse metabolic and cardiovascular outcomes of MAFLD. Finally, the expert panel also suggests potential areas for future research.

Published
2023
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5. Assessment of pathomorphological characteristics of the oral mucosa in patients with HBV, HCV and HIV

Author

Vahe, Azatyan, Lazar, Yessayan, Anna, Khachatryan, Anush, Perikhanyan, Alvard, Hovhannisyan, Melanya, Shmavonyan, Hasmik, Ghazinyan, Robert, Gish, Gayane, Melik-Andreasyan, and Kristina, Porksheyan

Subjects
Adult, Male, Mouth Mucosa, virus diseases, HIV Infections, General Medicine, Hepatitis C, Chronic, Middle Aged, Microbiology, digestive system diseases, Immunity, Humoral, Hepatitis B, Chronic, Infectious Diseases, Virology, Disease Progression, Humans, Female, Parasitology, Mouth Diseases, Aged
Abstract

Introduction: Oral clinical manifestations in HBV HCV and HIV patients indicate a deterioration in general health status. The aim of the study was to assess pathomorphologic features of oral mucosa observed in patients with these diseases. Methodology: The study was conducted in N1 Dental Clinic of YSMU after M. Heratsi. The total number of patients taking part in the research was 120, including HBV (n = 40), HCV (n = 40) and HIV (n = 40). After biopsy and subsequent histological examination of the oral mucosa, statistical analysis was carried out using Excel 2013 and R software. Results: Pathomorphological examination revealed inflammatory infiltrations in all samples collected from HBV, HCV and HIV patients. These changes included microcirculatory disorders in 98.3% of samples: fibrinous-like deposits lining the surface of erosions and ulcers on the oral mucosa (1.67%), fibrosis of the mucous membrane (70%), dystrophy of squamous epithelium (93.3%) and bone sequestration (3.3%). Comparative analysis of pathomorphological characteristics revealed distinct content of infiltrates: lymphoplasmacytic infiltration in patients with HBV and HCV, while HIV patients showed neutrophils infiltration and lack of plasmocytes. Conclusions: There are common abnormal morphological changes in the oral mucosa typical of all patients with HBV, HCV and HIV, as well as liver diseases specific to each of them. Inflammation in the patients with HIV indicated impairment of the humoral immune system. Understanding the distinct characteristic of inflammation in the oral cavity could be useful for early differential diagnosis and management of patients with HIV, HBV and HCV.

Published
2021
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6. Global multi-stakeholder endorsement of the MAFLD definition

Author

Nahum Méndez-Sánchez, Elisabetta Bugianesi, Robert G Gish, Frank Lammert, Herbert Tilg, Mindie H Nguyen, Shiv K Sarin, Núria Fabrellas, Shira Zelber-Sagi, Jian-Gao Fan, Gamal Shiha, Giovanni Targher, Ming-Hua Zheng, Wah-Kheong Chan, Shlomo Vinker, Takumi Kawaguchi, Laurent Castera, Yusuf Yilmaz, Marko Korenjak, C Wendy Spearman, Mehmet Ungan, Melissa Palmer, Mortada El-Shabrawi, Hans-Juergen Gruss, Jean-François Dufour, Anil Dhawan, Heiner Wedemeyer, Jacob George, Luca Valenti, Yasser Fouad, Manuel Romero‐Gomez, Mohammed Eslam, Maria Lorena Abate, Bahaa Abbas, Ahmed Amr Abbassy, Waleed Abd El Ghany, Amira Abd Elkhalek, Emad Abd ElMajeed, Mohammad Abdalgaber, Mohamed AbdAllah, Marwa Abdallah, Nourhan Abdallah, Shereen Abdelaleem, Yasser Abdelghani, Wael Abdelghany, Safaa Mohamed Abdelhalim, Wafaa Abdelhamid, Nehal Abdelhamid, Nadia A. Abdelkader, Elsayed Abdelkreem, Aly Mohamed Abdelmohsen, Awny Ali Abdelrahman, Sherief M Abd-elsalam, Doaa Abdeltawab, Abdulbaset Abduh, Nada Abdulhakam, Maheeba Abdulla, Navid Abedpoor, Ludovico Abenavoli, Fredrik Åberg, Omala Ablack, Mostafa Abo elftouh, Yousry Esam-Eldin Abo-Amer, Ashraf Aboubkr, Alaa Aboud, Amr M. Abouelnaga, Galal A. Aboufarrag, Ashraf Aboutaleb, Leticia Abundis, Gupse Adalı, Enrique Adames, Leon Adams, Danjuma Adda, Noor Adel, Nada Adel, Muhammad Adel Sayed, Taiba Jibril Afaa, Nawal Afredj, Gulnara Aghayeva, Alessio Aghemo, Carlos A. Aguilar-Salinas, Golo Ahlenstiel, Walid Ahmady, Wafaa Ahmed, Amira Ahmed, Samah Nasser Ahmed, Heba Mostafa Ahmed, Rasha Ahmed, Elmar Aigner, Mesut Akarsu, Maisam Akroush, Umit Akyuz, Mamun Al Mahtab, Tahani Al Qadiri, Yusriya Al Rawahi, Razzaq AL rubaee, Muna Al Saffar, Shahinul Alam, Zaid Al-Ani, Agustín Albillos, Mohamed Alboraie, Said Al-Busafi, Mohamed Al-Emam, Jawaher Alharthi, Kareem Ali, Basma Abdelmoez Ali, Mohammad Ali, Raja Affendi Raja Ali, Anna Alisi, Ali Raad AL-Khafaji, Maryam Alkhatry, Rocio Aller, Yahya Almansoury, Khalid Al-Naamani, Alaa Alnakeeb, Anna Alonso, Saleh A. Alqahtani, Leina Alrabadi, Khalid Alswat, Mahir Altaher, Turki Altamimi, Jose Altamirano, Mario R. Alvares-da-Silva, Elsragy Adel M. Aly, Amgad Alzahaby, Ahmed Alzamzamy, Keisuke Amano, Maysa A. Amer, Mona A. Amin, Sayed A. Amin, Ashraf A. Amir, Javier Ampuero, Noha Anas, Pietro Andreone, Soa Fy Andriamandimby, Mahmoud Anees, Peltec Angela, Manal Antonios, Wael Arafat, Jose Moreno Araya, Juan Armendariz-Borunda, Matthew J. Armstrong, Hassan Ashktorab, Patricia Aspichueta, Fathia Assal, Mira Atef, Dina Attia, Hoda Atwa, Reham Awad, Mohyeldeen Abd Elaziz Awad, Sally Awny, Obafemi Awolowo, Yaw Asante Awuku, Ibrahim Ayada, Than Than Aye, Sherif Ayman, Hedy Ayman, Hesham Ayoub, Hosny M. Azmy, Romiro P. Babaran, Omneya Badreldin, Ahmed Badry, İbrahim Halil Bahçecioğlu, Amira Bahour, Jiajia Bai, Yasemin Balaban, Muthuswamy Balasubramanyam, Khaled Bamakhrama, Jesus M Banales, Babu Bangaru, Jianfeng Bao, Jorge Suazo Barahona, Salma Barakat, Sandra Maria Barbalho, Bikwa Barbra, Beatriz Barranco, Francisco Barrera, Ulrich Baumann, Shamardan Bazeed, Eva Bech, Aourarh Benayad, Andreas Benesic, David Bernstein, Fernando Bessone, Susie Birney, Cyrille Bisseye, Martin Blake, Bilal Bobat, Leonilde Bonfrate, Dmitry S Bordin, Francisco Bosques-Padilla, Jerome Boursier, Boushab Mohamed Boushab, David Bowen, Patricia Medina Bravo, Paul N Brennan, Bisi Bright, Ilse Broekaert, Xabier Buque, Diego Burgos-Santamaría, Julio Burman, Luca Busetto, Chris D. Byrne, Patricia Anne I. Cabral-Prodigalidad, Guillermo Cabrera-Alvarez, Wei Cai, Francesca Cainelli, Ali Riza Caliskan, Ali Canbay, Ana Cano-Contreras, Hai-Xia Cao, Zhujun Cao, Andres Carrion, Francesca Carubbi, Teresa Casanovas, Marlen Ivón Castellanos Fernández, Jin Chai, Siew Pheng Chan, Phunchai Charatcharoenwitthaya, Norberto Chavez-Tapia, Kazuaki Chayama, Jinjun Chen, Lin Chen, Zhong-Wei Chen, Huiting Chen, Sui-Dan Chen, Qiang Chen, Yaxi Chen, Gang Chen, En-Quang Chen, Fei Chen, Pei-Jer Chen, Robert Cheng, Wendy Cheng, Jack Tan Wei Chieh, Imad Chokr, Evangelos Cholongitas, Ashok Choudhury, Abhijit Chowdhury, Evaristus Sunday Chukwudike, Stefano Ciardullo, Michelle Clayton, Karine Clement, Marie Michelle Cloa, Cecilia Coccia, Cristina Collazos, Massimo Colombo, Arif Mansur Cosar, Helma Pinchemel Cotrim, Joris Couillerot, Alioune Coulibaly, Gonzalo Crespo, Javier Crespo, Maria Cruells, Ian Homer Y. Cua, Hesham K. Dabbous, George N Dalekos, Patricia D'Alia, Li Dan, Viet Hang Dao, Mostafa Darwish, Christian Datz, Milagros B Davalos-Moscol, Heba Dawoud, Blanca Olaechea de Careaga, Robert de Knegt, Victor de Ledinghen, Janaka de Silva, Nabil Debzi, Marie Decraecker, Elvira Del Pozo, Teresa C Delgado, Manuel Delgado-Blanco, Łukasz Dembiński, Adilson Depina, Moutaz Derbala, Hailemichael Desalegn, Christèle Desbois-Mouthon, Mahmoud Desoky, Anouk Dev, Agostino Di Ciaula, Moisés Diago, Ibrahima Diallo, Luis Antonio Díaz, Melisa Dirchwolf, Paola Dongiovanni, Andrriy Dorofeyev, Xiaoguang Dou, Mark W. Douglas, Michael Doulberis, Cecil K. Dovia, Adam Doyle, Ivana Dragojević, Joost PH Drenth, Xuefei Duan, Audrius Dulskas, Dan L Dumitrascu, Oliver Duncan, Vincent Dusabejambo, Rev. Shem N.A. Dwawhi, Sho Eiketsu, Doaa El Amrousy, Ahmed El Deeb, Ghada El Deriny, Hesham Salah El Din, Salwa El Kamshishy, Mohamed El Kassas, Maissa El Raziky, Osama A Elagamy, Wafaa Elakel, Dina Elalfy, Hanaa Elaraby, Heba ElAwady, Reda Elbadawy, Hanaa Hassan Eldash, Manal S. Eldefrawy, Carol Lezama Elecharri, Amel Elfaramawy, Mohammed Elfatih, Mahmoud Elfiky, Mohamed Elgamsy, Mohamed Elgendy, Mohamed A. El-Guindi, Nagi Elhussieny, Ahmed Maher Eliwa, Zeineb Elkabbany, Hesham El-Khayat, Nehal M. El-Koofy, Alaa Elmetwalli, Amr Elrabat, Fathiya El-Raey, Fatma Elrashdy, Medhat Elsahhar, Esraa M. Elsaid, Shimaa Elsayed, Hany Elsayed, Aly Elsayed, Amr M. Elsayed, Hamdy Elsayed, Magdy El-Serafy, Ahmed M. Elsharkawy, Reem Yehia Elsheemy, Eman Elsayed Elshemy, Sara Elsherbini, Naglaa Eltoukhy, Reda Elwakil, Ola Emad, Shaimaa Emad, Mohamed Embabi, Ilkay Ergenç, Tatiana Ermolova, Gamal Esmat, Doaa M. Esmat, Enrique Carrera Estupiñan, Said Ettair, Tcaciuc Eugen, Mohammed Ezz-Eldin, Lidia Patricia Valdivieso Falcón, Yu-Chen Fan, Samah Fandari, Mahmoud Farag, Taghreed Mohamed Farahat, Eman M. Fares, Michael Fares, Eduardo Fassio, Hayam Fathy, Dina Fathy, Wael Fathy, Soheir Fayed, Dan Feng, Gong Feng, Miguel Fernández-Bermejo, Cristina Targa Ferreira, Javier Díaz Ferrer, Alastair Forbes, Rabab Fouad, Hanan M. Fouad, Tove Frisch, Hideki Fujii, Shuhei Fukunaga, Shinya Fukunishi, Hacer Fulya, Masato Furuhashi, Yasmine Gaber, Augusto Jose G. Galang, Jacqueline Cordova Gallardo, Rocío Galloso, Mahmoud Gamal, Reham Gamal, Hadeel Gamal, Jian Gan, Anar Ganbold, Xin Gao, George Garas, Tony Garba, Miren García-Cortes, Carmelo García-Monzón, Javier García-Samaniego, Amalia Gastaldelli, Manuel Gatica, Elizabeth Gatley, Tamar Gegeshidze, Bin Geng, Hasmik Ghazinyan, Salma Ghoneem, Luca Giacomelli, Gianluigi Giannelli, Edoardo G. Giannini, Matthew Giefer, Pere Ginès, Marcos Girala, Pablo J Giraudi, George Boon-Bee Goh, Ahmed Ali Gomaa, Benbingdi Gong, Dina Hilda C. Gonzales, Humberto C. Gonzalez, Maria Saraí Gonzalez-Huezo, Isabel Graupera, Ivica Grgurevic, Henning Grønbæk, Xuelian Gu, Lin Guan, Ibrahima Gueye, Alice Nanelin Guingané, Ozen Oz Gul, Cuma Bulent Gul, Qing Guo, Pramendra Prasad Gupta, Ahmet Gurakar, Juan Carlos Restrepo Gutierrez, Ghada Habib, Azaa Hafez, Emilia Hagman, Eman Halawa, Osama Hamdy, Abd Elkhalek Hamed, Dina H. Hamed, Saeed Hamid, Waseem Hamoudi, Yu Han, James Haridy, Hanan Haridy, David C H Harris Harris, Michael Hart, Fuad Hasan, Almoutaz Hashim, Israa Hassan, Ayman Hassan, Essam Ali Hassan, Adel Ahmed Hassan, Magda Shehata Hassan, Fetouh Hassanin, Alshymaa Hassnine, John Willy Haukeland, Amr Ismael M. Hawal, Jinfan He, Qiong He, Yong He, Fang-Ping He, Mona Hegazy, Adham Hegazy, Osama Henegil, Nelia Hernández, Manuel Hernández-Guerra, Fatima Higuera-de-la-Tijera, Ibrahim Hindy, Keisuke Hirota, Lee Chi Ho, Alexander Hodge, Mohamed Hosny, Xin Hou, Jiao-Feng Huang, Yan Huang, Zhifeng Huang, Yuan Huang, Ang Huang, Xiao-Ping Huang, Sheng Hui-ping, Bela Hunyady, Mennatallah A. Hussein, Osama Hussein, Shahinaz Mahmoud Hussien, Luis Ibáñez-Samaniego, Jamal Ibdah, Luqman Ibrahim, Miada Ibrahim, Ibrahim Ibrahim, Maria E. Icaza-Chávez, Sahar Idelbi, Ramazan Idilman Idilman, Mayumi Ikeda, Giuseppe Indolfi, Federica Invernizzi, Iram Irshad, Hasan Mohamed Ali Isa, Natacha Jreige Iskandar, Abdulrahman Ismaiel, Mariam Ismail, Zulkifli Ismail, Faisal Ismail, Hideki Iwamoto, Kathryn Jack, Rachael Jacob, Fuad Jafarov, Wasim Jafri, Helen Jahshan, Prasun K Jalal, Ligita Jancoriene, Martin Janicko, Hiruni Jayasena, Meryem Jefferies, Vivekanand Jha, Fanpu Ji, Yaqiu Ji, Jidong Jia, Changtao Jiang, Ni Jiang, Zong-zhe Jiang, Xing Jin, Yi Jin, Xu Jing, Qian Jingyu, Maia Jinjolava, FX Himawan Haryanto Jong, Alina Jucov, Ibecheole Julius, Mona Kaddah, Yoshihiro Kamada, Abobakr kamal, Enas Mohamed Kamal, Ashraf Sayed Kamel, Jia-Horng Kao, Maja Karin, Thomas Karlas, Mohammad Kashwaa, Leolin Katsidzira, Eda Kaya, M.Azzam Kayasseh, Bernadette Keenan, Caglayan Keklikkiran, William Keml, Deia K. Khalaf, Rofida Khalefa, Sherin Khamis, Doaa Khater, Hamed khattab, Anatoly Khavkin, Olga Khlynova, Nabil Khmis, Nazarii Kobyliak, Apostolos Koffas, Kazuhiko Koike, Kenneth Y.Y. Kok, Tomas Koller, Narcisse Patrice Komas, Nataliya V. Korochanskaya, Yannoula Koulla, Shunji Koya, Colleen Kraft, Bledar Kraja, Marcin Krawczyk, Mohammad Shafi Kuchay, Anand V Kulkarni, Ashish Kumar, Manoj Kumar, Sulaiman Lakoh, Philip Lam, Ling Lan, Naomi F. Lange, Kamran Bagheri Lankarani, Nicolas Lanthier, Kateryna Lapshyna, Sameh A. Lashen, Konang Nguieguia Justine Laure, Leonid Lazebnik, Didier Lebrec, Samuel S. Lee, Way Seah Lee, Yeong Yeh Lee, Diana Julie Leeming, Nathalie Carvalho Leite, Roberto Leon, Cosmas Rinaldi Adithya Lesmana, Junfeng Li, Qiong Li, Jun Li, Yang-Yang Li, Yufang Li, Lei Li, Min Li, Yiling li, Huiqing Liang, Tang Lijuan, Seng Gee Lim, Lee-Ling Lim, Shumei Lin, Han-Chieh Lin, Rita Lin, Rania Lithy, Yaru Liu, Yuanyuan Liu, Xin Liu, Wen-Yue Liu, Shourong Liu, Ken Liu, Tian Liu, Amedeo Lonardo, Mariana Bravo López, Eva López-Benages, Patricio Lopez-Jaramillo, Huimin Lu, Lun Gen Lu, Yan Lu, John Lubel, Rashid Lui, Iulianna Lupasco, Elena Luzina, Xiao-Hui Lv, Kate Lynch, Hong-Lei Ma, Mariana Verdelho Machado, Nonso Maduka, Katerina Madzharova, Russellini Magdaong, Sanjiv Mahadeva, Amel Mahfouz, Nik Ritza Kosai Nik Mahmood, Eman Mahmoud, Mohamed Mahrous, Rakhi Maiwall, Ammar Majeed, Avik Majumdar, Loey Mak, Madiha M Maklouf, Reza Malekzadeh, Claudia Mandato, Alessandra Mangia, Jake Mann, Hala Hussien Mansour, Abdellah Mansouri, Alessandro Mantovani, Jun qian Mao, Flor Maramag, Giulio Marchesini, Claude Marcus, Rui António Rocha Tato Marinho, Maria L Martinez-Chantar, Antonieta A. 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Neuman, M, Ng'Wanasayi, M, Ni, Y, Nicoll, A, Niizeki, T, Nikolova, D, Ningning, W, Niriella, M, Nogoibaeva, K, Nordien, R, O Sullivan, C, O'Beirne, J, Obekpa, S, Ocama, P, Ochwoto, M, Ogolodom, M, Ojo, O, Okrostsvaridze, N, Oliveira, C, Omana, R, Omar, O, Omar, H, Omar, M, Omran, S, Omran, R, Osman, M, Owise, N, Owusu-Ansah, T, Padilla- Machaca, P, Palle, S, Pan, Z, Pan, X, Pan, Q, Papaefthymiou, A, Paquissi, F, Par, G, Parkash, A, Payawal, D, Peltekian, K, Peng, X, Peng, L, Peng, Y, Pengoria, R, Perez, M, Perez, J, Perez, N, Persico, M, Pessoa, M, Petta, S, Philip, M, Plaz Torres, M, Polavarapu, N, Poniachik, J, Portincasa, P, Pu, C, Purnak, T, Purwanto, E, Qi, X, Qian, Z, Qiang, Z, Qiao, Z, Qiao, L, Queiroz, A, Rabiee, A, Radwan, M, Rahetilahy, A, Ramadan, Y, Ramadan, D, Ramli, A, Ramm, G, Ran, A, Rankovic, I, Rao, H, Raouf, S, Ray, S, Reau, N, Refaat, A, Reiberger, T, Remes-Troche, J, Reyes, E, Richardson, B, Ridruejo, E, Riestra Jimenez, S, Rizk, I, Roberts, S, Roblero, J, Robles, J, Rockey, D, Rodriguez, M, Rodriguez Hernandez, H, Roman, E, Romeiro, F, Romeo, S, Rosales-Zabal, J, Roshdi, G, Rosso, N, Ruf, A, Ruiz, P, Runes, N, Ruzzenente, A, Ryan, M, Saad, A, Sabbagh, E, Sabbah, M, Saber, S, Sabrey, R, Sabry, R, Saeed, M, Said, D, Said, E, Sakr, M, Salah, Y, Salama, R, Salama, A, Saleh, H, Saleh, A, Salem, A, Salifou, A, Salih, A, Salman, A, Samouda, H, Sanai, F, Sanchez-Avila, J, Sanker, L, Sano, T, Sanz, M, Saparbu, T, Sawhney, R, Sayed, F, Sayed, S, Sayed, A, Sayed, M, Sebastiani, G, Secadas, L, Sediqi, K, Seif, S, Semida, N, Senates, E, Serban, E, Serfaty, L, Seto, W, Sghaier, I, Sha, M, Shabaan, H, Shalaby, L, Shaltout, I, Sharara, A, Sharma, V, Shawa, I, Shawkat, A, Shawky, N, Shehata, O, Sheils, S, Shewaye, A, Shi, G, Shi, J, Shimose, S, Shirono, T, Shou, L, Shrestha, A, Shui, G, Sievert, W, Sigurdardottir, S, Sira, M, Siradj, R, Sison, C, Smyth, L, Soliman, R, Sollano, J, Sombie, R, Sonderup, M, Sood, S, Soriano, G, Stedman, C, Stefanyuk, O, Stimac, D, Strasser, S, Strnad, P, Stuart, K, Su, W, Su, M, Sumida, Y, Sumie, S, Sun, D, Sun, J, Suzuki, H, Svegliati-Baroni, G, Swar, M, Taharboucht, S, Taher, Z, Takamura, S, Tan, L, Tan, S, Tanwandee, T, Tarek, S, Tatiana, G, Tavaglione, F, Tecson, G, Tee, H, Teschke, R, Tharwat, M, Thong, V, Thursz, M, Tine, T, Tiribelli, C, Tolmane, I, Tong, J, Tongo, M, Torkie, M, Torre, A, Torres, E, Trajkovska, M, Treeprasertsuk, S, Tsutsumi, T, Tu, T, Tur, J, Turan, D, Turcan, S, Turkina, S, Tutar, E, Tzeuton, C, Ugiagbe, R, Uygun, A, Vacca, M, Vajro, P, Van der Poorten, D, Van Kleef, L, Vashakidze, E, Velazquez, C, Velazquez, M, Vento, S, Verhoeven, V, Vespasiani-Gentilucci, U, Vethakkan, S, Vilaseca, J, Vitek, L, Volkanovska, A, Wallace, M, Wan, W, Wang, Y, Wang, X, Wang, C, Wang, M, Wangchuk, P, Weltman, M, White, M, Wiegand, J, Wifi, M, Wigg, A, Wilhelmi, M, William, R, Wittenburg, H, Wu, S, Wubeneh, A, Xia, H, Xiao, J, Xiao, X, Xiaofeng, W, Xiong, W, Xu, L, Xu, J, Xu, W, Xu, K, Xu, Y, Xu, S, Xu, M, Xu, A, Xu, C, Yan, H, Yang, J, Yang, R, Yang, Y, Yang, Q, Yang, N, Yao, J, Yara, J, Yaras, S, Yilmaz, N, Younes, R, Younes, H, Young, S, Youssef, F, Yu, Y, Yu, M, Yuan, J, Yue, Z, Yuen, M, Yun, W, Yurukova, N, Zakaria, S, Zaky, S, Zaldastanishvili, M, Zapata, R, Zare, N, Zerem, E, Zeriban, N, Zeshuai, X, Zhang, H, Zhang, X, Zhang, Y, Zhang, W, Zhang, Z, Zhao, J, Zhao, R, Zhao, H, Zheng, C, Zheng, Y, Zheng, R, Zheng, T, Zheng, K, Zhou, X, Zhou, Y, Zhou, H, Zhou, L, Zhu, L, Zhu, Y, Zhu, P, Ziada, E, Ziring, D, Ziyi, L, Zou, S, Zou, Z, Zou, H, Zuart Ruiz, R, and Global Multi-Stakeholder Consensus on the Redefinition of Fatty Liver Disease

Subjects
Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11], Hepatology, Non-alcoholic Fatty Liver Disease, NAFLD, consensu, Gastroenterology, MAFLD, definition, Humans, MAFLD, NAFLD, Human medicine
Abstract

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Published
2022
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7. The global NAFLD policy review and preparedness index: Are countries ready to address this silent public health challenge?

Author

Jeffrey V. Lazarus, Henry E. Mark, Marcela Villota-Rivas, Adam Palayew, Patrizia Carrieri, Massimo Colombo, Mattias Ekstedt, Gamal Esmat, Jacob George, Giulio Marchesini, Katja Novak, Ponsiano Ocama, Vlad Ratziu, Homie Razavi, Manuel Romero-Gómez, Marcelo Silva, C. Wendy Spearman, Frank Tacke, Emmanuel A. Tsochatzis, Yusuf Yilmaz, Zobair M. Younossi, Vincent W.-S. Wong, Shira Zelber-Sagi, Helena Cortez-Pinto, Quentin M. Anstee, Samir Rouabhia, Hasmik Ghazinyan, Natacha Jreige Iskandar, Michael Trauner, Gulnara Aghayeva, Flloyd Carter, Kannan Sridharan, Mamun Al Mahtab, Sven Francque, Nicolas Kodjoh, Ruben Muñoz Camacho, Motswedi Anderson, Claudia Pinto Marques Souza de Oliveira, Lyudmila Mateva, Abdel Karim Serme, Antonieta A. Soares Martins, Mark G. Swain, Narcisse Patrice Komas, Ming-Hua Zheng, Patricio Lopez Jaramillo, Omar Alfaro Murillo, Ivana Mikolasevic, Emmelia Vounou, Radan Brůha, Charles Mbendi Nlombi, Maja Thiele, Marlene Perez, Juan José Suárez M, Imam Waked, Riina Salupere, Hailemichael Desalegn, Hannele Yki-Järvinen, Tengiz Tsertsvadze, Lali Sharvadze, Maia Butsashvili, Yaw Asante Awuku, Georgios Papatheodoridis, Bela Hunyady, Einar Stefan Bjornsson, Ajay Duseja, Cosmas Rinaldi A. Lesmana, Reza Malekzadeh, Suzanne Norris, Kazuhiko Koike, Alexander V. Nersesov, Missiani Ochwoto, Mohammad Jamal, Tobokalova Saparbu, Ieva Tolmane, Raymond Sayegh, Dhastagir Sultan Sheriff, Jonas Valantinas, Joseph Weber, Isaac Thom Shawa, Soek-Siam Tan, Sophia E. Martínez Vázquez, Oidov Baatarkhuu, Undram Lkhagvaa, Tsolmon Jadamba, Tahiri Mohammed, K.C Sudhamshu, Kirsten Coppell, Charles Onyekwere, Dafina Nikolova, Mette Vesterhus, Khalid Al-Naamani, Saeed Hamid, Juan Paredes Méndez, María Cecilia Cabrera Cabrejos, Robert Flisiak, Esther A. Torres, Shahrad Taheri, Ki-Chul Sung, Turcanu Adela, Liana Gheorghe, Faisal M. Sanai, Tamara Milovanovic, George Boon Bee Goh, Marek Rac, Anuradha Dassanayake, Shahinaz Bedri Osama, M. Elsanousi, Jean-François Dufour, Jia-Horng Kao, Dilshod Saidi, Sombat Treeprasertsuk, Ger Koek, Asma Labidi, Igor Skrypnyk, Maryam Salem AlKhatry, Shakhlo Sadirova, Shokhista Bakieva, Edford Sinkala, Repositório da Universidade de Lisboa, Lazarus, Jeffrey V., Mark, Henry E., Villota-Rivas, Marcela, Palayew, Adam, Carrieri, Patrizia, Colombo, Massimo, Ekstedt, Mattias, Esmat, Gamal, George, Jacob, Marchesini, Giulio, Novak, Katja, Ocama, Ponsiano, Ratziu, Vlad, Razavi, Homie, Romero-Gómez, Manuel, Silva, Marcelo, Spearman, C. Wendy, Tacke, Frank, Tsochatzis, Emmanuel A., Yilmaz, Yusuf, Younossi, Zobair M., Wong, Vincent W.-S., Zelber-Sagi, Shira, Cortez-Pinto, Helena, Anstee, Quentin M., NAFLD policy review collaborators, University of Barcelona, EASL International Liver Foundation [Geneva, Switzerland] (ILF), University of Washington [Seattle], Sciences Economiques et Sociales de la Santé & Traitement de l'Information Médicale (SESSTIM - U1252 INSERM - Aix Marseille Univ - UMR 259 IRD), Institut de Recherche pour le Développement (IRD)-Aix Marseille Université (AMU)-Institut National de la Santé et de la Recherche Médicale (INSERM), Institut des sciences de la santé publique [Marseille] (ISSPAM), IRCCS San Raffaele Hospital, Linköping University (LIU), Cairo University, The University of Sydney, University of Bologna/Università di Bologna, Alma Mater Studiorum Università di Bologna [Bologna] (UNIBO), University Medical Centre Ljubljana [Ljubljana, Slovenia] (UMCL), Makerere University [Kampala, Ouganda] (MAK), CHU Pitié-Salpêtrière [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Center for Disease Analysis Foundation [Lafayette, CO, États-Unis], Biomedicine Institute of Sevilla [Seville, Spain], Hospital Universitario Austral, University of Cape Town, Charité - UniversitätsMedizin = Charité - University Hospital [Berlin], Institute for Liver & Digestive Health [London, UK], Marmara University [Kadıköy - İstanbul], Inova Medicine [Falls Church, Virginia, USA] (IM), The Chinese University of Hong Kong [Hong Kong], University of Haifa [Haifa], Tel Aviv Sourasky Medical Center [Te Aviv], Universidade de Lisboa = University of Lisbon (ULISBOA), Newcastle University [Newcastle], Newcastle Upon Tyne Hospitals NHS Foundation Trust, EASL International Liver Foundation, Bristol-Myers Squibb, Genfit, MSD, Gilead Sciences, Allergan Foundation, Pfizer, Resoundant, Wong, Vincent Wai-Sun, and Malbec, Odile

Subjects
policy preparedness, Adult, [SDV]Life Sciences [q-bio], non-alcoholic steatohepatitis (NASH), multiple correspondence analysis, Global Health, digestive system, Policy preparednesss, Non-alcoholic fatty liver disease (NAFLD), liver health, Non-alcoholic Fatty Liver Disease, Humans, Obesity, Non-alcoholic steatohepatitis (NASH), BIOMEDICINE AND HEALTHCARE. Clinical Medical Sciences. Internal Medicine, BIOMEDICINA I ZDRAVSTVO. Kliničke medicinske znanosti. Interna medicina, global public health, Hepatology, Liver health, nutritional and metabolic diseases, health policy, digestive system diseases, Health policy, Multiple correspondence analysis, [SDV] Life Sciences [q-bio], Policy, Policy preparedness, Public Health, Global public health
Abstract

[Background & Aims]: Non-alcoholic fatty liver disease (NAFLD) is a highly prevalent, yet largely underappreciated liver condition which is closely associated with obesity and metabolic disease. Despite affecting an estimated 1 in 4 adults globally, NAFLD is largely absent on national and global health agendas., [Methods]: We collected data from 102 countries, accounting for 86% of the world population, on NAFLD policies, guidelines, civil society engagement, clinical management, and epidemiologic data. A preparedness index was developed by coding questions into 6 domains (policies, guidelines, civil awareness, epidemiology and data, NAFLD detection, and NAFLD care management) and categorising the responses as high, medium, and low; a multiple correspondence analysis was then applied., [Results]: The highest scoring countries were India (42.7) and the United Kingdom (40.0), with 32 countries (31%) scoring zero out of 100. For 5 of the domains a minority of countries were categorised as high-level while the majority were categorised as low-level. No country had a national or sub-national strategy for NAFLD and, [Conclusions]: Although NAFLD is a pressing public health problem, no country was found to be well prepared to address it. There is a pressing need for strategies to address NAFLD at national and global levels., The data collection and analysis were funded by the EASL International Liver Foundation with support from, Intercept, Bristol-Myers-Squibb Company, Genfit, and MSD. Data collection for the original European data was funded by the EASL International Liver Foundation supported by Gilead Sciences Europe Ltd., Allergan Pharmaceutical International Ltd., Bristol-Myers-Squibb Company, Pfizer Inc., and Resoundant Inc.

Published
2021
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8. Asian Pacific association for the study of liver (APASL) guidelines: hepatitis B virus in pregnancy

Author

Manoj Kumar, Zaigham Abbas, Milad Azami, Maria Belopolskaya, A. K. Dokmeci, Hasmik Ghazinyan, Jidong Jia, Ankur Jindal, Han Chu Lee, Wei Lei, Seng Gee Lim, Chun-Jen Liu, Qiang Li, Mamun Al Mahtab, David H. Muljono, Madunil Anuk Niriella, Masao Omata, Diana A. Payawal, Shiv K. Sarin, Olivier Ségéral, Tawesak Tanwandee, Nirupma Trehanpati, Kumar Visvanathan, Jin Mo Yang, Man‑Fung Yuen, Yingjie Zheng, and Y. H. Zhou

Subjects
Hepatitis B virus, Hepatitis B, Chronic, Hepatology, Pregnancy, Child, Preschool, Humans, Female, Hepatitis B e Antigens, Child, Hepatitis B
Abstract

Hepatitis B virus (HBV) infection still remains a major public health issue in the Asia-Pacific region. Most of the burden of HBV-related disease results from infections acquired in infancy through perinatal or early childhood exposure to HBV in Asia-Pacific. Hepatitis B during pregnancy presents unique management issues for both the mother and fetus. These APASL guidelines provide a comprehensive review and recommendations based on available evidence in the literature, for the management of females with HBV infection through every stage of pregnancy and postpartum. These also address the concerns, management challenges, and required follow-up of children born to hepatitis B-positive mothers.

Published
2021

9. Correction to: Acute-on-chronic liver failure: consensus recommendations of the Asian Pacific association for the study of the liver (APASL): an update

Author

Abhijit Chowdhury, Pratibha Kale, Cosmas Rinaldi A Lesmana, Vikrant Sood, Eileen L Yoon, Dharmesh Kapoor, Qin Ning, Cyriac Abby Philips, Ashok Choudhury, Samir Shah, Neeraj Saraf, Barjesh Chander Sharma, Rino Alvani Gani, Subash Gupta, Archana Rastogi, P N Rao, Madunil A. Niriella, Hai Li, Kemal Fariz Kalista, Vinod Arora, Shalimar, Chundamannil E. Eapen, Chetan Kalal, Dong Joon Kim, Hasmik Ghazinyan, Guresh Kumar, Vandana Midha, B. R. Thapa, Anil Arora, Ajit Sood, Anshu Srivastava, Khin Maung Win, Ke Ma, Edward Gane, Wasim Jafri, Ajay Duseja, Ashok Kumar, Harshad Devarbhavi, Sudhir Maharashi, Zeeshan Ahmad Wani, Madhumita Premkumar, V Rajan, Xiaolong Qi, Virender Singh, Mamun Al Mahtab, Gamal Shiha, Akash Shukla, Rajeev Khanna, Diana A. Payawal, Laurentius A. Lesmana, Vivek Vij, Amna Subhan Butt, Samba Siva Rao Pasupuleti, Sanjiv Saigal, Kaushal Madan, Jinhua Hu, Hitendra Garg, Guan H Lee, G Carpio, Viniyendra Pamecha, Mohd Rela, Do Seon Song, Amit Rastogi, R. K. Dhiman, Surender Kumar Yachha, A Olithselvan, Chhagan Bihari Sharma, Atsushi Tanaka, Anoop Saraya, Omesh Goyal, Rajan P Mathur, Jose D. Sollano, Man-Fung Yuen, Zaigham Abbas, A. Kadir Dokmeci, Zhongping Duan, Jin Mo Yang, Yogesh Chawla, Ashish Goel, Shahinul Alam, Rakhi Maiwall, Manoj K Sharma, Lovkesh Anand, Manav Wadhawan, Fazal Karim, Soek Siam Tan, Puja Sakhuja, Vivek A. Saraswat, Osamu Yokosuka, Vishal Garg, Ankur Jindal, Tanmay Vyas, Tao Chen, Sunil Taneja, Seema Alam, Dominic Ray Chaudhuri, Priyanka Jain, Bikrant Bihari Lal, Salimur Rahman, Satoshi Mochida, Meenu Bajpai, Seng Gee Lim, Ananta Shresta, Manoj Sahu, Sombat Treeprasertsuk, Chen Yu, Shiv Kumar Sarin, V G Mohan Prasad, Arvinder S. Soin, Wei Ting Chen, G K Lau, and Saeed Hamid

Subjects
medicine.medical_specialty, MEDLINE, Internet portal, Jaundice, Decompensation, Guidelines, Acute decompensation, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Acute on chronic liver failure, Hepatology, business.industry, Chronic liver disease, Liver failure, Correction, AARC, Alcoholic liver disease, Colorectal surgery, Cirrhosis, 030220 oncology & carcinogenesis, ALF, 030211 gastroenterology & hepatology, business
Abstract

The first consensus report of the working party of the Asian Pacific Association for the Study of the Liver (APASL) set up in 2004 on acute-on-chronic liver failure (ACLF) was published in 2009. With international groups volunteering to join, the “APASL ACLF Research Consortium (AARC)” was formed in 2012, which continued to collect prospective ACLF patient data. Based on the prospective data analysis of nearly 1400 patients, the AARC consensus was published in 2014. In the past nearly four-and-a-half years, the AARC database has been enriched to about 5200 cases by major hepatology centers across Asia. The data published during the interim period were carefully analyzed and areas of contention and new developments in the field of ACLF were prioritized in a systematic manner. The AARC database was also approached for answering some of the issues where published data were limited, such as liver failure grading, its impact on the ‘Golden Therapeutic Window’, extrahepatic organ dysfunction and failure, development of sepsis, distinctive features of acute decompensation from ACLF and pediatric ACLF and the issues were analyzed. These initiatives concluded in a two-day meeting in October 2018 at New Delhi with finalization of the new AARC consensus. Only those statements, which were based on evidence using the Grade System and were unanimously recommended, were accepted. Finalized statements were again circulated to all the experts and subsequently presented at the AARC investigators meeting at the AASLD in November 2018. The suggestions from the experts were used to revise and finalize the consensus. After detailed deliberations and data analysis, the original definition of ACLF was found to withstand the test of time and be able to identify a homogenous group of patients presenting with liver failure. New management options including the algorithms for the management of coagulation disorders, renal replacement therapy, sepsis, variceal bleed, antivirals and criteria for liver transplantation for ACLF patients were proposed. The final consensus statements along with the relevant background information and areas requiring future studies are presented here., Article Highlights Updated on the basis of AARC data of >3300 cases enrolled into AARC registry prospectivelyACLF is distinct form Acute Decompensation of cirrhosisNewer sections on DILI-ACLF, AIH-ACLF, PVT/HVOTO–ACLFReversibility of Chronic Liver Disease in ACLFPortal and systemic hemodynamics and their relevance in ACLFAcute Portal Hypertension and Variceal progression in ACLFAARC score as a guide for treatment strategies in ACLFACLF in Children-first consensus on pediatric ACLF

Published
2019

10. Systemic inflammatory response syndrome in acute-on-chronic liver failure: Relevance of 'golden window': A prospective study

Author

Ashok, Choudhury, Manoj, Kumar, Barjesh C, Sharma, Rakhi, Maiwall, Viniyendra, Pamecha, Richard, Moreau, Yogesh K, Chawla, Ajay, Duseja, Mamun, Mahtab, Salimur, Rahman, Saeed S, Hamid, Amna S, Butt, Wasim, Jafri, Seok Siam, Tan, Harshad, Devarbhavi, Deepak, Amarapurkar, Qin, Ning, C E, Eapen, Ashish, Goel, Dong J, Kim, Hasmik, Ghazinyan, Gamal, Shiha, Guan H, Lee, Zaigham, Abbas, Diana A, Payawal, A Kadir, Dokmeci, Man-Fung, Yuen, Laurentius A, Lesmana, Ajit, Sood, Albert, Chan, George K, Lau, Ji Dong, Jia, Zhongping, Duan, Chen, Yu, Osamu, Yokosuka, Priyanka, Jain, Ajeet S, Bhadoria, Guresh, Kumar, and Shiv K, Sarin

Subjects
Adult, Male, Survival Rate, Time Factors, Multiple Organ Failure, Sepsis, Acute-On-Chronic Liver Failure, Humans, Female, Prospective Studies, Middle Aged, Systemic Inflammatory Response Syndrome, Liver Transplantation
Abstract

Systemic inflammatory response syndrome (SIRS) is an early marker of sepsis and ongoing inflammation and has been reported in large proportion of acute-on-chronic liver failure (ACLF) patients. Whether sepsis is the cause or the result of liver failure is unclear and is vital to know. To address this, the study investigated the course and outcome of ACLF patients without SIRS/sepsis.Consecutive ACLF patients were monitored for the development of SIRS/sepsis and associated complications and followed till 90 days, liver transplant or death.Of 561 patients, 201 (35.8%) had no SIRS and 360 (64.2%) had SIRS with or without infection. New onset SIRS and sepsis developed in 74.6% and 8% respectively in a median of 7 (range 4-15) days, at a rate of 11% per day. The cumulative incidence of new SIRS was 29%, 92.8%, and 100% by days 4, 7, and 15. Liver failure, that is, bilirubin 12 mg/dL (odds ratio [OR] = 2.5 [95% confidence interval {CI} = 1.05-6.19], P = 0.04) at days 0 and 4, and renal failure at day 4 (OR = 6.74 [95%CI = 1.50-13.29], P = 0.01), independently predicted new onset SIRS. Absence of SIRS in the first week was associated with reduced incidence of organ failure (20% vs 39.4%, P = 0.003), as was the 28-day (17.6% vs 36%, P = 0.02) and 90-day (27.5% vs 51%,P = 0.002) mortality. The 90-day mortality was 61.6% in the total cohort and that for those having no SIRS and SIRS at presentation were 42.8% and 65%, respectively (P 0.001).Liver failure predicts the development of SIRS. New onset SIRS in the first week is an important determinant of early sepsis, organ failure, and survival. Prompt interventions in this 'golden window' before development of sepsis may improve the outcome of ACLF.

Published
2016

11. Drug-nduced hepatotoxicity 2011–2012

Author

Stepan Atoyan, Hasmik Ghazinyan, Ara Asoyan, and Aregnazan Mkhitaryan

Subjects
Drug, Hepatology, business.industry, media_common.quotation_subject, Medicine, Pharmacology, business, media_common
Published
2013
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