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Background: Advanced chronic liver disease (ACLD) patients are usually malnourished, and both conditions in combination increase the likelihood of unfavourable clinical outcomes. Handgrip strength (HGS) has been suggested as a relevant parameter for nutritional assessment and predictor of adverse clinical outcomes in ACLD. However, the HGS cut‐off values for ACLD patients have not yet been reliably established. The aims of this study were to preliminarily identify HGS reference values in a sample population of ACLD male patients and to assess their association with survival over a 12‐month follow‐up period. Methods: This was a prospective observational study with preliminary analysis of outpatients and inpatients. A total of 185 male patients with a medical diagnosis of ACLD met the inclusion criteria and were invited to participate in the study. The physiological variation in muscle strength related to the age of the individuals included in the study was considered to obtain cut‐off values. Results: After categorising HGS by age group (adults: 18–60 years; elderly: ≥60 years), the reference values obtained were 32.5 kg for the adults and 16.5 kg for the elderly. During the 12‐month follow‐up, 20.5% of the patients died, and 76.3% of those had been identified with reduced HGS. Conclusions: Patients with adequate HGS showed significantly higher 12‐month survival than those with reduced HGS within the same period. Our findings show that HGS is an important predictive parameter for clinical and nutritional follow‐up in ACLD male patients. Key points: Strength measurement is an indicator of nutritional status that is not compromised by the presence of oedema and ascites and, therefore, has an advantage over methods traditionally used in clinical practice for advanced chronic liver disease (ACLD) patients.However, to date, very few studies have presented cut‐off values for ACLD patients. Furthermore, studies that have accounted for variables that directly influence muscle strength, including age group and various levels of severity of liver disease, are scarce.As dynamometry is a low‐cost method and easily reproducible in clinical practice, handgrip strength (HGS) can be effectively applied for inpatient and outpatient nutritional care. HGS cut‐off values may be used to plan a more tailored nutritional therapy and, most importantly, for the early detection of individuals at greater risk of negative outcomes in ACLD.The results of this study show that reduced HGS was associated with increased mortality and reduced survival in ACLD male patients.A multicentre study which presents HGS cut‐off accurate enough to predict mortality in larger populations of ACLD adult and elderly patients of both sexes will bring certainty as to the applicability of our results to larger settings. [ABSTRACT FROM AUTHOR]

Background IL28B polymorphisms are predictors of therapy response in hepatitis C virus ( HCV) patients. We do not know whether they are markers of treatment response in admixed populations or not. Aims To determine whether IL28B polymorphisms are predictors of therapy response in patients with HCV from an admixed population and are influenced by genetic ancestry. Methods rs12979860 and rs8099917 were genotyped in 222 HCV patients treated with pegylated interferon and ribavirin. Ancestry was determined using genetic markers. Results IL28B rs12979860 C/C was associated with sustained virological response ( SVR), whereas C/T and T/T were associated with failure to therapy ( P = 1.12 × 10−5). IL28B rs8099917 T/T was associated with SVR, and G/G and G/T were associated with nonresponse/relapse ( NR/R) ( P = 8.00 × 10−3). Among HCV genotype 1 patients with C/C genotype, genomic ancestry did not interfere with therapy response. Among patients with rs12979860 T/T genotype, African genetic contribution was greater in the NR/R group ( P = 1.51 × 10−3), whereas Amerindian and European genetic ancestry contribution were higher in the SVR group ( P = 3.77 × 10−3 and P = 2.16 × 10−2 respectively). Among HCV type 1 patients with rs8099917 T/T, African genetic contribution was significantly greater in the NR/R group ( P = 5.0 × 10−3); Amerindian and European ancestry genetic contribution were greater in the SVR group. Conclusion IL28B rs12979860 and rs8099917 polymorphisms were predictors of therapy response in HCV genotypes 1, 2 and 3 subjects from an admixed population. Genomic ancestry did not interfere with response to therapy in patients with rs12979860 C/C, whereas it interfered in patients with C/T and T/T genotypes. Among HCV genotype 1 rs8099917 T/T patients, genomic ancestry interfered with response to therapy. [ABSTRACT FROM AUTHOR]

Objectives: To discuss relevant aspects in a series of cases in which interferon-α-triggered depressive symptoms persisted up to 4 years after therapy cessation in HCV-infected patients., Methods: Two experienced psychiatrists (AGA and LCQ) identified these four cases in a systematic evaluation program of HCV patients in the Hepatology Unit of the Teaching Hospital at the Federal University of Bahia, Brazil. Lifetime psychiatric diagnoses were confirmed by the Mini International Neuropsychiatric Interview (MINI Plus), and a questionnaire was submitted in order to gather clinical and sociodemographic characteristics., Results: In three out of the four cases identified, major depression diagnosis was reached after more than 12 months of interferon-α therapy interruption and, in one case, depression recurred 6 months after antiviral treatment cessation in a patient on antidepressants. The only case that referred a past history of psychiatric diagnosis reported no offer of mental health care despite the presence of a major depressive episode with psychotic features and suicidal behaviour during the cytokine usage., Conclusions: Interferon-α-triggered depression may remain undiagnosed even in tertiary university hospitals, may persist years after the antiviral therapy cessation, and may recur even in patients on adequate antidepressant treatment.