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BACKGROUND & AIMS: Tenofovir alafenamide fumarate (TAF) has been approved as a first-line therapy for chronic hepatitis B (CHB) because of its high antiviral activity and less side effect risk. There are very limited data about the efficacy and safety of TAF in preventing hepatitis B virus (HBV) reactivation in in-dividuals who receive chemo/immunosuppressive therapy. Therefore, we aimed to investigate the effectiveness and safety of TAF in preventing HBV reactivation in HBV-infected individuals undergoing chemo/immunosuppressive therapy. METHODS: In this retrospective, multi-center, observational study, we reviewed 68 HBV-infected patients. A special electronic case report form (CRF) was designed in computer environment. Data were entered from each center and collected from the CRF. Biochemical and serological tests at the beginning of treatment and during the treatment period (on 3, 6, 9, 12, 18 and 24th months) were recorded. The median follow-up period was 8,6 months (range: 1.1-21.3 months).. RESULTS: A total of 68 patients treated with TAF. Mean age was 61.2±13.5, and there was a male gender predominance (M/F:38/30). Of the 68 patients, 29 patients were HBsAg positive; 17 of the 29 patients had detectable HBV DNA. The remaining 29 patients were anti-HBc positive. Among them, 32 (47%) were received cytotoxic chemotherapy, 18 (27%) were received B cell depleting therapy, and 9 (13%) patients were received other treatments. None of the 68 patients experienced HBV reactivation under TAF treatment. HBV DNA became negative in 13 patients within 3-12 months. In the remaining four patients, HBV DNA levels continued to decrease. The renal function tests and lipid profiles did not significantly change. No serious adverse events were reported at the follow-up. CONCLUSIONS: Based on the results of this preliminary study, TAF is effective and tolerable in HBV-infected individuals undergoing chemo/immunosuppressive treatment. [ABSTRACT FROM AUTHOR]

BACKGROUND & AIMS: Tenofovir alafenamide fumarate (TAF) has been newly approved for the treatment of chronic hepatitis B (CHB). We aimed to investigate the real-life safety and effectiveness of TAF in patients with cirrhosis and liver transplant recipients. METHODS: This retrospective analysis involved 76 recipients with liver transplantation (LT) and 34 patients with cirrhosis from 12 centers in Turkey. Demographic and clinical data were documented at baseline upon initiation of TAF and at month 3, 6, 9 and 12.. RESULTS: Seventy-six recipients with LT and 34 patients with cirrhosis were analyzed. The mean age of LT recipients and cirrhotic patients was 57±9 years and 64±12 years, respectively. The patients were predominantly male gender (80% and 51%, respectively). Most common indication for TAF treatment was renal disfunction and osteoporosis. Of the 76 LT recipients, 90% and 47% of the recipients were on tacrolimus-based treatment and everolimus-based treatment, respectively. Of the 34 patients with cirrhosis, 5 (14.7%) were decompensated. Among LT recipients 5% were HBeAg positive while none of cirrhotic patients were HBeAg positive. Baseline characteristics of the patients were shown in Table 1. After the start of TAF treatment, the virological and biochemical response was observed in all patients with detectable HBV DNA level between 3 and 12 months. After the switch to TAF treatment, none of the CHB patients experienced HBV reactivation. Renal function tests and lipid profiles remained stable during the treatment. No serious adverse effects were reported.. CONCLUSION: Based on the result of this preliminary study, TAF is effective and tolerable in liver transplant recipients and cirrhotic patients. [ABSTRACT FROM AUTHOR]

The article presents a case study of a 65-year-old lady who was admitted with a complaint heartburn. It states that upper gastrointestinal (GI) endoscopy revealed an intraluminal polypoid mass with stalk occupying ¾ of the esophageal lumen, originating at 20 centimeter (cm) from the incisors, with Grade B esophagitis. Moreover, Endoscopic ultrasonograpy (EUS) confirmed the submucosal origin of mass on right proximal wall of the esophagus which was homogeneously hyperechoic with regular margins.

Nonalcoholic fatty liver disease (NAFLD) is a multisystem disease and is significantly associated with obesity, insulin resistance, type 2 diabetes mellitus, metabolic syndrome, and cardiovascular disease. NAFLD has become the most prevalent chronic liver disease in Western countries, and the proportion of NAFLD-related cirrhosis among patients on liver transplantation waiting lists has increased. In light of the accumulated data about NAFLD, and to provide a common approach with multi-disciplines dealing with the subject, it has become necessary to create new guidance for diagnosing and treating NAFLD. This guidance was prepared following an interdisciplinary study under the leadership of the Turkish Association for the Study of the Liver (TASL), Fatty Liver Special Interest Group. This new TASL Guidance is a practical application guide on NAFLD and was prepared to standardize the clinical approach to diagnosing and treating NAFLD patients. This guidance reflects many advances in the field of NAFLD. The proposals in this guidance are meant to aid decision-making in clinical practice. The guidance is primarily intended for gastroenterology, endocrinology, metabolism diseases, cardiology, internal medicine, pediatric specialists, and family medicine specialists., Competing Interests: The authors have no conflict of interest to declare., (© Copyright 2023 by Hepatology Forum.)

Background and Aim: This study aims to investigate the effects of chronic coffee consumption (>5 years) and type of coffee in non-alcoholic steatohepatitis (NASH), non-alcoholic fatty liver (NAFLD) and patients who have regular alcohol consumption., Materials and Methods: In this study, 158 healthy individuals and 101 patients with histologically proven NASH were enrolled. The daily amount of coffee intake, amount of alcohol use and type of coffee were calculated for all patients. The degree of steatosis and fibrosis was analyzed by transient elastography and liver ultrasound in non-NASH and by liver biopsy in NASH patients., Results: Patients with a history of coffee consumption (n=132) had lower liver enzyme levels compared to the non-coffee group (n=127) (p=0.001). Serum ALT level was significantly lower [ALT: 21.2±11.7 U/L vs. 56.4±15.6 U/L (p=0.004)], and the liver histopathology was significantly better for patients with a coffee consumption of daily for >5years (p=0.045 for fibrosis score for NASH, p=0.036 for LSM and p=0.015 for CAP measurements for the non-NASH patient)., Conclusion: Coffee seems to have a positive protective effect on liver histology and liver enzyme levels in healthy individuals, in patients with chronic alcohol consumption, NAFLD and NASH. These results are more prominent in patients who drink coffee on a regular daily base for more than five years., Competing Interests: The authors does mot have any conflict of interest., (© Copyright 2020 by Hepatology Forum.)

Background and Aim: Recent studies have reported that the widely accepted range of upper limits of normal (ULN) alanine aminotransferase (ALT) levels (ULN<40U/L) is high for the healthy population. We aimed to find the correct ULN level for men and women in a presumed healthy liver population group., Materials and Methods: The data of 7410 healthy subjects visiting the check-up clinics were retrospectively analysed in this study. Patients were divided in to "healthy liver group" (n=2694) and "high-risk liver group" (n=4716) based on fatty liver on ultrasound, existing of chronic liver disease, ongoing significant alcohol consumption, diabetes mellitus and dyslipidaemia. Receiver operating characteristic (ROC) curves were generated and the area under the curve (AUC) was calculated at the 95 th percentiles for both men and women., Results: The AUC score of ALT for men was 0.92, and the ULN for the serum ALT in men was found as 32.10 U/L (sensitivity of 0.89, specificity 0.85). The AUC score of ALT for women was 0.90, and the ULN for serum ALT was found as 23.15 U/L (sensitivity of 0.90, the specificity of 0.88)., Conclusion: ULN for serum ALT level should be lowered and different cut-off values should be used for men (32.10 U/L) and women (23.15 U/L)., Competing Interests: The authors does mot have any conflict of interest., (© Copyright 2020 by Hepatology Forum.)