easl

This conversation ties up several issues related to MASH and the new MASLD nomenclature that the panel did not touch on earlier in the episode. These range from the impact the nomenclature might have on other elements of treatment to the impact of this effort over time. Finally, the panelists grade the process to date (they admit, their views might be a bit biased) and signs of success. 

Roger Green starts this conversation by asking what impact panelists believe the new MASLD nomenclature might have on NITs. From one perspective, Meena Bansal notes that it should have no impact given that NAFLD/NASH and MASLD/MASH map so similarly on top of one another. From a different perspective, Jeff Lazarus asks whether the nomenclature and accompanying guidelines from professional societies will result in more testing. The group aligns around the idea that patients living with Type 2 diabetes are an excellent target for increased testing with NITs given the high overlap of the two groups. Maru Rinella comments specifically that all efforts to tie T2DM to MASLD as frequently common metabolic diseases will be helpful and that discussing the proper use of NITs might be one way to make this connection. Louise Campbell agrees that increased focus on "Healthy Livers, Healthy Lives" will drive exactly these kinds of discussions. The rest of the episode consists of Roger asking panelists three questions, to which they respond: 

1. What might change over the next year or two? Meena believese that approval of a drug will drive significant growth in the learning curve and, with that, enhanced disease awareness and understanding. Jeff suggests that this will not take the form of a transition from NAFLD to MASLD, but instead that people first learning about the disease will use the new nomenclature properly. Mike Betel notes that on the Fatty Liver Alliance website, ~98% of searches are simply for "fatty liver disease." Over time, he anticipates this will change and also that websites like FLA will address "fatty liver" queries in terms of new nomenclature. 
2. Impact on ICD codes. Meena, who is doing significant work in this area, answers that the goal is to have no impact but simply a smooth cutover. 
3. How the group would grade its work on this activity to date. As Jeff notes, answers from the people who led the process are likely to be quite biased, but all gave fairly high grades. 

This conversation focuses on how the new MASLD nomenclature might improve providers' explanations of MASH to patients. Louise Campbell describes new opportunities, while Meena Bansal describes how focusing on metabolism provides a richer opportunity for providers to explain to MASH patients why fat on the liver matters.

Louise Campbell starts this conversation by discussing a new NHS program providing primary care centers with VCTE units they can use to screen patients for MASLD and MASH. She points out that this will provide a unique opportunity to present the new MASLD nomenclature to primary care and allied health providers in a way that connects immediately to diagnosing patients and educating them properly about their disease. She notes that at the patient level, the discussion is still likely to focus on excess fat on the liver but presents the idea of "fat" in a less stigmatizing way.

Meena Bansal focuses more specifically on exactly how provider-patient conversations might change. For years, she suggests, physicians have written "hepatic steatosis" on patient charts, but then told patients they "just have a little fat on the liver." In her view, the new nomenclature will take the word "just" out of the discussion and present the "little fat on the liver" as part of a metabolic syndrome that requires treatment. She goes on to mention another source of excitement: the ability to consider MetALD patients as part of the same MASLD community and add them to Mt. Sinai's longitudinal patient registry, which will likely become a rich source of MetALD data.
Earlier in the episode, Jeff Lazarus had mentioned his excitement at the growing role and publicity for the "Healthy Livers, Healthy Lives" initiative. Louise notes that increasing focus on liver awareness and awareness of the importance of liver health, as discussed in Season 5 Episode 2, aligns neatly with Meena's disease description and the new communication opportunities for new physician and allied health specialties.

This conversation shifts from the rearview to the path ahead. Louise Campbell starts by asking about the role of Allied Health Providers in the process. After this issue, process leaders Maru Rinella, Jeff Lazarus and Meena Bansal discuss how this will roll out as we move ahead.

It starts with Louise Campbell asking why there Allied Health Providers did not play a larger role in the Delphi process. Maru Rinella replies that, in her vision, this group’s involvement will be critical in the rollout and message development but less so in a Delphi process that was mostly about hashing out, as Maru puts it, “the nuances of the disease.” To Maru, this is also the place where patient voice brings the most pivotal value. Meena Bansal notes that there were some PAs and NPs in the Delphi process. Meena Bansal agrees that their role will be critical in discussions on how to communicate the disease to the patient (a topic we return to in later conversations). Louise appreciates, accepts and largely agrees with this discussion. 

Roger Green shifts focus from the past process to ask about the rollout phase: when it began, what it will include and when it might end. Meena says it will never end. Jeff Lazarus comments that while publication was the formal rollout, even before then groups were vying to be the first to change their names. He also noted that the article was published simultaneously in several journals with broad, rapid uptake in the literature. Since the key is to raise awareness and educate the population, he considers the speed and breadth of uptake a major sign of success. Maru Rinella comments that journal participation has been generally excellent.

This conversation focuses on the Delphi process for a new MASLD nomenclature. It starts with Jeff Lazarus describing what a Delphi process is and how it worked here. Jeff and two other key players in this process, Maru Rinella and Meena Bansal, describe what they consider some of its greatest strengths as well as one thing they wish had worked out better.

Jeff's description focuses on the four rounds of data gathering and some key activities that transpired before the formal process began. He goes on to identify what he considers some of the pivotal outputs of this one. In particular, Jeff describes the focus on patients with alcohol and diet issues, and the naming of a new discreet disease for these patients (MetALD) as being “revolutionary.” 

Roger Green agrees with Jeff's assessment that the naming of MetALD was an important outcome and that the process had clear benefits in this way. He goes on to ask why people opted out of the process. Maru Rinella comments that some people opted out after the third phase due to disagreements with the direction of the activity. Roger refines the question to ask why people opted out in the first place. Jeff and Maru note the amount of work required for this kind of activity, and he, Maru Rinella and Meena Bansal all describe that not all invitees understood how important this process would be upon first invitation. Jeff and Maru go on to mention that the participation rate was high, somewhere around 80%.

Roger asks what could have gone better. Maru, Jeff and Meena Bansal each note groups for which they wish participation had been broader, including possibly a broader representation of stakeholders (notably, more patients, although Maru notes this was not for lack of trying) and more organizations or countries.

This conversation focuses on the issues and visions that led to the identified need for a new MASLD nomenclature. Maru Rinella and Jeff Lazarus discuss the original goals of the process and how focus broadened and shifted throughout.

It starts with Maru Rinella describing what she terms “an existential crisis” for the field around a publication suggesting changing the name of the disease from “non-alcoholic” fatty liver disease to “metabolic” fatty liver disease. She considers this the main impetus for key global players to converge. Jeff Lazarus notes that stigma and several other processes came into the discussion. Maru and Jeff agree that the participant recruitment process came in two phases, one where it was hard to get participants and a later point where it was to manage the size of the exercise. Jeff felt the tipping point happened when people understood how the Delphi process would work and also the need for this to succeed. Maru felt that people had to grasp the implications of a consensus process, which Delphi is. As the conversation ends, another leader in the process, Meena Bansal and a patient advocate participant, Mike Betel of the Fatty Liver Alliance, describe how they came to enroll.

In this episode, Douglas Dieterich, MD, leads a panel discussion with Camilla S. Graham, MD, MPH, and Robert Wong, MD, MS, to consider advantages and barriers to universal screening for chronic HBV infection and universal HDV screening in adults with HBV in the United States. Topics include:

• Updated CDC recommendations for one-time universal screening for HBV
• Addressing patient-, provider-, and system-level barriers to universal HBV screening
• Best practices for implementation of HDV screening

Presenters:

Douglas Dieterich, MD
Director, Institute for Liver Medicine

Professor of Medicine

Division of Liver Diseases

Mount Sinai School of Medicine

New York, New York

Camilla S. Graham, MD, MPH
Co-Director, Viral Hepatitis Clinic
Division of Infectious Diseases
Beth Israel Deaconess Medical Center
Harvard Medical School
Boston, Massachusetts

Robert Wong, MD, MS 
Clinical Associate Professor
Division of Gastroenterology and Hepatology
Stanford University School of Medicine
Palo Alto, California

Link to full program:
https://bit.ly/3TuqFHI

Link to the slides: 
https://bit.ly/4atS42z

In this episode, Douglas Dieterich, MD, leads a panel discussion with Camilla S. Graham, MD, MPH, and Robert Wong, MD, MS, to consider advantages and barriers to universal screening for chronic HBV infection and universal HDV screening in adults with HBV in the United States. Topics include:

• Updated CDC recommendations for one-time universal screening for HBV
• Addressing patient-, provider-, and system-level barriers to universal HBV screening
• Best practices for implementation of HDV screening

Presenters:

Douglas Dieterich, MD
Director, Institute for Liver Medicine

Professor of Medicine

Division of Liver Diseases

Mount Sinai School of Medicine

New York, New York

Camilla S. Graham, MD, MPH
Co-Director, Viral Hepatitis Clinic
Division of Infectious Diseases
Beth Israel Deaconess Medical Center
Harvard Medical School
Boston, Massachusetts

Robert Wong, MD, MS 
Clinical Associate Professor
Division of Gastroenterology and Hepatology
Stanford University School of Medicine
Palo Alto, California

Link to full program:
https://bit.ly/3TuqFHI

Link to the slides: 
https://bit.ly/4atS42z

In this episode, Douglas Dieterich, MD, leads a panel discussion with Camilla S. Graham, MD, MPH, and Robert Wong, MD, MS, to consider advantages and barriers to universal screening for chronic HBV infection and universal HDV screening in adults with HBV in the United States. Topics include:

• Updated CDC recommendations for one-time universal screening for HBV
• Addressing patient-, provider-, and system-level barriers to universal HBV screening
• Best practices for implementation of HDV screening

Presenters:

Douglas Dieterich, MD
Director, Institute for Liver Medicine

Professor of Medicine

Division of Liver Diseases

Mount Sinai School of Medicine

New York, New York

Camilla S. Graham, MD, MPH
Co-Director, Viral Hepatitis Clinic
Division of Infectious Diseases
Beth Israel Deaconess Medical Center
Harvard Medical School
Boston, Massachusetts

Robert Wong, MD, MS 
Clinical Associate Professor
Division of Gastroenterology and Hepatology
Stanford University School of Medicine
Palo Alto, California

Link to full program:
https://bit.ly/3TuqFHI

Link to the slides: 
https://bit.ly/4atS42z

Should quantitative HBsAg testing be used routinely in clinical practice for patients living with chronic hepatitis B?

In this episode, Tatyana Kushner, MD, MSCE, discusses the role of quantitative hepatitis B surface antigen testing in people living with chronic hepatitis B, including:

• Determination of inactive carrier status
• Prediction of liver fibrosis/cirrhosis
• Prediction of hepatocellular carcinoma development
• Monitoring response to treatment, including future HBV treatments in the development pipeline
• Prediction of HBsAg loss

Joining her for the panel discussion are Ira M. Jacobson, MD, and Paul Y. Kwo, MD.

Presenters:

Ira M. Jacobson, MD
Professor of Medicine
Director of Hepatology
NYU Langone Health
New York, New York

Tatyana Kushner, MD, MSCE
Associate Professor
Division of Liver Diseases
Icahn School of Medicine at 
Mount Sinai
New York, New York

Paul Y. Kwo, MD
Professor of Medicine 
Director of Hepatology 
Stanford University School of Medicine
Palo Alto, California

Link to the full program: 
https://bit.ly/3R1PMi4

Link to the slides: 
https://bit.ly/3N5Fpsm

Are we treating HBV early enough? Is it time to move the goalposts regarding the timing of treatment initiation? What are the potential benefits of earlier treatment?

To answer these questions, Ira M. Jacobson, MD, leads a panel discussion with Tatyana Kushner, MD, MSCE, and Paul Y. Kwo, MD, exploring which patients with HBV we should be treating, including a focus on:

• Guideline-based treatment recommendations and their limitations
• Data describing the relationship between viral suppression and HBV DNA integration
• More expansive indications for HBV treatment based on virologic considerations

Presenters:

Ira M. Jacobson, MD
Professor of Medicine
Director of Hepatology
NYU Langone Health
New York, New York

Tatyana Kushner, MD, MSCE
Associate Professor
Division of Liver Diseases
Icahn School of Medicine at 
Mount Sinai
New York, New York

Paul Y. Kwo, MD
Professor of Medicine 
Director of Hepatology 
Stanford University School of Medicine
Palo Alto, California

Link to the full program: https://bit.ly/3R1PMi4

Link to the slides: https://bit.ly/3N5Fpsm

This week on SurfingNASH, we introduce the audience to new guest, Dr Roberta Forlano, who's been awarded an EASL Juan Rodes PhD Fellowship and has completed a PhD in Translational Hepatology at Imperial college London in 2022. Her current research interest are screening strategies for NAFLD in primary care, automated quantitation of histological features , lifestyle management, CV risk assessment and non-invasive markers in NAFLD. These interests and much more are shared and discussed with Jörn Schattenberg, Louise Campbell and Roger Green in a compelling episode with an overarching theme focusing on screening strategies for gender-based SLD challenges. To offer an example of how immensely productive and busy Roberta and her team have been, they recently presented 6 posters at the recently concluded SLD Summit.

This final conversation covers the other paper discussed in the episoe at large, a literature review looking at how MASH and MASLD might differ in women compared to men. Roberta starts by noting the gap in literature about gender differences in MASH studies, and that women appear represented in most clinical trials. Most of the rest of the conversation involves Roberta and Louise commenting on gender differences and the impact of menopausal status on MASH and MASLD in women. When this finishes, Roger asks Louise and Jörn to describe one thing we discussed that might affect their practices or patterns. He also asks Roberta what she would like listeners to take away from the conversation.

With that as a very brief introduction to a fascinating conversation well-worth a listen, surf on to learn more about Roberta and critical ideas around screening strategies and much more. If you have questions or comments stemming from this episode, or any others for that matter, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com.

Stay Safe and Surf On!

The EASL SLD Summit aims at updating a global community of liver stakeholders on the most recent advances in SLD research, both pre-clinically and clinically, focusing on MASLD and tackling the issue of MetALD.

In this episode, Jörn Schattenberg, Louise Campbell and Roger Green review the recently concluded meeting with faculty members Sven Francque and Hannes Hagström in two seperate interviews.

This final conversation starts with Roger’s observation that one reason the energy in this meeting might have been higher is sessions like this one, that was less about sharing answers and more about identifying new topics and raising questions. Jörn segues to a talk he gave on weight loss and bariatric surgery and what it might mean for how we consider and treat MASLD patients. Louise asks whether the audience for this meeting was more diverse than in previous years, specifically mentioning the Society of Obesity. Jörn mentions that the impact of the video stream made the meeting far more accessible than in past years. Hannes notes he would like to hear questions from different specialists and more general physicians and surgeons than in years past. Roger notes that he saw more cardiovascular discussion than in prior years, and also perhaps speakers from more geographic regions. Roger also mentions a session on new techniques and their pitfalls and promises. Jörn notes that the outcomes from this basic science will define the targets for future drug research. The rest of the conversation revolves around the impact of making our focus less liver-specific and more metabolic or multi-organ. In closing, Louise asks what came up that we can use today and Hannes goes back to diagnostic pathways and FIB-4.

Listen to the full episode to gain a richer understanding than can be described in this summary. If you have questions or comments around the Summit or any other themes addressed in this episode, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com.

This episode From the Vault comes from last year's SurfingNASH review of the 2022 NAFLD Summit with Mazen Noureddin, Sven Francque and Hannes Hagström.

The 2022 NAFLD Summit uniquely presented a range of perspectives and insights on fatty liver and metabolic diseases.

Program speakers Mazen Noureddin, Sven Francque and Hannes Hagström join Surfer, Roger Green, on site from Dublin to review their reactions immediately after the conference ended. At the outset of this episode, the group discusses the benefits of participating in a smaller conference more focused on the challenges presented by the field of NAFLD. Mazen likens the NAFLD Summit to NASH-TAG, asserting that these specific conferences advance the field and address deeper layers around the issues that matter most. “You start being provocative.”

Mazen goes on to raise the issue of glycemic control and the impact of glycemic control on NASH drug performance. This bleeds into a brief point about the value of simply stopping fibrosis progression instead of the need to prove regression. He then identifies two sessions he considered particularly valuable: the Saturday morning autopsy of failed Phase 3 trials and therapeutic discussion about drugs at different stages in development. This segues into a discussion of optimism which can derive from the recent Akero and Altimmune results. In terms of Altimmune, Mazen asks whether the drug should go directly from Phase 1b to Phase 3. In general, the group believes that Phases 2a and 2b have value here. The panel agrees that the presentations on three failed Phase 3 trials were richly valuable and that each offered its own clear lessons for researchers.

The EASL SLD Summit aims at updating a global community of liver stakeholders on the most recent advances in SLD research, both pre-clinically and clinically, focusing on MASLD and tackling the issue of MetALD.

In this episode, Jörn Schattenberg, Louise Campbell and Roger Green review the recently concluded meeting with faculty members Sven Francque and Hannes Hagström in two seperate interviews.

This final conversation from our interview with Sven centers on the research that Sven and his colleagues presented at the SLD Summit.  Most of this research focuses on portal pressures in pre-cirrhotic patients, including those with fibrosis levels as low as F0 or F1. Sven notes that relatively few of these patients have elevations of 10mmHg or more in these earlier stage scenarios, but a significant number have elevations from 5-9 mmHG, which might affect health in more subtle ways. Roger asks about the impact of this work on how we treat patients today and into the future. Sven follows up by identifying several areas for future research. As the groups moves toward the end of the interview, Louise asks questions around using NITs, notably FibroScan, to check for pressures because in some of her work, VCTE in biopsied and non-biopsied livers demonstrated different results. Sven congratulates Louise on the question and indicates this might be a powerful area for future research. 

With that, listen to the full episode to gain a richer understanding than can be described in this summary. If you have questions or comments around the Summit or any other themes addressed in this episode, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com.

From the official EASL SLD Summit website:

The EASL SLD Summit aims at updating a global community of liver stakeholders on the most recent advances in SLD research, both pre-clinically and clinically, focusing on MASLD and tackling the issue of MetALD. You will gain insights in the most key techniques employed in research, clinical trials and clinical practice, with an understanding of their potential as well as limitations. You will learn about the most recent advances in our understanding of the disease, including the role of sexual dimorphism, circadian clock or vascular mechanisms, and potential new targets as well as modalities of treatment. You will exchange on these topics with both young fellows and established experts in the field in a highly interactive format with a lot of room for discussion. You will get the latest update on where we stand with the efforts of having MASLD, and SLD in general, on the agenda as a public health problem and the roadmap and policies to tackle this problem, in which the people living with SLD, and many stakeholders have been increasingly joining forces. In light of the latter, the Summit will also provide a space to further discuss the nomenclature change and its potential impact on research clinical practice and awareness. A session will be dedicated to discussing in-depth the issue of people who combine alcohol use and metabolic risk factors, designated as MetALD in the latest nomenclature. You will also get the latest data on diagnosis and prognostication in MASH and on how to tackle MASLD as a multisystem disease, informing you not only on what you need to do, but also on the science and evidence behind it.

The EASL SLD Summit aims at updating a global community of liver stakeholders on the most recent advances in SLD research, both pre-clinically and clinically, focusing on MASLD and tackling the issue of MetALD.

In this episode, Jörn Schattenberg, Louise Campbell and Roger Green review the recently concluded meeting with faculty members Sven Francque and Hannes Hagström in two seperate interviews.

This conversation starts with Roger asking Sven for his impression about whether the three diseases - MASH, MetALD, Alcoholic SLD - lie on a single continuum or whether the alcoholic and non-alcoholic causes of disease are separate dimensions. Sven suggests that there are different dimensions that can be seen in elements of hepatic structure and vascularization, but that neither are completely independent. Switching to a different challenge around MetALD and alcohol, Jörn discusses the complexity in patients assessing their own drinking behaviors given that much drinking is a weekend-oriented social event rather than a consistent pattern of daily consumption. In the course of this discussion, both Sven and Jörn note their hope that AI/ML will provide pivotal new insights on these issues. Sven comments that he hopes that research will continue to develop along a path of basic science rather than simple drug testing and development. Roger suggests that the relatively low level of efficacy with late stage development drug suggests that we need to learn far more about the basic science to support development of highly successful drugs and NITs.

With that, listen to the full episode to gain a richer understanding than can be described in this summary. If you have questions or comments around the Summit or any other themes addressed in this episode, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com.

From the official EASL SLD Summit website:

The EASL SLD Summit aims at updating a global community of liver stakeholders on the most recent advances in SLD research, both pre-clinically and clinically, focusing on MASLD and tackling the issue of MetALD. You will gain insights in the most key techniques employed in research, clinical trials and clinical practice, with an understanding of their potential as well as limitations. You will learn about the most recent advances in our understanding of the disease, including the role of sexual dimorphism, circadian clock or vascular mechanisms, and potential new targets as well as modalities of treatment. You will exchange on these topics with both young fellows and established experts in the field in a highly interactive format with a lot of room for discussion. You will get the latest update on where we stand with the efforts of having MASLD, and SLD in general, on the agenda as a public health problem and the roadmap and policies to tackle this problem, in which the people living with SLD, and many stakeholders have been increasingly joining forces. In light of the latter, the Summit will also provide a space to further discuss the nomenclature change and its potential impact on research clinical practice and awareness. A session will be dedicated to discussing in-depth the issue of people who combine alcohol use and metabolic risk factors, designated as MetALD in the latest nomenclature. You will also get the latest data on diagnosis and prognostication in MASH and on how to tackle MASLD as a multisystem disease, informing you not only on what you need to do, but also on the science and evidence behind it.

The EASL SLD Summit aims at updating a global community of liver stakeholders on the most recent advances in SLD research, both pre-clinically and clinically, focusing on MASLD and tackling the issue of MetALD.

In this episode onSurfing NASH , Jörn Schattenberg, Louise Campbell and Roger Green review this recently concluded meeting with faculty members Sven Francque and Hannes Hagström. Jörn joins both guests as a fellow presenter and the group dives into program highlights with many fascinating takes and interplaying ideas. 

The first featured interview is with Sven, who served as one of three organizing members for this year's Summit. In addition, Sven chaired both the opening and closing Plenary sessions on the subject of Metabolism, Alcohol and Toxicity. Sven also delivered a presentation titled Anti-platelet drugs in MASLD: pre-clinical and clinical data. The following feature with Hannes explores elements of his presentation on how common alcohol overconsumption is in MASLD and how highly this increases risk for future cirrhosis. Throughout both interviews, Jörn is able to elaborate and reflect on his high level of engagement at the Summit as he chaired an industry session and gave three presentations with subjects ranging from clinical trial data (MAESTRO-NASH for resmetirom) to endoscopic bariatric therapies and mitochondrial uncoupling.

With that, listen to the full episode to gain a richer understanding than can be described in this summary. If you have questions or comments around the Summit or any other themes addressed in this episode, we kindly ask that you submit reviews wherever you download the discourse. Alternatively, you can write to us directly at questions@SurfingNASH.com.

From the official EASL SLD Summit website:

The EASL SLD Summit aims at updating a global community of liver stakeholders on the most recent advances in SLD research, both pre-clinically and clinically, focusing on MASLD and tackling the issue of MetALD. You will gain insights in the most key techniques employed in research, clinical trials and clinical practice, with an understanding of their potential as well as limitations. You will learn about the most recent advances in our understanding of the disease, including the role of sexual dimorphism, circadian clock or vascular mechanisms, and potential new targets as well as modalities of treatment. You will exchange on these topics with both young fellows and established experts in the field in a highly interactive format with a lot of room for discussion. You will get the latest update on where we stand with the efforts of having MASLD, and SLD in general, on the agenda as a public health problem and the roadmap and policies to tackle this problem, in which the people living with SLD, and many stakeholders have been increasingly joining forces. In light of the latter, the Summit will also provide a space to further discuss the nomenclature change and its potential impact on research clinical practice and awareness. A session will be dedicated to discussing in-depth the issue of people who combine alcohol use and metabolic risk factors, designated as MetALD in the latest nomenclature. You will also get the latest data on diagnosis and prognostication in MASH and on how to tackle MASLD as a multisystem disease, informing you not only on what you need to do, but also on the science and evidence behind it.

In this episode, Stefan Zeuzem, MD, discusses new data on viral hepatitis presented at EASL 2023, including:

• Hepatitis B virus
  • Durability of response with bepirovirsen
  • HBsAg loss with siRNA VIR-2218 combined with either VIR-3434 (novel monoclonal antibody) or pegIFN-alfa
• Hepatitis delta virus
  • 96-week follow-up of immediate vs delayed bulevirtide
  • Off-treatment response for lonafarnib + ritonavir ± pegIFN-alfa 
  • Safety and efficacy outcomes with siRNA JNJ-3989 + nucleos(t)ide analogue
• Hepatitis C virus
  • Collaborative service at opiate substitution treatment clinic to improve linkage to care in Ireland
  • Nurse-led test-and-treat program to increase screening and diagnosis at female prisons in the United Kingdom
  • FIND-C study using machine learning to improve screening-to-diagnosis ratio using clinical factors and social determinants of health

Presenter:

Stefan Zeuzem, MD
Professor of Medicine 
Chief, Department of Medicine 
JW Goethe University Hospital 
Frankfurt, Germany

Link to full program: 

https://bit.ly/3JQQj3J

In this episode, Tarik Asselah, MD, PhD, and Ira Jacobson, MD, provide expert insight on HDV screening, diagnosis, and management, including:

• Approach to screening
• Barriers to screening (eg, test availability)
• Disease progression and complications
• Differentiating between coinfection and superinfection
• Approach to treatment (eg, whom to treat and when, treatment options, considerations for combination therapy)
• Management of patients with decompensated cirrhosis
• Surrogate markers to measure treatment success
• Role of correcting thrombocytopenia before initiating therapy

Faculty:

Tarik Asselah, MD, PhD
Professor of Medicine 
Department of Hepatology
Hôpital Beaujon
Université de Paris
Clichy, France

Ira Jacobson, MD
Professor of Medicine
NYU School of Medicine
Director of Hepatology
Division of Gastroenterology and Hepatology
NYU Langone Health
New York, New York

Link to full program: https://bit.ly/3yp1Lxf

In this episode, Nancy Reau, MD, and Heiner Wedemeyer, MD, provide expert insight on HDV management, including:

• Use of noninvasive imaging or biopsy for staging liver disease
• Screening for hepatocellular carcinoma
• HBV treatment
• Role of comedications (eg, erythropoietin, eltrombopag)
• Approach to complex cases, such as patients with:
  • Significant fibrosis and low HDV RNA levels
  • Hepatitis delta antibody positivity, but HDV RNA negativity
  • HIV coinfection
  • Decompensated or recently decompensated cirrhosis

Faculty:

Nancy Reau, MD
Professor of Medicine
Chief, Section of Hepatology
Associate Director, Solid Organ Transplantation
Richard B. Capps Chair of Hepatology
Rush University Medical Center
Chicago, Illinois

Heiner Wedemeyer, MD
Professor and Chairman
Department of Gastroenterology, Hepatology and Endocrinology 
Hannover Medical School
Hannover, Germany

Link to full program: 
http://bit.ly/3yp1Lxf

In this episode, Maria Buti, MD, and Richard H. Davis, PA-C, address key considerations when screening, diagnosing, and treating patients with hepatitis delta virus (HDV), such as:

• Barriers to screening 
• HDV screening based on patient risk factors 
• Universal screening for all patients with positive hepatitis B surface antigen (HBsAg)
• Reflex testing 
• Availability of commercial testing
• Monitoring suggestions in HBsAg positive and HDV antibody positive patients with negative HDV RNA
• Limitations to evaluating advanced fibrosis in patients with HDV
• Data on novel HDV therapies (eg, bulevirtide and lonafarnib)
• Extending HDV therapy (eg, peginterferon) based on treatment response
• Stopping rules (eg, HDV RNA negativity, HBsAg loss) for discontinuing HDV therapy

Faculty:

Maria Buti, MD
Professor of Medicine
Hospital Universitario Vall d’Hebron
Barcelona, Spain

Richard H. Davis, PA-C
Senior PA
Gastroenterology
University of Florida
UF Health
Gainesville, Florida

Link to full program: 
http://bit.ly/3yp1Lxf