We prospectively evaluated liver stiffness (LS), controlled attenuation parameter, and the FibroScan-AST (FAST) score in patients with human immunodeficiency virus (HIV) using transient elastography. The study comprised 166 patients, including 60 (45.9%) patients with hepatitis B antigen positivity, 30 (18.1%) patients with hepatitis C who achieved sustained virologic response by direct-acting antivirals or interferon, and 54 (32.5%) patients with metabolic dysfunction associated steatotic liver disease (MASLD). None of the hepatitis B-positive patients undergoing antiretroviral therapy had no liver cirrhosis (LC), whereas LS was decreased in patients with hepatitis C. LC and hepatocellular carcinoma were found in 5 and 1 patient with MASLD, respectively. The FAST score and LS were significant progression factors leading to death and LC in patients with HIV and MASLD. In conclusion, the risk of progression to LC was higher despite the younger age of patients with HIV and MASLD compared to the general population. LS and the FAST score were significant factors associated with MASLD progression to LC in patients with HIV.

This is a qualitative descriptive study of the educational effects of a lecture for nursing students on "Nursing Care for Patients with Chronic Liver Disease" conducted by a nurse educator who was trained and worked as a hepatitis medical care coordinator. This study identified six categories from brief reports submitted by the students. The lecture addressed the necessity of nursing care based on the characteristics of liver disease and determined self-care support suitable for disease severity and each patient through multidisciplinary collaboration. It encouraged individuals to undergo blood tests to detect HBV and HCV infections for early diagnosis and treatment and provided psychological support to patients and their families. Furthermore, it promoted social outreach to eliminate prejudice and discrimination for patients with liver disease and disseminated correct knowledge so that unconscious words and actions of medical staff do not lead to prejudice and discrimination for these patients.

A woman in her 40s visited our hospital in 20XX to seek treatment for chronic hepatitis C and to undergo a thorough evaluation of a liver tumor. Abdominal ultrasound revealed a 35 mm liver mass in segment 2/3. The contrast-enhanced computer tomography scan and magnetic resonance imaging with EOB showed enhancement of the tumor from the periphery to the center, leading to a diagnosis of hepatic hemangioma. The tumor remained stable for a while; however, in 20XX+9, it shrank to 27 mm. In 20XX+10, a contrast-enhanced abdominal ultrasound revealed a 7 mm cyst at the site of a previous hepatic hemangioma, and surrounding it, a 14 mm area with poor contrast enhancement and a defect in the Kupffer phase. In 20XX+11, there was a further reduction in the contrast enhancement around the cyst; however, the cyst's diameter remained unchanged. Herein, we report a case of a degenerated hepatic hemangioma with long-term follow-up.

The Nara Declaration 2023 recommends that patients with ALT levels of >30 U/L and those who have steatosis, diabetes, hypertension, and/or dyslipidemia should be referred to a hepatologist, considering the results of the FIB4 index and/or platelet count. ALT levels of >30 U/L is a simple and useful indicator and, when combined with the FIB4 index and platelet count, can detect MASLD cases that require further treatment and follow-up. Moreover, among patients with MAFLD and ALT levels of ≤30 U/L, the FIB4 index may be useful for identifying those at risk of MASLD. The Nara Declaration 2023 is an important and convenient guideline that provides primary care doctors with specific indications for referral to a hepatologist. When combined with the FIB4 index, ALT levels of >30 U/L is expected to predict high-risk MASLD cases.