An 80-year-old man underwent a blood test and was tested positive for hepatitis C virus antibody in 2005; thereafter, he visited the hospital regularly every 3 months. In February 2015, when the patient was 90 years of age, his abdominal ultrasound examination revealed a hepatic tumor; subsequently, contrast-enhanced computed tomography (CT) showed diffuse hepatocellular carcinoma (HCC) with portal vein tumor thrombosis (PVTT). He was referred to our hospital in March 2015 because he wasn't suitable to hepatic resection due to elderly age. An indwelling port was inserted in the right femoral area, and a combination therapy of 5-fluorouracil hepatic arterial infusion and systemic interferon was administered. After three cycles of chemotherapy, his tumor marker values lowered to within the normal range and contrast-enhanced CT revealed regression of intrahepatic lesions and PVTT; this was classified as a complete response, according to the modified RECIST guidelines. The patient is alive without recurrence. Thus, this report describes the case of a 90-year-old man with advanced HCC and PVTT who was successfully treated with hepatic arterial infusion chemotherapy.

Recently, non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis are increasingly being implicated as the cause of cirrhosis. In patients with NAFLD, disease prognosis is correlated with the stage of liver fibrosis; however, it is not feasible to perform liver biopsy for all patients with NAFLD. Therefore, the condition is monitored by regular, non-invasive measurement of liver stiffness.

In this study, shear wave velocity (SWV) as a measurement of liver stiffness and transaminase activity were compared in 10 patients with NAFLD before and after the administration of the sodium-glucose linked transporter 2 inhibitor, luseogliflozin. After >24 weeks of luseogliflozin initiation, there were significant improvements in the body mass index, glycosylated hemoglobin, alanine transaminase levels, fibrosis-4 index, and SWV.

A possibility that luseogliflozin improves the prognosis of NAFLD patients is considered.

A 32-year-old Japanese woman was diagnosed with Budd-Chiari syndrome with complete obstruction of the right and the middle hepatic vein as well as severe stenosis in the left hepatic vein. She had esophageal varices (F2) and low platelet counts (10.7 × 10⁴/mm³). She underwent percutaneous transluminal angioplasty (PTA) for the left hepatic vein. Liver stiffness was decreased from 66.4 kPa before PTA to 16.8 kPa after 3 h and 10.4 kPa after 4 months with an improvement in the esophageal varices (F0) and platelet count (16.5 × 10⁴/mm³). Furthermore, the serum level of hyaluronic acid decreased from 76 ng/ml before PTA to <9 ng/ml after 4 months. To our knowledge, this is the first case wherein liver stiffness was able to reflect hepatic congestion and helped monitor the therapeutic effect in Budd-Chiari syndrome.

A 76-year-old man with advanced non-small cell lung cancer (cT4N3M1a, stage IV A) received pembrolizumab treatment. At 8 days after the administration of pembrolizumab, he developed acute liver injury that worsened over time. Thus, liver biopsy was performed. Pathological examination revealed severe inflammation and focal necrosis in the central venous region; periportal inflammation was also detected. No remarkable fibrotic changes were observed. The infiltrating cells mainly comprised lymphocytes, and most of them were positive for CD8 staining. Based on this finding, an immune-related adverse event caused by pembrolizumab was suspected, and corticosteroid therapy was initiated, which immediately reduced liver injury. To our knowledge, this is the first report to describe the pathological features of pembrolizumab-induced liver injury, and our findings suggest that cytotoxic T cells play a crucial role in pembrolizumab-induced liver injury.

In this prospective multicenter study, we evaluate the efficacy and safety of glecaprevir/pibrentasvir (GLE/PIB) combination therapy for genotype 1b chronic hepatitis C patients undergoing hemodialysis. Of 17 patients who received GLE/PIB for 8 or 12 weeks, 11 completed the treatment and the 12-week follow-up care that followed. All 11 patients (100%) achieved sustained virologic response 12 (SVR12). Adverse events were observed in 41.2% of all patients and the most frequent adverse event was pruritus. This study suggests that GLE/PIB combination therapy is highly effective and safe even in genotype 1b chronic hepatitis C patients undergoing hemodialysis.