Magnetic resonance imaging (MRI) is widely used for liver imaging in chronic liver disease (CLD); however, it is rarely used for sarcopenia diagnosis. This study used MR elastography imaging data to develop diagnosis criteria of sarcopenia in Asians. Age, body mass index, albumin, and liver fibrosis (F3 or above) in CLD were independently associated with sarcopenia that is diagnosed by the new criteria, and the new criteria sarcopenia was shown as an independent prognostic factor in cirrhosis. The usefulness and future potential of liver MRI for diagnosing sarcopenia were demonstrated.

A Post-marketing surveillance of ombitasvir/paritaprevir/ritonavir (OBV/PTV/r) was conducted to assess the durability of sustained virologic response (SVR) and monitor the liver cancer incidence after OBV/PTV/r treatment. Patients with hepatitis C virus genotype 1b infection with/without compensated cirrhosis who completed the phase 2 or 3 clinical trials were followed up for 4 years after the 48-week follow-up period of the trials. Of the 330 patients for efficacy analysis, the SVR rate was 100% for 5 years. Liver cancer was confirmed in 10 patients for 5 years (cumulative incidence proportion [95% confidence interval] : 3.2% [1.73-5.87] ). The cumulative incidence proportion was significantly lower in patients who achieved SVR 12 weeks after treatment than in those who did not. Serious adverse events occurred in 25/334 (7.5%) patients for safety analysis. These results suggest that SVR is durable for 5 years after treatment, and achieving SVR 12 weeks after treatment may suppress liver cancer occurrence.

A male patient in his 70s had been treated with lenvatinib, ramucirumab, and hepatic arterial infusion chemotherapy for hepatitis B virus-related-unresectable multiple hepatocellular carcinomas. We administered atezolizumab and bevacizumab combination therapy owing to tumor progression. He was administered five cycles of chemotherapy, and he was admitted to the hospital due to a temperature of 40°C, malaise, and rash on the trunk 4 months after the treatment initiation. We administered steroids with the diagnosis of skin damage due to immune-related adverse events. The rash on the trunk improved; however, purpura was observed on both lower limbs and the platelet counts were markedly decreased to <5000/μl 4 days after admission. The platelet count slowly recovered after steroid administration. Here, we present a rare case of immune thrombocytopenic purpura caused by combination therapy with atezolizumab and bevacizumab for unresectable hepatocellular carcinoma.

The Fibrosis-4 (FIB-4) index and nonalcoholic fatty liver disease (NAFLD) fibrosis score (NFS) are screening tests that are recommended by the Japanese Society of Hepatology and the Japanese Society of Gastroenterology to detect advanced liver fibrosis in patients with NAFLD. Further inspections are recommended for patients with >1.3 FIB-4 index and −1.44 NFS. We investigated the characteristics of patients with severe hepatic fibrosis with scores under the cutoff values. Patients with advanced liver fibrosis were defined as patients with Stages 3 and 4 who showed higher body mass index (BMI) and serum ferritin compared to patients with stages 0-2. Higher BMI and ferritin as well as other scores, including ferritin, such as NAFIC score, can be useful screening options to detect advanced liver fibrosis among patients with lower FIB-4 index or NFS.

Aichi Dental Association (ADA) has developed a hepatitis project for dentists and held a hepatitis medical care coordinator (hepatitis-coordinator) training course. According to the questionnaire (response rate of 91.2% [145/159] ) for participants, dentists have more opportunities to interact with patients with hepatitis than the attendees from the non-dental field (p = 0.001). Dentists had expanded their knowledge of the role of hepatitis coordinators (p = 0.047) and wished to recommend the hepatitis B vaccination (p < 0.001). The number of dentists became the largest among hepatitis coordinators by occupation in Aichi Prefecture since 94 dentists were certified as hepatitis coordinators. The training courses by ADA provided an opportunity to take a leading position on hepatitis for dentists.