3b:I[281230,["/_next/static/immutable/chunks/0l5c-zsrs2aic.js","/_next/static/immutable/chunks/3_n0rk2989-8h.js","/_next/static/immutable/chunks/3ofw495lt1gr1.js","/_next/static/immutable/chunks/3tofdpg99uc12.js","/_next/static/immutable/chunks/2rzojj6zgb9d9.js","/_next/static/immutable/chunks/42jxjvozn2thc.js","/_next/static/immutable/chunks/1jp6nkbajpbfs.js","/_next/static/immutable/chunks/3jn_lf7v27x-6.js","/_next/static/immutable/chunks/33qq2-hg37d0b.js","/_next/static/immutable/chunks/15isb0svrppbz.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/0asz50g5_lfq9.js","/_next/static/immutable/chunks/30ia-cxa0yoyc.js","/_next/static/immutable/chunks/3ghibkczd0agr.js","/_next/static/immutable/chunks/20mjl75wrar8n.js","/_next/static/immutable/chunks/3nxreg9fiyt2y.js","/_next/static/immutable/chunks/0c04lgvo3p78i.js","/_next/static/immutable/chunks/1u78gf_avpn77.js"],"PaperListPageClient"] 3e:I[70339,["/_next/static/immutable/chunks/355lxm8rh3fxr.js"],"IconMark"] 3c:T707,Steatotic liver disease (SLD) and liver fibrosis are major comorbidities in people with HIV (PWH). Guidelines recommend stepwise screening using the Fibrosis-4 (FIB-4) index followed by transient elastography (TE), yet its accuracy and the extent of FIB-4 misclassification in PWH remain uncertain. We evaluated the diagnostic performance of FIB-4 against TE, quantified missed fibrosis, and assessed whether metabolic and HIV-specific factors improve risk prediction. We conducted a multinational study of 4,917 PWH without viral hepatitis coinfection or hazardous alcohol intake undergoing TE screening across seven centers. SLD was defined by controlled attenuation parameter >275 dB/m and classified as metabolic dysfunction-associated SLD (MASLD) or metabolic dysfunction-associated alcohol-related liver disease (MetALD). Significant fibrosis (liver stiffness measurement [LSM] ≥8 kPa) was present in 12.6% of participants, advanced fibrosis (LSM ≥11 kPa) in 6.1%, and SLD in 21.7% (20.6% MASLD, 1.1% MetALD). FIB-4 showed modest accuracy for significant fibrosis (AUROC 0.69, 95% CI 0.67-0.72) and misclassified 36% of fibrosis cases as low risk (FIB-4 <1.3). Performance was poorer in MASLD than in non-MASLD (AUROC 0.60 vs 0.76; p <0.001). Participants with false-negative FIB-4 exhibited a more metabolic phenotype, including higher BMI and steatosis. Incorporating metabolic and HIV-specific factors improved discrimination and reclassification and enabled development of the FIB-HIV score, which outperformed FIB-4 (AUROC 0.78 vs 0.69; p <0.001). In PWH, liver fibrosis is common and frequently missed by FIB-4, particularly in MASLD. TE-centered screening strategies augmented by metabolic and HIV-specific indicators may improve early fibrosis detection and risk stratification.3d:T9b6, Background and Aims: Steatotic liver disease (SLD) and liver fibrosis are major comorbidities in people with HIV (PWH). Guidelines recommend stepwise screening using the Fibrosis-4 (FIB-4) index followed by transient elastography (TE), yet its accuracy and the extent of FIB-4 misclassification in PWH remain uncertain. We evaluated the diagnostic performance of FIB-4 against TE, quantified missed fibrosis, and assessed whether metabolic and HIV-specific factors improve risk prediction. Approach and Results: We conducted a multinational study of 4,917 PWH without viral hepatitis coinfection or hazardous alcohol intake undergoing TE screening across seven centers. SLD was defined by controlled attenuation parameter >275 dB/m and classified as metabolic dysfunction-associated SLD (MASLD) or metabolic dysfunction-associated alcohol-related liver disease (MetALD). Significant fibrosis (liver stiffness measurement [LSM] ≥8 kPa) was present in 12.6% of participants, advanced fibrosis (LSM ≥11 kPa) in 6.1%, and SLD in 21.7% (20.6% MASLD, 1.1% MetALD). FIB-4 showed modest accuracy for significant fibrosis (AUROC 0.69, 95% CI 0.67–0.72) and misclassified 36% of fibrosis cases as low risk (FIB-4 <1.3). Performance was poorer in MASLD than in non-MASLD (AUROC 0.60 vs 0.76; p <0.001). Participants with false-negative FIB-4 exhibited a more metabolic phenotype, including higher BMI and steatosis. Incorporating metabolic and HIV-specific factors improved discrimination and reclassification and enabled development of the FIB-HIV score, which outperformed FIB-4 (AUROC 0.78 vs 0.69; p <0.001). Conclusions: In PWH, liver fibrosis is common and frequently missed by FIB-4, particularly in MASLD. TE-centered screening strategies augmented by metabolic and HIV-specific indicators may improve early fibrosis detection and risk stratification. 28:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Transient Elastography: Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Transient Elastography (modality). Clinician-written summaries and actionable practice insights. 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FIB-4 was originally derived in HIV/hepatitis C coinfection, and its performance across all SLD subtypes may vary. The review acknowledges that FIB-4 alone cannot reliably identify F2–F3 disease or exclude cirrhosis for drug eligibility decisions.","practice_takeaway":"Use FIB-4 as a scalable, first-line triage test in SLD, but always confirm staging with transient elastography or a second-line test before making treatment eligibility decisions—FIB-4 alone should not determine who qualifies for pharmacotherapy."}},{"doi":"10.1016/j.cgh.2026.07.027","pmid":"42776095","title":"AGA Clinical Practice Update on the Evaluation and Management of Metabolic Dysfunction– and Alcohol-Associated Liver Disease: Expert Review","journal_title":"Clinical Gastroenterology and Hepatology","journal_issn":"1542-3565","published_at":"2026-09-23T00:00:00.000Z","url":"https://doi.org/10.1016/j.cgh.2026.07.027","source_score":42,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-29T13:50:09.792Z","updated_at":"2026-09-29T13:50:09.792Z","tags":[{"paper_doi":"10.1016/j.cgh.2026.07.027","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.027","tag_type":"brand","value":"Rezdiffra","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.027","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.027","tag_type":"condition","value":"Alcohol Use Disorder","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.027","tag_type":"condition","value":"Metabolic Dysfunction- and Alcohol-Associated Liver Disease","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.027","tag_type":"condition","value":"Steatotic Liver Disease","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.027","tag_type":"generic","value":"resmetirom","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.027","tag_type":"generic","value":"semaglutide","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.027","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.027","tag_type":"level_of_evidence","value":"7","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.027","tag_type":"modality","value":"Alcohol Use Disorder Pharmacotherapy","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.027","tag_type":"modality","value":"GIP Receptor Agonist","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.027","tag_type":"modality","value":"GLP-1 Receptor Agonist","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.027","tag_type":"modality","value":"Noninvasive Fibrosis Assessment","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.027","tag_type":"modality","value":"Thyroid Hormone Receptor Beta Agonist","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.027","tag_type":"modality","value":"Transient Elastography","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.027","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.027","tag_type":"study_design","value":"Expert Review / Clinical Practice Guideline","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.027","tag_type":"warning","value":"FDA-approved MASLD therapies (resmetirom, semaglutide) have not been studied in MetALD-specific trials; the GLP-1/GIP data on alcohol craving reduction is described as preliminary only","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.027","tag_type":"warning","value":"Liver stiffness measurements by elastography can be transiently elevated by active alcohol use, which may lead to fibrosis overestimation if this context is not accounted for in clinical interpretation","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.027","tag_type":"warning","value":"These Best Practice Advice statements are based on expert opinion and narrative literature review—not systematic review or meta-analysis—so no formal evidence grading or recommendation strength was assigned","value_numeric":null}],"summaries":{"what_studied":"This AGA Clinical Practice Update provides Best Practice Advice (BPA) on the diagnosis, staging, and treatment of metabolic dysfunction– and alcohol-associated liver disease (MetALD), a newly defined category under the 2023 multisociety consensus nomenclature for steatotic liver disease (SLD).","key_result":"Nine BPA statements were issued, covering: classification of MetALD by alcohol intake thresholds (≈140–350 g/wk in women, 210–420 g/wk in men) plus cardiometabolic risk factors; annual alcohol screening; abstinence counseling; tiered noninvasive fibrosis assessment starting with FIB-4; cautious interpretation of elastography during active drinking; micronutrient repletion and exercise; preliminary GLP-1/GIP receptor agonist data suggesting reduced alcohol cravings; pharmacotherapy for alcohol use disorder; and avoidance of bariatric/endobariatric surgery due to insufficient safety data.","limitations":"Systematic reviews were not performed, so BPA statements carry no formal evidence quality ratings or strength-of-recommendation grades. FDA-approved MASLD treatments (resmetirom, semaglutide) have not been formally studied in MetALD populations, leaving a key therapeutic gap.","practice_takeaway":"Classify SLD patients into MetALD using the 140–350 g/wk (women) and 210–420 g/wk (men) alcohol thresholds, screen at least annually with validated tools, and use a tiered FIB-4–first strategy for fibrosis staging. Advise complete alcohol abstinence, replete micronutrients, prescribe aerobic exercise, and offer alcohol use disorder pharmacotherapy for moderate-to-severe AUD; avoid bariatric surgery in MetALD patients."}},{"doi":"10.1016/j.cgh.2026.08.032","pmid":"42710771","title":"Personalised prediction of the individual risk of liver-related events in MASLD using the dynamics of non-invasive tests","journal_title":"Clinical Gastroenterology and Hepatology","journal_issn":"1542-3565","published_at":"2026-09-08T00:00:00.000Z","url":"https://doi.org/10.1016/j.cgh.2026.08.032","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-13T06:21:55.025Z","updated_at":"2026-09-13T06:21:55.025Z","tags":[{"paper_doi":"10.1016/j.cgh.2026.08.032","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.08.032","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.08.032","tag_type":"condition","value":"Hepatocellular Carcinoma","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.08.032","tag_type":"condition","value":"Liver Cirrhosis","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.08.032","tag_type":"condition","value":"Metabolic Dysfunction-Associated Steatotic Liver Disease","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.08.032","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.08.032","tag_type":"level_of_evidence","value":"2","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.08.032","tag_type":"modality","value":"Non-Invasive Fibrosis Testing","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.08.032","tag_type":"modality","value":"Transient Elastography","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.08.032","tag_type":"sample_size","value":"n=13627","value_numeric":13627},{"paper_doi":"10.1016/j.cgh.2026.08.032","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.08.032","tag_type":"study_design","value":"Multicenter Prospective Cohort Study","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.08.032","tag_type":"warning","value":"Study design is labeled as a prospective cohort but the abstract does not explicitly confirm prospective enrollment; observational registry design is possible.","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.08.032","tag_type":"warning","value":"The DOI publication date (2026-09-08) is very recent; external validation of the JLCM in independent cohorts has not yet been reported as of this paper.","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.08.032","tag_type":"warning","value":"The JLCM described in this study is a research-grade statistical model; clinical implementation tools or calculators are not yet described in the abstract, so bedside applicability may require further validation.","value_numeric":null}],"summaries":{"what_studied":"This study evaluated whether a joint latent class model (JLCM) using serial non-invasive fibrosis tests (LSM by VCTE, FIB-4, sex, age, platelets) could personalize prediction of liver-related events (LRE: cirrhosis decompensation or hepatocellular carcinoma) in adults with MASLD, across an international multicentre cohort with median follow-up of 4.0 years.","key_result":"In 13,627 patients with 238 LREs, the JLCM achieved excellent discrimination with integrated AUROCs rising from 88.2% at baseline to 92.2% at 5-year follow-up — outperforming standalone LSM (39–56% sensitivity) and FIB-4 (32–60%), with the JLCM identifying 61–80% of patients who later experienced LRE as high risk.","limitations":"- Outcome events were relatively rare (238 LREs in 13,627 patients), which may limit subgroup analyses.\n- Median follow-up of 4.0 years may be insufficient to capture long-term LRE risk trajectories in MASLD.\n- The JLCM requires serial measurements over time, limiting its applicability at a single baseline visit.","practice_takeaway":"Tracking LSM and FIB-4 serially over time — rather than relying on a single snapshot — significantly improves identification of MASLD patients at high risk for cirrhosis decompensation or liver cancer. Clinicians should consider longitudinal monitoring with validated non-invasive tests as a routine strategy for personalized LRE risk stratification in MASLD."}},{"doi":"10.14309/ajg.0000000000004191","pmid":"42678758","title":"Do Patients on Glucagon-Like Peptide-1 (GLP-1) Receptor Agonists Require Longer Fasting Prior to Vibration Controlled Transient Elastography?","journal_title":"American Journal of Gastroenterology","journal_issn":"0002-9270","published_at":"2026-09-01T00:00:00.000Z","url":"https://doi.org/10.14309/ajg.0000000000004191","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-08T06:32:12.850Z","updated_at":"2026-09-08T06:32:12.850Z","tags":[{"paper_doi":"10.14309/ajg.0000000000004191","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004191","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004191","tag_type":"condition","value":"Cirrhosis","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004191","tag_type":"condition","value":"Liver Fibrosis","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004191","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004191","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004191","tag_type":"modality","value":"GLP-1 Receptor Agonist","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004191","tag_type":"modality","value":"Transient Elastography","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004191","tag_type":"sample_size","value":"n=23","value_numeric":23},{"paper_doi":"10.14309/ajg.0000000000004191","tag_type":"study_design","value":"Prospective Observational Study","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004191","tag_type":"warning","value":"No specific GLP-1 RA agents, doses, or drug durations are reported in the abstract, limiting applicability to individual agents.","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004191","tag_type":"warning","value":"Sex of participants is not reported in the abstract.","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004191","tag_type":"warning","value":"Study design is not explicitly labeled in the abstract; classified as prospective observational based on context (serial measurements after standardized meal). Confirm in full text.","value_numeric":null},{"paper_doi":"10.14309/ajg.0000000000004191","tag_type":"warning","value":"The proportion of patients who required 4 hours to return to baseline is not quantified — clinicians should interpret the 'subset' caveat cautiously.","value_numeric":null}],"summaries":{"what_studied":"This study evaluated whether the standard 3-hour fasting recommendation before vibration-controlled transient elastography (VCTE) remains adequate in patients on GLP-1 receptor agonists (GLP-1 RAs), which delay gastric emptying and alter postprandial hemodynamics. 23 participants (including 12 with cirrhosis) underwent serial liver stiffness measurements (LSM) after a standardized meal.","key_result":"LSM peaked at 20.6% above baseline at 30–60 minutes post-meal, then fell to <10% above baseline by 3 hours. Most patients returned to baseline by 3–4 hours, supporting the adequacy of a 3-hour fast, though some required up to 4 hours.","limitations":"Very small sample size (n=23) limits generalizability. The study does not stratify results by GLP-1 RA agent, dose, or duration of use. The subset requiring 4 hours is not precisely quantified.","practice_takeaway":"A standard 3-hour fast before VCTE appears adequate for most patients on GLP-1 RAs, but clinicians should be aware that a subset may need 4 hours. Consider extending the fast to 4 hours when results seem unexpectedly elevated."}},{"doi":"10.1071/py25195","pmid":"42070789","title":"Acceptability of an integrated care program to identify patients at risk of advanced chronic liver disease in Australian primary care settings","journal_title":"Australian Journal of Primary Health","journal_issn":"1448-7527","published_at":"2026-05-04T00:00:00.000Z","url":"http://hdl.handle.net/1959.4/107718","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-05-17T13:21:40.859Z","updated_at":"2026-05-17T13:21:40.859Z","tags":[{"paper_doi":"10.1071/py25195","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1071/py25195","tag_type":"category","value":"Primary Health Care","value_numeric":null},{"paper_doi":"10.1071/py25195","tag_type":"condition","value":"Advanced Chronic Liver Disease","value_numeric":null},{"paper_doi":"10.1071/py25195","tag_type":"condition","value":"Liver Cirrhosis","value_numeric":null},{"paper_doi":"10.1071/py25195","tag_type":"condition","value":"Metabolic Dysfunction-Associated Steatotic Liver Disease","value_numeric":null},{"paper_doi":"10.1071/py25195","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1071/py25195","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1071/py25195","tag_type":"modality","value":"Integrated Care Program","value_numeric":null},{"paper_doi":"10.1071/py25195","tag_type":"modality","value":"Transient Elastography","value_numeric":null},{"paper_doi":"10.1071/py25195","tag_type":"sample_size","value":"n=11","value_numeric":11},{"paper_doi":"10.1071/py25195","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1071/py25195","tag_type":"study_design","value":"Qualitative Study","value_numeric":null},{"paper_doi":"10.1071/py25195","tag_type":"warning","value":"No patient-reported outcomes or patient interviews were included, which is an acknowledged gap by the authors.","value_numeric":null},{"paper_doi":"10.1071/py25195","tag_type":"warning","value":"Sample size for qualitative interviews is very small (n=11), and only 5 of 9 pilot practices participated, limiting transferability of findings.","value_numeric":null},{"paper_doi":"10.1071/py25195","tag_type":"warning","value":"The POLAR software and CHL model are specific to this pilot — findings about tool usability may not apply to other ACLD screening platforms.","value_numeric":null},{"paper_doi":"10.1071/py25195","tag_type":"warning","value":"The study reflects a single pilot program in Sydney, Australia; results may not generalise to other health systems or countries.","value_numeric":null}],"summaries":{"what_studied":"This qualitative study examined the feasibility and acceptability of the Liver Toolkit (LTK) — an integrated ACLD screening and management program piloted across nine general practices in Sydney, Australia — among 11 general practice and hospital staff (4 GPs, 1 practice manager, 5 Clinical Hospital Liaison staff, 1 PHN project staff), using the Theoretical Framework of Acceptability (TFA) to guide thematic analysis of semi-structured interviews conducted in 2023.","key_result":"Acceptability was mixed: staff recognised the LTK's value (32,270 patients screened; 703 flagged at risk; 179 successfully recalled), but key barriers included low GP self-efficacy with the POLAR software, high burden (4–5 hours per recall list), poor workflow coherence (67 metrics in reports vs. 10–15 relevant), and over-sensitivity leading to many false-positive recalls; hospital-led CHL support was the main enabler.","limitations":"- Small sample (n=11) from only 5 of 9 practices; indirect recruitment via external organisations likely reduced participation.\n- No patient perspectives were captured, limiting understanding of the program's impact from the patient side.\n- Interviews conducted during post-COVID-19 work pressures, which may have heightened perceived burden.","practice_takeaway":"GPs adopting ACLD screening tools should anticipate significant workflow and training demands — embedding decision-support directly into existing clinical software and using nurse-led recall may be key to sustainable implementation. Until the POLAR tool is simplified and integrated, broad roll-out in general practice is premature."}},{"doi":"10.1097/hep.0000000000001773","pmid":"42065895","title":"FIB-4 fails to identify significant liver fibrosis in people with HIV: A large multinational screening study","journal_title":"Hepatology","journal_issn":"0270-9139","published_at":"2026-05-01T00:00:00.000Z","url":"https://doi.org/10.1097/hep.0000000000001773","source_score":22,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-05-08","doi":"10.1097/hep.0000000000001773","days":"7","issn":"0270-9139","rank":"5","field":"Clinical Medicine","score":"22","category":"Gastroenterology & Hepatology","categories":["Gastroenterology & Hepatology"],"_categories":["Gastroenterology & Hepatology"]},"pubmed":{"doi":"10.1097/HEP.0000000000001773","title":"FIB-4 fails to identify significant liver fibrosis in people with HIV: A large multinational screening study.","journal":"Hepatology (Baltimore, 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Milano, Milan, Italy"}]},{"given":"Sahar","family":"Saeed","sequence":"additional","affiliation":[{"name":"Public Health Sciences, Queen’s University, Kingston, ON, Canada"}]},{"given":"Francesca","family":"Farina","sequence":"additional","affiliation":[{"name":"Chronic Viral Illness Service, McGill University Health Centre, Montreal, Canada"},{"name":"San Raffaele Hospital, Milan, Italy"}]},{"given":"Dana","family":"Kablawi","sequence":"additional","affiliation":[{"name":"Chronic Viral Illness Service, McGill University Health Centre, Montreal, Canada"}]},{"given":"Jihoon","family":"Lim","sequence":"additional","affiliation":[{"name":"Center for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Canada"}]},{"given":"Antonio","family":"Cascio","sequence":"additional","affiliation":[{"name":"Department of Health Promotion Sciences and Mother and Child Care “Giuseppe D’Alessandro”, University of Palermo, Palermo, Italy"}]},{"given":"Claudia","family":"Gioè","sequence":"additional","affiliation":[{"name":"Department of Health Promotion Sciences and Mother and Child Care “Giuseppe D’Alessandro”, University of Palermo, Palermo, Italy"}]},{"given":"Emmanuel","family":"Tsochatzis","sequence":"additional","affiliation":[{"name":"UCL Institute for Liver and Digestive Health, Royal Free Hospital and UCL, London, UK"}]},{"given":"Rosa","family":"Lombardi","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy"},{"name":"SC Medicina Indirizzo Metabolico, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy"}]},{"given":"Ahmed","family":"Cordie","sequence":"additional","affiliation":[{"name":"Endemic Medicine Department, Cairo University Hospitals, Cairo, Egypt"}]},{"given":"Rahma","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Endemic Medicine Department, Cairo University Hospitals, Cairo, Egypt"}]},{"given":"Ahmed M.","family":"Kamel","sequence":"additional","affiliation":[{"name":"Clinical Pharmacy Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt"}]},{"given":"Gamal","family":"Esmat","sequence":"additional","affiliation":[{"name":"Endemic Medicine Department, Cairo University Hospitals, Cairo, Egypt"},{"name":"Research Center, Badr University in Cairo, Badr City, Egypt"}]},{"given":"Alessandra","family":"Bandera","sequence":"additional","affiliation":[{"name":"Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy"},{"name":"Infectious Diseases Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy"}]},{"given":"Jovana","family":"Milic","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy"}]},{"given":"Dominik","family":"Benke","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Venusberg Campus 1, University Hospital Bonn, Bonn, Germany"}]},{"given":"Fauzi","family":"Elamouri","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Venusberg Campus 1, University Hospital Bonn, Bonn, Germany"}]},{"given":"Jürgen K.","family":"Rockstroh","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine I, Venusberg Campus 1, University Hospital Bonn, Bonn, Germany"}]},{"given":"Giovanni","family":"Guaraldi","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, Modena, Italy"}]},{"given":"Giada","family":"Sebastiani","sequence":"additional","affiliation":[{"name":"Chronic Viral Illness Service, McGill University Health Centre, Montreal, Canada"},{"name":"Center for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montreal, Canada"},{"name":"Division of Gastroenterology and Hepatology, Royal Victoria Hospital, McGill University Health Centre, Montreal, Canada"}]}],"issued":{"date-parts":[[2026,5,1]]},"member":"276","prefix":"10.1097","source":"Crossref","volume":null,"created":{"date-time":"2026-05-01T16:00:14Z","timestamp":1777651214000,"date-parts":[[2026,5,1]]},"indexed":{"date-time":"2026-05-07T10:15:07Z","timestamp":1778148907187,"date-parts":[[2026,5,7]]},"subject":[],"abstract":"$3d","language":"en","relation":{},"resource":{"primary":{"URL":"https://journals.lww.com/10.1097/HEP.0000000000001773"}},"subtitle":[],"assertion":[{"name":"received","group":{"name":"publication_history","label":"Publication History"},"label":"Received","value":"2026-02-04"},{"name":"accepted","group":{"name":"publication_history","label":"Publication 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