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Article ; Online: The quest for the ideal NASH biomarker.

Sebastiani, Giada

The lancet. Gastroenterology & hepatology

2023 Volume 8, Issue 8, Page(s) 685–687

MeSH term(s)	Humans ; Non-alcoholic Fatty Liver Disease/diagnosis ; Biomarkers
Chemical Substances	Biomarkers
Language	English
Publishing date	2023-03-21
Publishing country	Netherlands
Document type	Journal Article
ISSN	2468-1253
ISSN (online)	2468-1253
DOI	10.1016/S2468-1253(23)00063-8
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Article ; Online: Fatty liver in children with HIV: a clinical iceberg?

Sebastiani, Giorgia / Sebastiani, Giada

AIDS (London, England)

2022 Volume 36, Issue 10, Page(s) 1469–1471

MeSH term(s)	Child ; Fatty Liver ; HIV Infections/complications ; Humans ; Non-alcoholic Fatty Liver Disease
Language	English
Publishing date	2022-07-25
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Comment
ZDB-ID	639076-6
ISSN	1473-5571 ; 0269-9370 ; 1350-2840
ISSN (online)	1473-5571
ISSN	0269-9370 ; 1350-2840
DOI	10.1097/QAD.0000000000003251
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Zs.A 2228: Show issues

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ab Jg. 2022: Lesesaal (EG)

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Article: Hepatitis C Virus-Lipid Interplay: Pathogenesis and Clinical Impact.

Elgretli, Wesal / Chen, Tianyan / Kronfli, Nadine / Sebastiani, Giada

Biomedicines

2023 Volume 11, Issue 2

Abstract: Hepatitis C virus (HCV) infection represents the major cause of chronic liver disease, leading to a wide range of hepatic diseases, including cirrhosis and hepatocellular carcinoma. It is the leading indication for liver transplantation worldwide. In ... ...

Abstract	Hepatitis C virus (HCV) infection represents the major cause of chronic liver disease, leading to a wide range of hepatic diseases, including cirrhosis and hepatocellular carcinoma. It is the leading indication for liver transplantation worldwide. In addition, there is a growing body of evidence concerning the role of HCV in extrahepatic manifestations, including immune-related disorders and metabolic abnormalities, such as insulin resistance and steatosis. HCV depends on its host cells to propagate successfully, and every aspect of the HCV life cycle is closely related to human lipid metabolism. The virus circulates as a lipid-rich particle, entering the hepatocyte via lipoprotein cell receptors. It has also been shown to upregulate lipid biosynthesis and impair lipid degradation, resulting in significant intracellular lipid accumulation (steatosis) and circulating hypocholesterolemia. Patients with chronic HCV are at increased risk for hepatic steatosis, dyslipidemia, and cardiovascular disease, including accelerated atherosclerosis. This review aims to describe different aspects of the HCV viral life cycle as it impacts host lipoproteins and lipid metabolism. It then discusses the mechanisms of HCV-related hepatic steatosis, hypocholesterolemia, and accelerated atherosclerosis.
Language	English
Publishing date	2023-01-19
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2720867-9
ISSN	2227-9059
ISSN	2227-9059
DOI	10.3390/biomedicines11020271
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Article ; Online: Geographical disparities in gastroenterologists and transient elastography across Canada.

Burnside, Jessica / Thomas, Tyler / Sebastiani, Giada / Saeed, Sahar

Canadian liver journal

2023 Volume 6, Issue 4, Page(s) 417–424

Abstract: Background: In the next decade, the incidence and prevalence of advanced liver disease are expected to increase across Canada. However, little is known about the country's resources for monitoring patients requiring specialized care. A resource ... ...

Abstract	Background: In the next decade, the incidence and prevalence of advanced liver disease are expected to increase across Canada. However, little is known about the country's resources for monitoring patients requiring specialized care. A resource assessment was conducted to evaluate regional disparities of specialists and transient elastography machines across Canada. Methods: Demographic data on licenced gastroenterologists were obtained from Scott's Medical Directory as of October 2022. The primary location of each specialist was linked to 2016 Statistics Canada to obtain the population size and density of provinces/territories and census division (CD). Results were summarized per 100,000 persons. CDs were classified as resource scare or approaching resource scarcity. A list of transient elastography (TE) was provided by KNS Canada Inc. and summarized per 1,000,000 persons by province. Results: Eight hundred fifty-three specialists were identified. Rates of gastroenterologists per 100,000 people ranged from 0 in the territories to 2.9 in Quebec. Half the provinces had fewer than 2.0 gastroenterologists per 100,000 persons. Gastroenterologists were concentrated in 24% (71/293) of the CDs across Canada. We identified Conclusion: We found significant variation in liver-specific resources across Canada. Given the increasing number of people living with liver disease, policies must be implemented to address access to specialized care.
Language	English
Publishing date	2023-12-20
Publishing country	Canada
Document type	Journal Article
ISSN	2561-4444
ISSN (online)	2561-4444
DOI	10.3138/canlivj-2023-0010
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Article ; Online: Effectiveness and safety of direct oral anticoagulants among patients with non-valvular atrial fibrillation and liver disease: A multinational cohort study.

Douros, Antonios / Cui, Ying / Platt, Robert W / Filion, Kristian B / Sebastiani, Giada / Renoux, Christel

Thrombosis research

2024 Volume 237, Page(s) 71–78

Abstract: Background and aims: The effects of direct oral anticoagulants (DOACs) in patients with non-valvular atrial fibrillation (NVAF) and liver disease remain poorly understood. Our multinational cohort study assessed the effectiveness and safety of DOACs in ... ...

Abstract	Background and aims: The effects of direct oral anticoagulants (DOACs) in patients with non-valvular atrial fibrillation (NVAF) and liver disease remain poorly understood. Our multinational cohort study assessed the effectiveness and safety of DOACs in this high-risk population. Methods: We assembled two population-based cohorts in United Kingdom and in Québec of NVAF patients with liver disease initiating DOACs or vitamin K antagonists (VKAs) between 2011 and 2020. Using an as-treated exposure definition, we compared DOACs to VKAs and apixaban to rivaroxaban. After inverse probability of treatment weighting, Cox proportional hazards models estimated site-specific hazard ratios (HRs) and 95 % confidence intervals (CIs) of ischemic stroke and major bleeding. Site-specific estimates were pooled using random-effects models. Analyses were repeated among NVAF patients with cirrhosis. Results: There were 11,881 NVAF patients with liver disease (2683 with cirrhosis). Among those, 8815 initiated DOACs (4414 apixaban, 2497 rivaroxaban) and 3696 VKAs. The HRs (95 % CIs) for DOACs compared to VKAs were 1.01 (0.76-1.34) for ischemic stroke and 0.87 (0.77-0.99) for major bleeding. Results were consistent among patients with cirrhosis. The HRs (95 % CIs) for apixaban compared to rivaroxaban were 0.85 (0.60-1.20) for ischemic stroke and 0.80 (0.68-0.95) for major bleeding. This decreased bleeding risk was not observed among patients with cirrhosis (HR, 1.01; 95 % CI 0.72-1.43). Conclusions: Among NVAF patients with liver disease, DOACs were as effective and slightly safer than VKAs, and apixaban was as effective but safer than rivaroxaban. The safety benefit with apixaban was not present among patients with cirrhosis.
MeSH term(s)	Humans ; Atrial Fibrillation/drug therapy ; Atrial Fibrillation/complications ; Female ; Male ; Aged ; Cohort Studies ; Administration, Oral ; Liver Diseases/complications ; Liver Diseases/drug therapy ; Anticoagulants/therapeutic use ; Anticoagulants/adverse effects ; Middle Aged ; Hemorrhage/chemically induced ; Rivaroxaban/therapeutic use ; Rivaroxaban/adverse effects ; Factor Xa Inhibitors/therapeutic use ; Factor Xa Inhibitors/adverse effects ; Pyridones/therapeutic use ; Pyridones/adverse effects ; Pyrazoles/therapeutic use ; Pyrazoles/adverse effects ; Aged, 80 and over
Chemical Substances	Anticoagulants ; Rivaroxaban (9NDF7JZ4M3) ; apixaban (3Z9Y7UWC1J) ; Factor Xa Inhibitors ; Pyridones ; Pyrazoles
Language	English
Publishing date	2024-03-25
Publishing country	United States
Document type	Journal Article ; Multicenter Study
ZDB-ID	121852-9
ISSN	1879-2472 ; 0049-3848
ISSN (online)	1879-2472
ISSN	0049-3848
DOI	10.1016/j.thromres.2024.03.024
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Zs.A 863: Show issues

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Article ; Online: Nutritional and Lifestyle Therapy for NAFLD in People with HIV.

Cinque, Felice / Cespiati, Annalisa / Lombardi, Rosa / Guaraldi, Giovanni / Sebastiani, Giada

Nutrients

2023 Volume 15, Issue 8

Abstract: HIV infection and nonalcoholic fatty liver disease (NAFLD) are two major epidemics affecting millions of people worldwide. As people with HIV (PWH) age, there is an increased prevalence of metabolic comorbidities, along with unique HIV factors, such as ... ...

Abstract	HIV infection and nonalcoholic fatty liver disease (NAFLD) are two major epidemics affecting millions of people worldwide. As people with HIV (PWH) age, there is an increased prevalence of metabolic comorbidities, along with unique HIV factors, such as HIV chronic inflammation and life-long exposure to antiretroviral therapy, which leads to a high prevalence of NAFLD. An unhealthy lifestyle, with a high dietary intake of refined carbohydrates, saturated fatty acids, fructose added beverages, and processed red meat, as well as physical inactivity, are known to trigger and promote the progression of NAFLD to nonalcoholic steatohepatitis, liver fibrosis, and hepatocellular carcinoma. Furthermore, with no currently approved pharmacotherapy and a lack of clinical trials that are inclusive of HIV, nutritional and lifestyle approaches still represent the most recommended treatments for PWH with NAFLD. While sharing common features with the general population, NAFLD in PWH displays its own peculiarities that may also reflect different impacts of nutrition and exercise on its onset and treatment. Therefore, in this narrative review, we aimed to explore the role of nutrients in the development of NAFLD in PWH. In addition, we discussed the nutritional and lifestyle approaches to managing NAFLD in the setting of HIV, with insights into the role of gut microbiota and lean NAFLD.
MeSH term(s)	Humans ; Non-alcoholic Fatty Liver Disease ; HIV Infections/complications ; HIV Infections/therapy ; Obesity/metabolism ; Nutritional Status ; Life Style
Language	English
Publishing date	2023-04-20
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2518386-2
ISSN	2072-6643 ; 2072-6643
ISSN (online)	2072-6643
ISSN	2072-6643
DOI	10.3390/nu15081990
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Article ; Online: Sarcopenic obesity at the crossroad of pathogenesis of cardiometabolic diseases.

Guaraldi, Giovanni / Milic, Jovana / Sebastiani, Giada / Raggi, Paolo

Atherosclerosis

2021 Volume 335, Page(s) 84–86

MeSH term(s)	Body Composition ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/epidemiology ; Humans ; Obesity/complications ; Obesity/diagnosis ; Obesity/epidemiology ; Sarcopenia/epidemiology
Language	English
Publishing date	2021-09-06
Publishing country	Ireland
Document type	Editorial ; Research Support, Non-U.S. Gov't
ZDB-ID	80061-2
ISSN	1879-1484 ; 0021-9150
ISSN (online)	1879-1484
ISSN	0021-9150
DOI	10.1016/j.atherosclerosis.2021.09.006
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Zs.A 226: Show issues

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Article ; Online: Metabolic dysfunction-associated steatotic liver disease: An opportunity for collaboration between cardiology and hepatology.

Raggi, Paolo / Milic, Jovana / Manicardi, Marcella / Cinque, Felice / Swain, Mark G / Sebastiani, Giada / Guaraldi, Giovanni

Atherosclerosis

2024 Volume 392, Page(s) 117523

Abstract: Altered metabolic function has many detrimental effects on the body that can manifest as cardiovascular and liver diseases. Traditional approaches to understanding and treating metabolic dysfunction-associated disorders have been organ-centered, leading ... ...

Abstract	Altered metabolic function has many detrimental effects on the body that can manifest as cardiovascular and liver diseases. Traditional approaches to understanding and treating metabolic dysfunction-associated disorders have been organ-centered, leading to silo-type disease care. However, given the broad impact that systemic metabolic dysfunction has on the human body, approaches that simultaneously involve multiple medical specialists need to be developed and encouraged to optimize patient outcomes. In this review, we highlight how several of the treatments developed for cardiac care may have a beneficial effect on the liver and vice versa, suggesting that there is a need to target the disease process, rather than specifically target the cardiovascular or liver specific sequelae of metabolic dysfunction.
Language	English
Publishing date	2024-03-16
Publishing country	Ireland
Document type	Journal Article ; Review
ZDB-ID	80061-2
ISSN	1879-1484 ; 0021-9150
ISSN (online)	1879-1484
ISSN	0021-9150
DOI	10.1016/j.atherosclerosis.2024.117523
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Zs.A 226: Show issues

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Article ; Online: HIV, Elevated Transaminases, Fatty Liver: The Perfect Storm?

Cai, Jia / Sebastiani, Giada

Journal of acquired immune deficiency syndromes (1999)

2019 Volume 81, Issue 1, Page(s) e23–e25

MeSH term(s)	Biopsy ; HIV Infections ; Humans ; Liver ; Non-alcoholic Fatty Liver Disease ; Transaminases
Chemical Substances	Transaminases (EC 2.6.1.-)
Language	English
Publishing date	2019-04-12
Publishing country	United States
Document type	Letter ; Research Support, Non-U.S. Gov't ; Comment
ZDB-ID	645053-2
ISSN	1944-7884 ; 1077-9450 ; 0897-5965 ; 0894-9255 ; 1525-4135
ISSN (online)	1944-7884 ; 1077-9450
ISSN	0897-5965 ; 0894-9255 ; 1525-4135
DOI	10.1097/QAI.0000000000001984
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Zs.A 2442: Show issues

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Article ; Online: Limitations of non-invasive tests for assessment of liver fibrosis.

Patel, Keyur / Sebastiani, Giada

JHEP reports : innovation in hepatology

2020 Volume 2, Issue 2, Page(s) 100067

Abstract: The diagnostic assessment of liver injury is an important step in the management of patients with chronic liver disease (CLD). Although liver biopsy is the reference standard for the assessment of necroinflammation and fibrosis, the inherent limitations ... ...

Abstract	The diagnostic assessment of liver injury is an important step in the management of patients with chronic liver disease (CLD). Although liver biopsy is the reference standard for the assessment of necroinflammation and fibrosis, the inherent limitations of an invasive procedure, and need for repeat sampling, have led to the development of several non-invasive tests (NITs) as alternatives to liver biopsy. Such non-invasive approaches mostly include biological (serum biomarker algorithms) or physical (imaging assessment of tissue stiffness) assessments. However, currently available NITs have several limitations, such as variability, inadequate accuracy and risk factors for error, while the development of a newer generation of biomarkers for fibrosis may be limited by the sampling error inherent to the reference standard. Many of the current NITs were initially developed to diagnose significant fibrosis in chronic hepatitis C, subsequently refined for the diagnosis of advanced fibrosis in patients with non-alcoholic fatty liver disease, and further adapted for prognostication in CLD. An important consideration is that despite their increased use in clinical practice, these NITs were not designed to reflect the dynamic process of fibrogenesis, differentiate between adjacent disease stages, diagnose non-alcoholic steatohepatitis, or follow longitudinal changes in fibrosis or disease activity caused by natural history or therapeutic intervention. Understanding the strengths and limitations of these NITs will allow for more judicious interpretation in the clinical context, where NITs should be viewed as complementary to, rather than as a replacement for, liver biopsy.
Language	English
Publishing date	2020-01-20
Publishing country	Netherlands
Document type	Journal Article ; Review
ISSN	2589-5559
ISSN (online)	2589-5559
DOI	10.1016/j.jhepr.2020.100067
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