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  1. Article ; Online: Acute severe autoimmune hepatitis - timing for steroids and role of other immunosuppressive agents.

    Liberal, Rodrigo / Macedo, Guilherme

    Journal of hepatology

    2021  Volume 75, Issue 2, Page(s) 494–495

    MeSH term(s) Hepatitis, Autoimmune/drug therapy ; Hepatitis, Autoimmune/etiology ; Humans ; Immunosuppressive Agents/adverse effects ; Steroids
    Chemical Substances Immunosuppressive Agents ; Steroids
    Language English
    Publishing date 2021-04-30
    Publishing country Netherlands
    Document type Letter ; Comment
    ZDB-ID 605953-3
    ISSN 1600-0641 ; 0168-8278
    ISSN (online) 1600-0641
    ISSN 0168-8278
    DOI 10.1016/j.jhep.2021.03.031
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    Zs.A 2027: Show issues Location:
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  2. Article ; Online: 2022 International Autoimmune Hepatitis Group non-response criteria in autoimmune hepatitis: A too early endpoint?

    Medas, Renato / Liberal, Rodrigo / Cardoso, Hélder / Macedo, Guilherme

    Journal of hepatology

    2022  Volume 77, Issue 5, Page(s) 1461–1462

    MeSH term(s) Hepatitis, Autoimmune/diagnosis ; Humans
    Language English
    Publishing date 2022-06-16
    Publishing country Netherlands
    Document type Letter ; Comment
    ZDB-ID 605953-3
    ISSN 1600-0641 ; 0168-8278
    ISSN (online) 1600-0641
    ISSN 0168-8278
    DOI 10.1016/j.jhep.2022.06.007
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  3. Article ; Online: "Long-term follow-up and prognosis of celiac hepatitis".

    Garrido, Isabel / Liberal, Rodrigo / Peixoto, Armando / Macedo, Guilherme

    European journal of gastroenterology & hepatology

    2022  Volume 34, Issue 12, Page(s) 1255–1260

    Abstract: Introduction: Celiac disease has been associated with abnormal liver function tests at diagnosis that usually resolve with a gluten-free diet (GFD). The aim of this study was to assess the evolution of liver involvement and possible long-term ... ...

    Abstract Introduction: Celiac disease has been associated with abnormal liver function tests at diagnosis that usually resolve with a gluten-free diet (GFD). The aim of this study was to assess the evolution of liver involvement and possible long-term complications in patients on a GFD.
    Methods: Retrospective and single-center study, which included all individuals with Celiac disease followed in specialized consultation in a tertiary referral hospital.
    Results: A total of 162 patients were included, most of them female (77.8%) with a median age of 24 years (IQR, 7-39). Seventy-four (45.7%) patients had abnormal liver function tests at diagnosis. These individuals had higher anti-tissue transglutaminase IgA (tTG-IgA) antibody titers (126 vs. 29 IU/L; P  = 0.003). There were no significant differences in the Marsh classification ( P  = 0.599). During follow-up, most celiac hepatitis patients had normalization of liver function tests and tTG-IgA antibodies. At the last follow-up, all the patients had fibrosis-4 index <2.4 and an aspartate aminotransferase-to-platelet ratio index score <0.6. Vibration-controlled transient elastography showed values <6.4 kPa in all cases. On the other hand, it was found that 42.9% of the individuals had a controlled attenuation parameter >206.5 db/m.
    Conclusions: In our cohort, liver function tests normalized in the vast majority of celiac hepatitis patients on a GFD, with no progression to chronic liver disease. It should be noted the high number of individuals who present hepatic steatosis during follow-up, which may be related to a diet that tends to be hyperlipidemic and hypercaloric.
    MeSH term(s) Humans ; Female ; Child ; Adolescent ; Young Adult ; Adult ; Celiac Disease ; Transglutaminases ; Follow-Up Studies ; Immunoglobulin A ; Retrospective Studies ; Diet, Gluten-Free ; Hepatitis ; Prognosis ; Hepatitis A
    Chemical Substances Transglutaminases (EC 2.3.2.13) ; Immunoglobulin A
    Language English
    Publishing date 2022-09-23
    Publishing country England
    Document type Journal Article
    ZDB-ID 1034239-4
    ISSN 1473-5687 ; 0954-691X
    ISSN (online) 1473-5687
    ISSN 0954-691X
    DOI 10.1097/MEG.0000000000002455
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  4. Article ; Online: Established and novel therapeutic options for autoimmune hepatitis.

    Liberal, Rodrigo / de Boer, Ynto S / Heneghan, Michael A

    The lancet. Gastroenterology & hepatology

    2021  Volume 6, Issue 4, Page(s) 315–326

    Abstract: Autoimmune hepatitis is an immune-mediated disorder characterised by hypergammaglobulinaemia, autoantibodies, and interface hepatitis. The mainstay of treatment is non-specific immunosuppression, consisting of steroids with or without azathioprine. ... ...

    Abstract Autoimmune hepatitis is an immune-mediated disorder characterised by hypergammaglobulinaemia, autoantibodies, and interface hepatitis. The mainstay of treatment is non-specific immunosuppression, consisting of steroids with or without azathioprine. Although most patients respond satisfactorily to steroid and thiopurine-based treatment regimens, up to 40% relapse and 10% undergo liver transplantation. The cause of autoimmune hepatitis is unknown, but evidence implicates both genetic and environmental factors in its pathogenesis. An imbalance between effector and regulatory mechanisms leads to the breakdown of immune tolerance and the consequent development of an autoimmune attack. Signalling pathways that have been implicated in the pathogenesis of autoimmune hepatitis involve the proinflammatory cytokines interferon-γ, IL-12, tumour necrosis factor-α, IL-6, and IL-23. Numerical and functional defects of regulatory T cells have a permissive role that enables autoimmune liver injury to occur and persist. New therapeutic strategies are needed, with the aim of obtaining long-lasting disease remission without inducing non-specific immunosuppression and a focus on inhibiting the intrahepatic proinflammatory milieu or expanding the pool of regulatory T cells, or both.
    MeSH term(s) Hepatitis, Autoimmune/drug therapy ; Humans
    Language English
    Publishing date 2021-02-08
    Publishing country Netherlands
    Document type Journal Article ; Review
    ISSN 2468-1253
    ISSN (online) 2468-1253
    DOI 10.1016/S2468-1253(20)30328-9
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  5. Article: Discontinuation of antiviral therapy in chronic hepatitis B patients.

    Medas, Renato / Liberal, Rodrigo / Macedo, Guilherme

    World journal of clinical cases

    2021  Volume 9, Issue 24, Page(s) 6979–6986

    Abstract: Nucleos(t)ide analogs (NUC) are the first-line therapy for patients with chronic hepatitis B (CHB) recommended by most current guidelines. NUC therapy decreases progression of liver disease, reduces the risk of liver-related complications, and improves ... ...

    Abstract Nucleos(t)ide analogs (NUC) are the first-line therapy for patients with chronic hepatitis B (CHB) recommended by most current guidelines. NUC therapy decreases progression of liver disease, reduces the risk of liver-related complications, and improves the quality of life of patients with CHB. Although indefinite or long-term NUC therapy is usually recommended, this strategy raises several concerns, such as side-effects, adherence, costs, and patient willingness to stop therapy. Recent data showed the feasibility, efficacy, and safety of stopping antiviral therapy in carefully selected CHB patients, leading to its incorporation in international guidelines. Patients who discontinue NUC have a higher likelihood of hepatitis B surface antigen (HBsAg) loss compared to patients who continue on therapy. Recommendations pertaining endpoints allowing safety discontinuation of NUC therapy differ among international guidelines. For hepatitis B e antigen (HBeAg)-positive patients, durable HBeAg seroconversion is considered an acceptable treatment endpoint. For HBeAg-negative patients, some guidelines propose undetectability hepatitis B virus DNA for at least 2 or 3 years, while others consider HBsAg loss as the only acceptable endpoint. CHB patients who stop therapy should remain under strict clinical and laboratorial follow-up protocols to detect and manage relapses in a timely manner. No reliable predictor of relapse has been consistently identified to date, although quantitative HBsAg has been increasingly studied as a reliable biomarker to predict safe NUC discontinuation.
    Language English
    Publishing date 2021-09-14
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 2307-8960
    ISSN 2307-8960
    DOI 10.12998/wjcc.v9.i24.6979
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  6. Article ; Online: Cirrhosis management in a major referral center during COVID-19.

    Garrido, Isabel / Liberal, Rodrigo / Gaspar, Rui / Macedo, Guilherme

    JHEP reports : innovation in hepatology

    2020  Volume 2, Issue 5, Page(s) 100146

    Keywords covid19
    Language English
    Publishing date 2020-07-15
    Publishing country Netherlands
    Document type Journal Article
    ISSN 2589-5559
    ISSN (online) 2589-5559
    DOI 10.1016/j.jhepr.2020.100146
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  7. Article ; Online: Letter: liver disease and COVID-19-not the perfect storm. Authors' reply".

    Garrido, Isabel / Liberal, Rodrigo / Macedo, Guilherme

    Alimentary pharmacology & therapeutics

    2020  Volume 52, Issue 3, Page(s) 574–575

    Keywords covid19
    Language English
    Publishing date 2020-07-12
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 639012-2
    ISSN 1365-2036 ; 0269-2813 ; 0953-0673
    ISSN (online) 1365-2036
    ISSN 0269-2813 ; 0953-0673
    DOI 10.1111/apt.15886
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  8. Article ; Online: Letter: unknown denominator and misleading conclusions in Covid-19-authors' reply.

    Garrido, Isabel / Liberal, Rodrigo / Macedo, Guilherme

    Alimentary pharmacology & therapeutics

    2020  Volume 52, Issue 7, Page(s) 1243–1244

    Keywords covid19
    Language English
    Publishing date 2020-10-02
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 639012-2
    ISSN 1365-2036 ; 0269-2813 ; 0953-0673
    ISSN (online) 1365-2036
    ISSN 0269-2813 ; 0953-0673
    DOI 10.1111/apt.16056
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  9. Article ; Online: Reply: Lack of complete biochemical response in autoimmune hepatitis leads to adverse outcome-First report of the IAIHG retrospective registry.

    Slooter, Charlotte D / van den Brand, Floris F / Lleo, Ana / Liberal, Rodrigo / de Boer, Ynto S

    Hepatology (Baltimore, Md.)

    2023  Volume 79, Issue 4, Page(s) E113–E114

    MeSH term(s) Humans ; Hepatitis, Autoimmune ; Retrospective Studies ; Liver Cirrhosis, Biliary ; Autoantibodies ; Pathologic Complete Response
    Chemical Substances Autoantibodies
    Language English
    Publishing date 2023-11-16
    Publishing country United States
    Document type Journal Article
    ZDB-ID 604603-4
    ISSN 1527-3350 ; 0270-9139
    ISSN (online) 1527-3350
    ISSN 0270-9139
    DOI 10.1097/HEP.0000000000000689
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  10. Article ; Online: Cirrhosis management in a major referral center during COVID-19

    Isabel Garrido / Rodrigo Liberal / Rui Gaspar / Guilherme Macedo

    JHEP Reports, Vol 2, Iss 5, Pp 100146- (2020)

    2020  

    Keywords Diseases of the digestive system. Gastroenterology ; RC799-869 ; covid19
    Language English
    Publishing date 2020-10-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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