Publications by authors named "Norah Terrault"
Importance: Alcohol-associated hepatitis (AH) has high mortality, and rates are increasing among adolescents and young adults (AYAs).
Objective: To define the sex-specific epidemiology of AH in AYAs and the association between female sex and liver-related outcomes after a first presentation of AH.
Design, Setting, And Participants: A retrospective, population-based cohort study of routinely collected health care data held at ICES from Ontario, Canada, was conducted.
In this position statement, we explore the intricate relationship between alcohol intake and metabolic dysfunction in the context of the 2023 nomenclature update for steatotic liver disease (SLD). Recent and lifetime alcohol use should be accurately assessed in all patients with SLD to facilitate classification of alcohol use in grams of alcohol per week. Alcohol biomarkers (i.
View Article and Find Full Text PDFHealth disparities in cirrhosis care and liver transplantation.
Nat Rev Gastroenterol Hepatol
October 2024
Article Synopsis
- - Morbidity and mortality rates from cirrhosis are rising, highlighting significant health disparities in care and access to liver transplantation.
- - Key affected groups include racial and ethnic minorities, sexual and gender minorities, lower socioeconomic individuals, and underserved rural communities, leading to delays in diagnosis and treatment for liver diseases.
- - Addressing these disparities requires comprehensive interventions across the entire care process for chronic liver disease to improve health equity and outcomes for all populations.
Introduction: Withdrawal of nucleos(t)ide analog (NA) therapy is associated with hepatitis B surface antigen (HBsAg) loss and sustained, off-therapy partial cure (normal ALT [≤30 U/L males, ≤20 U/L females) with HBV DNA <2000 IU/mL) but should be offered only to those most likely to benefit. HBVRNA may be useful for risk stratification.
Methods: The Hepatitis B Research Network Immune-Active Trial prospectively evaluated treatment with tenofovir (TDF) for 192 weeks ± peginterferon-α (PegIFN) for initial 24 weeks followed by protocolized withdrawal of TDF amongst eligible participants (NCT01369212).
Article Synopsis
- Acamprosate is a treatment for people with alcohol problems, but we don't know much about how safe it is for those who have had a liver transplant.
- In a study with 30 participants, some took acamprosate and others received standard care over 14 weeks, looking at side effects and how well the treatment worked.
- The results showed that acamprosate seemed safe and worked just as well as standard care, which is good news for future research on helping liver transplant patients with alcohol issues.
Background And Aims: There are limited data on the progression of liver stiffness measurement (LSM) by vibration-controlled transient elastography (VCTE) in people with type 2 diabetes mellitus (T2DM) versus those without T2DM in biopsy-proven metabolic dysfunction-associated steatotic liver disease. We examined LSM progression in participants with T2DM versus those without T2DM in a large, prospective, multicenter cohort study.
Approach And Results: This study included 1231 adult participants (62% female) with biopsy-proven metabolic dysfunction-associated steatotic liver disease who had VCTEs at least 1 year apart.
The gap between organ supply and demand in liver transplantation remains large in most parts of the world. One strategy to increase the donor pool is to use grafts infected with HCV, HBV, and/or HIV viruses. We aimed to explore the current use of HBsAg-positive liver grafts worldwide.
View Article and Find Full Text PDFIntroduction: One of the primary goals of the Liver Cirrhosis Network (LCN) is to develop a cohort study to better understand and predict the risk of hepatic decompensation and other clinical and patient-reported outcomes among patients with Child A cirrhosis.
Methods: The LCN consists of a Scientific Data Coordinating Center and 10 clinical centers whose investigators populate multiple committees. The LCN Definitions and Measurements Committee developed preliminary definitions of cirrhosis and its complications by literature review, expert opinion, and reviewing definition documents developed by other organizations.
Introduction: Early (i.e., without mandated period of abstinence) liver transplant (LT) for alcohol-associated hepatitis is the fastest-growing indication for LT in the United States and Europe.
View Article and Find Full Text PDFBackground: Liver transplantation (LT) for alcohol-associated liver disease (ALD) is increasing and may impact LT outcomes for patients listed for HCC and other indications.
Methods: Using US adults listed for primary LT (grouped as ALD, HCC, and other) from October 8, 2015, to December 31, 2021, we examined the impact of center-level ALD LT volume (ATxV) on waitlist outcomes in 2 eras: Era 1 (6-month wait for HCC) and Era 2 (MMaT-3). The tertile distribution of ATxV (low to high) was derived from the listed candidates as Tertile 1 (T1): <28.
Alcohol-associated liver disease (ALD) is a major cause of morbidity and mortality worldwide, and a leading indication for liver transplantation (LT) in many countries, including the United States. However, LT for ALD is a complex and evolving field with ethical, social, and medical challenges. Thus, it requires a multidisciplinary approach and individualized decision-making.
View Article and Find Full Text PDFMost patients with alcohol-associated liver disease (ALD) engage in heavy drinking defined as 4 or more drinks per day (56 g) or 8 (112 g) or more drinks per week for women and 5 or more drinks per day (70 g) or 15 (210 g) or more drinks per week for men. Although abstinence from alcohol after diagnosis of ALD improves life expectancy and reduces the risk of decompensation of liver disease, few studies have evaluated whether treatment of alcohol use disorders will reduce progression of liver disease and improve liver-related outcomes. In November 2021, the National Institute of Alcohol Abuse and Alcoholism commissioned a task force that included hepatologists, addiction medicine specialists, statisticians, clinical trialists and members of regulatory agencies to develop recommendations for the design and conduct of clinical trials to evaluate the effect of alcohol use, particularly treatment to reduce or eliminate alcohol use in patients with ALD.
View Article and Find Full Text PDFArticle Synopsis
- The PNPLA3 rs738409 variant is linked to an increased risk of major adverse liver outcomes (MALOs) in individuals with metabolic dysfunction-associated steatotic liver disease (MASLD).
- In a study involving 2,075 adults, advanced fibrosis, older age, and type 2 diabetes significantly heightened the risk of developing MALOs, particularly in those carrying the G-allele variant.
- The negative impact of the PNPLA3 variant on liver health is intensified by factors like advanced fibrosis, age over 60, type 2 diabetes, and female sex, highlighting the importance of these conditions in assessing liver disease risk.
Country- and region-specific estimates of hepatitis B virus (HBV) screening, prevalence, and immunity rates are provided for 202 868 adults from 174 unique countries in a large urban safety-net system. Of these, 41.8% (95% confidence interval, 41.
View Article and Find Full Text PDFArticle Synopsis
- Current guidelines suggest that children exposed to HCV in utero should be screened by 18 months of age, but only a small percentage actually receive this screening in Canada.
- A study analyzed data from children born between 2000 and 2016 to mothers with HCV, discovering that only 29% were screened by age two and highlighting significant maternal social determinants of health such as income and neighborhood stability.
- The findings indicate that factors like rural living and residing in high-dependency areas are linked to lower screening rates, while younger maternal age, HIV co-infection, and specialist involvement are associated with higher screening rates.