Editorial

Breakthroughs in hepatology
Norah A. Terrault1,*, Jean-François Dufour2, Robert F. Schwabe3, Vincent Wai-Sun Wong4
1
Division of Gastrointestinal and Liver Diseases, University of Southern California, Los Angeles, USA; 2Department for BioMedical Research,
Hepatology, University of Bern, Bern, Switzerland; 3Department of Medicine, Columbia University, New York, USA; 4Medical Data Analytics
Center, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong

In medicine, nothing is more satisfying than witnessing the
accumulation of knowledge through research efforts and the
transformation of clinical practice that follows. Many colleagues
from our generation remember the days when we struggled to
care for patients with chronic viral hepatitis, with few therapies to
offer and the inevitable deterioration in some patients over time.
Fast forward to the present where chronic hepatitis C infection is
eradicated with 8 to 12 weeks of direct-acting antivirals and
essentially 100% of patients treated with entecavir or tenofovir for
chronic hepatitis B achieve sustained viral suppression. Moreover,
these highly effective treatments have translated into meaningful
reductions in liver-related morbidity and mortality. Liver trans-
plantation, once viewed as radical and risky, is now a standard of
care in patients with end-stage liver disease and is associated with
excellent long-term survival. We are indeed the beneficiaries of
decades of innovation and breakthroughs.
While we celebrate these triumphs, we concurrently recog-
nise that liver disease burden remains high. In 2020, an esti-
mated 56.8 million people worldwide remained viraemic for
hepatitis C virus infection.1 292 million people have chronic
hepatitis B virus infection, of whom only 10% have been diag-
nosed.2 According to GLOBOCAN, there were 905,677 new cases
of and 830,180 deaths from primary liver cancer in 2020, making
it the third leading cause of cancer death worldwide.3 Certainly
more needs to be done. On one hand, cutting-edge research must
continue to advance new diagnostics and treatments. On the
other hand, given that the greatest impact on patients’ lives more
often relies on the consistent adoption of effective though not
necessarily new practices, diligent application of new discoveries
to patient care is essential.
In this supplement of the Journal of Hepatology, leading ex-
perts in different disciplines tell us wonderful stories of how
researchers around the globe have contributed to bettering the
lives of patients with liver diseases. This issue starts with an
update on the treatments of chronic hepatitis B, non-alcoholic
steatohepatitis and alcohol-associated hepatitis.4–6 This is fol-
lowed by a discussion on the management of advanced liver
disease, ranging from coagulation issues, through use of albumin,
to liver transplantation and management of hepatocellular car-
cinoma.7–11 One article describes the use of non-invasive tests in
Received 4 April 2022; accepted 4 April 2022
* Corresponding author. Address: Gastrointestinal and Liver Diseases Division, Keck
Medicine of University of Southern California, 1520 San Pablo St, Suite 1000, Los
Angeles, CA 90033, USA.
E-mail address: terrault@usc.edu (N.A. Terrault).
https://doi.org/10.1016/j.jhep.2022.04.001
hepatology practice and the road ahead.12 Finally, accumulating
data have highlighted the importance of molecular biology and
the gut microbiome in the diagnosis and treatment of various
liver diseases.13,14
We hope that you will find this supplement illuminating. Let’s
all work together to achieve the next breakthroughs
in hepatology.
Conflict of interest
Norah Terrault has received institutional grant support from
Gilead Sciences, GlaxoSmithKline, Roche-Genentech and Helio
Health and served as consultant for Moderna. Vincent Wong has
served as a consultant or advisory committee member for Abb-
Vie, Boehringer Ingelheim, Echosens, Gilead Sciences, Intercept,
Inventiva, Merck, Novo Nordisk, Pfizer, ProSciento, Sagimet Bio-
sciences and TARGET PharmaSolutions; and a speaker for Abbott,
AbbVie, Echosens, Gilead Sciences and Novo Nordisk. He has
received a research grant from Gilead Sciences, and is a
cofounder of Illuminatio Medical Technology Limited. Jean-
François Dufour and Robert F. Schwabe have no relevant conflict
of interest.
Please refer to the accompanying ICMJE disclosure forms for
further details.
Supplementary data
Supplementary data to this article can be found online at https://
doi.org/10.1016/j.jhep.2022.04.001.
References
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00472-6. 2022 Feb 15 https://doi.org/10.1016/S2468-1253(21)00472-6.
Online ahead of print.
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[3] Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al.
Global cancer statistics 2020: GLOBOCAN estimates of incidence and
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