SBP is associated with significant in-hospital mortality, especially in patients with concurrent risk factors. SBP remains a significant burden to the healthcare system.

The coronavirus disease 2019 (COVID-19) pandemic has brought challenges to clinicians caring for patients with chronic liver disease. In the past 6 months, COVID-19 has led to over 150,000 deaths in the United States and over 660,000 deaths around the world. Mounting evidence suggests that chronic liver diseases can have an adverse effect on the clinical outcomes of patients with COVID-19. We present a comprehensive review of the latest literature on preexisting liver diseases and its interrelationship with COVID-19 infection in cirrhosis, hepatocellular carcinoma, nonalcoholic fatty liver disease, autoimmune hepatitis, and viral hepatitis B. As social distancing and telemedicine gain new footing, we synthesize recommendations from 3 major hepatology societies [American Association for the Study of Liver Disease (AASLD), the European Association for the Study of Liver (EASL), and the Asian Pacific Association for the Study of Liver (APASL)] to present the best approaches for caring for patients with liver diseases as well as those requiring liver transplantation.

Background & Aims Despite the use of administrative data to perform epidemiological and cost-effectiveness research on patients with hepatitis B or C virus (HBV, HCV), there are no data outside of the Veterans Health Administration validating whether International Classification of Disease, Ninth Revision, Clinical Modification (ICD-9-CM) codes can accurately identify cirrhotic patients with HBV or HCV. The validation of such algorithms is necessary for future epidemiological studies. Methods We evaluated the positive predictive value (PPV) of ICD-9-CM codes for identifying chronic HBV or HCV among cirrhotic patients within the University of Pennsylvania Health System, a large network that includes a tertiary care referral center, a community-based hospital, and multiple outpatient practices across southeastern Pennsylvania and southern New Jersey. We reviewed a random sample of 200 cirrhotic patients with ICD-9-CM codes for HCV and 150 cirrhotic patients with ICD-9-CM codes for HBV. Results The PPV of 1 inpatient or 2 outpatient HCV codes was 88.0% (168/191, 95% CI: 82.5–92.2%), while the PPV of 1 inpatient or 2 outpatient HBV codes was 81.3% (113/139, 95% CI: 73.8–87.4%). Several variations of the primary coding algorithm were evaluated to determine if different combinations of inpatient and/or outpatient ICD-9-CM codes could increase the PPV of the coding algorithm. Conclusions ICD-9-CM codes can identify chronic HBV or HCV in cirrhotic patients with a high PPV, and can be used in future epidemiologic studies to examine disease burden and the proper allocation of resources.

Hepatocellular carcinoma HCC is the sixth most common cancer in the world and the second leading cause of cancer death. Hepatitis " virus H"V infection is one of the major risk factors for the development of HCC in the world. Most of the burden of disease % is observed in the H"V endemic regions. Chronic infection with H"V predisposes patients with or without cirrhosis to HCC. Patients with high H"V DN" levels are at an increased risk for HCC. Studies have shown that the suppression of H"V with anti-viral therapy nucleos t ide analogs N"s decreases the incidence of HCC but does not eliminate the risk entirely. Chronic viral suppression alone is not suicient treatment to prevent HCC development. Therefore, along with N"s, treatment may need to include targeting the cccDN" and inhibiting the viral entry into the newly formed hepatocytes and T-cell vaccine which speciically targets H"V and enhancing innate immunity with Toll-like receptor agonist. With all of these working together, we may achieve the goal of H"V cure.