Liver diseases are complex and varied, leading to重大负担和不同的治疗挑战。在许多西方国家，alcohol abuse is one of the main causes of liver diseases，导致医疗保健系统使用的大量资源和important social consequences. In contrast, some lower income countries also experience burden of与生活方式有关的肝病, but face challenges with meeting costs associated with treatment. Finding the best regimen for each patient is problematic in many situations.
Unanswered clinical and ethical questions are ongoing issues in liver disease management, and here we report some of the latest findings discussed at ILC 2016.
HIV and global Hepatitis
Gottfried Hirschnallopened the conference by focusing on the need to scale up viral hepatitis response, an issue that still causes considerable health and economic burden worldwide.
倡导和提供治疗的新方法的增加对于保持动力是必要的，并将当前的计划和研究变成真正的行动。
Gottfried Hirschnall
在每种情况下，治疗肝炎都是一个挑战，但是我们必须保持乐观正在减少并且治疗更容易管理。倡导和提供治疗的新方法的增加对于保持动力是必要的，并将当前的计划和研究变成真正的行动。
Hepatitis C – one combination of drugs for all?
众所周知，丙型肝炎很难治疗。病毒基因型起着基本作用，但是个体的患者状况和合并症会影响治疗成功或失败。
卡洛斯·费尔南德斯·卡里略（Carlos Fernandez Carrillo）提出了results（摘要GS01）来自Hepa-C registry肝硬化晚期和等待肝移植的西班牙患者，研究在代偿肝硬化患者中使用直接作用抗病毒药（DAA）的风险。
治疗方案是组合的抗病毒药（例如：Sofosbuvir，Simeprevir，Daclatasvir）。持续的病毒学反应数据在12周时（SVR12）结果报告说，与补偿患者相比，肝硬化失代偿的患者的预后较差，强调了以前亚组中DAA治疗的风险。需要大量研究来确认这些发现，但是在治疗晚期肝病患者时需要谨慎。
也很大程度上的长期结果是未知的liver transplant recipients from Hepatitis C virus (HCV) cohorts. At a press conference,Zobair Younossi解释说，由于器官短缺，1995年至2013年之间使用HCV阳性器官进行肝移植有两倍风险尚不清楚.
从移植接受者的科学注册表, he argued that HCV-positive grafts could be a reasonably safe option for patients awaiting transplant and with chronic HCV infection, and HCV status of the liverdid not affect移植后死亡率（请参阅摘要PS040）。必须进行未来的研究来确认这些初步结论，因为长期死亡率的结果在统计学上没有显着意义。
Resource allocation and ethics in end-stage liver disease.
Cirrhosis and organ failure are often associated with high mortality, and therapy during end-stage liver diseasecan be problematic.Katrine Lindvigargued that at advanced stages of disease, treatment may be futile or unethical. To assist clinicians’ decision making, she presented a理论算法（摘要PS059）基于前病前肝功能和急性智力肝衰竭（ACLF）。
Based on融合,孩子和CLIF-SOFAscores and data from 354 patients with acute decompensation, the algorithm takes into account premorbid liver function and acute-on-chronic liver failure (ACLF), dividing patients into likely to survive ICU or unlikely to benefit from further treatment.
Lindvig stated that although the algorithm has its limitations and clinicians’ judgment is always final, it can be used to make clinical decisions more objective. These new findings are likely to spark further debate in the field and we look forward to future studies on the reliability of decision-making tools.
Hard drinking and genetics – should you avoid the last call?
Half of all cirrhosis deaths in the western world are due toexcessive alcoholconsumption, but do genes also contribute?Stephen Atkinson解释说，大多数肝病患者都是无症状的，他们想找出为什么每个人都不会出现严重的酒精性肝炎。
他们的GWASstudy (Abstract GS03) on alcoholic hepatitis and healthy patients from theUCL consortiumreveals the rs738409 variant in thePNLPA3gene is significantly associated with a higher risk of developing severe hepatitis in heavy drinkers. Importantly, they also identified variations in theSLC38A4基因是一种潜在的新型风险基因座，可发展酗酒肝炎。
这两种基因变异在普通人群中都很常见，强调了某些人酗酒后严重肝病的风险增加，以及巨大的医疗保健负担。进一步的研究将阐明某些患者是否会比其他患者受益更多。
Updated WHO guidelines for Hepatitis C management
4月15日，星期五，World Health Organization发布updated guidelinesfor screening and treatment, from the 2014 edition.New treatment drugs在过去的几年中已获得批准，treatment costs are lowerthan before and more accessible in low income countries.
The new recommendations mainly focus on disease treatment and the use of generics, and take into account liver disease severity. It is widely hoped that the introduction of generic drugs will sharply increase chances for people who are now unable to afford treatment.
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