Although hepatitis delta virus (HDV) co-infection with hepatitis B virus (HBV) is a global health concern, the global prevalence of HDV infections remains unknown due to insufficient data in many countries. In Japan, HDV prevalence has not been updated for over 20 years. The objective of our study was to investigate the recent prevalence of HDV infections in Hokkaido, Japan. We found that the current prevalence of HDV infections in Japanese patients with HBV was 1.7% (10/601). These patients experienced rapid liver fibrosis progression, highlighting the importance of routine HDV testing.

Patients with nonalcoholic fatty liver disease in high-risk groups (F3–4 of fibrosis stage, rule-in [IN] of Agile 3+, and IN of Agile 4) showed a stepwise increase of liver-related events. Hazard ratios of the high-risk groups were much higher in Agile 3+ and Agile 4 than fibrosis, compared to their counterparts.

This study focused on patients with primary biliary cholangitis (PBC) who did not respond well to the usual treatment with ursodeoxycholic acid (UDCA), and received a combination therapy with UDCA and bezafibrate (BZF). The study explored factors that could predict the outcomes of patients who received a combination therapy of two drugs. The results showed that certain indicators, such as high bilirubin levels and advanced histological stage, were associated with the patients' survival without requiring liver transplantation. The study emphasizes the need for early diagnosis of PBC to improve the effectiveness of the combination treatment.

A combination of a serial AFP-increase of ≥10% every 3–6 months with an AFP level of ≥20 ng/ml may predict the risk of HCC in 6 months. Regular AFP surveillance helps to detect HCC at early stage and should be included in the surveillance test for HCC.