Hepatology : official journal of the American Association for the Study of Liver Diseases
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Detection of autoantibodies is a mainstay of diagnosing autoimmune hepatitis (AIH). However, conventional autoantibodies for workup of AIH lack either sensitivity or specificity leading to substantial diagnostic uncertainty. We aimed to identify more accurate serological markers of AIH with a protein macro-array. ⋯ pIgG could be used as a new promising marker to improve the diagnostic workup of liver diseases with a higher specificity for AIH compared to conventional autoantibodies and a utility in autoantibody negative AIH. Likewise, pIgG could be a major source of assay interference in untreated AIH.
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Chronic liver diseases (CLD) affect approximately 2% of the U.S. population and are associated with substantial burden of hospitalization and costs. We estimated the national burden and consequences of financial hardship from medical bills in individuals with CLD. ⋯ One in 3 adults with CLD experience financial hardship from medical bills, and frequently experience financial toxicity and unplanned healthcare use. These financial determinates of health have important implications in the context of value-based care.
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The Model for End-Stage Liver Disease score may have eliminated racial disparities on the waitlist for liver transplantation (LT), but disparities prior to waitlist placement have not been adequately quantified. We aimed to analyze differences in patients who are listed for LT, undergo transplantation, and die from end-stage liver disease (ESLD), stratified by state and race/ethnicity. ⋯ Black patients face a disparity in access to LT due to low listing rates for transplant relative to deaths from ESLD.
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Racial/ethnic minority children have worse liver transplant outcomes. We evaluated whether neighborhood socioeconomic deprivation affected associations between race/ethnicity and waitlist mortality. ⋯ Household and neighborhood socioeconomic factors and disease severity at waitlist entry help explain racial/ethnic disparities for children awaiting transplant. A nuanced understanding of how social adversity contributes to waitlist outcomes may inform strategies to improve outcomes.