Untreated chronic hepatitis B virus (HBV) infection can lead to chronic liver disease and may progress to cirrhosis or hepatocellular carcinoma (HCC). HBV infection has been prevalent in Vietnam, but there is little information available on the genotypes, sub-genotypes, and mutations of HBV in patients with HBV-related HCC confirmed by histopathological diagnosis. We studied the molecular characteristics of HBV and its genetic variants in Vietnamese HCC patients after liver tumor resection. We conducted a descriptive cross-sectional study on 107 HBV-related HCC hospitalized patients from October 2018 to April 2019. The specimens collected included EDTA anticoagulant blood and liver tissues. Extracted HBV DNA was subjected to whole genome sequencing by the Sanger method. We discovered 62 individuals (57.9%) with genotype B and 45 patients (42.1%) with genotype C, with only sub-genotypes B4 and C1. Among the mutations, the double mutation, A1762T-G1764A, had the most significant frequency (73/107 samples; 68.2%) and was higher in genotype C than in genotype B (p < 0.001). The most common genotypes found in HCC patients in this investigation were B and C, with sub-genotypes B4 and C1 for each. The prevalence of genotype B4 was greater in HBV-infected Vietnamese HCC patients.

Early recognition of severe acute pancreatitis (AP) is crucial for timely intervention. This study aims to evaluate the prognostic accuracy of the Emergency Room Assessment of AP (ERAP) score and compare it with the Bedside Index for Severity in AP (BISAP) score in predicting severe AP, mortality, and persistent multiple organ failure (MOF) in Vietnamese patients. This prospective cohort study included AP patients admitted to Cho Ray Hospital between August 2021 and May 2022. Patient data, including demographics, clinical presentations, and laboratory results, were collected upon admission. The ERAP and BISAP scores were calculated from these admission data. The prognostic accuracy for severe AP, mortality, and persistent MOF was assessed via the area under the receiver-operating characteristic curve (AUC). Among 167 AP patients (mean age 41.5 ± 12.0 years), hypertriglyceridemia (34.7%) and alcohol (22.2%) were the most prevalent etiologies. Severe AP accounted for 33.5% of the patients. Mortality rates were higher in persistent MOF patients (42.9%) than in persistent single-organ failure patients (3.6%), with a P value <.001. The ERAP score had AUCs for predicting severe AP, mortality, and persistent MOF of 0.899, 0.817, and 0.867, respectively, with an optimal cutoff of ≥2. The ERAP score had a better prognostic value than the BISAP score in predicting severe AP (AUC: 0.899 vs 0.820; P = .0072) and persistent MOF (AUC: 0.867 vs 0.785; P = .0193) but had a similar prognostic value for mortality (AUC: 0.817 vs 0.728; P = .0628). The ERAP score has strong predictive value for severe AP and persistent MOF, surpassing the BISAP score in these categories while maintaining similar accuracy for mortality prediction in the Vietnamese population. The ERAP score can be a valuable tool for the early identification of high-risk AP patients, enabling timely and appropriate clinical interventions.

Spontaneous bacterial peritonitis (SBP) is a potentially fatal complication in patients with liver cirrhosis. Early diagnosis and prompt treatment of SBP are vital to shorten hospital stays and reduce mortality. According to society guidelines, patients with cirrhosis and ascites who are admitted to the hospital should have diagnostic paracentesis. However, for various reasons, paracentesis may be delayed or not performed. Therefore, recent research has focused on identifying non-invasive parameters useful in SBP prediction which require urgent antibiotic therapy if rapid and secure paracentesis is not possible or there is insufficient experience with this method. In this review, we discuss the non-invasive methods available to predict SBP.

Eosinophilic gastrointestinal disorders are rare inflammatory conditions marked by eosinophilic infiltration of the gastrointestinal tract. Endoscopic manifestations vary from patient to patient. However, ulcerative lesion is a rare occurence. A 57-year-old patient presented with chronic diarrhea and significant peripheral blood eosinophilia. During endoscopy, multiple ulcers were discovered throughout the stomach, duodenum, and colon. Biopsies showed excess tissue eosinophilia suggestive of eosinophilic gastroenteritis and colitis. The patient responded dramatically with corticosteroid. However, he developed steroid dependency necessitating the use of azathioprine. In conclusion, a rare case of eosinophilic gastroenteritis and colitis presented with multiple ulcerative lesions was described. Physicians should be aware that eosinophilic gastroenteritis and colitis may be a cause of chronic diarrhea, particularly, in patients presented with peripheral blood eosinophilia. Corticosteroid is the mainstay of treatment. In steroid dependency case, azathioprine may be an option.

Nhan Trung Phan, Phat Tan Ho, Nguyen Phuoc Ma, Chau Huyen Nguyen, Trong Dang Nguyen Huynh, Thinh Van Hoang and Thong Quang Pham. Korean J Gastroenterol 2025;85:537-42. https://doi.org/10.4166/kjg.2025.070

Background: Acute variceal bleeding (AVB) continues to carry considerable mortality despite therapeutic advances. Simple, objective prognostic tools are needed for early risk stratification. We evaluated the prognostic performance of the Platelet–Albumin–Bilirubin (PALBI) score compared with the Albumin–Bilirubin (ALBI), Model for End-Stage Liver Disease (MELD), and AIMS65 scores for predicting 5-day, 6-week, and 90-day mortality in cirrhotic patients with AVB. Methods: This single-center observational cohort study included consecutive adults with cirrhosis admitted for esophageal variceal AVB at Cho Ray Hospital, Vietnam (October 2021–October 2022). PALBI, ALBI, MELD, and AIMS65 scores were calculated at admission. Primary outcomes were all-cause mortality at 5 days, 6 weeks, and 90 days. Discrimination was assessed using the area under the receiver operating characteristic curve (AUC). Multivariable logistic regression evaluated independent associations between PALBI and mortality. Results: Of 232 patients (mean age 55.0 ± 11.2 years; 78.9% male), 44.4% had alcohol-related cirrhosis and 78.0% were Child–Pugh class B or C. Mortality rates were 3.4% at 5 days, 12.9% at 6 weeks, and 18.9% at 90 days. For 5-day mortality, ALBI (AUC 0.926) performed modestly better than PALBI (AUC 0.902; p = 0.025), though both were excellent. At 6 weeks, PALBI (AUC 0.840) and ALBI (AUC 0.842) performed similarly ( p = 0.929), both significantly outperforming MELD and AIMS65 ( p < 0.01). A PALBI cut-off of − 1.42 identified 5-day survivors with 100% sensitivity and negative predictive value. PALBI remained an independent predictor of 6-week and 90-day mortality in multivariable models. Conclusion: PALBI and ALBI provide superior discrimination for early and mid-term mortality following AVB compared to MELD and AIMS65. Specifically, a PALBI cut-off of − 1.42 reliably rules out 5-day mortality, and cut-offs around − 1.6 identify lower-risk patients at 6 weeks and 90 days, supporting the score's utility for practical risk stratification.