CLDF Podcast

Explore the evolving management of chronic hepatitis B (HBV) with Drs. Ira Jacobson, Paul Martin, and Robert Gish in the first installment of the What’s New in Hepatitis B series. This case-based discussion reviews hepatitis B treatment guidelines, comparing published recommendations with the panel’s perspectives on antiviral treatment eligibility, HBV DNA and ALT thresholds, and managing patients with high viral loads and normal liver enzymes or indeterminate-phase disease. The experts also address shared decision-making and the importance of considering stigma, quality of life, and patient preferences when discussing treatment. Additional topics include low-level viremia, quantitative hepatitis B surface antigen (HBsAg) testing, emerging approaches to functional cure, and considerations for discontinuing antiviral therapy in selected patients. The conversation concludes with hepatocellular carcinoma (HCC) surveillance, including monitoring after HBsAg loss and the challenges of applying age-based screening recommendations to individual patients. Gain practical perspectives on hepatitis B risk assessment, treatment decisions, and patient-centered care through expert discussion of complex clinical cases.

Christina Hanson, FNP, and Dr. Marcelo Kugelmas of South Denver Gastroenterology review linerixibat, an ileal bile acid transporter (IBAT) inhibitor, and its role in managing cholestatic pruritus in primary biliary cholangitis (PBC). This medication review podcast explores how blocking bile acid reabsorption in the ileum targets a pathway involved in persistent itching. The discussion covers the phase 2 GLIMMER study and phase 3 GLISTEN trial, including findings on itch reduction, sleep interference, and treatment response in patients with moderate to severe pruritus. The speakers also examine safety and tolerability considerations, including diarrhea, abdominal pain, nausea, elevated liver enzymes, and treatment discontinuation. Additional topics include preliminary results from the linerixibat long-term safety and tolerability study (LLSAT), maintenance of itch relief, and the need for further research on combining linerixibat with PPAR agonists. Designed for nurse practitioners, physician assistants, and other gastroenterology and hepatology professionals, this episode offers a clinical perspective on IBAT inhibitor therapy, persistent PBC-related itching, and the balance between symptom improvement and treatment tolerability.

Clarifications and context within the video 👇

• Linerixibat, an IBAT inhibitor, is the first FDA approved treatment for cholestatic pruritus in adults with PBC.
• WI-NRS is used to assess itch severity on a scale of 0-10.
• At 6:43, correction regarding the diagnosis of cirrhosis: It was 10% in the placebo group and 11% in the linerixibat group.
• At 10:24, the primary endpoints of the LLSAT study are frequency and severity of adverse events.
• At 11:20, the LLSAT mean WI-NRS reduction of 4.87 is for patients assigned to linerixibat in GLISTEN Part A and Part B after 52 weeks of continuous treatment.

How can clinicians better recognize and manage itching and fatigue in primary biliary cholangitis (PBC)? In this podcast, hepatology clinicians from RUSH University Medical Center discuss the impact of PBC-related pruritus and fatigue on sleep, daily activities, and quality of life. The conversation explores proactive symptom screening, assessing itch severity, and individualizing treatment with options such as cholestyramine, PPAR therapies, rifampin, and sertraline. The speakers discuss how their treatment approaches have evolved and why ongoing communication helps identify when symptom management needs to change. For patients experiencing PBC fatigue, they address evaluating contributing factors such as thyroid dysfunction, vitamin D deficiency, and anemia, along with sleep hygiene, exercise, and realistic expectations for treatment. Throughout the discussion, they emphasize that symptom severity does not necessarily reflect liver disease progression or biochemical response. This episode highlights the importance of looking beyond liver tests, validating patients’ experiences, and encouraging patient advocacy and support networks as part of comprehensive PBC care.

In this educational podcast, Paul Kwo, MD discusses how the goals of hepatitis B treatment are changing and what the future may look like for people living with chronic hepatitis B. While current medications do an excellent job of controlling the virus, most patients still need to stay on treatment long term. Dr. Kwo explains the growing focus on achieving a “functional cure,” which means losing the hepatitis B surface antigen—a key milestone that may allow some patients to eventually stop treatment and further reduce their risk of serious liver complications.

Throughout the presentation, Dr. Kwo reviews the benefits of today's hepatitis B therapies, including their ability to keep the virus under control and lower the risk of liver damage. He also discusses why achieving a functional cure is important, not only for reducing the risk of liver cancer but also for improving quality of life and helping patients feel less burdened by their disease.

The video also explores new treatment approaches being studied, how healthcare providers monitor patients over time, and what factors may help identify people who could benefit from future therapies. As hepatitis B research continues to advance, Dr. Kwo shares his perspective on how these developments may bring patients closer than ever to achieving long-term disease control and, potentially, a functional cure.

Dr. Anthony Martinez, Medical Director of Hepatology at the University at Buffalo and Erie County Medical Center, discusses the evolving landscape of chronic hepatitis B management and the shift from viral suppression to precision immune control. In this expert overview, he highlights the latest 2025 AASLD and EASL guideline updates and explains how quantitative hepatitis B surface antigen (qHBsAg) testing is changing treatment decisions, particularly for hepatitis B e antigen-negative patients. This discussion explores when clinicians may consider stopping nucleos(t)ide analog therapy, the importance of the ≤100 IU/mL qHBsAg threshold, and why treatment discontinuation should never be considered in patients with cirrhosis or unreliable follow-up. Dr. Martinez also reviews how qHBsAg trends can help personalize monitoring, HCC surveillance, and treatment timing while supporting the pursuit of functional cure. Using a real-world clinical scenario, he examines emerging strategies aimed at antigen reduction, including PEG interferon add-on therapy and novel functional cure approaches. This video is ideal for hepatologists, gastroenterologists, and advanced practice providers looking to stay current on modern hepatitis B management, functional cure strategies, and the growing role of immune-informed decision-making.

In this expert discussion presented in collaboration with the Chronic Liver Disease Foundation, Amanda Cheung, MD, transplant hepatologist at Northwestern Medicine, and Peter Hedera, MD, neurologist and medical geneticist at University of Louisville, explore the complex challenges of medication adherence and long-term compliance in patients with Wilson disease. This educational conversation reviews the lifelong management of Wilson disease, highlighting how both neurologic and hepatic manifestations can significantly impact quality of life, daily functioning, and long-term outcomes. The discussion examines common neurologic symptoms including tremor, dystonia, ataxia, and parkinsonism, as well as hepatic complications ranging from asymptomatic liver enzyme elevations to cirrhosis and acute liver failure. Experts also discuss how Wilson disease can mimic other conditions such as fatty liver disease, contributing to delayed diagnosis and treatment.

Throughout the discussion, the faculty address the real-world barriers that affect adherence to Wilson disease therapies, including lifelong treatment burden, complex dosing schedules, food restrictions, medication side effects, cost and insurance challenges, and the transition from pediatric to adult care. The conversation also reviews currently available chelation therapies such as penicillamine and trientine, the role of zinc maintenance therapy, and emerging treatment strategies aimed at improving convenience and patient compliance. Additional insights include the importance of multidisciplinary care teams, patient education, shared decision-making, pharmacy support programs, psychiatric care, and social work involvement in optimizing long-term disease management. This video provides valuable clinical pearls for hepatologists, neurologists, advanced practice providers, and healthcare professionals involved in the care of patients with Wilson disease.

In this informative CLDF podcast, Sammy Saab provides a clear, big-picture overview of cirrhosis and portal hypertension, breaking down how clinicians approach this complex condition in today’s evolving healthcare landscape. Rather than focusing on technical details, this discussion highlights the key ways cirrhosis impacts the body and why early recognition, ongoing monitoring, and coordinated care are so important for improving patient outcomes.

The episode emphasizes how cirrhosis is best understood in stages—from earlier phases where lifestyle changes and preventive care can make a meaningful difference, to more advanced stages that require closer management and support. A major theme throughout the conversation is the importance of a multidisciplinary approach, with hepatologists working alongside nutritionists, radiologists, transplant teams, and other specialists to provide comprehensive, patient-centered care.

Listeners will also gain insight into how modern hepatology is evolving, including the growing role of imaging, nutrition, and collaboration across specialties. This high-level overview is ideal for healthcare professionals looking to better understand the broader strategy behind managing cirrhosis and portal hypertension, while staying aligned with current trends in liver disease care and improving long-term patient outcomes.

In this insightful CLDF podcast recorded at the 6th Annual Liver Connect Conference, John Vierling, MD, shares a forward-looking overview of Wilson’s disease and the major shifts shaping its future diagnosis and management. This episode explores why Wilson’s disease remains difficult to recognize, often going undiagnosed for years due to its wide range of symptoms and its ability to mimic more common conditions. The conversation highlights the real-world challenges faced by patients, families, and clinicians, including inconsistencies in care and the impact on quality of life.

Looking ahead, the discussion focuses on the exciting progress being made across genetics, diagnostics, and treatment development. Learn how new research is uncovering a broader understanding of how common Wilson’s disease may actually be, along with emerging technologies that could enable earlier and more accurate detection. The episode also touches on the evolution of treatment approaches, including improvements to existing therapies and the potential for innovative options on the horizon.

This high-level overview is ideal for hepatology providers, gastroenterology clinicians, and advanced practice providers who want to stay informed on where the field is headed—without getting lost in complex clinical detail. Discover why Wilson’s disease is entering a new era of innovation and what that could mean for improving patient outcomes in the years ahead.

In this engaging CLDF podcast episode, Fred Gordon, MD, and Valentina Medici, MD, explore the fundamentals of Wilson’s disease and why it remains one of the most challenging liver conditions to recognize in clinical practice. The conversation focuses on the importance of awareness, highlighting how this rare disease can present in many different ways and often goes overlooked or misdiagnosed.

Listeners will gain a high-level understanding of when to consider Wilson’s disease, why early detection is so important, and how clinicians approach the diagnostic journey. The discussion also touches on the role of family history, the complexities of confirming a diagnosis, and the evolving tools that support better identification of the disease. This episode is ideal for healthcare professionals looking for a clear, accessible overview of Wilson’s disease and its impact on liver health, without getting lost in overly technical details.

In this high-level hepatology update from the 6th Annual Liver Connect Conference, Sujit Janardhan, MD, PhD, provides an overview of how the understanding and management of cirrhosis and portal hypertension are evolving in 2026. The discussion focuses on the big-picture shifts in the field, including earlier identification of patients at risk, updated definitions of disease progression, and how these changes are influencing overall treatment approaches.

Rather than focusing on individual therapies in depth, this session highlights how clinicians are thinking differently about preventing complications, improving long-term outcomes, and using newer, less invasive tools to guide decision-making. It also touches on the broader impact of complications like liver failure, fluid buildup, and cognitive changes, while reinforcing the importance of proactive management and patient-centered care. This overview is ideal for healthcare professionals looking to stay current on the direction of hepatology and the evolving strategies shaping chronic liver disease management.