Drs. Stephen A. Harrison and Salvatore Petta discuss the paper: The severity of steatosis influences liver stiffness measurement in patients with nonalcoholic fatty liver disease from the November 2015 issue of HEPATOLOGY.

Note: Published earlier in 2015. Drs. Stephen A. Harrison and Saleh A. Alqahtani discuss the paper: Safety and Tolerability of Ledipasvir/Sofosbuvir With and Without Ribavirin in Patients with Chronic Hepatitis C Virus Genotype 1 Infection: Analysis of Phase III ION Trials.

Drs. Stephen A. Harrison and Lisa B. VanWagner discuss the paper: Association of nonalcoholic fatty liver disease with subclinical myocardial remodeling and dysfunction: A population-based study.

Drs. Stephen A. Harrison and Sasan Roayaie discuss the paper: The Role of Hepatic Resection in the Treatment of Hepatocellular Cancer.

Drs. Stephen A. Harrison and Saleh A. Alqahtani discuss the paper: Safety and Tolerability of Ledipasvir/Sofosbuvir With and Without Ribavirin in Patients with Chronic Hepatitis C Virus Genotype 1 Infection: Analysis of Phase III ION Trials.

Drs. Stephen A. Harrison and Leon A. Adams discuss the paper: The Impact of Phlebotomy in Nonalcoholic Fatty Liver Disease: A Prospective, Randomized, Controlled Trial.

Drs. Stephen A. Harrison and Annalisa Berzigotti discuss the paper: Portal hypertension and the outcome of surgery for hepatocellular carcinoma in compensated cirrhosis: A systematic review and meta-analysis from the Februrary issue of HEPATOLOGY.

Drs. Stephen A. Harrison and Eric M. Yoshida discuss the paper: Concordance of sustained virological response 4, 12, and 24 weeks post-treatment with sofosbuvir-containing regimens for hepatitis C virus from the January issue of HEPATOLOGY.

Drs. Stephen A. Harrison and Karim J. Hazalun discuss the paper: Standing the test of time: Outcomes of a decade of prioritizing patients with hepatocellular carcinoma, results of the UNOS natural geographic experiment from the December issue of HEPATOLOGY.

Stephen A. Harrison, MD and Taro Yamashita, MD, PhD, discuss Gd-EOB-DTPA-enhanced MRI and Alpha-fetoprotein Predict Prognosis of Early Early Stage HCC.

Ursodeoxycholic acid (UDCA) is no longer recommended for management of adult patients with primary sclerosing cholangitis (PSC). We undertook a prospective evaluation of UDCA withdrawal in a group of consecutive patients with PSC. Twenty six patients, all treated with UDCA (dose range: 10-15 mg/kg/day) were included. Paired blood samples for liver biochemistry, bile acids, and fibroblast growth factor 19 (FGF19) were collected before UDCA withdrawal and 3 months later. Liquid chromatography/tandem mass spectrometry was used for quantification of 29 plasma bile acid metabolites. Pruritus and health-related quality of life (HRQoL) were assessed with a 10-point numeric rating scale, the Medical Outcomes Study Short Form-36 (SF-36), and PBC-40 questionnaires. UDCA withdrawal resulted in a significant deterioration in liver biochemistry (increase of alkaline phosphatase of 75.6%; P < 0.0001; gamma-glutamyl transpeptidase of 117.9%, P < 0.0001; bilirubin of 50.0%, P < 0.001; alanine aminotransferase of 63.9%, P < 0.005; and aspartate aminotransferase of 45.0%, P < 0.005) and increase of Mayo Risk Score for PSC (change from baseline of +0.5 point; P < 0.003). Bile acid analysis revealed a significant decrease in lithocholic acid and its derivatives after UDCA withdrawal, but no effect on concentrations of primary bile acids aside from an increased accumulation of their taurine conjugates. After UDCA removal cholestatic parameters, taurine species of cholic acid and chenodeoxycholic acid correlated with serum FGF19 levels. No significant effect on HRQoL after UDCA withdrawal was observed; however, 42% of patients reported a deterioration in their pruritus. Conclusion: At 3 months, discontinuation of UDCA in patients with PSC causes significant deterioration in liver biochemistry and influences concentrations of bile acid metabolites. A proportion of patients report increased pruritus, but other short-term markers of quality of life are unaffected.