Viral, genetic and immune-mediated liver diseases

Problem

Viral hepatitis, particularly hepatitis B and C, continues to be a major cause of cirrhosis, hepatocellular carcinoma, and liver-related mortality worldwide. In hepatitis B (and Delta) infection, we still lack a curative treatment. Autoimmune and cholestatic liver diseases are becoming increasingly prevalent and pose a significant clinical burden due to their chronic nature. At the same time, metabolic disorders such as Wilson’s disease and hemochromatosis are often diagnosed late and may progress silently to cirrhosis. Finally, the incidence of drug-induced liver injury (DILI) is rising due to the widespread use of medications in the general population.

Approach

We address the problem through a translational approach that integrates immunology, virology, and clinical data. We analyse virus–host interactions and T- and B‑cell dysfunction in HBV/HDV, both in blood and in the liver, including intrahepatic populations and viral replication. In autoimmune diseases, we characterise the immune profile across different stages to better understand disease pathogenesis and identify predictors of response. In parallel, we study epidemiological, genetic, and environmental factors in DILI and metabolic diseases to improve their diagnosis and management.

Impact

We have contributed to demonstrating the impact of hepatitis C cure in patients with advanced disease. Currently, we aim to identify virological and immunological biomarkers that can predict disease progression and treatment response in HBV/HDV. In autoimmune hepatitis, we seek transcriptomic and immunological factors to anticipate therapeutic response and move towards more personalized medicine, optimizing treatment according to each patient’s profile. In Wilson’s disease, we have validated new biomarkers to improve diagnosis and monitoring.