As in all areas of health and medicine, COVID-19 was a leading topic in liver disease news this year. In the early days of the pandemic, Hep published a roundup of what people with liver disease need to know about the new coronavirus (No. 1). At the time, little was known about COVID-19 and the liver. Although liver disease itself generally is not on the list of underlying health conditions associated with a higher risk of severe COVID-19, people with liver disease often have other comorbidities that are, including heart disease, obesity and diabetes.

As time went on, it became clear that COVID-19 is not just a respiratory disease—it has detrimental effects throughout the body, including the liver (No. 2, No. 7). More recent research has shown that the risk of COVID-19 complications is higher for people with liver cirrhosis (No. 15), fatty liver disease, alcoholic liver disease and liver cancer. People who have undergone liver transplants are a particular concern because they take drugs that suppress their immune system, but much remains to be learned (No. 6).

Now that hepatitis C can be easily treated and hepatitis B can be prevented with a vaccine, fatty liver disease—including non-alcoholic fatty liver disease (NAFLD) and its more severe form, non-alcoholic steatohepatitis (NASH)—has become a leading cause of advanced liver disease and liver-related death. Studies show that fatty liver disease is increasingly common in the United States and worldwide (No. 9, No. 14), and it has become a leading reason for liver transplants (No. 16).

Unfortunately, treatments for NAFLD and NASH have proved challenging to develop (No. 8). Several drugs that appeared promising in early studies did not show the expected benefits in larger clinical trials (No. 5, No. 10). With no approved therapies, management currently relies on lifestyle changes, such as weight loss and exercise.

As studies continue to confirm the effectiveness of hepatitis C treatment in all population groups, attention has now turned to the elimination of hep C as a public health threat. Although direct-acting antiviral drugs can now cure almost everyone, new cases continue to rise (No. 18), affecting younger age groups as a consequence of the ongoing opioid crisis. In order to realize the promise of hep C elimination, more people need to be screened for the virus (No. 10), and states must change policies that block wider access to treatment.

Here are the Hep treatment news stories with the most views this year:

1. What People With Liver Disease Need to Know About the New Coronavirus
Posted: March 2

2. The New Coronavirus Appears to Affect the Liver
Posted: April 1

3. People With 10-Plus Lifetime Sexual Partners More Likely to Develop Cancer
Posted: February 20

4. Hepatitis C Drugs Show Promise Against New Coronavirus
Posted: July 12

5. FDA Delays Approval of Ocaliva for Fatty Liver Disease
Posted: July 10

6. Immunosuppressants for Liver Transplant Recipients May Not Increase COVID-19 Risk
Posted: April 21

7. Abnormal Liver Tests Linked to Worse COVID-19 Outcomes
Posted: September 24

8. What’s in the Pipeline for NAFLD and NASH Treatment?
Posted: October 26

9. Nearly a Quarter of North Americans May Have Fatty Liver Disease
Posted: December 10

10. CDC Says Test All Adults for Hepatitis C
Posted: April 10

11. First Hepatitis D Treatment Approved in Europe
Posted: August 17

12. Switching From Viread to Vemlidy Keeps Hepatitis B Suppressed for Two Years
Posted: September 2

13. Six Weeks of Mavyret Is Highly Effective for Recent Hepatitis C Infection
Posted: May 22

14. Fatty Liver Disease Highly Prevalent in American Adults
Posted: August 19

15. Advanced Cirrhosis Tied to Much Higher Risk of Death From COVID-19
Posted: June 8

16. NASH, Alcohol Now the Top Reasons for Liver Transplants
Posted: February 11

17. Fatty Liver Disease Signals High-Risk Pregnancy
Posted: June 17

18. New Hepatitis C Cases Tripled Over the Past Decade
Posted: April 14

19. Ocaliva Improves Liver Fibrosis in People With NASH
Posted: January 3

20. Predicting Liver Cancer in People Cured of Hepatitis C
Posted: September 16