Scholars@Duke
Kara Wegermann

Kara Wegermann

Assistant Professor of Medicine
Medicine, Gastroenterology

Selected Publications

The Basics of Metabolic Dysfunction-Associated Steatotic Liver Disease for Cardiologists: Pathophysiology, Diagnosis, and Treatment.

Journal Article J Am Coll Cardiol · November 18, 2025 Metabolic dysfunction-associated steatotic liver disease (MASLD) is now recognized as a multisystem disease closely linked to cardiovascular disease, which is the leading cause of death in this population. MASLD and cardiovascular disease share overlapping ... Full text Link to item Cite

Incident heart failure is common and underrecognized in patients with biopsy-proven metabolic dysfunction-associated steatotic liver disease.

Journal Article Eur J Heart Fail · November 2025 AIMS: Metabolic dysfunction-associated steatotic liver disease (MASLD) is associated with heart failure (HF), independent of shared risk factors. Our aim was to describe the incidence of HF in patients with biopsy-proven MASLD. METHODS AND RESULTS: We foll ... Full text Link to item Cite

Female Sex is Protective Against MASLD With Clinically Significant Fibrosis in a Large Cross-sectional Cohort of Persons With HIV.

Journal Article Open Forum Infect Dis · November 2025 BACKGROUND: Men are at higher risk for metabolic dysfunction-associated steatotic liver disease (MASLD) with clinically significant fibrosis (CSF) than premenopausal women, but data are lacking in persons with HIV (PWH). The aim of this study was to discov ... Full text Link to item Cite

Short-chain per- and polyfluoroalkyl substances associate with elevated alanine aminotransferase: Cross-sectional analysis results from the STRIVE cohort.

Journal Article Environ Res · October 15, 2025 BACKGROUND: The impact of short-chain, low molecular weight polyfluoroalkyl substances (PFAS) and long-chain, high molecular weight PFAS on elevated alanine aminotransferase (ALT) remains unclear. Additionally, demographic and behavioral factors influencin ... Full text Link to item Cite

Vascular outflow obstruction changes and low prevalence of advanced fibrosis characterize the liver pathology in orthotopic heart transplant recipients.

Journal Article Am J Clin Pathol · October 4, 2025 OBJECTIVE: The number of orthotopic heart transplants (OHTs) performed each year continues to increase, as does the post-transplant survival rate. Little is known, however, about the morphologic changes in the liver after the patient has undergone an OHT. ... Full text Link to item Cite

Beyond the HIV Organ Policy Equity Act: Roadmap to expanding kidney and liver transplants for people with human immunodeficiency virus utilizing grafts from donors with human immunodeficiency virus.

Journal Article Am J Transplant · October 2025 People living with human immunodeficiency virus (HIV) (PWH) face limited access to organ transplantation despite higher rates of end-organ disease. The HIV Organ Policy Equity Act, enacted in 2015, allowed transplants from donors with HIV to recipients wit ... Full text Link to item Cite

S5384 Abscess Denied: Hepatic Abscess in a Young Patient With Diabetic Ketoacidosis

Conference American Journal of Gastroenterology · October 2025 Full text Cite

S5570 Perplexing Severe Cholestasis in the Post-Partum Period

Conference American Journal of Gastroenterology · October 1, 2025 Full text Cite

Plasma Lipid Metabolites Differentiate Metabolic From Viral Chronic Liver Disease.

Journal Article J Infect Dis · August 14, 2025 BACKGROUND: Lipid metabolism is altered in human immunodeficiency virus (HIV) infection and chronic liver diseases, but common and unique pathways have not been elucidated, limiting prevention and treatment strategies. The aim of this study was to discover ... Full text Link to item Cite

Ubiquitous Environmental Exposures and Risk of Hepatocellular Carcinoma: A Narrative Review.

Journal Article Dig Dis Sci · August 10, 2025 BACKGROUND: Hepatocellular carcinoma (HCC) is among the most prevalent and deadly cancers worldwide. Chronic liver disease is the most established risk factor for HCC, but environmental exposures are increasingly recognized as contributor. In this narrativ ... Full text Link to item Cite

Bioactive lipid profiles as non-invasive biomarkers of advanced fibrosis in people with HIV/HCV co-infection.

Journal Article Metabolomics · July 1, 2025 Non-invasive assessments for advanced liver fibrosis have limited accuracy in persons with human immunodeficiency virus (HIV) (PWH) who have hepatitis C virus (HCV) co-infection, and new tools are needed. Our aim was to discover oxylipin profiles associate ... Full text Link to item Cite

Hepatitis C Nucleic Acid Test Positive (NAT+) Solid Organ Consent Rates Are Highest in Patients Listed for Liver Transplant and With an English Language Preference.

Journal Article Clin Transplant · June 2025 BACKGROUND: Transplantation of hepatitis C virus (HCV) nucleic acid (NAT) positive organs is associated with shorter time to transplant and decreased risk of death on the waiting list. Treatment for HCV post-transplant is well-tolerated, successful, and le ... Full text Link to item Cite

Vascular flow alteration is a dominant pattern of liver pathology in patients with orthotopic lung transplants: a retrospective observational study.

Journal Article Histopathology · May 2025 AIMS: The number of orthotopic lung transplants (OLT) has skyrocketed since the 1960s, generating an ever-increasing cohort of post-OLT patients. Many challenges exist in the post-OLT timeframe, including donor graft dysfunction, infection, malignancy, and ... Full text Link to item Cite

Clinical Phenotypes May be Able to Identify Populations With Nonalcoholic Fatty Liver-Spectrum Disease.

Journal Article Gastro Hep Adv · 2025 BACKGROUND AND AIMS: Despite causing significant morbidity and mortality, nonalcoholic fatty liver disease (NAFLD) is underdiagnosed. Clinical indices developed to identify hepatic steatosis are often used by providers but their potential for use at the po ... Full text Link to item Cite

Global prevalence and characteristics of infections and clinical outcomes in hospitalised patients with cirrhosis: a prospective cohort study for the CLEARED Consortium.

Journal Article Lancet Gastroenterol Hepatol · November 2024 BACKGROUND: Infections have a poor prognosis in inpatients with cirrhosis. We aimed to determine regional variations in infections and their association with clinical outcomes in a global cohort of inpatients with cirrhosis. METHODS: In this prospective co ... Full text Link to item Cite

A Case of Immune Checkpoint Inhibitor-Induced Duodenitis.

Journal Article ACG Case Rep J · October 2024 Immune checkpoint inhibitors improve patient survival in multiple cancers, but immune-related adverse events, including new immunologic conditions arising during therapy, pose a significant challenge. Gastrointestinal immune-related adverse events, althoug ... Full text Link to item Cite

S4259 A Case of Herpes Simplex Virus Hepatitis in Patient With SLE on Belimumab

Conference American Journal of Gastroenterology · October 2024 Full text Cite

Predictors of Respiratory Failure Development in a Multicenter Cohort of Inpatients With Cirrhosis.

Journal Article Am J Gastroenterol · April 1, 2024 INTRODUCTION: Hospitalized patients with cirrhosis can develop respiratory failure (RF), which is associated with a poor prognosis, but predisposing factors are unclear. METHODS: We prospectively enrolled a multicenter North American cirrhosis inpatient co ... Full text Link to item Cite

Racial and ethnic disparities in metabolic dysfunction-associated steatotic liver disease

Journal Article Metabolism and Target Organ Damage · January 1, 2024 Metabolic dysfunction-associated steatotic liver disease (MASLD) has an increasing prevalence, morbidity, and mortality both within the United States and globally. Here, we review newer evidence demonstrating racial and ethnic disparities that exist in the ... Full text Cite

Chemoprevention of hepatocellular carcinoma associated with metabolic dysfunction-associated steatotic liver disease: an updated review

Journal Article Hepatoma Research · January 1, 2024 With the predicted rise in metabolic dysfunction-associated steatotic liver disease (MASLD) prevalence over the next decade, strategies to prevent hepatocellular carcinoma (HCC), which is the third most common cause of cancer-related death, are paramount. ... Full text Cite

Fatty Liver Disease: Enter the Metabolic Era.

Journal Article Curr HIV/AIDS Rep · December 2023 PURPOSE OF REVIEW: The goal of this review is to summarize the recent literature linking HIV to metabolic dysfunction-associated steatotic liver disease (MASLD). This is a pressing issue due to the scale of the MASLD epidemic and the urgent need for preven ... Full text Link to item Cite

Abstract 16282: Incident Heart Failure With Preserved Ejection Fraction in a Cohort of Patients With Biopsy-Proven Non-Alcoholic Fatty Liver Disease

Conference Circulation · November 7, 2023 Introduction: Non-alcoholic fatty liver disease (NAFLD) is associated with heart failure with preserved ejection fraction (HFpEF), independent of shared risk factors. The aim of this study was to dete ... Full text Cite

S3974 A Case of Pembrolizumab-Related Duodenopathy

Conference American Journal of Gastroenterology · October 2023 Full text Cite

Serum Metabolites Are Associated With HFpEF in Biopsy-Proven Nonalcoholic Fatty Liver Disease.

Journal Article J Am Heart Assoc · July 18, 2023 Background Nonalcoholic fatty liver disease (NAFLD) and heart failure with preserved ejection fraction (HFpEF) share common risk factors, including obesity and diabetes. They are also thought to be mechanistically linked. The aim of this study was to defin ... Full text Link to item Cite

Access to technology to support telehealth in areas without specialty care for liver disease.

Journal Article Hepatology · January 1, 2023 BACKGROUND AND AIMS: Telehealth may be a successful strategy to increase access to specialty care for liver disease, but whether the areas with low access to care and a high burden of liver-related mortality have the necessary technology access to support ... Full text Link to item Cite

Long-term clinical outcomes of patients with COVID-19 and chronic liver disease: US multicenter COLD study.

Journal Article Hepatol Commun · January 1, 2023 BACKGROUND: COVID-19 is associated with higher morbidity and mortality in patients with chronic liver diseases (CLDs). However, our understanding of the long-term outcomes of COVID-19 in patients with CLD is limited. METHODS: We conducted a multicenter, ob ... Full text Link to item Cite

Challenges and barriers in hepatocellular carcinoma (HCC) surveillance for patients with non-alcoholic fatty liver disease (NAFLD)

Journal Article Hepatoma Research · January 1, 2023 The proportion of hepatocellular carcinoma (HCC) cases due to NAFLD is expected to increase, paralleling the rise in NAFLD due to the obesity epidemic. Early detection is critical, as it potentially enables curative treatment. Current guidelines recommend ... Full text Cite

Trends and Disparities in Hepatology Televisits at a Large Tertiary Care Center

Conference AMERICAN JOURNAL OF GASTROENTEROLOGY · 2023 Cite

Patient Disparities in Consent for HCV NAT plus Solid Organ Transplant

Conference AMERICAN JOURNAL OF TRANSPLANTATION · 2023 Cite

A Case of Pembrolizumab-Related Duodenopathy

Conference AMERICAN JOURNAL OF GASTROENTEROLOGY · 2023 Cite

Racial and Socioeconomic Disparities in Utilization of Telehealth in Patients with Liver Disease During COVID-19.

Journal Article Dig Dis Sci · January 2022 BACKGROUND AND AIMS: The coronavirus disease 2019 (COVID-19) pandemic resulted in a rapid expansion of telehealth services in hepatology. However, known racial and socioeconomic disparities in internet access potentially translate into barriers for the use ... Full text Link to item Cite

Nonalcoholic Fatty Liver Disease and Risk of Heart Failure Among Medicare Beneficiaries.

Journal Article J Am Heart Assoc · November 16, 2021 Background Nonalcoholic fatty liver disease (NAFLD) and heart failure (HF) are increasing in prevalence. The independent association between NAFLD and downstream risk of HF and HF subtypes (HF with preserved ejection fraction and HF with reduced ejection f ... Full text Link to item Cite

Relationship of Nonalcoholic Fatty Liver Disease and Heart Failure With Preserved Ejection Fraction.

Journal Article JACC Basic Transl Sci · November 2021 Although there is an established bidirectional relationship between heart failure with reduced ejection fraction and liver disease, the association between heart failure with preserved ejection fraction (HFpEF) and liver diseases, such as nonalcoholic fatt ... Full text Link to item Cite

The Impact of the 2017 Kidney Allocation Policy Change on Simultaneous Liver-Kidney Utilization and Outcomes.

Journal Article Liver Transpl · August 2021 Historically in the United States, kidneys for simultaneous liver-kidney transplantation (SLKT) candidates were allocated with livers, prioritizing SLKT recipients over much of the kidney waiting list. A 2017 change in policy delineated renal function crit ... Full text Link to item Cite

Health Equity and Telemedicine in Gastroenterology and Hepatology.

Journal Article Clin Gastroenterol Hepatol · August 2021 Full text Link to item Cite

Predictors of Outcomes of COVID-19 in Patients With Chronic Liver Disease: US Multi-center Study.

Journal Article Clin Gastroenterol Hepatol · July 2021 BACKGROUND & AIMS: Chronic liver disease (CLD) represents a major global health burden. We undertook this study to identify the factors associated with adverse outcomes in patients with CLD who acquire the novel coronavirus-2019 (COVID-19). METHODS: We con ... Full text Link to item Cite

REPLY.

Journal Article Hepatology · April 2021 Full text Link to item Cite

Serum Bile Acid, Vitamin E, and Serotonin Metabolites Are Associated With Future Liver-Related Events in Nonalcoholic Fatty Liver Disease.

Journal Article Hepatol Commun · April 2021 Identifying patients at higher risk for poor outcomes from nonalcoholic fatty liver disease (NAFLD) remains challenging. Metabolomics, the comprehensive measurement of small molecules in biological samples, has the potential to reveal novel noninvasive bio ... Full text Link to item Cite

Sex and Menopause Modify the Effect of Single Nucleotide Polymorphism Genotypes on Fibrosis in NAFLD.

Journal Article Hepatol Commun · April 2021 The development of fibrosis in nonalcoholic fatty liver disease (NAFLD) is influenced by genetics, sex, and menopausal status, but whether genetic susceptibility to fibrosis is influenced by sex and reproductive status is unclear. Our aim was to identify m ... Full text Link to item Cite

Association of liver fibrosis risk scores with clinical outcomes in patients with heart failure with preserved ejection fraction: findings from TOPCAT.

Journal Article ESC Heart Fail · April 2021 AIMS: Non-alcoholic fatty liver disease leads to progressive liver fibrosis and appears to be a frequent co-morbid disease in heart failure with preserved ejection fraction (HFpEF). It is well known that liver fibrosis severity predicts future liver-relate ... Full text Link to item Cite

Biological Aspects of Cancer Health Disparities.

Book · January 27, 2021 Racial and ethnic disparities span the continuum of cancer care and are driven by a complex interplay among social, psychosocial, lifestyle, environmental, health system, and biological determinants of health. Research is needed to identify these determina ... Full text Link to item Cite

Molecular Mechanisms Linking Nonalcoholic Steatohepatitis to Cancer.

Journal Article Clin Liver Dis (Hoboken) · January 2021 Watch a video presentation of this article Watch an interview with the author Answer questions and earn CME. ... Full text Link to item Cite

Small Bowel Adenocarcinoma After Bariatric Surgery: A Case Report

Conference AMERICAN JOURNAL OF GASTROENTEROLOGY · 2021 Cite

Use of Skeletal Muscle Index as a Predictor of Wait-List Mortality in Patients With End-Stage Liver Disease.

Conference Liver Transpl · September 2020 The aim of this study is to validate a proposed definition of sarcopenia in predicting wait-list mortality. We retrospectively evaluated 355 adults (age ≥18 years) with cirrhosis listed for first-time LT from January 1, 2010, to April 1, 2018 from our cent ... Full text Link to item Cite

Standardizing inpatient colonoscopy preparations improves quality and provider satisfaction.

Journal Article Int J Health Care Qual Assur · March 9, 2020 PURPOSE: Inpatient colonoscopy bowel preparation quality is frequently suboptimal. This quality improvement (QI) intervention is focused on regimenting this process to impact important outcomes. DESIGN/METHODOLOGY/APPROACH: Define, Measure, Analyze, Improv ... Full text Open Access Link to item Cite

An Insoluble Mystery: Fiber and Diverticulitis.

Journal Article Gastroenterology · March 2020 Full text Link to item Cite

Branched chain amino acid transaminase 1 (BCAT1) is overexpressed and hypomethylated in patients with non-alcoholic fatty liver disease who experience adverse clinical events: A pilot study.

Journal Article PLoS One · 2018 BACKGROUND AND OBJECTIVES: Although the burden of non-alcoholic fatty liver disease (NAFLD) continues to increase worldwide, genetic factors predicting progression to cirrhosis and decompensation in NAFLD remain poorly understood. We sought to determine wh ... Full text Open Access Link to item Cite

Hospital readmissions in decompensated cirrhotics: Factors pointing toward a prevention strategy.

Journal Article World J Gastroenterol · October 7, 2017 AIM: To reduce readmissions and improve patient outcomes in cirrhotic patients through better understanding of readmission predictors. METHODS: We performed a single-center retrospective study of patients admitted with decompensated cirrhosis from January ... Full text Link to item Cite

Epigenetics of Childhood Obesity

Journal Article Current Pediatrics Reports · September 1, 2017 Purpose of Review: We sought to describe how epigenetics, the study of potentially heritable changes in gene expression that do not involve changes in the underlying DNA sequence, has promise in the development of effective preventive interventions for chi ... Full text Cite

Diagnosis of Capnocytophaga canimorsus Sepsis by Whole-Genome Next-Generation Sequencing.

Journal Article Open Forum Infect Dis · September 2016 We report the case of a 60-year-old man with septic shock due to Capnocytophaga canimorsus that was diagnosed in 24 hours by a novel whole-genome next-generation sequencing assay. This technology shows great promise in identifying fastidious pathogens, and ... Full text Open Access Link to item Cite

Impact of EGF, IL28B, and PNPLA3 polymorphisms on the outcome of allograft hepatitis C: a multicenter study.

Journal Article Clin Transplant · April 2016 Hepatitis C virus (HCV) infection is accelerated following liver transplantation (LT). Single nucleotide polymorphisms (SNPs) near the epidermal growth factor (EGF) (rs4444903), IL28B (rs12979860), and PNPLA3 (rs738409) loci are associated with treatment r ... Full text Link to item Cite

A genomic and clinical prognostic index for hepatitis C-related early-stage cirrhosis that predicts clinical deterioration

Journal Article Gut · August 2015 ObjectiveThe number of patients with HCV-related cirrhosis is increasing, leading to a rising risk of complications and death. Prognostic stratification in patients with e ... Full text Cite