In recent years, management of patients with liver-related diseases has been revolutionized by improvements in diagnostic techniques as well as by the availability of new therapeutic options.

The development of potent oral antivirals against hepatitis B (HBV) and C (HCV) viruses led to improved disease course, which translated into a reduction in liver-related complications and better survival. Thus, the WHO goal of HBV and HCV elimination by 2030 represents the most ambitious clinical endpoint of the last years. In addition, the first antiviral against HDV has become available, and opens the way to new medical challenges.

Despite these novelties, liver-related complications still represent a major burden affecting outcomes and survival of patients with cirrhosis. On the other hand, new therapies are awaited to gap unmet needs in settings different from viral hepatitis.

In this complex scenario, current efforts are focused toward development of personalized management approaches aiming at optimization of diagnostic, therapeutic and surveillance algorithms. Non-invasive tools have gained a leading role in the identification of patients at increased risk of liver-related complications; however, several efforts are still necessary in order to define surveillance and management strategies based on individual risk assessment.

Therefore, despite recent and profound changes in the epidemiology of liver diseases as well as in medical and therapeutic knowledges, Hepatologists are going to tackle new challenges, trying to achieve increasingly ambitious clinical goals.