In August 2020, Nature Reviews Gastroenterology & Hepatology attended The Digital International Liver Congress (ILC) 2020, hosted by the European Association for the Study of the Liver (EASL). This year, owing to the ongoing coronavirus disease 2019 (COVID-19) pandemic, the conference moved online. The virtual meeting was attended by ~7,400 people from 114 countries.

The event boasted a stylish user interface and featured exciting preclinical and clinical research on fields such as cirrhosis, liver tumours, metabolism and viral hepatitis. Each day kicked off with sessions from the EASL Studio, in which topics such as hepatitis C virus elimination and the therapeutic pipeline for hepatitis B virus were discussed. Abstract sessions, on fields as varied as liver immunology and the drug pipeline for nonalcoholic fatty liver disease (NAFLD), and digital poster sessions provided a platform for the latest findings and trial results.

Notable research highlights included the presentation of positive phase II results for use of the FGF19 analogue aldafermin in patients with nonalcoholic steatohepatitis (NASH), encouraging phase IIb results of the ATLAS trial for cilofexor and firsocostat combination therapy in patients with bridging fibrosis and cirrhosis due to NASH, and a genome-wide association study for alcohol-related cirrhosis that identified two new risk loci in MARC1 and HNRNPUL1.

A common theme across the conference was the role of the gut microbiota in liver disease. For example, novel data from mouse studies suggested that intestinal dysbiosis drives hepatocarcinogenesis by shaping the hepatic inflammatory microenvironment. The genetic and metabolic aspects of NAFLD were also well represented. Indeed, the contested proposed name change of NAFLD to metabolic associated fatty liver disease (MAFLD) cropped up frequently.

Also included were presentations on the use of FXR and PPAR agonists for cholangiopathies, as well as a session on the latest developments in pathogenesis and treatment of hepatitis E virus infection — the session highlighted how much work there is left to do regarding this virus. A timely session on COVID-19 and the liver explored the implications of, for example, the pandemic on liver transplantation programmes.

In contrast to this year’s virtual setting, ILC 2021 is due to take place in Amsterdam, The Netherlands, next June.