BIO

Anna Marie Hefner PhD, RN, CPNP, FAASLD is a board-certified Pediatric Nurse Practitioner, and expert nurse in the field of Hepatology, specializing in fatty liver disease and non-alcoholic steatohepatitis. Anna Marie is an Associate Professor at Azusa Pacific University, School of Nursing, where she teaches undergraduate and graduate nursing students. Anna received her Masters of Science in Nursing from California State University in Long Beach, and her Masters of Arts, Education, and Special Education at Azusa Pacific University. Anna Marie completed her Doctorate in Nursing at the University of San Diego, with an emphasis in nutritional status of the patient with end-stage liver disease.

Anna Marie is the Director of the NASH-ville clinics at Southern California Liver Centers. Anna Marie has received three consecutive mid-level professional awards for her work on facilitating lifestyle changes to manage progressive fatty liver disease from the American Association for the Study of Liver Diseases. Anna Marie is a member of the National Association of Pediatric Nurse Practitioners and the American Academy of Nurse Practitioners.

MASLD-MASH Content Featuring Anna Marie

Webcast: Comparing F3 and F4 Fibrosis With Anna Marie Hefner & Renee Pozza

November 2025

Join Anna Marie Hefner, RN and Renee Pozza, FNP-BC from Southern California Liver & GI Centers for a practical, case-based deep dive into advanced MASLD/MASH—what F3 vs F4 (cirrhosis) really means for staging, treatment, and surveillance. Using a 55-year-old patient scenario, they walk through interpreting FIB-4, FibroScan® (kPa + CAP), ELF, and routine labs; when to add ultrasound + AFP for HCC surveillance, and when to scope for esophageal varices. You’ll hear how they structure follow-up (from biweekly check-ins early to every 3 months), tailor diet and exercise to real-world habits, incorporate GLP-1s for weight and metabolic control, and consider resmetirom for eligible F2–F3 patients (not F4). The session also covers when to escalate to colonoscopy for alternative bleeding sources, and how to alternate US with triphasic CT/MRI in high-risk patients. Perfect for GI/hepatology APPs looking for a clear, actionable framework to manage fibrosis progression and optimize outcomes.

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Common Questions From Primary Care Providers About MASH

October 2025

In this educational video, Anna Marie Hefner, CPNP, a hepatology nurse practitioner at the Southern California Liver and GI Centers, shares valuable insights for primary care providers managing patients with fatty liver disease. Anna Marie explains how her community-based practice collaborates with local clinicians to streamline care for patients with MASLD (Metabolic Associated Steatotic Liver Disease) and MASH (Metabolic Associated Steatohepatitis). She outlines a clear approach for evaluating patients with elevated liver enzymes and fatty liver, including when to use non-invasive testing (NITs) such as FibroScan and how to interpret fibrosis stages (F0–F4) to guide next steps in management. Anna Marie emphasizes that patients with early-stage fibrosis (F0–F1) can often be managed in primary care with regular weight monitoring, labs, and annual imaging, while those with advanced fibrosis (F3–F4) require hepatology referral for specialized care and cirrhosis management. She also discusses how her team supports community physicians—offering FibroScan services, consultative guidance, and direct communication to ensure patients receive coordinated, evidence-based care. This session is a practical resource for APPs, hepatology teams, and primary care providers navigating fatty liver disease screening, risk stratification, and referral pathways.

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NITs: A Practical Overview: Navigating the Basics

October 2025

In this informative session, Anna Marie Hefner, CPNP, a hepatology nurse practitioner at the Southern California Liver and GI Center, shares her 15+ years of experience managing patients with MASLD (Metabolic Associated Steatotic Liver Disease) and MASH (Metabolic Associated Steatohepatitis). She explains how her clinic has created a collaborative, patient-centered approach—hosting dedicated fatty liver clinics that foster education, peer support, and lifestyle discussion among patients. Anna Marie walks viewers through how to distinguish between simple steatosis and MASH, emphasizing that proper diagnosis drives appropriate management—from lifestyle counseling and diet modification for early stages to medication and specialist referral for advanced fibrosis or cirrhosis. She offers a detailed overview of non-invasive tests (NITs) such as FIB-4, ELF, FibroScan, and MRI elastography, outlining how each test is performed, how to interpret key cutoff values, and when to refer patients to hepatology. She also highlights the importance of evaluating comorbidities, including cardiovascular and metabolic risk factors, medication history, and family health background, as part of comprehensive liver assessment. Finally, she encourages providers to follow AASLD and EASL guidelines, utilize collaborative care across specialties, and engage with professional APP organizations like GHAPP to stay current on evolving best practices in fatty liver disease management.

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Webcast: MASLD Basics With Anna Marie Hefner & Renee Pozza

October 2025

In this MASLD Community Network session, Anna Hefner, PhD, RN, CPNP, and Renee Pozza, PhD, RN, CNS, FNP-BC, of Southern California GI & Liver Centers break down the new nomenclature for steatotic liver disease (SLD) and what it means for clinical practice. They clarify how to distinguish MASLD from MASH, introduce the overlap category MetALD (metabolic-associated alcohol-related liver disease), and review differential causes of steatosis—from medications and viral hepatitis to genetic and cryptogenic etiologies. The faculty walk through practical primary-care screening with FIB-4, when to escalate with noninvasive tests (FibroScan® CAP/kPa, ELF), and the roles of ultrasound and MRI/MRE—plus when a liver biopsy is still warranted. You’ll learn staging cues (F0–F4), progression risk, who needs closer follow-up, and how to counsel patients on cardiometabolic risk reduction (weight loss, activity, triglyceride/HDL management, blood pressure, glucose). The talk also highlights pediatric considerations, terminology changes to reduce stigma, and tips for consistent waist-circumference measurement and alcohol-intake assessment—equipping PCPs, GI, and hepatology teams to identify fibrosis early and improve outcomes.

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Management of Lifestyle Modification

January 2025

This video focuses on the comprehensive management of patients with metabolic-associated steatohepatitis (MASH), emphasizing lifestyle modifications, dietary adjustments, and exercise strategies. Key topics include the importance of addressing risk factors like diet, exercise habits, and alcohol intake, as well as referrals to medically supervised weight loss clinics or bariatric surgery for advanced cases. The speaker highlights the benefits of the Mediterranean diet, intermittent fasting, and avoiding ultra-processed foods while discussing the role of resistance training to combat sarcopenia and maintain muscle mass. Practical advice and tailored recommendations ensure a holistic approach to managing MASH and improving patient outcomes.

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Third Step of Lifestyle Management

January 2025

This video provides a comprehensive overview of emerging pharmacologic treatments for metabolic-associated steatohepatitis (MASH) and their tailored applications based on patient profiles. Topics include FDA-approved therapies, drugs in advanced clinical trials (such as semaglutide and lanifibranor), and the potential for combination treatments targeting both steatohepatitis and fibrosis. The speaker emphasizes the importance of patient-specific approaches considering metabolic profiles, obesity, and diabetes status, alongside lifestyle interventions. Additionally, the video discusses the evolving interdisciplinary care model and highlights the exciting progress in non-invasive testing and treatment advancements for F2-F3 fibrosis.

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Approved Medication for MASH/NASH

January 2025

This video provides detailed guidance on selecting and monitoring patients for emerging therapies targeting advanced fibrosis (F2-F3) in NASH. Key topics include contraindications for patients with cirrhosis, considerations for concomitant medications, and dose adjustments for statins. The video outlines ideal candidates based on specific thresholds for VCTE, MRE, ELF scores, and other non-invasive tests while emphasizing the importance of ruling out portal hypertension and other liver diseases. It also reviews a stepwise monitoring approach, focusing on tolerability at three months and efficacy assessments at six and twelve months, with an emphasis on histologic and non-invasive test improvements.

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Types of Diet for the Treatment of MASLD

January 2025

This video explores comprehensive strategies for managing metabolic-associated steatohepatitis (MASH), focusing on fibrosis risk stratification, lifestyle modifications, and pharmacologic interventions. Learn about dietary recommendations like the Mediterranean diet, exercise guidelines emphasizing resistance training, and the role of intermittent fasting and processed food avoidance. The video also highlights weight loss targets, diabetes management, and emerging therapies such as GLP-1 receptor agonists and bariatric surgery, all aimed at improving liver health and patient outcomes.

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NITs to Identify High Risk MASH Patients

January 2025

Explore advancements in non-invasive diagnostics and risk stratification for liver fibrosis and MASH. This video highlights tools like FIB-4, transient elastography, and innovative scoring systems (e.g., FAST and Agile) to identify and predict outcomes for high-risk patients. Learn about serum biomarkers, updated guidelines, and the role of lifestyle interventions alongside targeted therapies for managing metabolic risks and advancing care in hepatology.

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Highlighted Events

Breakthroughs in MASH Diagnosis & Management

January 14 @ 06:30 pm - 09:30 pm PST

Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with Sammy Saab, MD, MPH, Ke-Qin Hu, MD &am..

Breakthroughs in MASH Diagnosis & Management

January 15 @ 06:30 pm - 09:30 pm PST

Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with Robert Wong, MD, M.S, Bilal Hameed, MD..

Breakthroughs in MASH Diagnosis & Management

January 22 @ 06:30 pm - 09:30 pm PST

Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with Marina Roytman, MD, Paul Kwo, MD, &..

Breakthroughs in MASH Diagnosis & Management

January 29 @ 06:30 pm - 09:30 pm MST

Register to join us at a Liver Connect City Series Event, Breakthroughs in MASH Diagnosis & Management with Marcelo Kugelmas, MD, FAASLD, FACP, Ch..

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Related Content

Clinical Deep Dive: Unlocking the Treatment Potential of Rezdiffra

March 2025

This educational discussion dives into Rezdiffra, the first and only FDA-approved therapy for non-cirrhotic metabolic-associated steatohepatitis (MASH) with moderate to advanced fibrosis. The talk provides a clinical deep dive into the progression of MASH and fibrosis, highlighting the risks of untreated disease and the importance of early intervention. A key focus is the thyroid hormone receptor beta mechanism, explaining how Rezdiffra directly targets liver-specific pathways to reduce hepatic fat accumulation and fibrosis. Additionally, the discussion covers the rigorous FDA approval process and dual efficacy endpoints, detailing how Rezdiffra achieved significant fibrosis improvement and steatohepatitis resolution in the MAESTRO-NASH trial. The session also provides practical insights into patient access, prescribing considerations, and managing common side effects. With over 2,000 patients studied, Rezdiffra has demonstrated a strong safety profile and offers a once-daily oral treatment option that represents a major advancement in MASH management. This discussion is essential for gastroenterologists, hepatologists, and endocrinologists managing patients with MASH, as well as primary care providers and cardiologists who play a role in identifying at-risk individuals. If you are a healthcare professional looking to stay updated on the latest MASH research and treatment strategies, this session provides the insights you need.

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Liver Model Overview

July 2025

Join Alison Moe, PA-C with United Digestive, as she walks through a hands-on demonstration using a life-sized liver model to help patients better understand fibrosis and liver disease progression. In this engaging and practical overview, Allison explains how different stages of liver fibrosis—from normal liver to cirrhosis and hepatocellular carcinoma—can be felt and visualized using a segmented anatomical model. She shares how this tool enhances patient education during discussions about non-invasive liver testing, such as FibroScan, CAP scores, FIB-4, ELF testing, and more. Designed to support visual learners and improve comprehension of disease state, this video is a valuable resource for clinicians and patients navigating the complexities of metabolic-associated fatty liver disease (MASLD) and its progression to MASH. Learn how tactile and visual teaching aids can bridge the gap between diagnostics and patient understanding in hepatology care.

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Differentiating Between F3 and F4

July 2025

In this comprehensive discussion, HoChong Gilles, a nurse practitioner with 25 years of hepatology experience at the Richmond VA Medical Center, explores the critical importance of accurately distinguishing between F3 (advanced fibrosis) and F4 (cirrhosis) in patients with MASH (metabolic-associated steatohepatitis). While both stages carry increased risks of liver-specific and overall mortality, Gilles explains that F3 may still be reversible with lifestyle changes or pharmacotherapy, whereas F4 signals irreversible liver damage with heightened risk of complications like portal hypertension, hepatic encephalopathy, and liver cancer. Viewers will gain a deeper understanding of how non-invasive tests—like FIB-4, ELF, FibroScan, and MRE—perform in identifying fibrosis stage, including their limitations and overlaps. Gilles also outlines when to consider liver biopsy, especially in cases with discordant test results, atypical features, or clinical uncertainty. This video emphasizes how staging accuracy informs eligibility for therapies, surveillance strategies like HCC screening, and overall prognosis. Learn how to approach this nuanced distinction in clinical practice and why F3 vs. F4 isn't just semantics—it's a turning point in patient care.

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Addressing Health Disparities: Equity Considerations in MASH/MASLD Care

July 2025

In this episode, Patrick Horne, NP at the University of Florida (UF Health), explores the impact of health disparities and socioeconomic inequality on the diagnosis and management of MASH (metabolic-associated steatohepatitis) and MASLD (metabolic dysfunction-associated steatotic liver disease). With a focus on rural and underserved populations, Patrick discusses how limited access to quality healthcare, healthy food, exercise options, and non-invasive testing (NITs) like FibroScan or MRI elastography can delay diagnosis and worsen outcomes. He shares practical, empathetic strategies for individualizing care, such as using accessible tools like FIB-4 or APRI, promoting low-cost physical activity like walking or swimming, and providing culturally sensitive nutrition advice tailored to financial and geographic realities. Patrick emphasizes the provider’s role as a patient advocate and coach, helping patients navigate barriers and create sustainable lifestyle modifications. This episode offers key insights for clinicians working to close gaps in care and promote equity in liver disease management.

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Pharmacotherapy Review

July 2025

Join Christina Hanson, FNP-C, from South Denver Gastroenterology, as she provides an in-depth overview of the current pharmacologic treatment landscape for Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD) and Metabolic Dysfunction-Associated Steatohepatitis (MASH). This expert-led session explores the three cornerstones of MASH management—lifestyle and weight loss interventions, cardiovascular risk reduction, and liver-directed therapy—while highlighting the evolving role of GLP-1 receptor agonists and the recent FDA approval of resmetirom, the first medication indicated for adults with MASH and moderate to advanced fibrosis. Christina also discusses clinical trial data from MAESTRO-NASH, reviews historical agents like vitamin E and pioglitazone, and offers practical guidance on patient selection, safety considerations, and monitoring strategies. Whether you’re a GI provider, hepatology specialist, or primary care clinician managing fatty liver disease, this video provides valuable insights into how emerging therapies are shaping the future of MASH treatment.

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