Does noninvasive staging of fibrosis challenge liver biopsy as a gold standard in chronic hepatitis C?

Hepatology ◽  
2004 ◽  
Vol 39 (5) ◽  
pp. 1456-1457 ◽  
Author(s):  
Thomas Berg ◽  
Christoph Sarrazin ◽  
Holger Hinrichsen ◽  
Peter Buggisch ◽  
Tilman Gerlach ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Liver Biopsy ◽  
Chronic Hepatitis C ◽  
Gold Standard

scholarly journals Latent Class Analysis of Noninvasive Methods and Liver Biopsy in Chronic Hepatitis C: An Approach without a Gold Standard

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Flavia F. Fernandes ◽  
Hugo Perazzo ◽  
Luiz E. Andrade ◽  
Alessandra Dellavance ◽  
Carlos Terra ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Latent Class Analysis ◽  
Chronic Hepatitis C ◽  
Gold Standard ◽  
Latent Class ◽  
Noninvasive Methods ◽  
Without A Gold Standard

Aims.To evaluate the applicability of the Latent Class Analysis (LCA) and accuracy of transient elastography (TE), aspartate-to-platelet-ratio-index (APRI), enhanced liver fibrosis (ELF), and liver biopsy (LB) for liver fibrosis assessment in a model without a gold standard.Methods.Significant fibrosis was defined asTE≥7.1 kPa,APRI≥1.5,ELF≥9.37, or LB METAVIRF≥2. Cirrhosis was defined asTE≥12.5 kPa,APRI≥2.0,ELF≥10.31, or LB as METAVIRF=4.Results.117 patients with chronic hepatitis C were included. In the LCA, for significant fibrosis the sensitivities and specificities (95% CI) were 0.92 (0.86–0.98) and 0.79 (0.72–0.86) for TE; 0.47 (0.40–0.54) and 0.99 (0.95–1.00) for APRI; 0.81 (0.74–0.88) and 0.78 (0.71–0.85) for ELF; and 0.86 (0.68–1.00) and 0.91 (0.79–1.00) for LB. For cirrhosis, the sensitivities and specificities were 0.92 (0.76–1.00) and 0.94 (0.91–0.97) for TE; 0.57 (0.37–0.77) and 0.97 (0.93–1.00) for APRI; 0.94 (0.84–1.00) and 0.88 (0.82–0.94) for ELF; and 0.30 (0.12–0.48) and 1.00 for LB.Conclusion.LCA was useful to evaluate accuracy of methods for liver fibrosis staging. Sensitivities and specificities of noninvasive methods were increased in LCA compared to the use of LB as the gold standard.

scholarly journals Use of AST platelet ratio index (APRI Score) as an alternative to liver biopsy for treatment indication in chronic hepatitis C

2009 ◽  
Vol 8 (1) ◽  
pp. 26-31 ◽  
Author(s):  
Mônica Salum Valverde Borsoi Viana ◽  
Kioko Takei ◽  
Diva Carvalho Collarile Yamaguti ◽  
Betty Guz ◽  
Edna Strauss
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Liver Biopsy ◽  
Chronic Hepatitis C ◽  
Treatment Indication ◽  
Apri Score

553 Steatosis in chronic hepatitis C and development of fibrosis: A prospective paired liver biopsy study in 292 patients

2006 ◽  
Vol 44 ◽  
pp. S206
Author(s):  
N.I. Tagiuri ◽  
A.M. Zaitoun ◽  
S. Ratib ◽  
W.L. Irving ◽  
S.D. Ryder
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Liver Biopsy ◽  
Chronic Hepatitis C

scholarly journals Liver Biopsies for Chronic Hepatitis C: Should Nonultrasound-Guided Biopsies Be Abandoned?

2009 ◽  
Vol 23 (6) ◽  
pp. 425-430 ◽  
Author(s):  
Jennifer A Flemming ◽  
David J Hurlbut ◽  
Ben Mussari ◽  
Lawrence C Hookey
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Liver Biopsy ◽  
Chronic Hepatitis C ◽  
Hcv Infection ◽  
Significant Difference ◽  
The Us ◽  
Chronic Hcv Infection ◽  
Liver Biopsies ◽  
Chronic Hcv

BACKGROUND/OBJECTIVE: Liver biopsy has been the gold standard for grading and staging chronic hepatitis C virus (HCV)-mediated liver injury. Traditionally, this has been performed by trained practitioners using a nonimage-guided percutaneous technique at the bedside. Recent literature suggests an expanding role for radiologists in obtaining biopsies using an ultrasound (US)-guided technique. The present study was undertaken study to determine if the two techniques produced liver biopsy specimens of similar quality and hypothesized that at our institution, non-US-guided percutaneous liver biopsies for HCV would be of higher quality than US-guided specimens.METHODS: Liver biopsies from 100 patients with chronic HCV infection (50 consecutive US-guided and 50 consecutive non-US-guided), were retrospectively identified using a hospital histopathology database. All original biopsy slides were coded and prospectively reanalyzed by a single hepatopathologist who was blinded to the technique used in obtaining the biopsy. Additionally, all liver biopsies for chronic HCV infection completed at the centre from 1998 to 2007 were identified and the technique used was recorded. Biopsy quality was determined primarily by the number of complete portal tracts (CPTs) identifiable in the slides. The total length of specimen and the degree of fragmentation were secondary outcome measures.RESULTS: There was a slight difference observed between the US-guided and non-US-guided groups in mean age (46.3 years versus 42.5 years, repectively; P=0.018) but no differences in sex, presence of cirrhosis, bilirubin, creatinine, international normalized ratio, and grade or stage of disease. Biopsies obtained using the US-guided technique produced higher quality specimens than the non-US-guided technique based on our primary outcome of number of CPTs in the biopsy (11.8 versus 7.4; P<0.001). US-guided specimens also were longer (24.4 mm versus 19.7 mm; P=0.001), had less fragmentation (P=0.016), and a higher overall histopathological quality assessment (P=0.026) than the non-US-guided biopsies. However, there was no significant difference between the two groups in the ability to grade and stage the disease (96% US-guided versus 90% in non-US-guided (P=0.20). Over a 10-year period, 763 biopsies for chronic HCV infection were identified with an obvious trend toward the increased use of US-guided technique observed at 2% in 1998 to 85% in 2007.CONCLUSIONS: US-guided liver biopsies for chronic HCV are the most common method of obtaining specimens at the Kingston General Hospital, Kingston, Ontario, and are of higher quality than non-US-guided specimens. However, there is no significant difference in the two techniques in the ability to grade and stage chronic HCV.

Gold standard assays for the monitoring of patients with chronic hepatitis C

2018 ◽  
Vol 13 (8) ◽  
pp. 529-537
Author(s):  
Elisabetta Loggi ◽  
Ranka Vukotic ◽  
Fabio Conti ◽  
Stefano Gitto ◽  
Pietro Andreone
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Gold Standard

scholarly journals Nem invazív fibrosisdiagnosztika hepatitis C-vírus-infekcióban: szerepe a kezelés indikációjában, követésében és a prognózis megítélésében

2015 ◽  
Vol 156 (21) ◽  
pp. 855-861 ◽  
Author(s):  
Alajos Pár ◽  
Áron Vincze ◽  
Gabriella Pár
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Virus Infection ◽  
Liver Biopsy ◽  
Chronic Hepatitis C ◽  
Antiviral Treatment ◽  
Hepatitis C Virus Infection ◽  
Non Invasive ◽  
Chronic Hepatitis C Virus

Chronic hepatitis C virus infection associated with necroinflammation predisposes to liver fibrosis and cirrhosis, which lead to severe end-stage complications. Staging of fibrosis is of basic importance for the indication of antiviral treatment, for monitoring the response and predicting the prognosis of patients with hepatitis C virus related liver disease. Since liver biopsy, the “gold standard” diagnosis of fibrosis is invasive and it has some other limitations, non-invasive methods have been developed and widely used in the clinical practice. Serum biomarkers and physical approaches measuring liver stiffness by elastography as well as combination algorithms have been gradually been integrated into guidelines resulting in a reduction of the need for liver biopsy. The authors review these non-invasive fibrosis markers and discuss their role in the indication of treatment, follow-up, and assessment of prognosis of patients with chronic hepatitis C virus infection. Orv. Hetil., 2015, 156(21), 855–861.

scholarly journals The role of liver biopsy in chronic hepatitis C

Hepatology ◽  
2002 ◽  
Vol 36 (S1) ◽  
pp. S152-S160 ◽  
Author(s):  
Jules L. Dienstag
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Liver Biopsy ◽  
Chronic Hepatitis C
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