scholarly journals Prognostic Value of Transient Elastography in Human Immunodeficiency Virus-Infected Patients With Chronic Hepatitis C

2016 ◽  
Vol 3 (4) ◽  
Author(s):  
Leire Pérez-Latorre ◽  
Antonio Rivero-Juárez ◽  
Víctor Hontañón ◽  
Cristina Díez ◽  
Francisca Cuenca ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Prognostic Value ◽  
Transient Elastography ◽  
Sustained Viral Response ◽  
Liver Stiffness ◽  
Receiver Operating Characteristic Curves ◽  
Study Population

Abstract Background Our objective was to study the prognostic value of liver stiffness (LS) in HIV-infected patients with chronic hepatitis C (CHC). Methods We analyzed HIV-infected patients with compensated CHC and at least 1 determination of LS. The primary outcome was the occurrence of liver-related events (LRE), namely, decompensation or hepatocellular carcinoma, whichever occurred first. We selected patients without sustained viral response (SVR) or end-of-treatment response (ETR) during follow-up and allocated them to an estimation cohort (EC) and a validation cohort (VC). Results The study population comprised 1292 patients. After a median follow-up of 5.8 years, 90 patients experienced LRE and 73 died. In the subgroup of 957 patients without SVR or ETR, the area under the receiver operating characteristic curves (AUROCs) (95% confidence interval [CI]) of LS for prediction of LRE in the EC (n = 634) and the VC (n = 323) were 0.87 and 0.88, respectively. The best cutoff value of LS to rule out LRE in the EC was 12 kPa, with a negative predictive value of 98.3% in the EC and 98.2% in the VC. Per each 1 kPa and 5 kPa increase above 12 kPa, the hazard ratio of LRE (taking into account death as a competing risk) was 1.07 (95% CI, 1.05–1.08) and 1.38 (95% CI, 1.31–1.46), respectively. Conclusions Liver stiffness is very accurate for predicting LRE in coinfected patients. Patients with an LS <12 kPa had a 98% probability of not developing LRE after a median follow-up of almost 6 years. Above the 12-kPa cutoff, the hazard of LRE increases proportionally with LS.

scholarly journals Evaluation of long-term changes of aspartate—platelet ratio index, FIB4, and liver stiffness in chronic hepatitis C patients successfully treated by direct-acting antivirals

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Nadia Abdel Ataay Abdelkader ◽  
Osama Ashraf Ahmed ◽  
Ahmed Fouad Sherief ◽  
Doaa Mahmoud Kandil ◽  
Mohammed Soliman Gado ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Post Treatment ◽  
Chronic Hcv ◽  
Chronic Hepatitis C Patients

Abstract Background A large number of chronic hepatitis C patients had been successfully treated by directly acting antivirals; therefore, strategies for the long-term follow-up of these patients have to be planned based on the post-treatment fibrosis stage—the main determinant of prognosis. In this study, we aim to evaluate changes in aspartate-platelet ratio index, FIB4, and liver stiffness in chronic hepatitis C patients who achieved SVR and ended treatment more than 1 year by DAAs. Results One hundred chronic hepatitis C patients who achieved SVR were enrolled at a median of 16 months after the end of treatment by DAAs. According to the baseline liver stiffness, 63 and 37 patients belonged to early (F0, F1, and F2) and advanced (F3 and F4) fibrosis stages, respectively. Both groups showed a decline of the degree of liver stiffness at follow-up compared to the baseline that was statistically significant in the early fibrosis group (5.9±1.5 vs 5.4±2.2 Kpcal, p=0.04), while measurements in the advanced group were (18±8.8 vs 15.9 ± 7.8 Kpcal, p=0.07). Also, serum biomarkers of fibrosis improved in both groups, where the recorded APRI and FIB4 before and after treatment were 0.42±0.3 vs 0.24±0.1, p<0.01 and 1±0.6 vs 0.93 ±0.5, p=0.1 in the early group and 0.85 ±0.5 vs 0.4±0.2, p <0.001 and 2.9±2.3 vs 1.8±1.4, p<0.02) in the advanced group, respectively. Changes in APRI and FIB4 correlated with changes in AST and ALT, but liver stiffness changes were not affected by changes in liver enzymes. Conclusion Although long-term improvement of APRI, FIB4, and liver stiffness scores could be achieved in chronic HCV patients after SVR by DAAS. High measurements of liver stiffness before treatment likely persist. We recommend transient elastography as a reliable tool for fibrosis assessment post-treatment.

scholarly journals Liver stiffness in chronic hepatitis C virus infection

2019 ◽  
Vol 57 (2) ◽  
pp. 85-98
Author(s):  
Romeo-Gabriel Mihăilă
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Liver Fibrosis ◽  
Chronic Hepatitis C ◽  
Esophageal Varices ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Shear Wave Elastography ◽  
Stiffness Measurement ◽  
A Value

Abstract Introduction. The severity of liver fibrosis can be assessed noninvasively today by liver stiffness measurements. Vibration-controlled transient elastography, shear wave elastography or magnetic resonance elastography are techniques increasingly used for this purpose. Methods. This article presents the recent advances in the use of new techniques for liver fibrosis assessment in chronic hepatitis C: the correlation between liver stiffness values and liver fibrosis estimated by liver biopsies, the prognosis role of liver stiffness values, their usefulness in monitoring the treatment response, in assessing the severity of portal hypertension and in estimating the presence of esophageal varices. Scientific articles from January 2017 to January 2018 were searched in PubMed and PubMed Central databases, using the terms “liver stiffness” and “hepatitis C”. Results. The median liver stiffness values measured with different techniques are not identical, so that FibroScan thresholds cannot be used on any other elastographic machine. The higher the liver’s stiffness measurement, the higher the liver-related events in patients with chronic hepatitis C. A liver stiffness measurement over 17 kPa could be an independent predictor for the presence of esophageal varices as well as a spleen with a longitudinal span ≥ 15 cm for patients with a value of liver stiffness < 17 kPa. A progressive and persistent decrease in liver stiffness is dependent on sustained virological response achievement. The lack of liver stiffness decrease has been associated with relapsers and a low value of liver stiffness at baseline. Conclusion. Liver stiffness provides clues about the severity and evolution of liver disease.

scholarly journals Diabetes impacts liver stiffness in chronic hepatitis C patients with and without virological cure: a longitudinal study

2020 ◽  
Author(s):  
Daniela Malta Pontual ◽  
Leticia Cancella Nabuco ◽  
Ronir Raggio Luiz ◽  
Ana Carolina Cardoso ◽  
Renata M. Perez ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Longitudinal Study ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Associated Factors ◽  
Linear Regression Analysis ◽  
Liver Stiffness ◽  
Diabetic Patients ◽  
Rate Of Progression

Abstract Background: Transient elastography is controversial as a follow-up tool in chronic hepatitis C (CHC) patients. The aim was to assess the variation of liver stiffness measures and its associated factors on a cohort of CHC individuals composed of naïve, sustained virological response (SVR) and non-responder patients (NR).Methods: This was a longitudinal study in CHC patients who were followed with clinical, laboratorial and serial elastography (Fibroscan®). The rate of progression of liver stiffness was calculated and the associated factors for progression were assessed by multiple linear regression analysis. Results: Four hundred and six patients were included: 29% naïve, 24% NR and 47% SVR who were followed for 44 (35-53) months. There was a significant decrease in liver stiffness among SVR patients [11.8 (9.2) kPa vs 8.8 (8.4) kPa (p<0.001)], a trend for liver stiffness increasing in NR group [6.6 (5.2) kPa vs 7.1 (4.5) kPa; p=0.069)] and no change of liver stiffness in naïve group [6.3 (3.0) vs 6.0 (3.8); p=0.22]. The related factors for liver stiffness progression were lack of SVR (p=0.002) and diabetes (p=0.05). In non-diabetic SVR group, a negative rate of progression (- 0.047 kPa/month) was found compared to the highest rate in diabetic non-responder patients (+ 0.044 kPa/month). Diabetics with SVR showed a rate of (+) 0.037 kPa/month while in non-diabetic non-responder patients the ratio was (+) 0.028 kPA/month.Conclusion: Despite SVR, liver stiffness in diabetic patients progresses, suggesting that a close follow-up of diabetic patients should remain even after SVR.

scholarly journals The applicability of non-invasive methods for assessing liver fibrosis in hemodialysis patients with chronic hepatitis C

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0242601
Author(s):  
Jia-Jung Lee ◽  
Yu-Ju Wei ◽  
Ming-Yen Lin ◽  
Sheng-Wen Niu ◽  
Po-Yao Hsu ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Liver Fibrosis ◽  
Diagnostic Accuracy ◽  
Chronic Hepatitis C ◽  
Transient Elastography ◽  
Hemodialysis Patients ◽  
Accurate Assessment ◽  
Non Invasive

Background The accurate assessment of liver fibrosis among hemodialysis patients with chronic hepatitis C (CHC) is important for both treatment and for follow up strategies. Applying the non-invasive methods in general population with viral hepatitis have been successful but the applicability of the aminotransferase/platelet ratio index (APRI) or the fibrosis-4 index (FIB-4) in hemodialysis patients need further evaluation. Materials and methods We conducted a prospective, multi-center, uremic cohort to verify the applicability of APRI and FIB-4 in identifying liver fibrosis by reference with the standard transient elastography (TE) measures. Results There were 116 CHC cases with valid TE were enrolled in our analysis. 46 cases (39.6%) were classified as F1, 35 cases (30.2%) as F2, 11 cases (9.5%) as F3, and 24 cases (20.7%) as F4, respectively. The traditional APRI and FIB-4 criteria did not correctly identify liver fibrosis. The optimal cut-off value of APRI was 0.28 and of FIB-4 was 1.91 to best excluding liver cirrhosis with AUC of 76% and 77%, respectively. The subgroup analysis showed that female CHC hemodialysis patients had better diagnostic accuracy with 74.1% by APRI. And CHC hemodialysis patients without hypertension had better diagnostic accuracy with 78.6% by FIB-4. Conclusions This study confirmed the traditional category level of APRI and FIB-4 were unable to identify liver fibrosis of CHC hemodialysis patients. With the adjusted cut-off value, APRI and FIB-4 still showed suboptimal diagnostic accuracy. Our results suggest the necessary of TE measures for liver fibrosis in the CHC uremic population.

Liver stiffness measured by transient elastography correlates with fibrosis area in liver biopsy in patients with chronic hepatitis C

2009 ◽  
Vol 39 (7) ◽  
pp. 675-684 ◽  
Author(s):  
Yoshifumi Nitta ◽  
Naoto Kawabe ◽  
Senju Hashimoto ◽  
Masao Harata ◽  
Naruomi Komura ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Liver Biopsy ◽  
Chronic Hepatitis C ◽  
Transient Elastography ◽  
Liver Stiffness

scholarly journals Study of the effect of direct acting antivirals (DAAs) on fibrosis in chronic hepatitis C patients using transient elastography

2021 ◽  
Vol 10 (2) ◽  
pp. 135-145
Author(s):  
Alaa Aboud Mohammed ◽  
Dina Attia ◽  
Basel Abdelmonem Ebeid ◽  
Mariam Boulous Ibrahim
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Transient Elastography ◽  
Liver Stiffness ◽  
Critical Issue ◽  
Post Treatment ◽  
Liver Inflammation ◽  
Complication Risk ◽  
Chronic Hepatitis C Patients

Back ground: As DAA agents are leading to enormous cure rates, so identifying and monitoring patients who remain at a high complication risk after achieving SVR continue to be a critical issue. Numerous validated methods for noninvasive measurement of liver fibrosis can be used in the management of HCV infection. Methods study: A total of 50 Egyptian chronic HCV patients eligible for treatment with DAAs were enrolled in this prospective study. All subjects selected from Virology Unit of Tropical Medicine Department, Faculty of Medicine, Beni-Suef University received DAAs (SOV DCV) the endpoint was a sustained virologic response at 12 (SVR12) weeks post-treatment. All participants were evaluated non-invasively by Liver Stiffness Measurement (LSM) by Fibro Scan before DAAs treatment, and 6 months post-treatment. Results: SVR achieved by DAAs therapy was 96 % and was associated with significant improvement (p ˂0.05) of non-invasive fibrosis markers (FIB-4, APRI score, and LSM by Fibro Scan) from baseline compared to 6 months post-treatment. Using fibro scan regression of fibrosis in 30/45 patients (66%). Liver inflammation and synthetic functions also improved on follow up 12w and 6m post treatment. Conclusion: Regression of Liver inflammation and fibrosis in chronic hepatitis C patients post treatment with SOF DCV.

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