High serum angiopoietin‐2 level predicts non‐regression of liver stiffness measurement‐based liver fibrosis stage after direct‐acting antiviral therapy for hepatitis C

2020 ◽  
Vol 50 (6) ◽  
pp. 671-681 ◽  
Author(s):  
Naoki Kawagishi ◽  
Goki Suda ◽  
Megumi Kimura ◽  
Osamu Maehara ◽  
Tomoe Shimazaki ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Liver Fibrosis ◽  
Antiviral Therapy ◽  
Liver Stiffness ◽  
High Serum ◽  
Liver Stiffness Measurement ◽  
Stiffness Measurement ◽  
Direct Acting Antiviral ◽  
Direct Acting ◽  
Angiopoietin 2

Evaluation of liver fibrosis using hepatic extracellular volume fraction by contrast-enhanced computed tomography before and after direct-acting antiviral therapy in patients with chronic hepatitis C infection: comparison with serological liver fibrosis markers

2021 ◽  
Author(s):  
Akihiko Kanki ◽  
Kiyoka Maeba ◽  
Hidemitsu Sotozono ◽  
Kazuya Yasokawa ◽  
Atsushi Higaki ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Liver Fibrosis ◽  
Antiviral Therapy ◽  
Volume Fraction ◽  
Extracellular Volume ◽  
Control Group ◽  
Direct Acting Antiviral ◽  
Contrast Enhanced ◽  
Before And After ◽  
Direct Acting

Objective: To evaluate time-dependent changes in hepatic extracellular volume (ECV) fraction using contrast-enhanced CT (CECT) and serological liver fibrosis markers, the fibrosis-4 (FIB-4) index and aspartate aminotransferase to platelet ratio index (APRI), before and after direct-acting antiviral therapy (DAA) for hepatitis C virus (HCV) infection. Methods: 41 HCV-infected patients who achieved sustained virological response (SVR) after DAA (SVR group) and 10 control patients (untreated or unresponsive to treatment) who underwent CECT and serum biochemical tests before or after the first examination/DAA (T1) and at intervals thereafter (T2:<6 months after T1, T3: at 6–12 months, T4: at 12–24 months, and T5:>24 months) were evaluated. Results: In the control group, ECV fractions remained relatively unchanged through the study, and significant differences in FIB-4 index comparisons and APRI comparisons were only seen between the T2 and T4 values (p = 0.046 and p = 0.028, respectively). In the SVR group, ECV fractions were significantly different between T1 and T4 and T1 and T5 (p = 0.046 and 0.022, respectively), and both FIB-4 index and APRI were significantly different between T1 and all other time points (p = 0.017 to p < 0.001 and p = 0.001 to p < 0.001, respectively). Conclusion: After DAA, ECV fraction decreased slowly, suggesting an improvement in hepatic fibrosis, while serological liver fibrosis markers decreased immediately, probably due to improvement in hepatic inflammation. Advances in knowledge: ECV fraction has the potential to be a non-invasive biomarker for the assessment of liver fibrosis after direct-acting antiviral therapy.

Accuracy of the ElastPQ® Technique for the Assessment of Liver Fibrosis in Patients with Chronic Hepatitis C: a “Real Life” Single Center Study

2016 ◽  
Vol 25 (3) ◽  
pp. 331-335 ◽  
Author(s):  
Giovanna Ferraioli ◽  
Laura Maiocchi ◽  
Raffaella Lissandrin ◽  
Carmine Tinelli ◽  
Annalisa De Silvestri ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Liver Fibrosis ◽  
Chronic Hepatitis C ◽  
Liver Stiffness ◽  
Real Life ◽  
Advanced Fibrosis ◽  
Liver Stiffness Measurement ◽  
Significant Fibrosis ◽  
Stiffness Measurement

Background & Aims: Noninvasive assessment of liver stiffness has been increasingly used to evaluate fibrosis instead of liver biopsy, especially in patients with chronic viral hepatitis. The aim of this study was to assess the performance in staging liver fibrosis of the updated ElastPQ® technique (EPIQ7 ultrasound system, Philips Healthcare, Bothell, WA, USA) in the “real life” setting by using the FibroScan as the reference standard and to understand whether the use of the quality criteria improves the performance of the technique. Methods: This was a cross-sectional study: 278 patients affected by chronic hepatitis C referred for liver stiffness measurement with the FibroScan® 502 Touch device (Echosens, Paris, France) underwent measurements also with the ElastPQ® technique. For the assessment of significant fibrosis (F≥2), advanced fibrosis (F≥3) and cirrhosis (F=4), respectively, we used the cutoffs of 7.0, 9.5 and 12.0 kPa. The diagnostic performance of ElastPQ® was assessed using the area under the ROC (AUROC) curve analysis and was evaluated overall and for cases with (a) 10 measurements and IQR/M≤30%, (b) 5 measurements and IQR/M ≤30%, (c) 10 measurements and IQR/M>30%, (d) 5 measurements and IQR/M>30%. Results: The optimal cutoffs of ElastPQ® for significant fibrosis, advanced fibrosis and cirrhosis were 6.43, 9.54 and 11.34 kPa, respectively. For measurements with an IQR/M≤30%, there was no statistically significant decrease in sensitivity between 10 and 5 measurements (p=0.26, p=0.09, p=0.71, for F≥2, F≥3, and F=4, respectively). Conclusion: The ElastPQ® technique is reliable and accurate for staging liver fibrosis. The number of measurements does not affect the performance. Abbreviations: ALP: alkaline phosphatase; ALT: alanine aminotransferase; AST: aspartate aminotransferase; AUROC: area under the ROC curve; BMI: body mass index; GGT: gamma-glutamyl transferase; LR: likelihood ratio; LSM: liver stiffness measurement; pSWE: point shear wave elastography; ROC: receiver operating characteristic; VCTE: vibration controlled transient elastography; VTQ®: virtual touch quantification.

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