scholarly journals Non-Invasive Markers of Liver Fibrosis in Children with Chronic Hepatic Disorders

2020 ◽  
Vol 7 (3) ◽  
Author(s):  
Iraj Shahramian ◽  
Manijeh Khalili ◽  
Alireza Sargazi ◽  
Alireza Dechal ◽  
Mostafa Bazi ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Liver Fibrosis ◽  
Hepatic Fibrosis ◽  
Sensitivity And Specificity ◽  
Pediatric Population ◽  
Advanced Fibrosis ◽  
Non Invasive ◽  
The Mean ◽  
Biopsy Examination ◽  
Center Study

Background: The applicability of non-invasive markers for predicting hepatic fibrosis in the pediatric population with chronic liver abnormalities is unclear. Objectives: We investigated the applicability of common non-invasive liver fibrosis parameters for detecting liver fibrosis in children with chronic hepatitis. Methods: This was a double-center study in Amir-Almomenin Hospital of Zabol and Namazi Hospital of Shiraz (2015 - 2017). Liver fibrosis was confirmed by biopsy examination. AST to platelet ratio (APRI), AST to ALT ratio (AAR), and Fibrosis-4 (FIB-4) were evaluated. Results: Out of 47 patients, 23 (48.9%) were females, and 24 (51.1%) were males. The mean age was 9.8 ± 11.3 months. APRI and FIB-4 correlated with fibrosis stages (r = 0.1 and r = 0.2, respectively). APRI showed an AUC of 0.541 for detecting non-advanced fibrosis (stages 0, 1, and 2). AAR and FIB-4 represented AUCs of 0.622 and 0.592 for advanced fibrosis and cirrhosis, respectively. The highest sensitivity of APRI (70%) was obtained at the cut-off point of 0.81 for cirrhosis. The highest specificities for APRI were observed at 0.66 (68%) and 1.37 (68%) for fibrotic stages 0 and 2, respectively. At the thresholds of 0.71 and 0.59, AAR rendered 78% sensitivity and 90% specificity for advanced fibrosis (stages 3 and 4) and no fibrosis (stage = 0), respectively. FIB-4 showed the highest sensitivity and specificity (70% and 60%) at the cut-off point of 0.21 for detecting cirrhosis. Conclusions: APRI, FIB-4, and AAR can be regarded as useful markers in predicting fibrotic transformation in children with various etiologies of chronic hepatitis.

scholarly journals Utility of hepatic or total body iron burden in the assessment of advanced hepatic fibrosis in HFE hemochromatosis

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Justin Chin ◽  
Lawrie W. Powell ◽  
Louise E. Ramm ◽  
Oyekoya T. Ayonrinde ◽  
Grant A. Ramm ◽  
...  
Keyword(s):  
Hepatic Fibrosis ◽  
Sensitivity And Specificity ◽  
Iron Age ◽  
Iron Concentration ◽  
Advanced Fibrosis ◽  
Mean Values ◽  
Iron Stores ◽  
Advanced Liver Fibrosis ◽  
The Mean ◽  
Total Body

AbstractDevelopment of advanced hepatic fibrosis in HFE Hemochromatosis (HH) is influenced by hepatic iron concentration (HIC) and age. In patients with HH, it is important to assess the likelihood of cirrhosis and thus the need for confirmatory liver biopsy. Therapeutic phlebotomy also provides an estimate of mobilisable iron stores. We determined whether mobilisable iron stores may predict the presence of advanced fibrosis. Retrospective analysis of 137 male and 65 female HH subjects was undertaken. Biochemical, histological and phlebotomy data were available on all subjects. The mean values of HIC, HIC × [age], mobilisable iron, mobilisable iron × [age] and serum ferritin in the cohort were higher in the group with advanced fibrosis. HIC had an optimum sensitivity and specificity of 73% for the diagnosis of advanced liver fibrosis, with a cut-off HIC level of 200 µmol/g (AUROC 0.83, p < 0.0001). AUROC for HIC was greater in females (0.93) than males (0.79). Mobilisable iron had an optimum sensitivity and specificity both of 83% at a cut-off of 9.6 g for the prediction of advanced fibrosis in all subjects (AUROC 0.92, p < 0.0001). Mobilisable iron stores provide a simple, clinically useful indication of the risk of advanced fibrosis and should routinely be considered.

scholarly journals Investigating the Efficiency of APRI, FIB-4, AAR and AARPRI as Noninvasive Markers for Predicting Hepatic Fibrosis in Chronic Hepatitis B Patients in Bangladesh

2019 ◽  
Vol 13 (1) ◽  
pp. 34-40
Author(s):  
Fazley R. Sha ◽  
Moyen Uddin Pk ◽  
Nermeen Z. Abuelezz ◽  
Rumana Pervin ◽  
Rabiul I. Talukder ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Hepatic Fibrosis ◽  
Receiver Operating Curve ◽  
Aspartate Transaminase ◽  
Training Cohort ◽  
Non Invasive ◽  
Cohort Groups

Background and Aims:Accurate, affordable non-invasive markers are highly needed for efficient diagnosis and management of liver fibrosis caused by chronic hepatitis B. This is the first study to investigate the diagnostic efficiency of Aspartate Transaminase to Platelet Ratio (APRI), Fibrosis Index (FIB-4), Aspartate transaminase to Alanine Transaminase Ratio (AAR) and AAR/Platelet ratio index (AARPRI) as non-invasive markers to predict hepatic fibrosis caused by Chronic Hepatitis B (CHB) in Bangladesh.Methods:In this study, a training cohort of 1041 CHB patients were recruited, whereas 104 and 109 CHB patients of matched ages were recruited as internal and external validation cohort groups respectively. Histological and hematological data were analyzed. METAVIR scoring system was used to classify liver fibrosis stages. Area Under Receiver Operating Curve (AUROC), correlations and cutoff values for the four diagnostic markers were calculated and assessed.Results:92%, 81% and 84% of the patients had liver fibrosis in the training cohort, internal and external cohort groups respectively. Among the four noninvasive panels, APRI showed the best area under ROC; (0.767, CI: 0.780-0.914; 0.775) for the training cohort, (0.775, CI: 0.693-0.857), and (0.847, CI: 0.780-0.914) for the internal and external cohorts respectively. Cut-off value of APRI was 0.512 with sensitivity/specificity of 84%/67% in training cohort, 81% / 66% in the internal cohort, and 88% / 66% in an external cohort. The odds ratio for APRI was 32.95 (95%CI: 4.746-228.862,p<0.001).Conclusion:Among all the four tested markers, APRI is the most accurate non-invasive test to predict major liver fibrosis (F2-3) in Bangladeshi CHB patients.

scholarly journals A209 NON-INVASIVE ASSESSMENT OF LIVER FIBROSIS USING APRI, FIB-4, AND TRANSIENT ELASTOGRAPHY IN CHRONIC HEPATITIS B PATIENTS

2021 ◽  
Vol 4 (Supplement_1) ◽  
pp. 239-240
Author(s):  
D H Little ◽  
S Fischer ◽  
S K Fung
Keyword(s):  
Chronic Hepatitis ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Liver Biopsy ◽  
Chronic Hepatitis B ◽  
Transient Elastography ◽  
Hbv Dna ◽  
Advanced Fibrosis ◽  
Predictive Values ◽  
Non Invasive

Abstract Background Accurate assessment of liver fibrosis is important to identify patients with chronic hepatitis B (CHB) who require antiviral therapy. As liver biopsy is invasive and costly, non-invasive tests of liver fibrosis are increasingly being used. Aims We aimed to evaluate the performance of the aspartate aminotransferase-to-platelet ratio index (APRI), Fibrosis 4 index (FIB-4), and transient elastography (TE) in predicting fibrosis in patients with CHB. Methods We retrospectively analyzed a prospectively enrolled cohort of consecutive adults with CHB who underwent liver biopsy for routine clinical indications (ALT &gt; ULN and HBV DNA &gt; 2,000 IU/ml) from January 2018 to December 2019. Demographic information, routine biochemistry, HBV serology including HBV DNA, abdominal ultrasound, fibrosis stage by liver biopsy and TE data were collected. Positive predictive values (PPV) and negative predictive values (NPV) were calculated using published cut-off values with liver biopsy as the reference standard. Results Fifty-five patients of Asian ethnicity (mean age 46 years, 65% male) were included. Most patients were HBeAg-negative (67%) and treatment-naïve (80%). Eleven (20%) patients had advanced fibrosis (F3-F4 METAVIR) and 4 (7%) patients had cirrhosis (F4). APRI &lt;0.50 had a NPV of 73% for significant fibrosis (F2-F4) and APRI &gt;1.50 had a PPV of 33% for significant. All 4 patients with cirrhosis were misclassified as having no cirrhosis with an APRI &lt;1. FIB-4 &lt;1.45 had a NPV of 90% for advanced fibrosis (F3-F4). No patient, including 11 patients with advanced fibrosis, had a FIB-4 above the cut-off value to detect advanced fibrosis (&gt;3.25). TE data was available for 38 patients. TE &lt;7.25 kPa had a NPV of 78% for significant fibrosis and TE &gt;12.4 kPa had a PPV of 50% for cirrhosis. Conclusions In Asian patients with CHB and a low prevalence of advanced fibrosis or cirrhosis, APRI, FIB-4, and TE performed well in excluding those with advanced fibrosis but were unable to accurately identify those with significant/advanced fibrosis and cirrhosis. Further studies with larger numbers of CHB patients are needed to confirm our results. Funding Agencies None

scholarly journals Noninvasive Transient Elastography identifies initial stage liver fibrosis & cirrhosis in Hepatitis B patients

2020 ◽  
Vol 6 (2) ◽  
pp. 03-07
Author(s):  
Muhammad Naveed Anwar ◽  
Humaira Achakzai ◽  
Fahim Ullah ◽  
Rizwan Amin Kundi ◽  
Zeeshan Ayaz ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Hepatitis B ◽  
Hepatic Fibrosis ◽  
Transient Elastography ◽  
Tertiary Care ◽  
Medical Institute ◽  
Care Hospital ◽  
Advanced Fibrosis ◽  
Non Invasive ◽  
Therapeutic Decisions

Background: Among the many non-invasive techniques performed on patients with Hepatitis B Virus (HBV) related fibrosis, the most appropriate results have been obtained using Transient Elastography (FibroScan) to measure liver stiffness. The accurate diagnosis of fibrosis related to HBV is essential for prognostic and therapeutic decisions and offset the limitations of liver biopsy. Objective: To evaluate Transient Elastography (FibroScan) for detecting and staging hepatic fibrosis by comparing it with hepatic histopathology in patients with Hepatitis B at a tertiary care hospital of Peshawar. Materials & Methods: A descriptive study was done in March-April 2020 at Rehman Medical Institute, Peshawar, based on retrospective data from May 2016 to March 2020 on 145 HBV positive patients with various stages of hepatic fibrosis who had undergone non-invasive FibroScan during their first visit. Routine demographic, clinical and laboratory parameters were analyzed to predict the existence or absence of advanced fibrosis. At the end of the evaluation, the samples were categorized as F0 (No fibrosis), F1 (Initial fibrosis without septa), F2 (Fibrosis with septa), F3 (Advanced fibrosis) and F4 (Severe fibrosis with cirrhosis, C1). Descriptive data analysis was done by SPSS 17.0. Results: Out of 145 included patients of chronic hepatitis B, 110 were males and 35 were females. At initial stages the existing laboratory tools diagnosed chronic HBV-infected patients correctly, with minor fibrosis and cirrhosis. Independent indicators of liver fibrosis included platelet count, age, AST, ALT values and albumin; 80% of the patients were not affected by the disease, which means F0 was 80%. Yet some patients had fibrosis at different stages F1, F2, F3, F4 and C1. The FibroScan assessment revealed that out of 145 patients, only 11% patients were at stage F1 whereas the diagnostic value for F2, F3, F4, and C1 are ≤3% with F2=3%, F3=1%, F4=2%, and C1=2%. Conclusion: FibroScan is an effective method to detect HBV-related fibrosis and cirrhosis; it provided accurate distinction between various stages of fibrosis in Hepatitis B patients. Keywords: Cirrhosis, Liver; Hepatitis B; Liver Fibrosis; Carcinoma, Hepatocellular.

scholarly journals Total Antioxidant Capacity in HBV Carriers, a Promising Biomarker for Evaluating Hepatic Fibrosis: A Pilot Study

Antioxidants ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 77
Author(s):  
Jing-Hua Wang ◽  
Sung-Bae Lee ◽  
Dong-Soo Lee ◽  
Chang-Gue Son
Keyword(s):  
Oxidative Stress ◽  
Chronic Hepatitis ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Antioxidant Capacity ◽  
Chronic Hepatitis B ◽  
Hepatic Fibrosis ◽  
Total Antioxidant Capacity ◽  
Hbv Dna ◽  
Total Antioxidant

Oxidative stress plays a pivotal role in the progression of chronic hepatitis B; however, it is unclear whether the status of blood oxidative stress and antioxidant components differs depending on the degree of hepatic fibrosis. To explore the relationship between oxidative stress/antioxidant capacity and the extent of hepatic fibrosis, fifty-four subjects with liver fibrosis (5.5 ≤ liver stiffness measurement (LSM) score ≤ 16.0 kPa) by chronic hepatitis B virus (HBV) were analyzed. From the analysis of eight kinds of serum oxidative stress/antioxidant profiles and liver fibrosis degrees, the level of total antioxidant capacity (TAC) reflected a negative correlation with the severity of hepatic fibrosis (Pearson correlation, r = −0.35, p = 0.01). Moreover, TAC showed higher sensitivity (73.91%) than the aspartate transaminase (AST) to platelet ratio index (APRI, 56.52%) in the receiver operating characteristic (ROC) curves. Interestingly, the TAC level finely reflected the fibrosis degree in inactive carriers (HBV DNA < 2000 IU/mL), while the APRI did in active carriers (HBV DNA > 2000 IU/mL). In conclusion, TAC is a promising biomarker for evaluating the progression of liver fibrosis in patients with HBV, and this finding may indicate the involvement of TAC-composing factors in the pathogenesis of hepatic fibrosis in chronic HBV carriers.

Dynamic computed tomography with low- and high-molecular-mass contrast agents to assess microvascular permeability modifications in a model of liver fibrosis

2002 ◽  
Vol 103 (2) ◽  
pp. 213-216 ◽  
Author(s):  
Roland MATERNE ◽  
Laurence ANNET ◽  
Stéphane DECHAMBRE ◽  
Christine SEMPOUX ◽  
Anne M. SMITH ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Contrast Agents ◽  
Molecular Mass ◽  
Hepatic Fibrosis ◽  
Mean Transit Time ◽  
Distribution Volume ◽  
High Molecular Mass ◽  
Permeability Changes ◽  
Molecular Masses ◽  
The Mean

Interstitial collagen formation and transformation of the fenestrated hepatic sinusoids into continuous capillaries are major ultrastructural changes that occur in liver cirrhosis and fibrosis. These modifications lead to progressive restriction of blood–liver exchanges. The purpose of our study was to evaluate the permeability changes in a model of hepatic fibrosis by using dynamic computed tomography (CT) enhanced with contrast agents of different molecular masses. Dynamic single-section CT of the liver was performed after intravenous bolus administration of a low-molecular-mass contrast agent (iobitridol) and an experimental high-molecular-mass agent (P840) in normal control rabbits and in rabbits with hepatic fibrosis. Hepatic, aortic and portal venous time–density curves were fitted with a dual-input one-compartmental model to calculate the hepatic mean transit time and distribution volume of the contrast agents. In the rabbits with liver fibrosis, the mean transit time of the high-molecular-mass agent was shorter than that of the low-molecular-mass agent (10.0±1.8s and 12.0±1.2s respectively; P<0.05). The distribution volume accessible to the high-molecular-mass agent was also smaller (22.2±4.8% compared with 32.0±6.7%; P<0.01). In the normal rabbits, the mean transit times of the high- and low-molecular-mass agents did not differ significantly, and nor did their distribution volumes. Our results demonstrate decreased sinusoidal permeability for the high-molecular-mass agent P840 in a model of hepatic fibrosis. Non-invasive assessment of permeability changes in liver fibrosis can be performed with dynamic CT and contrast agents of different molecular masses.

Large-scale multicentre comparison of three algorithms combining serum non-invasive markers for liver fibrosis in chronic hepatitis C

2008 ◽  
Vol 40 (10) ◽  
pp. A119-A120
Author(s):  
G. Sebastiani ◽  
P. Halfon ◽  
L. Castera ◽  
A. Mangia ◽  
V. Di Marco ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Liver Fibrosis ◽  
Chronic Hepatitis C ◽  
Large Scale ◽  
Non Invasive

Significance of biglycan and osteopontin as non-invasive markers of liver fibrosis in patients with chronic hepatitis B virus and chronic hepatitis C virus

2018 ◽  
Vol 67 (3) ◽  
pp. 681-685 ◽  
Author(s):  
Ali Sobhy ◽  
Mohammed Fakhry M. ◽  
Haitham A Azeem ◽  
Ahmed M Ashmawy ◽  
Hamed Omar Khalifa
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Hepatitis B Virus ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Chronic Hepatitis C ◽  
Chronic Hepatitis B ◽  
Non Invasive ◽  
B Virus

Several studies were performed to evaluate the degree of liver fibrosis by non-invasive markers. We aimed to assess the diagnostic value of both biglycan (BGN) and osteopontin (OPN) as non-invasive markers of hepatic fibrosis in patients with chronic hepatitis B (CHB) and chronic hepatitis C (CHC). This study was performed on 100 patients with CHB virus, 100 patients with CHC virus and 100 normal controls. All participants were subjected to the following laboratory tests: hemoglobin, platelet, alanine aminotransferase, aspartate aminotransferase, albumin, international normalized ratio, HBs Ag, hepatitis C virus (HCV) antibody, hepatitis B virus DNA, HCV RNA, liver biopsy, BGN and OPN. We found that BGN level was significantly increased in the CHB group compared with the controls (p<0.001), but the level was not different between the CHC group and the controls (p<0.96). OPN was increased in both the CHB and CHC groups compared with the controls (p<0.001). Positive correlation was found between fibrosis stages and BGN level of the CHB group (r=0.64; p<0.001) and between fibrosis stages and OPN level of the CHB (r=0.63; p<0.001) and CHC (r=0.59; p<0.03) groups. The area under the curve (AUC), sensitivity and specificity of BGN were 1.0, 100% and 100% in predicting fibrosis in patients with CHB, and 0.50, 26% and 78% in predicting fibrosis in patients with CHC. OPN had an AUC of 0.997, sensitivity of 96% and specificity of 100% in predicting fibrosis in patients with CHB, and 0.974, 96.5% and 100% in predicting fibrosis in patients with CHC. In conclusion, BGN and OPN could be considered non-invasive markers for liver fibrosis assessment.

scholarly journals The Differences of T-Regulator Cells, Alanine Aminotransferase Serum and Aspartate Aminotranspherase Between Hepatitis B Chronic Patients with and without Liver Fibrosis

2021 ◽  
Vol 22 (2) ◽  
pp. 116-123
Author(s):  
Yostila Derosa ◽  
Nasrul Zubir ◽  
Raveinal Arnelis
Keyword(s):  
Chronic Hepatitis ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Alanine Aminotransferase ◽  
Chronic Patients ◽  
Cross Sectional ◽  
Medicine Department ◽  
The Mean ◽  
The Difference

Background: Hepatitis B is acute or chronic liver inflammation caused by hepatitis B viral and can progress to hepatic chirrosis or liver cancer. Chronic hepatitis B has a high risk for liver fibrosis. Chronic inflammation and liver fibrosis are interrelated processes. This study aimed to determine the differences in T-regulator cells, Alanine Aminotransferase (ALT) and Aspartate Aminotransferase (AST) between chronic hepatitis B patients with and without liver fibrosis.Method: This study used a cross-sectional method for patients diagnosed with chronic hepatitis B in the Inpatient and Outpatient Department of the Internal Medicine Department  DR. M. Djamil Padang and other hospitals in Padang city for 6 months. Samples were selected by consecutive sampling according to inclusion and exclusion criteria. Liver fibrosis is identified by fibroscan. Data were analyzed by SPSS 21.0.Results: thirty-two patients were diagnosed with chronic hepatitis B and 50% had liver fibrosis. The levels of T-regulator cells in chronic hepatitis B patients without liver fibrosis were 2.08% and liver fibrosis 2.25%, but this difference was not statistically significant (p 0.05). Mean ALT levels in the group without fibrosis were 19 IU/L (7IU/L-71IU/L) and liver fibrosis 61 IU / L (13IU/L-625IU/L). The mean AST level in the group without fibrosis were 15.5 IU/L (10IU/L-32IU/L) and liver fibrosis 35.5 IU/L (10IU/L-476IU/L). The difference between ALT and AST in the two groups was significant (p 0.05). Hepatitis B patients with liver fibrosis had higher ALT and AST levels than without fibrosis.Conclusion: There were differences levels of T-regulator cells in the two groups, but it was not statistically significant. ALT and AST levels were higher in the liver fibrosis group and statistically significant.

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