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Direct antiviral agent treatment of chronic hepatitis C results in rapid regression of transient elastography and fibrosis markers fibrosis‐4 score and aspartate aminotransferase‐platelet ratio index 下载免费PDF全文
Jacqueline A. Bachofner Piero V. Valli Arne Kröger Irina Bergamin Patrizia Künzler Adriana Baserga Dominique Braun Burkhardt Seifert Anja Moncsek Jan Fehr David Semela Lorenzo Magenta Beat Müllhaupt Benedetta Terziroli Beretta‐Piccoli Joachim C. Mertens 《Liver international》2017,37(3):369-376
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Value of Egy‐Score in diagnosis of significant,advanced hepatic fibrosis and cirrhosis compared to aspartate aminotransferase‐to‐platelet ratio index,FIB‐4 and Forns' index in chronic hepatitis C virus 下载免费PDF全文
Mohamed Alboraie Marwa Khairy Marwa Elsharkawy Noha Asem Aisha Elsharkawy Gamal Esmat 《Hepatology research》2015,45(5):560-570
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Arlinking Ong Vincent Wai‐Sun Wong Grace Lai‐Hung Wong Henry Lik‐Yuen Chan 《Liver international》2011,31(7):1047-1053
Background: Role of caffeine consumption in chronic hepatitis B virus (HBV)‐infected patients and the interaction with alcohol consumption is unclear. Aim: This study aimed to investigate the relationship between caffeine and alcohol consumption and liver stiffness in chronic HBV‐infected patients. Methods: Chronic HBV‐infected patients who underwent transient elastography examination in 2006–2008 were studied. Advanced fibrosis was defined as liver stiffness >9 kPa for patients with normal alanine aminotransferase (ALT) or >12 kPa for those with elevated ALT according to previous validation study. Caffeine and alcohol consumption was recorded using a standardized questionnaire. Excessive alcohol intake was defined as 30 g/day in men and 20 g/day in women. Results: The liver stiffness of 1045 patients who completed the questionnaire was 8.3 ± 6.2 kPa. Two hundred and sixteen (20.7%) patients had advanced fibrosis. Ninety‐five (19.0%) patients who drank ≥1 cup of coffee had advanced fibrosis, compared with 121 (22.2%) patients who drank <1 cup (P=0.21). The amount of caffeine intake had positive correlation with the amount of alcohol intake (rs=0.167, P<0.001). Although 231 (22.1%) patients reported alcohol consumption, only 11 (1%) had excessive alcohol intake. The prevalence of advanced fibrosis among patients with mild to moderate alcohol intake (26, 18.8%) was comparable to that among non‐drinkers (190, 21.0%) (P=0.57). Conclusion: Caffeine intake does not affect liver stiffness in chronic HBV‐infected patients. Patients who drink coffee regularly tend to drink alcohol. Most chronic HBV‐infected patients do not have excessive alcohol consumption. The prevalence of advanced fibrosis among mild to moderate alcohol drinkers was low in this population. 相似文献
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Patrick Marcellin Marianne Ziol Pierre Bedossa Catherine Douvin Raoul Poupon Victor De Lédinghen Michel Beaugrand 《Liver international》2009,29(2):242-247
Background: The need for new non‐invasive tools to assess liver fibrosis in chronic liver diseases has been largely advocated. Liver stiffness measurement (LSM) using transient elastography (FibroScan®, Echosens?) has been shown to be correlated to liver fibrosis in various chronic liver diseases. This study aims to assess its diagnosis accuracy in patients with chronic hepatitis B. Patients and methods: We prospectively enrolled 202 patients with chronic hepatitis B in a multicentre study. Patients underwent liver biopsy (LB) and LSM. METAVIR and Ishak liver fibrosis stages were assessed by two pathologists. Results: LSM or LB was considered unreliable in 29 patients. Statistical analysis was conducted in 173 patients. LSM was significantly (P<0.001) correlated with METAVIR (r=0.65) and Ishak fibrosis stage (0.65). The area under receiver‐operating characteristic curves were 0.81 (95% confidence intervals, 0.73–0.86) for F≥2, 0.93 (0.88–0.96) for F≥3 and 0.93 (0.82–0.98) for F=4. Optimal LSM cut‐off values were 7.2 and 11.0 kPa for F≥2 and F=4, respectively, by maximizing the sum D of sensitivity and specificity, and 7.2 and 18.2 kPa by maximizing the diagnosis accuracy. Conclusion: In conclusion, LSM appears to be reliable for detection of significant fibrosis or cirrhosis in HBV patients and cut‐off values are only slightly different from those observed in HCV patients. 相似文献
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James Fung Ching‐Lung Lai Daniel Yee‐Tak Fong John Chi‐Hang Yuen Danny Ka‐Ho Wong Man‐Fung Yuen 《Liver international》2008,28(10):1408-1416
Aim: To correlate liver stiffness with demographical factors and routine liver biochemistry and to assess the predictive value of these as potential markers of fibrosis. Methods: Transient elastography was performed in 1268 chronic hepatitis B (CHB) patients. According to a previous validated study for CHB, liver stiffness of >8.1 and >10.3 kPa were used as cut‐off values for defining severe fibrosis and cirrhosis respectively. Results: Liver stiffness correlated positively with bilirubin, alkaline phosphatase (ALP), γ‐glutamyl transpeptidase (GGT), aspartate aminotransferase (AST), alanine aminotransferase (ALT), globulin, α‐fetoprotein (AFP) and HBV DNA levels and negatively with albumin and platelet levels (P<0.05 for all correlations). From 13 parameters (age, sex, platelet, AST, ALT, GGT, AFP, albumin, globulin, bilirubin, ALP, HBV DNA and hepatitis B e‐antigen), four best parameters (AST, platelet, GGT and AFP) were used to derive a liver stiffness model. Using log (index)=1.44+0.1490(GGT)+0.3308 log (AST)−0.5846 log (platelets)+0.1148 log (AFP+1) to predict both severe fibrosis and cirrhosis had area under the receiver operating characteristics curve of 0.85. Conclusion: Routine liver biochemistry correlated well with liver stiffness in Asian CHB patients. A model using simple serum markers can predict liver stiffness, and further studies are required to validate the usefulness of these simple tests as non‐invasive markers of fibrosis in CHB. 相似文献
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Development of algorithms based on serum markers and transient elastography for detecting significant fibrosis and cirrhosis in chronic hepatitis B patients: Significant reduction in liver biopsy 下载免费PDF全文
Yan Li Qun Cai Yafei Zhang Qinxiu Xie Nan Xu Xiaoping Jiang Jun Li Xu Li Zhenhua Zhang 《Hepatology research》2016,46(13):1367-1379
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Wei Jia Duan Xiao Zhong Wang An Lin Ma Jia Shang Yue Min Nan Zhi Liang Gao Hong Tang Qing Chun Fu Qing Xie Qing Mao Jun Qi Niu Tao Han Jun Li Ying Han Jian Biao Cao Yuan Yuan Kong Xiao Yan Shi Fu Dong Lv Tai Ling Wang Hong Ma Hong You Xiao Juan Ou Ji Dong Jia 《Journal of digestive diseases》2020,21(9):519-525
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Transient elastography for patients with chronic hepatitis B and C virus infection: Non-invasive, quantitative assessment of liver fibrosis 总被引:2,自引:0,他引:2
Eiichi Ogawa Norihiro Furusyo Kazuhiro Toyoda Hiroaki Takeoka Shigeru Otaguro Maki Hamada Masayuki Murata Yasunori Sawayama Jun Hayashi 《Hepatology research》2007,37(12):1002-1010
Aim/Methods: The aim of the present study was to compare the diagnostic performance of transient elastography (FibroScan) with that of serum fibrosis markers and stages of hepatic fibrosis by biopsy in 68 patients with chronic hepatitis B virus (HBV) and in 161 patients with hepatitis C virus (HCV) infection. Results: The serum levels of hyaluronic acid (r = 0.601) and type IV collagen (r = 0.663) significantly positively associated with the FibroScan values (all P < 0.05). Classified by fibrosis stages, the median values of FibroScan were 3.5 kPa for F0, 6.4 kPa for F1, 9.5 kPa for F2, 11.4 kPa for F3, and 15.4 kPa forF4 in patients with chronic HBV infection, and were 6.3 kPa for F0, 6.7 kPa for F1, 9.1 kPa for F2, 13.7 kPa for F3, and 26.4 kPa for F4 in those with chronic HCV infection. The values were significantly correlated with fibrosis stage for both (HBV, r = 0.559, P = 0.0093, and HCV, r = 0.686, P < 0.0001). Conclusion: These results suggest that FibroScan is an efficient and simple method for evaluating liver fibrosis in patients with chronic infection, both for HBV and HCV. 相似文献
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目的评价天门冬氨酸氨基转移酶(AST)与血小板(PLT)比值在预测慢性乙型肝炎(CHB)肝纤维化分级中的作用。方法将178例CHB合并肝纤维化患者肝组织纤维化程度进行Ishak分期,同时检测患者AST和PLT,计算AST与PLT比值指数(APRI)。比较患者不同肝纤维化分期与APRI间的关系,通过APRI的受试者工作特征(ROC)曲线下面积,分析其预测显著肝纤维化及肝硬化的准确率,并对CHB肝纤维化患者抗病毒治疗前后肝组织纤维化分期和APRI的变化进行对比分析。结果 APRI与肝纤维化程度呈正比(P=0.001),APRI预测CHB进展为显著肝纤维化ROC曲线下面积为0.795,而预测肝硬化的ROC曲线下面积为0.714(P=0.003),APRI1.5和2分别为显著肝纤维化和肝硬化的截断点,其阳性预测值分别为96%和75%,阴性预测值分别为44%和74%。CHB患者经抗病毒药物治疗后,肝组织学检查结果显示其纤维化程度比治疗前明显减轻,而APRI也明显降低。结论 APRI可作为预测CHB患者发生显著肝纤维化及肝硬化的指标之一。 相似文献
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Beom Kyung Kim Do Young Kim Jun Yong Park Sang Hoon Ahn Chae Yoon Chon Ja Kyung Kim Yong Han Paik Kwan Sik Lee Young Nyun Park Kwang Hyub Han 《Liver international》2010,30(4):546-553
Backgrounds: To optimize management and predict long‐term clinical courses in patients with chronic hepatitis B (CHB), noninvasive tests to determine the degree of hepatic fibrosis have been developed. Aims: This study aimed to validate a simple, noninvasive FIB‐4 index, which was first derived from an HCV–HIV‐co‐infected population, in patients with CHB and to compare it with other noninvasive tests for predicting cirrhosis. Methods: From 2006–2008, a total of 668 consecutive CHB patients who underwent liver biopsies were enrolled. The fibrosis stage was assessed according to the Batts and Ludwig system by a single pathologist blinded to patients' data. Results: For prediction of significant (F≥2) and severe (F≥3) fibrosis, and cirrhosis (F=4), the area under the receiver‐operating characteristic curves were 0.865, 0.910 and 0.926 respectively. In predicting cirrhosis, it demonstrated diagnostic values comparable to the age–spleen platelet ratio index (0.937, P=0.414) and age–platelet index (0.928, P=0.888), and better outcomes than spleen–platelet ratio index (0.882, P=0.007), aspartate aminotransferase (AST)–platelet ratio index (0.731, P<0.001) and AST–alanine aminotransferase ratio index (0.730, P<0.001). FIB‐4 cut‐offs of 1.6 and 3.6 provided 93.2% negative predictive value and 90.8% positive predictive value for detection of cirrhosis respectively. Based on these results, liver biopsy could be avoided in 70.5% of the study population. These cut‐offs were validated internally using bootstrap resampling methods, showing good agreement. Conclusions: FIB‐4 is a simple, accurate and inexpensive method of predicting cirrhosis, with outcomes comparable to other noninvasive tests and may reduce the need for liver biopsy in the majority of CHB patients. 相似文献
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Roberto J. Carvalho‐Filho Leonardo L. Schiavon Janaína L. Narciso‐Schiavon Juliana P. Sampaio Valéria P. Lanzoni Maria Lucia G. Ferraz Antonio Eduardo B. Silva 《Liver international》2008,28(4):486-493
Aim: To assess the diagnostic value of modified cutoffs for aspartate aminotransferase to platelet ratio index (APRI) to predict significant liver fibrosis in human immunodeficiency virus (HIV)/hepatitis C virus (HCV) patients. Patients and Methods: This retrospective cross‐sectional study included consecutive patients with HIV/HCV co‐infection who underwent percutaneous liver biopsy. The accuracy of APRI for the diagnosis of significant fibrosis (F2/F3/F4 METAVIR) was evaluated by estimating the positive and negative predictive values (PPV and NPV respectively) and by measuring the area under the receiver operating characteristics curve (AUROC). Results: One hundred and eleven patients were included (73% men, mean age 40.2±7.8 years). Significant fibrosis was observed in 45 patients (41%). To discriminate these subjects, the AUROC of APRI was 0.774±0.045. An APRI≥1.8 showed a PPV of 75% for the presence of significant fibrosis, and an index <0.6 excluded significant fibrosis with an NPV of 87%. If biopsy indication was based only on APRI and restricted to scores in the intermediate range (≥0.6 and <1.8), 46% of liver biopsies could have been avoided as compared with 40% using the classical cutoffs. Conclusion: APRI with adjusted cutoffs can predict significant liver fibrosis in patients with HIV/HCV co‐infection and might obviate the need to perform a biopsy in a considerable percentage of those subjects. 相似文献
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Iman Ramzy Rabab Fouad Rabab Salama Zeinab Abdellatif Aisha Elsharkawy Naglaa Zayed Marwa Elsharkawy Wafaa El Akel Nader Bakheet 《Arab Journal Of Gastroenterology》2021,22(1):6-11
Background and study aimsAssessing the extent of fibrosis is an essential part of therapeutic decisions in patients with chronic hepatitis C (CHC). Liver biopsies are the “gold standard” for evaluating liver fibrosis but have many limitations. Thus, noninvasive predictors of fibrosis have been developed. This study aimed to determine the effectiveness of red cell distribution width (RDW) to platelet ratio as a simple noninvasive method for predicting the hepatic fibrosis stage in patients with CHC.Patients and methodsThis cross-sectional study included 197 Egyptian patients with CHC. A routine pretreatment reference needle liver biopsy was performed. Fib-4, transient elastography (TE) by Fibroscan, AST to Platelet Ratio Index (APRI), and RDW to platelet ratio (RPR) were measured. Predictors of significant fibrosis (Metavir score ≥ F2) and advanced fibrosis (Metavir score ≥ F3) were identified.ResultsFib-4, TE, APRI, and RPR values differed significantly when comparing different stages of fibrosis (p < 0.01). Fib-4, TE, APRI, and RPR were reliable diagnostic tools at cutoff values of 1.17, 7.75, 0.18, and 0.07, respectively, for predicting significant fibrosis and cutoff values of 1.99, 8, 1.77, and 0.08, respectively, for predicting advanced fibrosis. Using logistic regression analysis, TE was identified as an independent predictor associated with significant and advanced fibrosis. Fib-4 was significantly associated with advanced fibrosis only.ConclusionThe use of Fib-4, TE, APRI, and RPR measurements may decrease the need for liver biopsies for predicting significant and advanced fibrosis. RPR showed fair sensitivity, specificity, positive and negative predictive values, and overall accuracy for predicting significant fibrosis in patients with CHC. 相似文献
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P. M. Trembling P. Lampertico J. Parkes S. Tanwar M. Vigan F. Facchetti M. Colombo W. M. Rosenberg 《Journal of viral hepatitis》2014,21(6):430-438
Assessment of liver fibrosis is important in determining prognosis, disease progression and need for treatment in patients with chronic hepatitis B (CHB). Limitations to the use of liver biopsy in assessing fibrosis are well recognized, and noninvasive tests are being increasingly evaluated including transient elastography (TE) and serum markers such as the Enhanced Liver Fibrosis (ELF) test. We assessed performance of ELF and TE in detecting liver fibrosis with reference to liver histology in a cohort of patients with CHB (n = 182), and compared the performance of these modalities. Median age was 46 and mean AST 70 IU/L. Cirrhosis was reported in 20% of liver biopsies. Both modalities performed well in assessing fibrosis at all stages. Area under receiver operator characteristic (AUROC) curves for detecting METAVIR fibrosis stages F ≥ 1, F ≥ 2, F ≥ 3 and F4 were 0.77, 0.82, 0.80 and 0.83 for ELF and 0.86, 0.86, 0.90 and 0.95 for TE. TE performed significantly better in the assessment of severe fibrosis (AUROC 0.80 for ELF and 0.90 for TE, P < 0.01) and cirrhosis (0.83 for ELF and 0.95 for TE, P < 0.01). This study demonstrates that ELF has good performance in detection of liver fibrosis in patients with CHB, and when compared, TE performs better in detection of severe fibrosis/cirrhosis. 相似文献
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Nobuharu Tamaki Masayuki Kurosaki Shuya Matsuda Toru Nakata Masaru Muraoka Yuichiro Suzuki Yutaka Yasui Shoko Suzuki Takanori Hosokawa Takashi Nishimura Ken Ueda Kaoru Tsuchiya Hiroyuki Nakanishi Jun Itakura Yuka Takahashi Kotaro Matsunaga Kazuhiro Taki Yasuhiro Asahina Namiki Izumi 《Hepatology research》2014,44(7):720-727