- Identifying Nonalcoholic Fatty Liver Disease Advanced Fibrosis in the Veterans Health Administration. [Journal Article]
- DDDig Dis Sci 2018 May 19
- CONCLUSIONS: While NFS and FIB-4 scores exhibit good diagnostic accuracy, FIB-4 is optimal in identifying NAFLD advanced fibrosis in the VHA. Easily implemented as a point-of-care clinical test, FIB-4 can be useful in directing patients that are most likely to have advanced fibrosis to GI/hepatology consultation and follow-up.
- Do serum markers of liver fibrosis vary by HCV infection in patients with alcohol use disorder? [Journal Article]
- DADrug Alcohol Depend 2018 May 16; 188:180-186
- CONCLUSIONS: HCV infection is associated with severity of fibrosis in patients with excessive alcohol consumption. In this context, APRI and FIB-4 are highly correlated which facilitates the assessment of liver damage.
- The efficacy of serum brain natriuretic peptide for the early detection of portopulmonary hypertension in biliary atresia patients before liver transplantation. [Journal Article]
- PTPediatr Transplant 2018 May 07; :e13203
- Severe portopulmonary hypertension (POPH) is a contraindication for liver transplantation (LT) because of the high risk of postoperative heart failure. The early detection of POPH is important for pa...
Severe portopulmonary hypertension (POPH) is a contraindication for liver transplantation (LT) because of the high risk of postoperative heart failure. The early detection of POPH is important for patients with biliary atresia (BA). Brain natriuretic peptide (BNP) is known to be correlated with liver fibrosis in patients with liver cirrhosis. The aim of this study was to elucidate the efficacy of BNP measurement for the follow-up of patients with BA. Thirty-two patients with BA were identified from September 2011 to December 2016. As indices of liver fibrosis/cirrhosis, APRI (P < .0001), FIB-4 (P < .0001), Child-Pugh score (P < .0001), IV collagen (P = .0005), and hyaluronic acid (P = .0291) had high or moderate correlations with BNP. Patients with splenomegaly, esophageal varices, liver fibrosis, and collateral veins had significantly higher BNP levels than those without. Patients diagnosed with POPH had significantly higher BNP levels in comparison with those patients without (P = .0068). In contrast, PELD/MELD scores showed an almost negligible correlation with the BNP level. LT was successful in 3 asymptomatic BA patients with POPH who had high BNP levels despite the low PELD/MELD scores. In conclusion, routine serum BNP surveillance can be easy to predict asymptomatic POPH. This may help to identify POPH before it reaches a stage that would contraindicate LT.
- Evaluation of accuracy of elastography point quantification versus other noninvasive modalities in staging of fibrosis in chronic hepatitis C virus patients. [Journal Article]
- EJEur J Gastroenterol Hepatol 2018 May 01
- CONCLUSIONS: ElastPQ is a promising noninvasive US-based method for assessing liver fibrosis in HCV-related chronic liver disease patients with good diagnostic performance comparable to that of liver biopsy and TE.
- Improvement of LSM, ARFI measurements and non-invasive fibrosis markers after DAAs for HCV G4 recurrence post living donor liver transplantation: Egyptian cohort. [Journal Article]
- JMJ Med Virol 2018 May 02
- CONCLUSIONS: Sofosbuvir-based treatment resulted in an early improvement in parameters of liver fibrosis in post LT patients with hepatitis C recurrence. This article is protected by copyright. All rights reserved.
- Diagnostic Usefulness of APRI and FIB-4 for the Prediction of Liver Fibrosis After Liver Transplantation in Patients Infected with Hepatitis C Virus. [Journal Article]
- TPTransplant Proc 2018 Apr 25
- CONCLUSIONS: APRI and FIB-4 could effectively estimate liver fibrosis after LT for HCV-related liver disease. For LT patients with splenectomy, APRI and FIB-4 were also useful to estimate liver fibrosis, but the standard values should be adjusted lower than those for patients without splenectomy.
- Increased Circulating Follicular Regulatory T-Like Cells May Play a Critical Role in Chronic Hepatitis B Virus Infection and Disease Progression. [Journal Article]
- VIViral Immunol 2018 Apr 23
- Follicular helper T cells (TFH) and follicular regulatory T cells (TFR), subsets of T cells, co-regulate the reactions of germinal center (GC) B cells. TFH provide help to the GC response, while the ...
Follicular helper T cells (TFH) and follicular regulatory T cells (TFR), subsets of T cells, co-regulate the reactions of germinal center (GC) B cells. TFH provide help to the GC response, while the TFR suppress those processes. Nevertheless, the role of circulating TFR (cTFR) and circulating TFH (cTFH) in chronic hepatitis B virus (HBV) infection remains limited. Twenty healthy controls (HCs), 24 patients with chronic hepatitis B (CHB), 23 with HBV-related liver cirrhosis (LC), and 18 with HBV-related hepatocellular carcinoma were enrolled in our study between October 2015 and September 2016. We detected the frequencies of cTFR-like cells and cTFH-like cells, the percentage of programmed cell death-1 (PD-1), inducible co-stimulator (ICOS), and interleukin-21 (IL-21) expressed on circulating CD4+CXCR5+ T cells by flow cytometry. Compared to the HC group, the percentage of cTFR-like cells and ratio of cTFR-like/cTFH-like were significantly increased in patients with HBV infection. A raised percentage of PD-1 on circulating CD4+CXCR5+ cells and decreased IL-21-producing circulating CD4+CXCR5+ cells were observed in CHB and LC. The production of IL-21 by circulating CD4+CXCR5+ cells was significantly higher in HBeAg negative group than the positive one. Patients with high levels of alanine aminotransferase and HBV-DNA accompanied increased CXCR5+PD-1+CD4+ T cells. In addition, the frequency of cTFR-like cells and the ratio of cTFR-like/cTFH-like were positively correlated with FIB-4 and APRI. Increased cTFR-like cells and impairment of circulating CD4+CXCR5+ T cells might participate in HBV chronic infection and HBV-related diseases.
- Evaluation of ballooned hepatocytes as a risk factor for future progression of fibrosis in patients with non-alcoholic fatty liver disease. [Journal Article]
- JGJ Gastroenterol 2018 Apr 21
- CONCLUSIONS: The FIB-4 index was the best formula for estimating liver fibrosis in patients with biopsy-proven NAFLD, and the presence of ballooned hepatocytes was a risk factor for the progression of liver fibrosis.
- Both alcoholic and non-alcoholic steatohepatitis association with cardiovascular risk and liver fibrosis. [Journal Article]
- AAlcohol 2018; 69:63-67
- CONCLUSIONS: BASH remains an area not well explored, and of great implication given the increasing number of patients affected. We observed an additive effect of both etiologies in the development of high cardiovascular and liver disease risk.
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- Evaluating Diagnostic Accuracy of Noninvasive Tests in Assessment of Significant Liver Fibrosis in Chronic Hepatitis C Egyptian Patients. [Journal Article]
- VIViral Immunol 2018; 31(4):315-320
- Stage of liver fibrosis is critical for treatment decision and prediction of outcomes in chronic hepatitis C (CHC) patients. We evaluated the diagnostic accuracy of transient elastography (TE)-FibroS...
Stage of liver fibrosis is critical for treatment decision and prediction of outcomes in chronic hepatitis C (CHC) patients. We evaluated the diagnostic accuracy of transient elastography (TE)-FibroScan and noninvasive serum markers tests in the assessment of liver fibrosis in CHC patients, in reference to liver biopsy. One-hundred treatment-naive CHC patients were subjected to liver biopsy, TE-FibroScan, and eight serum biomarkers tests; AST/ALT ratio (AAR), AST to platelet ratio index (APRI), age-platelet index (AP index), fibrosis quotient (FibroQ), fibrosis 4 index (FIB-4), cirrhosis discriminant score (CDS), King score, and Goteborg University Cirrhosis Index (GUCI). Receiver operating characteristic curves were constructed to compare the diagnostic accuracy of these noninvasive methods in predicting significant fibrosis in CHC patients. TE-FibroScan predicted significant fibrosis at cutoff value 8.5 kPa with area under the receiver operating characteristic (AUROC) 0.90, sensitivity 83%, specificity 91.5%, positive predictive value (PPV) 91.2%, and negative predictive value (NPV) 84.4%. Serum biomarkers tests showed that AP index and FibroQ had the highest diagnostic accuracy in predicting significant liver fibrosis at cutoff 4.5 and 2.7, AUROC was 0.8 and 0.8 with sensitivity 73.6% and 73.6%, specificity 70.2% and 68.1%, PPV 71.1% and 69.8%, and NPV 72.9% and 72.3%, respectively. Combined AP index and FibroQ had AUROC 0.83 with sensitivity 73.6%, specificity 80.9%, PPV 79.6%, and NPV 75.7% for predicting significant liver fibrosis. APRI, FIB-4, CDS, King score, and GUCI had intermediate accuracy in predicting significant liver fibrosis with AUROC 0.68, 0.78, 0.74, 0.74, and 0.67, respectively, while AAR had low accuracy in predicting significant liver fibrosis. TE-FibroScan is the most accurate noninvasive alternative to liver biopsy. AP index and FibroQ, either as individual tests or combined, have good accuracy in predicting significant liver fibrosis, and are better combined for higher specificity.