Comparison between transient elastography (Fibroscan) and liver biopsy for the diagnosis of hepatic fibrosis in chronic hepatitis C genotype 4

Shiha, Gamal; Seif, Seham; Maher, Maha M; Etreby, Shahera; Samir, W.; Zalata, Khaled

doi:10.1097/01.elx.0000454686.81811.1a

Cited by 12 publications

(10 citation statements)

References 34 publications

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“…According to the standard guidelines, patients were diagnosed as having advanced liver fibrosis (F3) by transient elastography (>10.2 and ≤16.3 kPa) 11 . While they were considered to have cirrhosis (F4) when they fulfilled more than one of the following criteria: (a) definite clinical signs and laboratory parameters of cirrhosis (eg splenomegaly, albumin ≤3.5 g/dL, platelets count ≤100/cmm3); (b) abdominal ultrasonographic signs suggestive of cirrhosis (eg mild splenomegaly, minimal ascites, PV dilatation and collaterals); (c) transient elastography (>16.3 kPa) 11 . Cirrhotic patients (F4) were classified according to Child‐Pugh classification scoring.…”

Section: Methodsmentioning

confidence: 99%

GES: A validated simple score to predict the risk of HCC in patients with HCV‐GT4‐associated advanced liver fibrosis after oral antivirals

Shiha

Waked

Soliman

et al. 2020

Liver International

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Background & Aims: Hepatocellular carcinoma (HCC) risk persists after hepatitis C virus (HCV) eradication with direct-acting antivirals (DAAs), particularly in patients with cirrhosis. Identifying those who are likely to develop HCC is a critical unmet medical need. Our aim is to develop a score that offers individualized patient HCC risk prediction. Methods: This two-centre prospective study included 4400 patients, with cirrhosis and advanced fibrosis who achieved a sustained virologic response (SVR), including 2372 patients (derivation cohort). HCC-associated factors were identified by multivariable Cox regression analysis to develop a scoring model for prediction of HCC risk; and subsequently internally and externally validated in two independent cohorts of 687 and 1341 patients. Results: In the derivation cohort, the median follow-up was 23.51 ± 8.21 months, during which 109 patients (4.7%) developed HCC. Age, sex, serum albumin, α fetoprotein and pretreatment fibrosis stage were identified as risk factors for HCC. A simple predictive model (GES) score was constructed. The 2-year cumulative HCC incidence using Kaplan-Meier method was 1.2%, 3.3% and 7.1% in the low-risk, medium-risk and high-risk groups respectively. Internal and external validation showed highly significant difference among the three risk groups (P < .001) with regard to cumulative HCC risk. GES score has high predictive ability value (Harrell's C statistic 0.801), that remained robustly consistent across two independent validation cohorts (Harrell's C statistic 0.812 and 0.816). Conclusion: GES score is simple with validated good predictive ability for the development of HCC after eradication of HCV and may be useful for HCC risk stratification in those patients.

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Section: Methodsmentioning

confidence: 99%

GES: A validated simple score to predict the risk of HCC in patients with HCV‐GT4‐associated advanced liver fibrosis after oral antivirals

Shiha

Waked

Soliman

et al. 2020

Liver International

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“…A transient elastography was performed before treatment, 1 year after end of treatment and at yearly follow‐up visits to determine the fibrosis stage. For classification, the following cut‐off values were used: F0/F1/≤7 kPa; F2>7; kPa; F3>10.2 kPa; F4>16.3 kPa . Transient elastography was considered reliable when the following criteria had been met: (a) 10 successful measurements; (b) an interquartile range (IQR) lower than 30% of the median value; and (c) a success rate of more than 60% .…”

Section: Methodsmentioning

confidence: 99%

Changes in hepatic fibrosis stages after achieving SVR following direct‐acting anti‐viral treatment: a prospective study

et al. 2020

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Summary Introduction Chronic hepatitis C (CHC) represents a major global health problem. The availability of direct‐acting anti‐virals (DAAs) allowed the treatment of many patients with liver cirrhosis (F4) and advanced hepatic fibrosis (F3). The impact of viral clearance following DAAs treatment on the natural history of liver cirrhosis is uncertain or not clearly evident in the literature as most studies were retrospective, including small number of patients and for short follow‐up duration; there is a need for a long follow‐up, large prospective study evaluating the changes in hepatic fibrosis after achieving sustained virological response (SVR) in cirrhotics. Patients and methods This is a prospective study including CHC patients with liver cirrhosis or advanced hepatic fibrosis who achieved SVR following DAAs from January 2015 until August 2017. Patients were followed up every 4‐6 months for at least 1 year from end of treatment. Staging of liver fibrosis was done using transient elastography and non‐invasive scores (FIB‐4, FIB‐5 and APRI). Results A total of 2326 CHC patients who achieved SVR were included. Follow‐up period was 23.51 ± 8.21 months (range 12‐45). In cirrhotic patients, 21.8% showed reversal of cirrhosis, 27.4% showed fibrosis regression while 50.8% remained stationary. About 26.5% of F3 patients showed reversal of fibrosis , 31.5% showed fibrosis regression and 30.6% remained stationary while 11.4% progressed to F4. Conclusion HCV clearance following DAAs treatment in CHC patients with liver cirrhosis or advanced hepatic fibrosis is associated with reversal of cirrhosis and regression of hepatic fibrosis in about 50% of patients.

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“…Patients were categorized into F0 to F4 fibrosis stages. 18 The following cut-off values were used to determine fibrosis stage. Transient elastography: F0/F1/ F2 < − 10.2 kPa; F3 >10.2 kPa; F4 >16.3 kPa; and FIB-4: F0/F1/F2 < − 1.45; F3 >1.45; F4 >3.25.…”

Section: Diagnostic Assaysmentioning

confidence: 99%

An educate, test and treat model towards elimination of hepatitis C infection in Egypt: Feasibility and effectiveness in 73 villages

Shiha

Soliman

Mikhail

et al. 2020

Journal of Hepatology

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The treatment coverage and cure of 84.6% of the estimated 17,137 infected persons aged 12-80 years across 73 villages. >200,000 rural villagers Large community-based educate, test and treat programme Programme to eliminate HCV infection in Egypt rural communities Highlights An Educate, test and treat model programme is feasible and effective for HCV elimination in rural communities. Over 200,000 villagers were screened for HCV and there were high levels of linkage across all steps in the care cascade. A total of 14,495 infected patients received treatment.

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Comparison between transient elastography (Fibroscan) and liver biopsy for the diagnosis of hepatic fibrosis in chronic hepatitis C genotype 4

Cited by 12 publications

References 34 publications

GES: A validated simple score to predict the risk of HCC in patients with HCV‐GT4‐associated advanced liver fibrosis after oral antivirals

GES: A validated simple score to predict the risk of HCC in patients with HCV‐GT4‐associated advanced liver fibrosis after oral antivirals

Changes in hepatic fibrosis stages after achieving SVR following direct‐acting anti‐viral treatment: a prospective study

An educate, test and treat model towards elimination of hepatitis C infection in Egypt: Feasibility and effectiveness in 73 villages

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