Normal liver stiffness and its determinants in healthy blood donors

Colombo, Silvia; Belloli, Livio; Zaccanelli, Maurizio; Badia, Elisabetta; Jamoletti, Carlo; Buonocore, Marco; Poggio, P. Del

doi:10.1016/j.dld.2010.07.008

Cited by 70 publications

(61 citation statements)

References 23 publications

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“…According to transaminase levels, 19 of 95 patients with CD (20%) showed an increase in ALT and/or AST values that could suggest a liver impairment, whereas an actual hepatic involvement, evaluated by TE, was detected in only 10 CD patients. According to our data, significant or severe liver fibrosis is not a common finding in CD, thus confirming previous studies [54,59,60]. Moreover, from this study, the absolute values of TE observed in patients with CD were within the reference range, considering the group of healthy subjects as controls.…”

Section: Discussionsupporting

confidence: 92%

Transient elastography in patients with celiac disease: A noninvasive method to detect liver involvement associated with celiac disease

Massironi

Rossi

Fraquelli

et al. 2012

Scandinavian Journal of Gastroenterology

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Section: Discussionsupporting

confidence: 92%

Transient elastography in patients with celiac disease: A noninvasive method to detect liver involvement associated with celiac disease

Massironi

Rossi

Fraquelli

et al. 2012

Scandinavian Journal of Gastroenterology

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“…35 The outcome is measured in kPa and ranges from 2.5 kPa to 75 kPa, with 5 kPa often designated as normal and 13.4 kPa or more as cirrhosis. [36][37][38] Several studies have investigated the utility of this test in determining the degree of liver fibrosis in patients with HBV. A study of 202 patients with HBV found that this measure correlated well with stage of fibrosis on liver biopsy (r=0.65).…”

Section: Transient Elastographymentioning

confidence: 99%

Management of chronic hepatitis B infection

Sundaram

Kowdley

2015

BMJ

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Hepatitis B virus (HBV) is a global health problem that can lead to cirrhosis and hepatocellular carcinoma (HCC). Although HBV vaccination has reduced the prevalence Of HBV infection, the burden of disease remains high. Treatment with antiviral drugs reduces the risk of liver disease and the development of HCC, and it can even reverse liver fibrosis. However, challenges remain regarding optimal timing, as well as the modality and duration of treatment. Currently approved drugs include pegylated interferon and nucleos(t)ide analogs. Nucleos(t)ide analogs are better tolerated and provide excellent viral suppression with a low risk of antiviral resistance, but pegylated interferon offers the benefit of a finite duration of treatment. Monitoring of hepatitis B surface antigen (HBsAg) levels may help to predict the likelihood of response to treatment, particularly for pegylated interferon. Prolonged treatment is usually needed with oral antiviral agents, and relapse is common if treatment is discontinued. New treatments that result in sustained clearance of HBV DNA and the clearance of HBsAg are needed.

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“…LSM may vary with the etiology of liver fibrosis, as patients with hepatitis B virus (HBV) reportedly have lower LSM values than patients with hepatitis C virus (HCV) at the same stage of fibrosis [9]. Among blood donors with no signs of liver disease and in health care center-based screenings, median/95th percentile values have been reported to be 4.4/6.7 kiloPascal(kPa) and 5.3/8.0 kPa [10]–[12]. Two large meta-analyses determined cut-off values of 7.2/7.7 kPa for F2 and of 13.0/14.5 kPa for cirrhosis among patients with liver disease [13], [14].…”

Section: Introductionmentioning

confidence: 99%

Liver Stiffness Measurement among Patients with Chronic Hepatitis B and C: Results from a 5-Year Prospective Study

et al. 2014

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Liver stiffness measurement (LSM) is widely used to evaluate liver fibrosis, but longitudinal studies are rare. The current study was aimed to monitor LSM during follow-up, and to evaluate the association of LSM data with mortality and liver-related outcomes. We included all patients with chronic viral hepatitis and valid LSM using Fibroscan. Information about liver biopsy, antiviral treatment, and clinical outcome was obtained from medical records and national registers. The study included 845 patients: 597 (71%) with hepatitis C virus (HCV), 235 (28%) with hepatitis B virus (HBV) and 13 (2%) with dual infection. The initial LSM distribution (<7/7–9.9/10–16.9/≥17 kPa) was 58%/16%/14%/12%. Among patients with initial LSM values of 7–9.9 kPa, 60% of HCV patients and 83% of HBV patients showed LSM values of <7 kPa at the latest follow-up. Progression rates (defined as >20% and >2 kPa increase, with one measure >7 kPa) were 3.4/100 person years (PY) for HCV and 1.5/100 PY for HBV infected patients. Patients with LSM values of ≥17 kPa had the same liver-related complication incidence as patients with biopsy-proven cirrhosis (11.1 versus 12.1/100 PY). Thirteen liver-related deaths occurred among HCV patients (0.6/100 PY), but none among HBV patients. Among patients who died of liver-related causes, all but one had baseline LSM values of ≥17 kPa. Overall, patients with LSM values <17 kPa were not associated with adverse outcomes. In contrast, LSM values ≥17 kPa were associated with significant risk of liver-related problems. The results of the current study suggest that clinical decisions should not be taken based on a single LSM measurement.

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Normal liver stiffness and its determinants in healthy blood donors

Cited by 70 publications

References 23 publications

Transient elastography in patients with celiac disease: A noninvasive method to detect liver involvement associated with celiac disease

Transient elastography in patients with celiac disease: A noninvasive method to detect liver involvement associated with celiac disease

Management of chronic hepatitis B infection

Liver Stiffness Measurement among Patients with Chronic Hepatitis B and C: Results from a 5-Year Prospective Study

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