Prediction of Fibrosis Progression Rate in Patients with Chronic Hepatitis C Genotype 4: Role of Cirrhosis Risk Score and Host Factors

Abstract

The rate of liver fibrosis progression in chronic hepatitis C (CHC) patients is highly variable and affected by different factors. This study aimed to assess the role of cirrhosis risk score (CRS) based on 7 genetic variants (7 single-nucleotide polymorphisms [SNPs]) and host factors (age and sex) in the prediction of the rate of fibrosis progression in CHC. Duration of infection was determined in 115 patients. The fibrosis progression rate (FPR) per year was calculated as the ratio between fibrosis stage and the duration of infection. SNP genotyping were performed and CRS was determined based on it. FPR was significantly elevated in patients who acquired infection at age >40 years versus those who acquired infection at 30-40 years and those who acquired infection at <30 years. Median FPR was significantly higher in males than females (0.17 vs. 0.15) with P = 0.001. CRS value ≥0.8 is predictive of patients with high risk for cirrhosis, and CRS value <0.5 is predictive of patients with low risk for cirrhosis. There was significant positive correlation between CRS and FPR (P ≤ 0.001). CRS based on 7 SNPs at cutoff value ≥0.8, age at infection >40 years, and male sex are predictors of higher FPR.

Diffusion-weighted magnetic resonance imaging and micro-RNA in the diagnosis of hepatic fibrosis in chronic hepatitis C virus

“…On the other hand, other studies did not find an association between grading of fibrosis and the ADC values[35,36]. The results in our study may be explained by the increase of hepatic connective tissue with accumulation of collagen, fatty tissue, and inflammatory cells, which may lead to restricted diffusion with low ADC values in patients with late fibrosis[4,5,37].…”

“…Liver biopsy is currently the gold standard for pathological assessment of hepatic fibrosis. However, it is an invasive maneuver with risks of complications such as hemorrhage, penetration to abdominal viscera, and pneumothorax and may result in death in 0.018% of patients; furthermore, the procedure is also prone to sampling error and observer variability[4-6]. Non-invasive diagnosis and staging of hepatic fibrosis is important for evaluating disease progression in patients with chronic liver diseases.…”

Increase of non- HBV, non- HCV related hepatocellular carcinoma -Over 20 years single institution study-

“…This is because patients with NBNC-HCC do not receive regular HCC surveillance whereas HBV-HCC and HCV-HCC patients received regular HCC surveillance. HBV and HCV infection related to long-term infection and the progression of liver brosis often leads to chronic, hepatitis, cirrhosis, cirrhosis-related complications, and HCC [47], therefore, HBV and HCV patients received regular surveillance. Similar results have been reported in our past reports [8][9][10], it is necessary to recommend to receive regular HCC surveillance using ultrasonography and/or other available modalities even if patients don't have liver disease such as viral hepatitis, since still so many NBNC-HCC is detected in an advanced stage.…”

Interrelationship between Toll-like receptors and infection after orthotopic liver transplantation

“…Impairment of this secretory release promotes Th2 rather than Th1 cytokine response[ 40 , 41 ], leading to impaired HCV-directed T cell response, particularly with regards to CD4 + T cell protection against progression of liver disease[ 42 ]. Rapid progression of fibrosis in HCV patients is attributed to inadequate viral control by the immune system[ 43 , 44 ], leading to heightened production of pro-inflammatory cytokines with increased stimulation of pro-fibrogenic pathways[ 15 , 45 , 46 ].…”