Predictors and Noninvasive Identification of Severe Liver Fibrosis in Patients with Chronic Hepatitis C

Abstract

Diagnosis of severe fibrosis (stages III and IV) in hepatitis C has clinical implications. Our objective was to distinguish independent predictors of severe fibrosis and use them to identify patients with severe fibrosis without a liver biopsy. One hundred ninety-nine hepatitis C patients were included in the initial analysis to identify predictors of severe fibrosis. Univariate and multivariate analyses of 26 predetermined variables for significance in predicting severe fibrosis were performed. Based on the coefficient regression and P values, a scoring system was developed and applied to a second independent cohort (137 patients) for validation. In multivariate analysis, low platelet count, low albumin, aspartate transaminase level, history of blood transfusion, and hepatitis B core antibody were significant independent predictors of severe fibrosis. A scoring system (range, 0-9) was developed from the three variables with the lowest P values (platelet count, aspartate transaminase, and albumin). A cutoff point of 4 had 99% specificity and 94% positive predictive value. A cutoff point of 2 had 87% sensitivity and 95% negative predictive value. We conclude that severe fibrosis in hepatitis C may potentially be identified with a high degree of certainty in a substantial number of patients with a simple noninvasive scoring system.

Non‐alcoholic fatty liver disease progresses to hepatocellular carcinoma in the absence of apparent cirrhosis

“…Patients receiving insulin or oral antidiabetic drugs were assumed to have diabetes mellitus. Alcohol abuse was defined as consumption of more than two drinks daily or more than six drinks daily on weekends for at least 5 years,25 implying alcoholic liver disease.…”

“…Patients receiving insulin or oral antidiabetic drugs were assumed to have diabetes mellitus. Alcohol abuse was defined as consumption of more than two drinks daily or more than six drinks daily on weekends for at least 5 years, 25 implying alcoholic liver disease. 1 All patients presenting with one or more of these symptoms were labeled as non-cirrhotic, when histological confirmation could be obtained or no radiological signs of cirrhosis were shown and portal hypertension was allegeable by portal vein thrombosis.…”

The bioimpedance analysis of a parenchyma of a liver in the conditions of its extensive resection in experiment

“…To date, there are a large number of methods of assessing the degree of hepatic dysfunction. The most informative indicators of liver function available in clinical practice are: total bilirubin, albumin, albumin-globulin index, leukocyte index of intoxication, the level aspartataminotransferaza, alanine aminotransferase and duration of cholestasis before operation, indices of protein, pseudocholinesterase, fibrinogen, fibrins, prothrombin index, clearance test, indocyanine green [4,5,6].…”