Prospective Evaluation of Liver Stiffness Using Transient Elastography in Alcoholic Patients Following Abstinence

Gianni, Elena; Forte, Paolo; Galli, Valentina; Razzolini, Giulia; Bardazzi, G; Annese, Vito

doi:10.1093/alcalc/agw053

Cited by 36 publications

(17 citation statements)

References 28 publications

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“…18 Such decreases are more marked in patients remaining abstinent after initial detoxification. [10][11][12] Our study combined a prospective follow-up evaluation of LS with clinical and biological data and liver histology. TE was performed after a median of 6 days of abstinence, making it plausible that LS already had decreased in some patients.…”

Section: Discussionmentioning

confidence: 99%

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Transient Elastography Accurately Screens for Compensated Advanced Chronic Liver Disease in Patients With Ongoing or Recent Alcohol Withdrawal

Legros¹,

Bardou-Jacquet

Turlin³

et al. 2022

Clinical Gastroenterology and Hepatology

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At 1 and 2 months 300 Patients hospitalized for alcohol withdrawal with asymptomatic alcohol-related liver disease On the same day Within 10 days of alcohol cessation Liver biopsy Fibroscan® AST ALT bilirubin… At inclusion n =259 TE ≥ 25kPa TE< 10kPa No cACLD n = 185 cACLD n = 2 NPV 99% cACLD n = 25 No cACLD n = 2 PPV 93% Unclassified n=45 cACLD=18 No cACLD=27 Abstainers Relapsers cACLD No cACLD BACKGROUND & AIMS: Q9Liver stiffness measurement by transient elastography (TE) is a promising method for staging fibrosis in alcohol-related liver disease, but uncertainties remain regarding the influence of alcohol consumption and thus the ideal timing for TE performance. We evaluated the performance of TE compared with liver biopsy to exclude compensated advanced chronic liver disease (cACLD) in patients hospitalized for alcohol detoxification. METHODS:Patients were recruited prospectively at 6 in-patient addiction centers in France. Eligible patients had increased aspartate aminotransferase levels, and no history or signs of overt cirrhosis. TE, histology, and biochemistry measurements were obtained within a median of 6 days after alcohol withdrawal. TE and biochemistry were repeated 1 and 2 months later.

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Section: Discussionmentioning

confidence: 99%

“…9 However, the thresholds determined for severe fibrosis or cirrhosis have varied and are substantially higher than for other etiologies. LS decreases rapidly in patients with alcohol withdrawal, [10][11][12][13][14][15] but no prospective study has correlated histology and TE follow-up evaluation…”

mentioning

confidence: 99%

Transient Elastography Accurately Screens for Compensated Advanced Chronic Liver Disease in Patients With Ongoing or Recent Alcohol Withdrawal

Legros¹,

Bardou-Jacquet

Turlin³

et al. 2022

Clinical Gastroenterology and Hepatology

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“…Some authors have pointed out that steatohepatitis may lead to overestimation of liver fibrosis[ 54 ]. The risk of overestimation especially applies in patients who are abstinent, as liver stiffness decreases with cessation of alcohol use, especially with baseline values higher than 7 kPa[ 55 ].…”

Section: Non-invasive Methods For Assessment Of Liver Damagementioning

confidence: 99%

Assessment of liver disease in patients with chronic hepatitis C and unhealthy alcohol use

Fuster¹,

Garcia-Calvo²,

Bolao³

et al. 2021

WJG

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Hepatitis C virus (HCV) infection and unhealthy alcohol use are major drivers of the burden of liver disease worldwide and commonly co-occur. Assessment of underlying liver damage is a cornerstone of the clinical care of patients with chronic HCV infection and/or unhealthy alcohol use because many of them are diagnosed at advanced stages of disease. Early diagnosis of liver disease before decompensated liver cirrhosis becomes established is essential for treatment with direct acting antivirals and/or abstinence from alcohol consumption, which are the main therapeutic approaches for clinical management. In this review, we discuss current knowledge around the use of non-invasive methods to assess liver disease, such as abdominal ultrasound, controlled attenuation parameter, transient elastography, magnetic resonance imaging, and indices based on serum markers of liver injury.

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“…A study found elastography provided an assessment of fibrosis that was comparable to liver biopsy [16]. Other authors, however, have expressed concerns that alcohol-related steatohepatitis may distort results, leading to overestimation of liver fibrosis in this population [54], especially in patients who maintain abstinence from alcohol, as liver stiffness seems to dramatically decrease with cessation of alcohol use [55].…”

Section: Transient Elastographymentioning

confidence: 99%

Liver Ultrasound Abnormalities in Alcohol Use Disorder

Fuster¹,

Garcia-Calvo²,

Rivas³

et al. 2019

Essentials of Abdominal Ultrasound

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Alcohol-related liver disease is the most common alcohol-related medical illness, and it is the major driver of liver-related deaths worldwide. However, no screening guidelines currently exist for the early detection of liver disease in patients with risky drinking or those with alcohol use disorder. Moreover, most patients with alcohol-related liver fibrosis, which is the main prognostic factor of progression to end-stage liver disease, have normal blood tests. Abdominal ultrasound is a cheap and readily available diagnostic procedure that is rarely used in patients with alcohol use disorder without overt liver disease. In addition, abdominal ultrasound can detect other forms of liver disease, which are not uncommon in patients with unhealthy alcohol use, and can have a negative impact on the natural history of alcohol-related liver disease. In this chapter we will review the current knowledge about the use of liver ultrasound in patients with alcohol use disorder for the early detection of alcohol-related liver disease, as well as the potential use to detect other forms of liver disease. We will also briefly discuss other methods for the noninvasive detection of liver steatosis and/or liver fibrosis in patients with alcohol use disorder.

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Prospective Evaluation of Liver Stiffness Using Transient Elastography in Alcoholic Patients Following Abstinence

Abstract: We prospectively evaluated liver stiffness by Fibroscan in patients with alcohol-related liver disease at baseline and following abstinence. After 1 month of abstinence, the LS is dramatically reduced, especially when values are greater than 7 kPa and transaminase elevated at baseline.

Cited by 36 publications

References 28 publications

Transient Elastography Accurately Screens for Compensated Advanced Chronic Liver Disease in Patients With Ongoing or Recent Alcohol Withdrawal

Transient Elastography Accurately Screens for Compensated Advanced Chronic Liver Disease in Patients With Ongoing or Recent Alcohol Withdrawal

Assessment of liver disease in patients with chronic hepatitis C and unhealthy alcohol use

Liver Ultrasound Abnormalities in Alcohol Use Disorder

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