Risk assessment of clinical outcomes in Asian patients with chronic hepatitis B using enhanced liver fibrosis test

Kim, Hyun Sook; Yoo, Eun Jin; Oh, Eok Soo; Park, Jun Yong; Kim, Do Young; Ahn, Sang Hoon; Han, Kwang Hyub; Kim, Seung Up; Park, Young Nyun

doi:10.1002/hep.27389

Cited by 38 publications

(36 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A few other studies conducted in the pretransplant setting have also shown that noninvasive fibrosis tools are accurate in predicting prognosis of patients with chronic liver diseases. 6,7,15,29 In this era of developing noninvasive and safer approaches to diagnosis and screening, our findings have significant implications in the ongoing care of patients following LT. First, the transplant hepatologist, or any other physician involved in the care of these patients, may employ fibrosis biomarkers to screen LT recipients for prognostic evaluation, without having to resort to the invasive and costly procedure of liver biopsy. These tests could be easily repeated to monitor LT recipients and predict patient and graft outcome because our study reveals that the evolution of fibrosis scores over time is also predictive of prognosis.…”

Section: Discussionmentioning

confidence: 88%

“…Moreover, these noninvasive tools have meaningful prognostic utility in identifying patients at high risk for liver-related complications, death, and need for LT in chronic viral hepatitis and NAFLD. 6,7,15 A number of them have also been specifically validated in LT recipients, and the reported accuracy is similar to the pre-LT setting. [16][17][18][19][20][21][22] One report thus far has suggested the prognostic value of a noninvasive fibrosis tool in the posttransplant setting.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Serum fibrosis biomarkers predict death and graft loss in liver transplantation recipients

et al. 2015

View full text Add to dashboard Cite

Noninvasive serum fibrosis biomarkers predict clinical outcomes in pretransplant patients with chronic liver disease. We investigated the role of serum fibrosis biomarkers and of changes in biomarkers in predicting death and graft loss after liver transplantation (LT). We included 547 patients who underwent LT between 1991 and 2012 and who met the following criteria: patient and graft survival > 12 months; serum fibrosis biomarkers aspartate aminotransferase-to-platelet ratio index (APRI), fibrosis score 4 (FIB-4), and nonalcoholic fatty liver disease (NAFLD) fibrosis score available at 1 year after LT; and a minimum follow-up of 1 year. Delta of fibrosis biomarkers was defined as (end of follow-up score -baseline score)/followup duration. Baseline and delta fibrosis biomarkers were associated with death: APRI > 1.5 (adjusted hazard ratio [aHR], 2.2; 95% confidence interval [CI], 1.4-3.3; P < 0.001) and delta APRI > 0.5 (aHR, 5.3; 95% CI, 3.4-8.2; P < 0.001); FIB-4 > 3.3 (aHR, 1.9; 95% CI, 1.3-2.8; P 5 0.002) and delta FIB-4 > 1.4 (aHR, 2.4; 95% CI, 1.4-4.1; P 5 0.001); and NAFLD fibrosis score > 0.7 (aHR, 1.9; 95% CI, 1.3-2.9; P 5 0.002) and delta NAFLD fibrosis score (aHR, 3.7; 95% CI, 2.6-5.4; P < 0.001). Baseline and delta fibrosis biomarkers were associated also with graft loss. In conclusion, serum fibrosis biomarkers 1 year after LT and changes in serum fibrosis biomarkers predict death and graft loss in LT recipients. They may help in risk stratification of LT recipients and identify patients requiring closer monitoring.

show abstract

Section: Discussionmentioning

confidence: 88%

mentioning

confidence: 99%

Serum fibrosis biomarkers predict death and graft loss in liver transplantation recipients

et al. 2015

View full text Add to dashboard Cite

show abstract

“…We did not employ MELD score to predict clinical outcomes in this study. Indeed, previous prognostic studies showed that MELD score is not useful to predict clinical outcomes when the study population does not include mostly cirrhotic patients [26]. Diabetes is a known risk factor for malignancy and fibrosis progression rate in chronic liver diseases of various etiologies [39].…”

Section: Discussionmentioning

confidence: 99%

“…Non-invasive methods can also diagnose and grade steatosis, including radiologic techniques, such as ultrasonography [21] and Xenon-133 liver scan [22], and biomarkers such as hepatic steatosis index (HSI) [23]. Non-invasive tools for liver fibrosis may help identify patients at high risk for liver-related complications or death in chronic hepatitis C and B, and in NAFLD [24–26]. No study has specifically investigated the prognostic performance of non-invasive methods for liver fibrosis and hepatic steatosis for prediction of clinical outcomes in NASH as compared to the gold standard methods to diagnose liver fibrosis (histology) and clinically significant portal hypertension (HVPG).…”

Section: Introductionmentioning

confidence: 99%

Prognostic Value of Non-Invasive Fibrosis and Steatosis Tools, Hepatic Venous Pressure Gradient (HVPG) and Histology in Nonalcoholic Steatohepatitis

et al. 2015

View full text Add to dashboard Cite

Background & AimsNon-invasive diagnostic methods for liver fibrosis predict clinical outcomes in viral hepatitis and nonalcoholic fatty liver disease (NAFLD). We specifically evaluated prognostic value of non-invasive fibrosis methods in nonalcoholic steatohepatitis (NASH) against hepatic venous pressure gradient (HVPG) and liver histology.MethodsThis was a retrospective cohort study of 148 consecutive patients who met the following criteria: transjugular liver biopsy with HVPG measurement; biopsy-proven NASH; absence of decompensation; AST-to-Platelets Ratio Index (APRI), fibrosis-4 (FIB-4), NAFLD fibrosis score, ultrasound, hepatic steatosis index and Xenon-133 scan available within 6 months from biopsy; a minimum follow-up of 1 year. Outcomes were defined by death, liver transplantation, cirrhosis complications. Kaplan–Meier and Cox regression analyses were employed to estimate incidence and predictors of outcomes, respectively. Prognostic value was expressed as area under the curve (AUC).ResultsDuring a median follow-up of 5 years (interquartile range 3-8), 16.2% developed outcomes, including 7.4% who died or underwent liver transplantation. After adjustment for age, sex, diabetes, the following fibrosis tools predicted outcomes: HVPG >10mmHg (HR=9.60; 95% confidence interval [CI] 3.07-30.12), histologic fibrosis F3-F4 (HR=3.14; 1.41-6.95), APRI >1.5 (HR=5.02; 1.6-15.7), FIB-4 >3.25 (HR=6.33; 1.98-20.2), NAFLD fibrosis score >0.676 (HR=11.9; 3.79-37.4). Prognostic value was as follows: histologic fibrosis stage, AUC=0.85 (95% CI 0.76-0.93); HVPG, AUC=0.81 (0.70-0.91); APRI, AUC=0.89 (0.82-0.96); FIB-4, AUC=0.89 (0.83-0.95); NAFLD fibrosis score, AUC=0.79 (0.69-0.91). Neither histologic steatosis nor non-invasive steatosis methods predicted outcomes (AUC<0.50).ConclusionsNon-invasive methods for liver fibrosis predict outcomes of patients with NASH. They could be used for serial monitoring, risk stratification and targeted interventions.

show abstract

“…FibroTest, enhanced liver fibrosis panel) [92,93]. Abnormal fibrosis biomarkers are associated with HCC development [94]. Further studies are required to evaluate the possibility of combining these serum tests with other clinical parameters to improve HCC prediction.…”

Section: Diagnosis Of Cirrhosis As the Achilles Heelmentioning

confidence: 98%

Can we use HCC risk scores to individualize surveillance in chronic hepatitis B infection?

Wong

Janssen

2015

Journal of Hepatology

104

111

View full text Add to dashboard Cite

Chronic hepatitis B is one of the leading causes of hepatocellular carcinoma (HCC) worldwide. Accurate prediction of HCC risk is important for decisions on antiviral therapy and HCC surveillance. In the last few years, a number of Asian groups have derived and validated several HCC risk scores based on well-known risk factors such as cirrhosis, age, male sex and high viral load. Overall, these scores have high negative predictive values of over 95% in excluding HCC development in 3 to 10 years. The REACH-B score was derived from a community cohort of non-cirrhotic patients and is better applied in the primary care setting. In contrast, the GAG-HCC and CU-HCC scores were derived from hospital cohorts and include cirrhosis as a major integral component. While the latter scores may be more applicable to patients at specialist clinics, the diagnosis of cirrhosis based on routine imaging and clinical parameters can be inaccurate. To this end, recent developments in non-invasive tests of liver fibrosis may further refine the risk prediction. The application of HCC risk scores in patients on antiviral therapy and in other ethnic groups should be evaluated in future studies.

show abstract

Risk assessment of clinical outcomes in Asian patients with chronic hepatitis B using enhanced liver fibrosis test

Cited by 38 publications

References 34 publications

Serum fibrosis biomarkers predict death and graft loss in liver transplantation recipients

Serum fibrosis biomarkers predict death and graft loss in liver transplantation recipients

Prognostic Value of Non-Invasive Fibrosis and Steatosis Tools, Hepatic Venous Pressure Gradient (HVPG) and Histology in Nonalcoholic Steatohepatitis

Can we use HCC risk scores to individualize surveillance in chronic hepatitis B infection?

Contact Info

Product

Resources

About