Worsening of steatosis is an independent factor of fibrosis progression in untreated patients with chronic hepatitis C and paired liver biopsies

Castéra, Laurent; Hézode, Christophe; Roudot-Thoraval, F; Bastie, Anne; Es, Zafrani; Pawlotsky, Jean‐Michel; Dhumeaux, Daniel

doi:10.1136/gut.52.2.288

Cited by 276 publications

(237 citation statements)

References 40 publications

(37 reference statements)

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“…Many studies have now demonstrated a significant relationship between steatosis and hepatic fibrosis (Table 1), [9][10][11][12][13][14][15][16][17][18][19] although most did not adjust for other metabolic risk factors such as obesity, diabetes, or insulin resistance. 18 Adinolfi and colleagues 12 found an increased yearly rate of fibrosis progression in their patients with higher grades of steatosis, and we showed a similar relationship in our patients with chronic HCV (Fig.…”

Section: Steatosis Influences the Progression Of Fibrosis In Chronic Hcvmentioning

confidence: 99%

“…In addition, Westin and colleagues 13 found that progression of fibrosis on follow-up liver biopsy was more prevalent in patients whose initial biopsy showed steatosis, and in a recent study increasing levels of steatosis at second biopsy were associated with more rapid fibrosis progression. 14 Although most patients with chronic HCV have mild degrees of fat accumulation, even minor amounts of steatosis are associated with increased body mass index (BMI) and higher serum triglycerides 16 and may contribute to the natural history of fibrosis in chronic HCV. 19 As well as an increase in portal fibrosis, many patients with steatosis and chronic HCV have perisinusoidal fibrosis with a chicken-wire appearance similar to that seen in steatohepatitis 20 (Fig.…”

Section: Steatosis Influences the Progression Of Fibrosis In Chronic Hcvmentioning

confidence: 99%

“…8 The development of cirrhosis in patients with HCV may be associated with regression of steatosis, 21 as has previously been documented in non-alcoholic steatohepatitis (NASH). 22,23 The mechanisms leading to a reduction in steatosis in the liver with cirrhosis remain Mihm et al 99 Yes Ratziu et al 18 Yes Fartoux et al 19 Yes Czaja et al 9 Yes Yes Yes Hourigan et al 10,11 Yes Yes Yes Adinolfi et al 12 Yes Yes Yes Yes Westin et al 13 Yes Weak Yes Yes Castera et al 14 Yes Yes Monto et al 15 Yes Yes Yes Kumar et al 100 Yes Camps et al 101 Yes (BMI) Kaserer et al 102 Yes Bressler et al 60 Yes (BMI) Rubbia-Brandt et al 28 Yes Yes Poynard et al 16 Yes Yes Yes Yes Yes Patton et al 17 Yes Yes Yes Yes Yes Nair et al 70 No* Marrero et al 103 Yes Ohata et al 74 Yes *Steatosis was a risk for HCC in alcoholic and cryptogenic cirrhosis only. Abbreviation: BMI, body mass index.…”

Section: Steatosis Influences the Progression Of Fibrosis In Chronic Hcvmentioning

confidence: 99%

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Steatosis: Co-factor in Other Liver Diseases *

2005

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The prevalence of fatty liver is rising in association with the global increase in obesity and type 2 diabetes. In the past, simple steatosis was regarded as benign, but the presence of another liver disease may provide a synergistic combination of steatosis, cellular adaptation, and oxidative damage that aggravates liver injury. In this review, a major focus is on the role of steatosis as a co-factor in chronic hepatitis C (HCV), where the mechanisms promoting fibrosis and the effect of weight reduction in minimizing liver injury have been most widely studied. Steatosis, obesity, and associated metabolic factors may also modulate the response to alcohol-and drug-induced liver disease and may be risk factors for the development of hepatocellular cancer. The pathogenesis of injury in obesity-related fatty liver disease involves a number of pathways, which are currently under investigation. Enhanced oxidative stress, increased susceptibility to apoptosis, and a dysregulated response to cellular injury have been implicated, and other components of the metabolic syndrome such as hyperinsulinemia and hyperglycemia are likely to have a role. Fibrosis also may be increased as a by-product of altered hepatocyte regeneration and activation of bipotential hepatic progenitor cells. In conclusion, active management of obesity and a reduction in steatosis may improve liver injury and decrease the progression of fibrosis. (HEPATOLOGY 2005;42:5-13.)

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Section: Steatosis Influences the Progression Of Fibrosis In Chronic Hcvmentioning

confidence: 99%

Section: Steatosis Influences the Progression Of Fibrosis In Chronic Hcvmentioning

confidence: 99%

Section: Steatosis Influences the Progression Of Fibrosis In Chronic Hcvmentioning

confidence: 99%

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Steatosis: Co-factor in Other Liver Diseases *

2005

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“…14,20 -22 Worsening hepatic steatosis also is associated with increased periportal necrosis, hepatocyte apoptosis, and fibrosis progression. [23][24][25] Additionally, several studies have con- firmed a relationship between fibrosis and insulin resistance. 26 -28 Hui et al 28 have shown that insulin resistance is associated independently with the degree of fibrosis and the rate of fibrosis progression.…”

Section: Increased Fibrosismentioning

confidence: 99%

Steatosis and Chronic Hepatitis C Infection: Mechanisms and Significance

Harrison

2005

Clinical Gastroenterology and Hepatology

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“…Nevertheless, other authors think that BLP might also indicate liver fibrosis [13,[17][18][19][20]. In this study, the prevalence of BLP, its correlation with LS and fibrosis, and the utility of detecting BLP and skip areas for LS diagnosis were evaluated in a group of patients with chronic hepatitis C. Considering that steatosis, a frequent feature of chronic hepatitis C [27,28,30], is associated with progression of chronic HCV-related liver disease [24,[30][31][32][33][34], we thought that establishing a correlation between sonographic findings and LS could be of great usefulness in the management of these patients.…”

Section: Resultsmentioning

confidence: 99%

The prevalence of bright liver echo pattern in patients with chronic hepatitis C: correlation with steatosis and fibrosis

Loy¹,

Serra

Chessa

2014

J Ultrasound

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Purpose To evaluate the prevalence of bright liver echo pattern (BLP) on ultrasonography and its correlation with liver steatosis (LS), and fibrosis in patients with chronic hepatitis C. The usefulness of detecting skip areas for steatosis diagnosis has also been evaluated. Methods The study included 88 patients with chronic hepatitis C (55 men, 33 women, average age 45.7 ± 11.2 years). Ultrasound examination was performed in all patients before liver biopsy. The presence of BLP was assessed and graded from 1 to 3. Hypoechogenic areas (skip areas) around the gallbladder or near the portal vein were also evaluated. Hepatic fibrosis was assessed using the Ishak fibrosis score. Steatosis was graded as follows: 1, 2, 3 (\30, 30-70, [70 % of hepatocytes affected, respectively). Results Fifty-three of the 88 patients (60 %) showed BLP (40 grade 1, 13 grades 2 or 3). Skip areas were found in 14 patients (16 %). Histological steatosis was observed in 40 patients (45 %) and in 10 of them (25 %) was grades 2 and 3 (4 and 6 patients, respectively). As regards fibrosis, 2 patients showed F0, 34 F1, 28 F2, 20 F3, 4 F4, none of them F5 and F6. BLP of grades 2 or 3 and presence of skip areas were strongly correlated with LS (P = 0.00007 and P = 0.00003, respectively). No correlation was found between BLP and fibrosis. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of BLP for LS were 75, 50, 56, 68 and 61 %, respectively. When BLP of grades 2 and 3 and LS of 30 % or more were correlated, the sensitivity, specificity, PPV, NPV and accuracy of BLP were 72, 96, 61, 96 and 90 %, respectively. As regards skip areas the sensitivity, specificity, PPV, NPV and accuracy for LS were 35, 100, 100, 64 and 70 %, respectively. Conclusions In a well-defined group of patients with chronic hepatitis C, the detection of BLP grades 2 and 3 has a good sensitivity and high specificity for high grades of steatosis. A high specificity but low sensitivity for liver steatosis was also found for skip areas, whereas mild fibrosis does not seem to correlate with the hyperechogenicity of the liver.Keywords Liver steatosis Á Ultrasonography Á Bright liver echo pattern Á Skip areas Á Chronic hepatitis C Riassunto Scopo Scopo del lavoro é stato quello di valutare la prevalenza del ''bright liver echo pattern'' (BLP) all'ultrasonografia e la sua correlazione con la steatosi epatica (SE) e la fibrosi in un gruppo di pazienti con epatite cronica C. E' stata valutata anche l'utilità della determinazione delle cosiddette ''aree di risparmio'' per la diagnosi di steatosi. Metodi Lo studio ha incluso 88 pazienti con epatite cronica C (55 di sesso maschile, 33 di sesso femminile; età media 45.7 ± 11.2 anni). L'esame ultrasonografico é stato eseguito in tutti i pazienti prima di effettuare la biopsia epatica. La presenza di BLP é stata graduata da 1 a 3. É stata anche valutata la presenza o meno di aree ipoecogene (cosiddette ''aree di risparmio''), adiacenti alla colecisti o in sede parailare epatic...

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Worsening of steatosis is an independent factor of fibrosis progression in untreated patients with chronic hepatitis C and paired liver biopsies

Cited by 276 publications

References 40 publications

Steatosis: Co-factor in Other Liver Diseases *

Steatosis: Co-factor in Other Liver Diseases *

Steatosis and Chronic Hepatitis C Infection: Mechanisms and Significance

The prevalence of bright liver echo pattern in patients with chronic hepatitis C: correlation with steatosis and fibrosis

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