中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 37 Issue 12
Dec.  2021
Turn off MathJax
Article Contents
Article Navigation >  Journal of Clinical Hepatology  > 2021  >  37(12): 2808-2812

The cut off value of liver stiffness measurement needs to be lowered to predict liver fibrosis after sustained virologic response in chronic hepatitis C patients

DOI: 10.3969/j.issn.1001-5256.2021.12.016

  • Third Department of Liver Diseases, Beijing YouAn Hospital, Capital Medical University, Beijing 100069, China

Research funding:

Incubation Program for Young and Middle-aged Talents in Beijing YouAn Hospital Affiliated to Capital Medical University (YNKTTS20180105);

Study on Integrated Management Model of 'Screening-Referral-Treatment' for Viral Hepatits C in Beijing (2020-1-3011)

  • Received Date: 2021-05-19
  • Accepted Date: 2021-07-15
  • Published Date: 2021-12-20
    Abstract
  •   Objective  To further verify the ability of noninvasive diagnostic method for liver fibrosis in predicting liver fibrosis in chronic hepatitis C patients followed up after sustained virologic response (SVR) based on liver biopsy.  Methods  A prospective cohort study was performed for the chronic hepatitis C patients who attended Beijing YouAn Hospital, Capital Medical University, from October 2015 to December 2017, and all patients were followed up regularly after SVR and underwent liver biopsy. The diagnostic efficiency of the noninvasive diagnostic method for liver fibrosis was verified based on pathological results. The receiver operating characteristic (ROC) curve was used to evaluate the ability of LSM, aspartate aminotransferase-to-platelet ratio index (APRI), and fibrosis-4 (FIB-4) in the diagnosis of liver fibrosis, and STATA and R language were used to compare the area under the ROC curve (AUC).  Results  A total of 96 patients were successfully enrolled. The LSM after SVR was significantly lower than that at baseline, and LSM had a significantly larger AUC than APRI (0.89 vs 0.67, P < 0.05) and FIB (0.89 vs 0.69, P < 0.05) in the diagnosis of liver cirrhosis after SVR. LSM at a cut-off value of 7.95 kPa, and based on the best specificity, the diagnosis of liver cirrhosis could be considered when LSM was greater than 9.15 kPa, with a positive likelihood ratio of 5.91%; progressive liver fibrosis could be excluded based on LSM < 6.85 kPa, with a negative predictive value of 0.98. Follow-up time and antiviral regimen had no influence on the diagnostic ability of LSM.  Conclusion  The cut off value of LSM needs to be lowered to predict liver fibrosis after SVR in chronic hepatitis C patients.

     

    • FullText(HTML)
  • loading
    • References(12)
  • [1]
    Chinese Society of Hepatology and Chinese Society of Infectious Diseases, Chinese Medical Association. The guideline of prevention and treatment for hepatitis C: A 2015 update[J]. J Clin Hepatol, 2015, 31(12): 1961-1979. DOI: 10.3969/j.issn.1001-5256.2015.12.003.

    中华医学会肝病学分会, 中华医学会感染病学分会. 丙型肝炎防治指南(2015年更新版)[J]. 临床肝胆病杂志, 2015, 31(12): 1961-1979. DOI: 10.3969/j.issn.1001-5256.2015.12.003.
    [2]
    ISHAK K, BAPTISTA A, BIANCHI L, et al. Histological grading and staging of chronic hepatitis[J]. J Hepatol, 1995, 22(6): 696-699. DOI: 10.1016/0168-8278(95)80226-6.
    [3]
    WAI CT, GREENSON JK, FONTANA RJ, et al. A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C[J]. Hepatology, 2003, 38(2): 518-526. DOI: 10.1053/jhep.2003.50346.
    [4]
    STERLING RK, LISSEN E, CLUMECK N, et al. Development of a simple noninvasive index to predict significant fibrosis in patients with HIV/HCV coinfection[J]. Hepatology, 2006, 43(6): 1317-1325. DOI: 10.1002/hep.21178.
    [5]
    Chinese Foundation for Hepatitis Prevention and Control, Chinese Society of Infectious Disease and Chinese Medical Association. Consensus on clinical application of transient elastography detecting liver fibrosis: A 2018 update[J]. Chin J Hepatol, 2019, 27(3): 182-191. DOI: 10.3760/cma.j.issn.1007-3418.2019.03.004.

    中国肝炎防治基金会, 中华医学会感染病学分会, 中华医学会肝病学分会和中国研究型医院学会肝病专业委员会. 瞬时弹性成像技术诊断肝纤维化专家共识(2018年更新版)[J]. 中华肝脏病杂志, 2019, 27(3): 182-191. DOI: 10.3760/cma.j.issn.1007-3418.2019.03.004.
    [6]
    WEI L, HUANG YH. Long-term outcomes in patients with chronic hepatitis C in the current era of direct-acting antiviral agents[J]. Expert Rev Anti Infect Ther, 2019, 17(5): 311-325. DOI: 10.1080/14787210.2019.1588112.
    [7]
    SALEH SA, SALAMA MM, ALHUSSEINI MM, et al. M2BPGi for assessing liver fibrosis in patients with hepatitis C treated with direct-acting antivirals[J]. World J Gastroenterol, 2020, 26(21): 2864-2876. DOI: 10.3748/wjg.v26.i21.2864.
    [8]
    FERRAIOLI G, WONG VW, CASTERA L, et al. Liver Ultrasound elastography: An update to the world federation for ultrasound in medicine and biology guidelines and recommendations[J]. Ultrasound Med Biol, 2018, 44(12): 2419-2440. DOI: 10.1016/j.ultrasmedbio.2018.07.008.
    [9]
    HUANG R, RAO H, YANG M, et al. Noninvasive measurements predict liver fibrosis well in hepatitis C virus patients after direct-acting antiviral therapy[J]. Dig Dis Sci, 2020, 65(5): 1491-1500. DOI: 10.1007/s10620-019-05886-y.
    [10]
    KRONFLI N, YOUNG J, WANG S, et al. Liver fibrosis in human immunodeficiency virus (HIV)-hepatitis C virus (HCV) coinfection before and after sustained virologic response: What is the best noninvasive marker for monitoring regression?[J]. Clin Infect Dis, 2021, 73(3): 468-477. DOI: 10.1093/cid/ciaa702.
    [11]
    MARTÍNEZ-CAMPRECIÓS J, BONIS PUIG S, PONS DELGADO M, et al. Transient elastography in DAA era. Relation between post-SVR LSM and histology[J]. J Viral Hepat, 2020, 27(4): 453-455. DOI: 10.1111/jvh.13245.
    [12]
    CHEKURI S, NICKERSON J, BICHOUPAN K, et al. Liver stiffness decreases rapidly in response to successful hepatitis C treatment and then plateaus[J]. PLoS One, 2016, 11(7): e0159413. DOI: 10.1371/journal.pone.0159413.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(3)  / Tables(6)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (365) PDF downloads(44) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return