Decision letter for "The 13 C‐methactin breath test is non‐inferior to liver biopsy in predicting liver related death and transplantation: a seven‐year prospective follow up study in 132 patients with chronic hepatitis C infection"

2020 ◽  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Liver Biopsy ◽  
Chronic Hepatitis C ◽  
Breath Test ◽  
Hepatitis C Infection ◽  
Follow Up Study

Agreement in Pathologic Interpretation of Liver Biopsy Specimens in Posttransplant Hepatitis C Infection

1999 ◽  
Vol 123 (2) ◽  
pp. 143-145
Author(s):  
Zobair M. Younossi ◽  
Navdeep Boparai ◽  
Terry Gramlich ◽  
John Goldblum ◽  
Peggy George ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Liver Biopsy ◽  
Chronic Hepatitis C ◽  
The United States ◽  
Intraobserver Agreement ◽  
Hepatitis C Infection ◽  
Biopsy Specimens

Abstract Hepatitis C virus–related disease is rapidly becoming the most common indication for orthotopic liver transplant (OLT) in the United States. Although post-OLT hepatitis C viremia is universal, 40% to 60% of patients develop recurrent chronic hepatitis C. Distinguishing recurrent chronic hepatitis C infection from acute rejection may be difficult because of overlapping histopathologic features. To improve our diagnostic accuracy we undertook a study to determine interobserver and intraobserver agreement between pathologists examining post-OLT liver biopsy specimens in patients from our transplant database. Clinical data and microscopic sections from 26 patients with hepatitis C virus–related OLT were reviewed. Biopsy specimens were obtained because of abnormal liver enzymes (21/26) or routine post-OLT follow-up (5/26), representing both early (18 ± 11 days) and late (252 ± 206 days) post-OLT periods. Unidentified sections were examined by an experienced pathologist in a randomly assigned order and reexamined 6 weeks later in the same fashion by the initial reviewer and a second experienced pathologist. Interobserver and intraobserver agreement was calculated using κ statistic. The intraobserver agreement was 81% with a κ coefficient of 0.67 (P = .001). The interobserver agreement was 78% with a κ coefficient of 0.60 (P < .001). The early post-OLT biopsy specimens (18 ± 11 days) were the most difficult to interpret.

scholarly journals A Six‐Year Follow‐Up After Interferon‐Alpha Monotherapy for Chronic Hepatitis C Infection in Hemodialysis Patients

Renal Failure ◽  
2004 ◽  
Vol 26 (5) ◽  
pp. 583-588 ◽  
Author(s):  
Fatma Nurhan Ozdemir ◽  
Ali Akcay ◽  
Siren Sezer ◽  
Sedat Boyacioglu ◽  
Binnaz Handan Ozdemir ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Chronic Hepatitis C ◽  
Interferon Alpha ◽  
Hemodialysis Patients ◽  
Hepatitis C Infection

scholarly journals Sustained virological response halts fibrosis progression: A long-term follow-up study of people with chronic hepatitis C infection

PLoS ONE ◽  
2017 ◽  
Vol 12 (10) ◽  
pp. e0185609 ◽  
Author(s):  
Swee Lin G. Chen Yi Mei ◽  
Alexander J. Thompson ◽  
Britt Christensen ◽  
Georgina Cunningham ◽  
Lucy McDonald ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Sustained Virological Response ◽  
Virological Response ◽  
Hepatitis C Infection ◽  
Fibrosis Progression ◽  
Follow Up Study ◽  
Long Term Follow Up

scholarly journals Validation of Hepascore as a Predictor of Liver Fibrosis in Patients with Chronic Hepatitis C Infection

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Hamid Kalantari ◽  
Hannan Hoseini ◽  
Anahita Babak ◽  
Majid Yaran
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Liver Biopsy ◽  
Chronic Hepatitis C ◽  
Total Bilirubin ◽  
Serum Levels ◽  
Hepatitis C Infection ◽  
Glutamyl Transferase ◽  
Sensitivity Specificity ◽  
Severe Fibrosis

Introduction. Liver biopsy is an invasive determinator for hepatic fibrosis. Serum biomarkers can probably be used as an alternative to liver biopsy in assessment of the degree of fibrosis in patients with chronic Hepatitis C. Method. Eighty patients with chronic Hepatitis C were included in the study using simple nonrandom sampeling metod. After fulfillment of liver biopsy, the patients were categorized according to the METAVIR Scoring system. The Hepascore algorithm is computed based on age, sex, and the serum levels of total bilirubin, -glutamyl transferase, 2-Macroglobulin, and hyaluronic acid. The spearman and ROC tests were used. Results. According to the liver biopsy results, 12, 25, 20, 7 and 16 patients had F0, F1, F2, F3, and F4, respectively. With regard to the 0.34 cut-off point Hepascore had 67%, 56%, 64%, and 56% sensitivity, specificity, respectively, positive prediction value (PPV), and negative prediction value (NPV), respectively, for diagnosis of significant fibrosis. For a Hepascore cut-off point 0.61, sensitivity, specificity, respectively, PPV and NPB 82%, 86%, 70%, and 92% in diagnosis of severe fibrosis. For a Hepascore cut-off point 0.84, sensitivity, specificity, PPV and NPB were respectively 100%, 97%, 89%, and 100% for diagnosis of cirrhosis. Conclusion. Hepascore has a high value in diagnosis of the level of fibrosis, particularly cirrhosis. Therefore, it can be used for primary screening of patients to determine the need for liver biopsy.

scholarly journals FIB-4 and APRI scores for predicting severe fibrosis in chronic hepatitis C - a developing country's perspective in DAA era

2018 ◽  
Vol 12 (03) ◽  
pp. 178-182
Author(s):  
Uros Karic ◽  
Ivana Pesic-Pavlovic ◽  
Goran Stevanovic ◽  
Milos Korac ◽  
Natasa Nikolic ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis C ◽  
Liver Biopsy ◽  
Chronic Hepatitis C ◽  
Study Cohort ◽  
Hepatitis C Infection ◽  
Advanced Liver Disease ◽  
Non Invasive ◽  
Apri Score ◽  
Severe Fibrosis

Introduction: Chronic Hepatitis C Virus (HCV) infection leads to progressive fibrosis making fibrosis staging necessary in the evaluation of such patients. Different fibrosis scores are emerging as possible non-invasive alternatives for liver biopsy. The Fibrosis-4 Index (FIB-4) and AST to Platelet Ratio Index (APRI) scores are the most widely used and the most extensively tested. This study aims to determine if it was possible to accurately use these to identify patients that are unlikely to have severe fibrosis. Methodology: One hundred and forty-two patients with chronic hepatitis C infection who underwent liver biopsy since January 1st 2014 until May 31st 2017 at the Hospital for Infectious and Tropical Diseases in Belgrade were analyzed. The FIB-4 and APRI scores were calculated for each patient and compared to histologically determined fibrosis stage. Results: A comprehensive statistical analysis was conducted in order to compare patients with and without severe fibrosis and to evaluate the accuracy of the fibrosis scores. Patients with non-severe fibrosis were younger, had higher platelet counts and lower transaminase levels. FIB-4 had an AUC of 0.875 and the APRI score had an AUC of 0.861. No patients with severe fibrosis or cirrhosis had a FIB-4 lower than 1.08. FIB-4 was superior to APRI in identifying patients with severe fibrosis in the study cohort. Conclusion: FIB-4 was superior to APRI in the recognition of severe fibrosis. FIB-4 may prove very useful in identifying patients without advanced liver disease, especially if other non-invasive methods are inaccessible.

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