Liver Stiffness Measurement in Chronic Hepatitis C Patients Who Failed Pegylated-Interferon and Ribavirin Combination Therapy

Combine Pegylated interferon therapy and ribavirin is most commonly usedtreatment in chronic hepatitis C patients. Along with other complications, different psychiatricdisorders are observed during combination therapy including depression. Depression is themajor morbidity as it may lead to different destructive ideation including suicide among patientson treatment. We have tried to calculate the frequency of depression along with associatedfactors in our present study. Objectives: To find out the frequency of depression duringPegylated interferon therapy for chronic hepatitis C. Study Design: Descriptive study. Setting:Liaquat University of Medical & Health Sciences, Jamshoro / Hyderabad Duration: The durationof study was six months starting from 01-01-2014 to 31-06-2014. Methodology: Two hundredand fifty two cases of chronic hepatitis C on the basis of anti HCV (ELISA) and PCR positivewere selected in this study. Results: Out of 252 patients, 111 (44%) were males and 141(56%)were females. Most of the patients belonged to 26 to 50 years of age. The duration of treatmentwas 12 weeks. Two hundred & eight (82.5%) patients had ever married while the remaining17.5% were unmarried. Out of 106 (42%) depressed patients, 39 (37%) had mild, 31 (29%) hadmoderate, 20 (19%) had moderately severe and 15 (15%) had severe depression. Conclusion:It was observed that depression is a common during combination therapy with Peg interferonand the ribavirin in chronic HCV patients.

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Accuracy of the ElastPQ® Technique for the Assessment of Liver Fibrosis in Patients with Chronic Hepatitis C: a “Real Life” Single Center Study

Journal of Gastrointestinal and Liver Diseases ◽

10.15403/jgld.2014.1121.253.epq ◽

2016 ◽

Vol 25 (3) ◽

pp. 331-335 ◽

Cited By ~ 23

Author(s):

Giovanna Ferraioli ◽

Laura Maiocchi ◽

Raffaella Lissandrin ◽

Carmine Tinelli ◽

Annalisa De Silvestri ◽

...

Keyword(s):

Chronic Hepatitis ◽

Hepatitis C ◽

Liver Fibrosis ◽

Chronic Hepatitis C ◽

Liver Stiffness ◽

Real Life ◽

Advanced Fibrosis ◽

Liver Stiffness Measurement ◽

Significant Fibrosis ◽

Stiffness Measurement

Background & Aims: Noninvasive assessment of liver stiffness has been increasingly used to evaluate fibrosis instead of liver biopsy, especially in patients with chronic viral hepatitis. The aim of this study was to assess the performance in staging liver fibrosis of the updated ElastPQ® technique (EPIQ7 ultrasound system, Philips Healthcare, Bothell, WA, USA) in the “real life” setting by using the FibroScan as the reference standard and to understand whether the use of the quality criteria improves the performance of the technique. Methods: This was a cross-sectional study: 278 patients affected by chronic hepatitis C referred for liver stiffness measurement with the FibroScan® 502 Touch device (Echosens, Paris, France) underwent measurements also with the ElastPQ® technique. For the assessment of significant fibrosis (F≥2), advanced fibrosis (F≥3) and cirrhosis (F=4), respectively, we used the cutoffs of 7.0, 9.5 and 12.0 kPa. The diagnostic performance of ElastPQ® was assessed using the area under the ROC (AUROC) curve analysis and was evaluated overall and for cases with (a) 10 measurements and IQR/M≤30%, (b) 5 measurements and IQR/M ≤30%, (c) 10 measurements and IQR/M>30%, (d) 5 measurements and IQR/M>30%. Results: The optimal cutoffs of ElastPQ® for significant fibrosis, advanced fibrosis and cirrhosis were 6.43, 9.54 and 11.34 kPa, respectively. For measurements with an IQR/M≤30%, there was no statistically significant decrease in sensitivity between 10 and 5 measurements (p=0.26, p=0.09, p=0.71, for F≥2, F≥3, and F=4, respectively). Conclusion: The ElastPQ® technique is reliable and accurate for staging liver fibrosis. The number of measurements does not affect the performance. Abbreviations: ALP: alkaline phosphatase; ALT: alanine aminotransferase; AST: aspartate aminotransferase; AUROC: area under the ROC curve; BMI: body mass index; GGT: gamma-glutamyl transferase; LR: likelihood ratio; LSM: liver stiffness measurement; pSWE: point shear wave elastography; ROC: receiver operating characteristic; VCTE: vibration controlled transient elastography; VTQ®: virtual touch quantification.

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