Diagnostic Performance of AFP, Autotoxin and Collagen IV and their Combinations for Non-Invasive Assessment of Hepatic Fibrosis Staging in Liver Fibrosis Patients Associated with Chronic HCV

2017 ◽  
Vol 8 (04) ◽  
Author(s):  
Entsar A. Saad ◽  
Salem A. Habib ◽  
Mona S. Eltabeey
Keyword(s):  
Liver Fibrosis ◽  
Hepatic Fibrosis ◽  
Liver Damage ◽  
Diagnostic Performance ◽  
Collagen Iv ◽  
Laboratory Assessment ◽  
Non Invasive ◽  
Significant Change ◽  
Chronic Hcv ◽  
Study Laboratory

Background: Lately, several studies have utilized non-invasive serological markers to assess liver fibrosis and some are currently being validated as potential tools to determine liver damage. Purpose: Our aim was to investigate the diagnostic performance of AFP, autotoxin and collagen IV as non-invasive biomarkers of hepatic fibrosis. Patients and methods: 45 males and 15 females with chronic hepatitis C were enrolled in the current study. Laboratory assessment was done for all subjects in form of complete blood picture, liver function test, alpha fetoprotein (AFP), collagen IV and autotaxin. Patients were grouped according to the stage of fibrosis into F1, F2 and F3. Results: Mean serum values of AFP, autotaxin and collagen IV were elevated in all patients compared to healthy controls. Surprisingly, with increasing fibrosis stage AFP showed non-significant change while collagen IV and autotoxin showed significant increase (P less than 0.01 and P less than 0.0001, respectively). Autotaxin and collagen IV were significantly (P less than 0.01 and P less than 0.05, respectively) lower in F1 patients than those with F2-F3 but AFP level showed non-significant change. Autotaxin had the highest area under ROC curve and the highest accuracy for discrimination of F1 from F2-F3 patients and for discrimination of patients with F3 from F1-F2. Different combinations between AFP, collagen IV and autotoxin showed improvement in the accuracy. Conclusion: It was concluded that serum autotaxin may at least serve as a new clinical non-invasive alternative in patients who are not candidates for liver biopsy for diagnosis of liver damage. Autotaxin combination with collagen IV and AFP addition make them more useful.

Sialylation of HCV E2 Glycoprotein-Specific and Natural Anti-Glycan (TF, αGal) Antibodies as Signatures of Liver Damage

2021 ◽  
Vol 6 (1) ◽  
Author(s):  
Kurtenkov O ◽  
◽  
Jakovleva J ◽  
Sergejev B ◽  
Geller J ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Hepatic Fibrosis ◽  
Liver Damage ◽  
Hepatic Damage ◽  
High Rate ◽  
Specific Antibodies ◽  
Non Invasive ◽  
E2 Glycoprotein ◽  
Invasive Evaluation ◽  
Hcv E2 Glycoprotein

The E2 glycoprotein is the target of broadly neutralizing antibodies against Hepatitis C Virus (HCV). There is evidence that the HCV E2-specific antibody glycosylation profile is associated with hepatic fibrosis progression. The main aim of this study was to compare the sialylation of E2-specific and naturally occurring antiglycan Abs to determine whether their combination could be beneficial for the non-invasive evaluation of hepatic damage. Fifty-eight patients with various stages of hepatic fibrosis or without were tested. The sialylation of HCV E2 glycoprotein-specific antibodies (E2-Abs), the Thomsen-Friedenreich antigen- and αGal glycotope-specific antibodies (TF-Abs, αGal-Abs) was analysed using the ELISA platform. The level of IgG Abs and their reactivity to Sialospecific Sambucus Nigra Lectin (SNA) were determined and changes in Abs sialylation were analysed based on the stage of liver fibrosis, HCV genotype and antiviral therapy efficacy. The late stage of liver Fibrosis (F4) was characterized by dramatically decreased E2-Ab SNA reactivity unlike stages with no fibrosis (P=0.003) and stages F1–F3 (P=0.0007). In contrast, antiglycan Abs showed an increased sialylation. In multiple regression analysis, the combination of E2 and TF-Abs sialylation patterns gave a significant advantage in assessing liver damage. A high rate of discrimination between F0 and F4 stages of fibrosis as well as between F1–F3 and F4 was obtained (ACC=0.948 and ACC=0.90, respectively). Thus, the combined analysis of disease-specific and natural Abs sialylation can remarkably enhance the clinical value of the approach in the non-invasive evaluation of hepatic damage.

scholarly journals Sequential Combination of FIB-4 Followed by M2BPGi Enhanced Diagnostic Performance for Advanced Hepatic Fibrosis in an Average Risk Population

2020 ◽  
Vol 9 (4) ◽  
pp. 1119 ◽  
Author(s):  
Mimi Kim ◽  
Dae Won Jun ◽  
Huiyul Park ◽  
Bo-Kyeong Kang ◽  
Yoshio Sumida
Keyword(s):  
Liver Fibrosis ◽  
Hepatic Fibrosis ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Classification Tree ◽  
Intermediate Zone ◽  
Average Risk ◽  
Advanced Fibrosis ◽  
Risk Population ◽  
Advanced Liver Fibrosis

The fibrosis-4 (FIB-4) index is the most widely used estimated formula to screen for advanced hepatic fibrosis; however, it has a considerable intermediate zone. Here, we propose an algorithm to reduce the intermediate zone and improve the diagnostic performance of screening for advanced liver fibrosis by incorporating Mac-2-binding protein glycan isomer (M2BPGi) into a FIB-4 based screening strategy in an average risk group. Four-hundred eighty-eight healthy and chronic liver disease subjects were analyzed using a 1:1 propensity score matched for age and sex. Advanced liver fibrosis (≥F3) was defined by magnetic resonance elastography (MRE, ≥3.6 kPa). Classification tree analysis was employed to improve diagnostic performance using a combination of the FIB-4 index and M2BPGi. The median serum M2BPGi levels of healthy subjects, patients without advanced fibrosis, and those with the condition were 0.48, 0.94, and 2.93, respectively. The area under the receiver operating characteristic (AUROC) curve of M2BPGi (0.918) for advanced fibrosis was the highest compared to those of the FIB-4 index (0.887), APRI (0.873), and AST/ALT ratio (0.794). When M2BPGi was incorporated following the FIB-4 index, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 87.1%, 82.5%, 54.0%, and 96.4%, respectively. Moreover, 74.3% (133/179) of cases in the intermediate zone of the FIB-4 index avoided unnecessary referrals. Two-step pathway (FIB-4 followed by M2BPGi) could reduce unnecessary referrals and/or liver biopsies in an average-risk population.

scholarly journals Non-invasive methods for the diagnosis of liver fibrosis in chronic HCV infection

2019 ◽  
Vol 17 (8) ◽  
pp. 44-47
Author(s):  
A. I. Fazulzyanova ◽  
◽  
S. V. Tkacheva ◽  
A. K. Khusainova ◽  
N. F. Gayfutdinov ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Hcv Infection ◽  
Non Invasive ◽  
Chronic Hcv Infection ◽  
Chronic Hcv

scholarly journals Identifying Possible Hepatic Fibrosis of Hepatitis B Origin Using Non-invasive Markers: A Case-control Study in the South West Region of Cameroon

2019 ◽  
pp. 1-12
Author(s):  
Kukwah Anthony Tufon ◽  
Henry Dilonga Meriki ◽  
Kwenti Emmanuel Tebit ◽  
Teuwafeu Denis Georges ◽  
Nyeke James Tony ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Hepatitis B ◽  
Hepatic Fibrosis ◽  
Case Control Study ◽  
Case Control ◽  
Non Invasive ◽  
West Region ◽  
South West ◽  
Control Study ◽  
South West Region

Aim: HBV infection is known to cause liver fibrosis as well as some extrahepatic manifestations. We aimed at assessing hematological changes and identifying possible hepatic fibrosis of Hepatitis B origin using non-invasive markers (NIMs). Study Design: A hospital-based Case-control study Place and Duration of Study: Conducted at the Buea Regional Hospital, South West Region of Cameroon from February 2016 to December 2017 Methods: We enrolled HBV infected treatment naïve patients and “healthy” controls. All participants were subjected to alanine aminotransferase (ALT) and aspartate aminotransferase (AST) measurement, Full blood count (FBC), HBsAg, anti-HBc, HIV and HCV tests. Aspartate-platelet ratio index (APRI), fibrosis based on 4 factors (FIB-4), age-platelet index (API) and AST/ALT ratio (AAR) were generated from the test results. A questionnaire was administered to collect demographic data, alcohol consumption and history of liver/kidney disease or metabolic syndrome. Results: A total of 202 cases and 202 controls were enrolled. Hematocrit (HCT) was significantly higher (p<0.001) in cases than controls. The controls had significantly higher mean values for platelet (p=0.005), neutrophil (p=0.032) and number of individuals with AST/ALT ratio (AAR) ≥1. Liver fibrosis was significantly associated with cases than controls based on APRI (OR:6.06, CI:3.59-10.24), FIB-4 (OR:5.35, CI:2.75-10.39) and API (OR:8.02, CI:1.81-35.55). Among the HBV infected cases, 69 (34.2%), 36(17.8%) and 8(4.0%) had results indicative of fibrosis from at least 2, at least 3 and all 4 NIMs respectively. AAR detected possible fibrosis in 136 HBV infected cases of which up to 77 (56.6%) were not detected as fibrosis by the other NIMs. Conclusion: HBV infection affects neutrophil percentage, HCT, PLT, APRI, FIB-4 and API in our study population. AAR did not prove to be a reliable NIM. Using at least 3 NIMs for HBV infected patients can significantly scale up their reliability for determining liver fibrosis in clinical practice.

Assessment of Liver Fibrosis after Direct-Acting Antiviral Therapy in Compensated and Decompensated HCV-related Liver Disease

2019 ◽  
Vol 4 (04) ◽  
Author(s):  
Mohammed Amin Mohammed ◽  
Nesreen Moustafa Omar
Keyword(s):  
Liver Disease ◽  
Liver Fibrosis ◽  
Virologic Response ◽  
Post Treatment ◽  
Direct Acting Antiviral ◽  
Non Invasive ◽  
Apri Score ◽  
Fibrosis Regression ◽  
Chronic Hcv ◽  
Direct Acting

Background and Aim: Successful HCV eradication was associated with significant improvement in liver histology. Direct-acting antiviral (DAAs) therapy is associated with a significantly higher rate of sustained virologic response (SVR) compared to interferon-based therapies. Several non-invasive methods have been developed and validated with robust reliability and clinical applicability. Although these non-invasive tests are valuable in evaluating hepatic fibrosis prior to HCV therapy, use of these measures in monitoring fibrosis regression after HCV eradication with DAAs is currently limited. So, the aim was to assess the impact of DAAs on fibrosis regression in chronic HCV Egyptian patients with either compensated or decompensated liver disease. Patients and Methods: A total of 228 Egyptian chronic HCV patients eligible for treatment with DAAs were enrolled in this prospective study. All subjects selected from outpatient's Hepatology clinic of Mansoura university hospital received DAAs with different regimens after consent. The endpoint was a sustained virologic response at 12 (SVR12) weeks post-treatment. All participants were evaluated non-invasively by fibrosis-4 index (FIB-4), Aspartate Aminotransferase-to-Platelet Ratio Index (APRI) score, and liver stiffness measurement (LSM) by fibroscan before DAAs treatment, at end of treatment (EOT), 6- and 12-months post-treatment. Results: SVR achieved by DAAs therapy was associated with significant improvement (p ˂0.05) of non-invasive fibrosis markers (FIB-4, APRI score, and LSM by fibroscan) from baseline compared to EOT, 6-and 12-months post-treatment among HCV patients with significant and advanced liver fibrosis. Conclusions: fibrosis regression after DAAs therapy regardless of fibrosis grade. Baseline LSM by fibroscan predicted fibrosis regression.

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