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transient elastography

Julia L Marcus, Leo B Hurley, Scott Chamberland, Jamila H Champsi, Laura C Gittleman, Daniel G Korn, Jennifer B Lai, Jennifer O Lam, Mary Patricia Pauly, Charles P Quesenberry, Joanna Ready, Varun Saxena, Suk Seo, David J Witt, Michael J Silverberg
BACKGROUND & AIMS: Treatment with the combination of ledipasvir and sofosbuvir for 12 weeks has been approved by the Food and Drug Administration for patients with genotype 1 hepatitis C virus (HCV) infection; some patients can be treated with an 8-week course. Guidelines recommend a 12-week treatment course for black patients, but studies have not compared the effectiveness of 8 vs 12 weeks in black patients who are otherwise eligible for an 8-week treatment regimen. METHODS: We conducted an observational study of Kaiser Permanente Northern California members with HCV genotype 1 infection who were eligible for 8 weeks of treatment with ledipasvir and sofosbuvir (treatment-naïve, no cirrhosis, no HIV infection, level of HCV RNA <6 million IU/mL) and were treated for 8 or 12 weeks from October 2014 through December 2016...
March 10, 2018: Clinical Gastroenterology and Hepatology
Alexander Gutwerk, Thomas Wex, Kerstin Stein, Cosima Langner, Ali Canbay, Peter Malfertheiner, Alexander Link
The aim of the study was to evaluate the serological rate of Helicobacter pylori ( H. pylori ) infection in patients with chronic hepatitis C virus (HCV) infection and determine any correlations with liver damage and IL28B single-nucleotide polymorphism (SNP). One hundred eighty-nine patients with chronic HCV infection were included in the study, and H. pylori status was defined based on anti- H. pylori -IgG or anti-CagA-IgG antibodies using enzyme-linked immunosorbent assay (ELISA). Liver damage was assessed using histology or transient elastography...
March 5, 2018: Journal of Clinical Medicine
Sanaa Kamal, Khaled K Aldossari, Dhalia Ghoraba, Sara Mahmoud Abdelhakam, Amgad H Kamal, Mohamad Bedewi, Leila Nabegh, Khaled Bahnasy, Tamer Hafez
Objective: Concomitant non-alcoholic fatty liver disease (NAFLD) and coeliac disease (CD) have not been adequately studied. This study investigated the frequency of CD among NAFLD patients and the clinicopathological and immunological patterns and outcome of concomitant NAFLD and CD. Design: This prospective longitudinal study screened patients with NAFLD for CD (tissue transglutaminase antibodies (TTGA); anti-TTGA and antiendomysial antibodies (EMA)). Patients with concomitant NAFLD and CD and patients with either NAFLD or CD were enrolled and followed...
2018: BMJ Open Gastroenterology
Elisabetta Degasperi, Alessio Aghemo, Stefania Paolucci, Roberta D'Ambrosio, Marta Borghi, Riccardo Perbellini, Federica Novazzi, Stella De Nicola, Giovanna Lunghi, Fausto Baldanti, Pietro Lampertico
BACKGROUND: Ombitasvir/paritaprevir-ritonavir (OBT/PTV-r) plus ribavirin (RBV) for 12 weeks in hepatitis C virus (HCV) genotype 4 patients with advanced fibrosis has been only investigated in clinical trials. AIMS: To assess safety and efficacy of OBT/PTV-r + RBV for 12 weeks in real-life HCV-4 patients with advanced fibrosis. METHODS: HCV-4 patients with advanced fibrosis consecutively receiving OBT/PTV-r + RBV for 12 weeks in a single center were enrolled...
February 12, 2018: Digestive and Liver Disease
Natsuko Kobayashi, Hiroko Iijima, Toshifumi Tada, Takashi Kumada, Masahiro Yoshida, Tomoko Aoki, Takashi Nishimura, Chikage Nakano, Ryo Takata, Kazunori Yoh, Akio Ishii, Tomoyuki Takashima, Yoshiyuki Sakai, Nobuhiro Aizawa, Hiroki Nishikawa, Naoto Ikeda, Yoshinori Iwata, Hirayuki Enomoto, Seiichi Hirota, Jiro Fujimoto, Shuhei Nishiguchi
AIM: Whether direct-acting antiviral (DAA) therapy can reduce liver fibrosis and steatosis in patients with chronic hepatitis C virus (HCV) infection remains unclear. We evaluated sequential changes in liver stiffness and steatosis using transient elastography (TE) and the TE-based controlled attenuation parameter (CAP) in patients with HCV who received DAA therapy. PATIENTS AND METHODS: A total of 57 patients with HCV who received DAA therapy and achieved sustained virological response (SVR) were analyzed...
February 28, 2018: European Journal of Gastroenterology & Hepatology
Jia-Feng Wu, Chee-Seng Lee, Wen-Hsi Lin, Yung-Ming Jeng, Huey-Ling Chen, Yen-Hsuan Ni, Hong-Yuan Hsu, Mei-Hwei Chang
We investigated the utility of transient elastography for diagnosing biliary atresia (BA) in cholestatic infants and predicting the outcome of BA. Forty-eight cholestatic infants (9-87 days of age) with direct bilirubin level > 1 mg/dL were enrolled. Liver stiffness measurement (LSM) by transient elastography was performed during the cholestasis workup, and 15 subjects were diagnosed as BA. We assessed liver histology using liver biopsies from 36 subjects and graded fibrosis status using the METAVIR score...
February 27, 2018: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Gábor Horváth, Zsuzsanna Gerlei, Judit Gervain, Gabriella Lengyel, Mihály Makara, Alajos Pár, László Rókusz, Ferenc Szalay, István Tornai, Klára Werling, Béla Hunyady
Diagnosis and treatment of hepatitis B virus (HBV) and hepatitis D virus infection mean for the patient to be able to maintain working capacity, to increase quality of life, to prevent cancer, and to prolong life expectancy, while the society benefits from eliminating the chances of further transmission of the viruses, and decreasing the overall costs of serious complications. The guideline delineates the treatment algorithms from 22 September 2017 set by a consensus meeting of physicians involved in the treatment of these diseases...
February 2018: Orvosi Hetilap
Antonio Olveira, Lourdes Domínguez, Jesús Troya, Ana Arias, Federico Pulido, Pablo Ryan, Laura María Benítez, Juan González-García, María Luisa Montes
Guidelines recommend evaluating persistent alteration of liver tests in HCV-infected patients after sustained virological response (SVR) and its influence on liver disease progression. We studied the prevalence, aetiology, associated factors, and evolutionary implications of persistent alteration of liver tests in HCV patients after direct-acting antivirals (DAA) -induced SVR. This was a prospective study of HCV-infected patients and SVR after DAA. Those with another previously diagnosed liver disease were excluded...
February 24, 2018: Journal of Viral Hepatitis
Veeral Ajmera, Rohit Loomba
Ultrasound and magnetic resonance (MR)-based elastography have demonstrated excellent performance for noninvasive staging of fibrosis in patients with nonalcoholic fatty liver disease (NAFLD); however, their ability to differentiate isolated fatty liver from nonalcoholic steatohepatitis (NASH) is unclear. In this review, the authors provide background on elastography and review the ability of elastography to discriminate between isolated steatosis and NASH. Studies with available data on the diagnosis of NASH histology are limited to vibration-controlled transient elastography and MR elastography...
February 2018: Seminars in Liver Disease
Tobias Schmidt, Constantin Schmidt, Felix N Schmidt, Sebastian Butscheidt, Haider Mussawy, Jan Hubert, Thelonius Hawellek, Nicola Oehler, Florian Barvencik, Ansgar W Lohse, Thorsten Schinke, Christoph Schramm, Michael Amling, Tim Rolvien
Primary biliary cholangitis (PBC) is known to be a major risk factor for osteoporosis reflected by a reduction of bone mineral density (BMD). However, both the extent of the macro- and microstructural alterations of bone as well as the causative factors are unknown. We have retrospectively analyzed a total of 96 patients with PBC and 53 healthy controls matched for age, sex and body mass index. In addition to dual-energy X-ray absorptiometry (DXA) measurements at the lumbar spine and hip, high-resolution peripheral quantitative computed tomography (HR-pQCT) was used to assess the geometric, volumetric and microstructural changes of bone at the distal radius and tibia...
February 22, 2018: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
Pin-Nan Cheng, Yen-Cheng Chiu, Hung-Chih Chiu, Shih-Chieh Chien
BACKGROUND: Control of hepatitis C virus infection (HCV) is an increasingly important issue. Enhancing screening coverage is necessary to discover more HCV infected subjects in community. However, a substantial population is unaware of HCV infection that needs more attention. AIM: The aims of this study were to evaluate the status of HCV infected residents in remote villages, to compare characteristics between already known and unaware HCV infection subjects, and to analyze the disease insights...
2018: PloS One
Hend Ibrahim Shousha, Rasha Ahmed Abdelaziz, Sherief Musa Azab, Marwa Khairy, Shahira Ahmed Afifi, Mai Ismael Mehrez, Mohamed Ali Eshra, Ayman Yosry Abdelrahim
BACKGROUND: Direct Acting Agents (DAAs) have high cure rate but still lack the knowledge of their effect on hepatic steatosis in chronic hepatitis C (CHC). Controlled Attenuation Parameter (CAP), evaluated with transient elastography, could help in assessment of steatosis grades. We aim to evaluate the effect of DAAs on BMI and steatosis in CHC using CAP. PATIENTS AND METHODS: This cohort study included 155 CHC Egyptian patients divided into three groups according to the DAAs regimens...
February 22, 2018: Journal of Medical Virology
Geraldine J Ooi, Arul Earnest, William W Kemp, Paul R Burton, Cheryl Laurie, Ammar Majeed, Nathan Johnson, Catriona McLean, Stuart K Roberts, Wendy A Brown
INTRODUCTION: In obese individuals, nonalcoholic fatty liver disease (NAFLD) is common but often goes undiagnosed, and therefore untreated. The presence of significant fibrosis is a key determinant of NAFLD progression, and liver steatosis has substantial cardiovascular implications. We aimed to determine the diagnostic accuracy of common noninvasive diagnostic tests for steatosis and fibrosis in the obese. METHODS: We recruited 182 severely and morbidly obese individuals undergoing bariatric surgery (age 44 ± 12 years, body mass index 45...
January 30, 2018: International Journal of Obesity: Journal of the International Association for the Study of Obesity
Elliot B Tapper, Rohit Loomba
NAFLD is a global epidemic. The prevalence of NAFLD is 20-30% in North America, northern Europe, Australia, Japan, India and China. It is crucial that patients with NAFLD receive an assessment for their risk of advanced fibrosis, which increases the risk of hepatocellular carcinoma and other complications of cirrhosis. Risk stratification that is efficient, cost-effective, patient-centred and evidence-based is one of the most important issues facing clinicians who care for those with liver disease. Given patients' preference to avoid liver biopsy, noninvasive alternatives to assess liver fibrosis are in high demand...
February 21, 2018: Nature Reviews. Gastroenterology & Hepatology
Hui-Min Wu, Li Sheng, Qi Wang, Han Bao, Qi Miao, Xiao Xiao, Can-Jie Guo, Hai Li, Xiong Ma, De-Kai Qiu, Jing Hua
AIM: To investigate the performance of transient elastography (TE) for diagnosis of fibrosis in patients with autoimmune hepatitis-primary biliary cholangitis (AIH-PBC) overlap syndrome. METHODS: A total of 70 patients with biopsy-proven AIH-PBC overlap syndrome were included. Spearman correlation test was used to analyze the correlation of liver stiffness measurement (LSM) and fibrosis stage. Independent samples Student's t -test or one-way analysis of variance was used to compare quantitative variables...
February 14, 2018: World Journal of Gastroenterology: WJG
Llorenç Caballería, Guillem Pera, Ingrid Arteaga, Lluís Rodríguez, Alba Alumà, Rosa Ma Morillas, Napoleón de la Ossa, Alba Díaz, Carmen Expósito, Dolores Miranda, Carmen Sánchez, Rosa Ma Prats, Marta Urquizu, Angels Salgado, Magda Alemany, Alba Martinez, Irfan Majeed, Núria Fabrellas, Isabel Graupera, Ramón Planas, Isabel Ojanguren, Miquel Serra, Pere Torán, Juan Caballería, Pere Ginès
BACKGROUND AND AIMS: Liver fibrosis is the main determinant of long-term outcome in chronic liver diseases. Little is known about prevalence of liver fibrosis in general population. Aim of the study was to investigate the prevalence of liver fibrosis in general adult population with unknown liver disease. METHODS: Population-based, cross-sectional study, performed in Barcelona metropolitan area. Subjects aged 18-75yr were identified randomly from citizens included in primary health care registry...
February 13, 2018: Clinical Gastroenterology and Hepatology
T Karlas, D Petroff, M Sasso, J-G Fan, Y-Q Mi, V de Lédinghen, M Kumar, M Lupsor-Platon, K-H Han, A C Cardoso, G Ferraioli, W-K Chan, V W-S Wong, R P Myers, K Chayama, M Friedrich-Rust, M Beaugrand, F Shen, J-B Hiriart, S K Sarin, R Badea, H W Lee, P Marcellin, C Filice, S Mahadeva, G L-H Wong, P Crotty, K Masaki, J Bojunga, P Bedossa, V Keim, J Wiegand
BACKGROUND: Liver fibrosis is often accompanied by steatosis, particularly in patients with non-alcoholic fatty liver disease (NAFLD), and its non-invasive characterisation is of utmost importance. Vibration-controlled transient elastography is the non-invasive method of choice; however, recent research suggests that steatosis may influence its diagnostic performance. Controlled Attenuation Parameter (CAP) added to transient elastography enables simultaneous assessment of steatosis and fibrosis...
February 15, 2018: Alimentary Pharmacology & Therapeutics
Melissa Louise Kelly, Stephen M Riordan, Rohan Bopage, Andrew R Lloyd, Jeffrey John Post
INTRODUCTION: Achievement of the 2030 World Health Organisation (WHO) global hepatitis C virus (HCV) elimination targets will be underpinned by scale-up of testing and use of direct-acting antiviral treatments. In Australia, despite publically-funded testing and treatment, less than 15% of patients were treated in the first year of treatment access, highlighting the need for greater efficiency of health service delivery. To this end, non-invasive fibrosis algorithms were examined to reduce reliance on transient elastography (TE) which is currently utilised for the assessment of cirrhosis in most Australian clinical settings...
2018: PloS One
Laurent Castera
Non-alcoholic fatty liver disease is a major cause of liver disease worldwide and the most common liver disorder in Western countries, affecting around 25% of the general population. Fibrosis is the major long-term histological prognostic criteria of this disease. Liver biopsy cannot be realistically performed in such a huge population and, moreover, has well-known limitations (invasiveness, rare but potentially life-threatening complications and sampling variability). Over the past decade, there has been a growing interest in alternative novel strategies for the non-invasive evaluation of fibrosis...
February 2018: Liver International: Official Journal of the International Association for the Study of the Liver
Shufei Zang, Jin Chen, Yu Song, Lang Bai, Jinjun Chen, Xiaoling Chi, Fangping He, Huiping Sheng, Jing Wang, Shilong Xie, Wen Xie, Yongfeng Yang, Jing Zhang, Minghua Zheng, Zhengsheng Zou, Bingyuan Wang, Junping Shi
INTRODUCTION: Vitamin E is one of the most promising agents for nonalcoholic steatohepatitis (NASH) treatment, and its drug responsiveness may be closely associated with haptoglobin (Hp) genotype. However, its efficacy and safety remain unknown in China. This clinical trial of vitamin E versus placebo for the treatment of nondiabetic patients with nonalcoholic steatohepatitis (VENS) is conducted to evaluate (a) the efficacy and safety of treatment with vitamin E softgel (300 mg/day) determined from standardized histologic scoring of liver biopsies, (b) whether treatment with vitamin E improves biochemical parameters, cytokines, anthropometric parameters, controlled attenuation parameter (CAP), and transient elastography (TE) values determined by Fibroscan and health-related quality of life (SF-36), (c) whether the efficacy of vitamin E treatment is associated with the Hp genotype in nondiabetic adults with NASH...
February 6, 2018: Advances in Therapy
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