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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.

Introduction and Aims: Hypertension in chronic hemodialysis (HD) patients ( pts) is volume dependent on up to 80% of cases. Volume assessment by bioimpedance spectroscopy (BIS) could be more accurate and better target for the treatment then just clinically assessed dry weight (DW). The studies have shown that the relative overhydration (ROH) of HD pts above 15% of their total body extracellular water (ECW), poses increased mortality risk in this population. The concept of the Active Fluid Management (AFM) has been developed and proposed for better control of ECW and less CV complications. This randomized, prospective, blinded, single-center study was aimed to evaluate the impact of active fluid management (AFM) assessed by BIS on hypertension control in HD pts during nine-month period. Methods: Study included 59 BIS naive HD pts. BIS was performed by Body Composition Monitor (BCM). In the 1. (active) group according with AFM concept, this measurement has been done every time when their average weekly overhydration (AWOH) exceeded 15% of their normal extracellular volume (ECW) and their DW was time adjusted according to the finding along with clinical judgment. In the 2. (control) group, BIS has been performed monthly and its results did not influence the clinical assessment of their DW.We registered the average blood pressure of 6 successive dialysis measurements before and after dialysis sessions, as well as the number of antihypertensive (AHT) drugs, their equivalent dose (ED) units and N-terminal brain natriuretic peptide (NTpro-BNP) at the start and after 9 months.

Introduction: Patients with severe fibrosis or cirrhosis are at high risk for liver-related complications, even after successful antiviral treatment and/or regression of fibrosis. These are the first published results concerning the role of IL-28B genotypes as predictors of the durability of sustained virological response (SVR) and long-term outcome, in patients with baseline severe fibrosis and cirrhosis caused by hepatitis C (HCV) infection. Methodology: Genetic testing for three different single nucleotide polymorphisms (SNP) near the IL28B gene, rs12979860, rs12980275 and rs8099917, was performed in 42 patients with HCV-related advanced fibrosis and cirrhosis, who achieved SVR after successful interferon-based treatment. Baseline clinical and laboratory parameters were analysed, as well as IL28B genotype association with late virological relapse, fibrosis progression and clinical outcomes. Results: The most prevalent genotypes in all three tested SNP positions were: CCrs12979860 genotype in 69% of patients, GTrs8099917 in 78.6% and GGrs12980275 in 47.6% of patients. The presence of IL28B CCrs12979860 genotype was identified as a negative predictor of late virological relapse. Further analysis did not confirm the association of other IL28B genotypes with the progression of fibrosis and clinical outcomes. Conclusions: Varying long-term prognosis in patients with HCV-related severe fibrosis and cirrhosis is due to multiple interactions between host genetic factors, virus and environment. These are first published results demonstrating the significance of IL28B CCrs12979860 genotype as a negative predictor of late virological relapse. A further investigation concerning genetic factors is necessary to identify patients under risk for late relapse, complications and unfavorable outcomes, so that they can be reevaluated and offered new treatment options.