Advances in the diagnosis and treatment of liver fibrosis

Serum fibrosis index-based risk score predicts hepatocellular carcinoma in untreated patients with chronic hepatitis B

“…HCC surveillance was done every 6 to 12 months by ultrasound and alpha-fetoprotein (AFP) testing under the Hospital Authority. APRI, FIB-4, and Forns index were calculated as described ( Supplementary Table 1 ) [ 15 , 25 , 26 ]. We excluded the following patients: those co-infected with hepatitis C virus and/or hepatitis D virus based on ICD-9-CM diagnosis codes, viral and serological markers and/or use of antiviral therapy for hepatitis C; co-infected with human immunodeficiency virus based on ICD-9-CM diagnosis codes and/or use of antiviral therapy for human immunodeficiency virus; had other coexisting autoimmune and metabolic liver diseases based on ICD-9-CM diagnosis codes; had cancer including HCC and/or liver transplantation before or within the first 6 months after baseline date; follow-up duration less than 6 months; received rituximab and any chemotherapeutic agents ( Supplementary Tables 1 , 2 ).…”

“…APRI, FIB-4 and Forns index were calculated as described (Supplementary Table 1). 15,25,26 We excluded the following patients: those co-infected with hepatitis C virus and/or hepatitis D virus based on ICD-9-CM diagnosis codes, viral and serological markers and/or use of antiviral therapy for hepatitis C; co-infected with human immunodeficiency virus based on ICD-9-CM diagnosis codes and/or use of antiviral therapy for human immunodeficiency virus; had other coexisting autoimmune and metabolic liver diseases based on ICD-9-CM diagnosis codes; had cancer including HCC and/or liver transplantation before or within the first six months after baseline date; follow-up duration less than six months; received rituximab and any chemotherapeutic agents (Supplementary Tables 1-2). We also excluded patients with ICD-9-CM diagnosis codes of acute hepatitis B and/or positive immunoglobulin M to hepatitis B core antigen unless it was more than six months apart from a positive hepatitis B surface antigen result, patients with Child-Pugh class B or C or had any hepatic events before baseline.…”

“…The most commonly used formulae include aspartate aminotransferase (AST) to platelet ratio index (APRI), fibrosis-4 (FIB-4) index, and Forns index. 15 These serum fibrosis scores that reflected the severity of liver fibrosis could be useful to define the HCC risk of CHB patients, in particulars in those remained untreated. 16,17 Existing HCC risk scores for untreated CHB patients including the Chinese University of Hong Kong-HCC score (CU-HCC) score, the guide with age, gender, HBV DNA, core promoter mutations and cirrhosis-HCC (GAG-HCC) score (without core promoter mutation), and the risk estimation for HCC in CHB score (REACH-B) rely heavily on clinical diagnosis of cirrhosis.…”

“…A few formulae comprised of common laboratory tests have been widely used. The most commonly used formulae include aspartate aminotransferase to platelet ratio index (APRI), fibrosis-4 (FIB-4) index, and Forns index [ 15 ]. These serum fibrosis scores that reflected the severity of liver fibrosis could be useful to define the HCC risk of CHB patients, in particulars in those remained untreated [ 16 , 17 ].…”

Intravenous Umbilical Cord-derived Mesenchymal Stem Cells Transplantation Regulates Hyaluronic Acid and Interleukin-10 Secretion Producing Low-grade Liver Fibrosis in Experimental Rat

“…Liver fibrosis disrupts normal parenchyma of liver structure producing collagenous scar that finally could lead to liver cirrhosis and hepatocellular carcinoma (HCC), end-stage of liver disease; this initiates a calamity in liver tissue and occurs as a response for the noxious stimuli causing chronic liver diseases, such as viral infection, alcoholic consumption, autoimmune disease, and fatty liver ( 1 , 2 ). Liver cirrhosis and HCC have contributed to 2.5% of premature deaths worldwide, and more than 300 million people are diagnosed having one of the chronic liver diseases with viral hepatitis as the leading cause.…”