Clinical and Pathological Risk Factors Associated with Liver Fibrosis and Steatosis in African-Americans with Chronic Hepatitis C

Afsari, Ali; Lee, Edward; Shokrani, Babak; Boortalary, Tina; Sherif, Zaki A.; Nouraie, Mehdi; Laiyemo, Adeyinka O.; Alkhalloufi, Kawtar; Brim, Hassan; Ashktorab, Hassan

doi:10.1007/s10620-017-4626-7

Cited by 9 publications

(8 citation statements)

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“…Studies have demonstrated that patients with CHC have a higher prevalence of hepatic steatosis and dyslipidemia than healthy individuals and patients with chronic hepatitis B [9,36]. Hepatic steatosis has been implicated in hepatocellular injury, including liver fibrosis [37] and necroinflammation, in patients with CHC [38]. Afsari et al revealed that patients with any degree of hepatic steatosis, as determined using the Brunt scale, had a 1.6 times higher odds ratio of advanced liver fibrosis or cirrhosis than those without hepatic steatosis [37].…”

Section: Discussionmentioning

confidence: 99%

Effect of metabolic dysfunction on the risk of liver-related events in patients cured of hepatitis C virus

Hsu

2024

Am J Cancer Res

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The impact of metabolic dysfunction or metabolic dysfunction-associated fatty liver disease (MAFLD) on liver-related events (LREs) in patients with chronic hepatitis C (CHC) who had achieved a sustained virologic response (SVR) to direct-acting antiviral agents (DAAs) is unknown. A total of 924 patients with cured CHC and documented body mass index (BMI) were included in the analysis, and the data period was from September 2012 to April 2022. Hepatic steatosis was identified either through ultrasonography or blood biomarkers. Metabolic dysfunction was defined as the presence of overweight or obesity (BMI ≥ 23 kg/m 2 ), type 2 diabetes mellitus (DM), and metabolic dysregulation. Patients may have more than one metabolic dysfunction. Variables at 12 or 24 weeks after DAA therapy (PW12) were used to identify predictors of LREs. The median age of the 924 patients was 58 (49-65) years. Of the participants, 418 (45.2%) were male. The median BMI was 24.01 (21.78-26.73) kg/m 2 , and 174 (18.8%) patients had DM. A multivariable Cox regression analysis revealed that age, male, albumin, total bilirubin, alphafetoprotein (AFP), metabolic dysfunction (hazard ratio: 1.709, 95% confidence interval: 1.128-2.591, P = .011), and FIB-4 > 3.25 were independent predictors of LREs. Type 2 DM and metabolic dysregulation exhibited a larger time-dependent area under the receiver operating characteristic curve for LREs than did overweight or obesity. Moreover, metabolic dysfunction was identified to be an independent predictor of hepatocellular carcinoma. Metabolic dysfunction increased the risk of LREs and HCC in patients with CHC who had achieved an SVR to DAA therapy.

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Section: Discussionmentioning

confidence: 99%

Effect of metabolic dysfunction on the risk of liver-related events in patients cured of hepatitis C virus

Hsu

2024

Am J Cancer Res

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“…A study conducted on HCV-infected individuals has demonstrated that hepatic steatosis and a history of diabetes mellitus contribute to the progression of liver fibrosis [13] . Factors such as sex [14] and hypertension [15] can also influence the progression of liver fibrosis.…”

Section: Introductionmentioning

confidence: 99%

Evaluating short-term and long-term liver fibrosis improvement in hepatitis C patients post-DAA treatment

Wang,

Ma,

Zou

et al. 2024

J Biomed Res

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“…Chronic hepatitis C virus (HCV) infection can lead to liver inflammation, fibrosis, and ultimately cirrhosis and hepatocellular carcinoma (HCC). The results of previous studies suggest that older age, HIV infection, obesity, and diabetes are associated with advanced stages of fibrosis in HCV . However, these risk factors are likely interdependent and potentially exacerbated by other conditions that may contribute to liver fibrosis .…”

Section: Introductionmentioning

confidence: 99%

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confidence: 99%

Association of Obesity, Diabetes, and Alcohol Use With Liver Fibrosis Among US Adults With Hepatitis C Virus Infection

et al. 2022

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HIV infection, obesity, and diabetes are associated with advanced stages of fibrosis in HCV. [1][2][3][4][5] However, these risk factors are likely interdependent and potentially exacerbated by other conditions that may contribute to liver fibrosis. 6 Identifying patients with HCV who are at risk for advanced fibrosis is important for evidence-based, efficient HCC screening practices. We therefore examined the association of HCV, obesity, diabetes, and alcohol use with liver fibrosis by using electronic health records (EHRs) from a large database of patients with HCV seen at a safety-net hospital in Atlanta, Georgia. MethodsThis cross-sectional study was approved by the Emory University Institutional Review Board.Informed consent was waived because the research involved no more than minimal risk, the research could not practicably be carried out without the requested waiver or alteration, and the waiver would not adversely affect the rights and welfare of the subjects. The study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline.We conducted a retrospective, cross-sectional analysis of treatment-naive adults with HCV seen at Grady Memorial Hospital Liver Clinic in Atlanta, Georgia, who had index ultrasound elastography studies performed between January 1, 2018, and December 31, 2019. All data within approximately 12 months of ultrasound elastography were ascertained from EHRs. Continuous data are presented as the mean (SD) or median (IQR), and categorical data are presented as frequency distributions. To compare continuous variables, we conducted F tests or nonparametric tests for variables with nonnormal distributions and χ 2 tests for categorical variables. Data were stratified by diabetes and obesity (body mass index > 30, calculated as weight in kilograms divided by height in meters squared). The outcome variables of interest were fibrosis severity (F0/F1 to F4 stage) and steatosis severity (S0 to S3 stage). Because racial differences have been noted in liver-related outcomes such as steatosis and fibrosis, we gathered self-reported race and ethnicity data from the EHR. To explore effect modification, we investigated whether the association of diabetes with fibrosis and steatosis differed according to alcohol use, adding a multiplicative interaction term between diabetes status and alcohol use. Additional details are provided in the eMethods in the Supplement. ResultsWe identified 965 patients who underwent ultrasound elastography. Five patients were excluded because of missing data, resulting in a final sample of 960 patients with a mean (SD) age of 58.3 (10.2) years. Of these 960 patients, 632 (65.8%) were men, 761 (79.3%) were Black, 247 (25.7%) had obesity, 231 (24.0%) had diabetes, and 260 (27.1%) had a history of alcohol use. Overall fibrosis

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Clinical and Pathological Risk Factors Associated with Liver Fibrosis and Steatosis in African-Americans with Chronic Hepatitis C

Cited by 9 publications

References 51 publications

Effect of metabolic dysfunction on the risk of liver-related events in patients cured of hepatitis C virus

Effect of metabolic dysfunction on the risk of liver-related events in patients cured of hepatitis C virus

Evaluating short-term and long-term liver fibrosis improvement in hepatitis C patients post-DAA treatment

Association of Obesity, Diabetes, and Alcohol Use With Liver Fibrosis Among US Adults With Hepatitis C Virus Infection

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