Correlation Among Three Non-Invasive Methods (Apri, Fib-4 and Transient Elastography) to Evaluate Liver Function and Stiffness in Patients With Viral Hepatitis C or Schistosomiasis Mansoni

Nascimento, Marco Antônio de Jesus; Filho, Gilmar Palomares; Andrade, Marcel Lima; Reis, André Augusto de Vasconcelos Ouro; Baiao, Kennia M. Rocha; Nascimento, Tereza Virgínia Silva Bezerra do; Pacheco, Mauricio Soares

doi:10.5216/rpt.v47i2.53679

Cited by 3 publications

(1 citation statement)

References 25 publications

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“…(FIB-4) (NASCIMENTO et al, 2018) and with the findings of US (LIMA; LACET; PARISE, 2020). Nascimento et al (2018), when investigating 17 patients with schistosomiasis 45 patients with chronic hepatitis by HCV, reported a positive correlation between the results of APRI and FIB-4 and between FIB-4 and elastography in patients with schistosomiasis, suggesting that noninvasive methods for diagnosis and monitoring of liver fibrosis in this group have good acceptance. Similarly, Lima et al…”

Section: Global Health Trends and Perspectives In Health Sciencesmentioning

confidence: 86%

Hepatic and splenic evaluation by ultrasonography and elastography of fibrosis and portal hypertension in Schistosomiasis mansoni

Santos¹,

Pereira²,

Domingues³

et al. 2023

Global Health Trends and Perspectives in Health Sciences

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Schistosomiasis is a neglected tropical disease and an important public health problem, mainly due to its magnitude and transcendence. Although most cases are characterized as a mild infection, due to its morbidity, the untreated disease can cause economic burden and incapacitation. Periportal fibrosis (PPF) is the most common complication of schistosomiasis mansoni chronic infection and a large number of deaths are mainly caused by the rupture of esophageal varices resulting from portal hypertension (non-cirrhotic). Regarding the diagnosis and assessment of PPF and portal hypertension, different methods are applied. Although wedge liver biopsy is considered the gold standard, it is not justified in non-surgical patients, whereas percutaneous liver biopsy, even considered informative, does not have sufficient sensitivity. Thus, imaging techniques such as ultrasonography, computed tomography, magnetic resonance imaging and elastography have been applied, not only to support the diagnosis of schistosomiasis, but also to assess signs of portal hypertension. In the present chapter, an evaluation of the non-invasive imaging methods currently available for the evaluation of PPF and portal hypertension in schistosomiasis was carried out. The objectivity of elastography compared to ultrasonography is emphasized, because even though ultrasound is more frequently performed, it still has the limitation of being operator-dependent. Transient elastography (TE) has been applied more and it has shown good results in differentiating clinical forms and PPF stages, in addition to presenting potential in predicting esophageal varices. On the other hand, point shear wave elastography (pSWE) has shown more promising results in the analysis of spleen stiffness, when compared to liver stiffness. Therefore, there is a need for further studies applying liver and spleen elastography in the evaluation of PPF and portal hypertension in these patients.

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Section: Global Health Trends and Perspectives In Health Sciencesmentioning

confidence: 86%

Hepatic and splenic evaluation by ultrasonography and elastography of fibrosis and portal hypertension in Schistosomiasis mansoni

Santos¹,

Pereira²,

Domingues³

et al. 2023

Global Health Trends and Perspectives in Health Sciences

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Índice APRI como marcador de fibrose hepática em pacientes com Esquistossomose Mansônica

Wyszomirska

Lacet

Carvalho

et al. 2021

Rev. Port. Saúde e Sociedade

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ResumoA Esquistossomose Mansônica pode evoluir com fibrose periportal e a detecção da fibrose vem sendo estudada. Avaliar o índice APRI em pacientes portadores de Esquistossomose Mansônica. Foram avaliados 84 pacientes com formas diferentes da doença submetidos a exames de ultrassonografia, determinação de enzimas e cálculo do índice APRI. Os dados obtidos foram submetidos à análise estatística conforme a necessidade. A média de valores do APRI na forma EHE foi de 1,27 ± 0,93; na EHI, de 1,27 ± 0,93 e na EI foi de 0,25 ± 0,04, sendo observada uma diferença significativa (p<0,0001) à medida que a fibrose avançava. Foi observado um aumento significativo do espessamento periportal ao ultrassom na forma EHE da doença em relação às demais (p<0,001). A correlação entre o ultrassom e o APRI é sugestiva de haver uma concordância significativa entre os dois. O ponto de corte de 1,7 do APRI mostrou sensibilidade e especificidade de 100%. O APRI apresentou boa performance na identificação de fibrose hepática na Esquistossomose Mansônica. Um cálculo de APRI igual ou maior que 1,7 indica uma fibrose severa, enquanto um limiar abaixo de 0,35 indica, com segurança, que não existe fibrose. É seguro usar o APRI para identificar a existência de fibrose hepática. Para a estratificação do grau de fibrose, um resultado do APRI acima de 1,7 confirma a presença de fibrose severa.

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Noninvasive diagnosis of periportal fibrosis in schistosomiasis mansoni: A comprehensive review

Santos¹,

Pereira²,

Domingues³

et al. 2022

WJH

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Schistosomiasis mansoni is a neglected disease and key public health problem, mainly due to its high prevalence, the scarcity of public policies, and the severity of some clinical forms. Periportal fibrosis (PPF) is the commonest complication of chronic schistosomiasis mansoni and its diagnosis requires different techniques. Even though wedge biopsy of the liver is considered the gold standard, it is not justified in non-surgical patients, and percutaneous liver biopsy may be informative but does not have sufficient sensitivity. Noninvasive PPF tests mostly include biological (serum biomarkers or combined scores) or physical assessments (imaging assessment of fibrosis pattern or tissue stiffness). Moreover, imaging techniques, such as ultrasound, computed tomography, magnetic resonance imaging, and elastography are applied not only to support the diagnosis of schistosomiasis, but also to assess and detect signs of portal hypertension and organ damage due to chronic schistosomiasis. A combination between a comprehensive history and physical examination with biomarkers for liver fibrosis and imaging methods seems to offer the best approach for evaluating these patients. In addition, understanding their strengths and limitations will allow a more accurate interpretation in the clinical context and can lead to greater accuracy in estimating the degree of fibrosis in patients with Schistosomiasis mansoni (S. mansoni) infection. This review will discuss the different noninvasive methods that are currently available for the evaluation of PPF in S. mansoni infection, and their application, advantages, and limitations in clinical practice.

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Correlation Among Three Non-Invasive Methods (Apri, Fib-4 and Transient Elastography) to Evaluate Liver Function and Stiffness in Patients With Viral Hepatitis C or Schistosomiasis Mansoni

Cited by 3 publications

References 25 publications

Hepatic and splenic evaluation by ultrasonography and elastography of fibrosis and portal hypertension in Schistosomiasis mansoni

Hepatic and splenic evaluation by ultrasonography and elastography of fibrosis and portal hypertension in Schistosomiasis mansoni

Índice APRI como marcador de fibrose hepática em pacientes com Esquistossomose Mansônica

Noninvasive diagnosis of periportal fibrosis in schistosomiasis mansoni: A comprehensive review

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