Development and validation of a model to diagnose cirrhosis in patients with hepatitis C

Kaul, Vivek; Friedenberg, Frank K.; Braitman, Leonard E.; Anis, Uzma; Zaeri, Nayere; Fazili, Javid; Herrine, Steven K.; Rothstein, Kenneth D.

doi:10.1111/j.1572-0241.2002.06040.x

Cited by 51 publications

(16 citation statements)

References 22 publications

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“…[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Our model has several notable advantages over those published previously.…”

Section: Discussionmentioning

confidence: 78%

“…Current models to predict cirrhosis have relied upon a combination of clinical features, serum biochemical tests, an array of fibrosis markers, radiological studies, and other measures of hepatic function. [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Most models were derived from small cohorts of patients, some of which included subjective variables or laboratory tests that are costly and not readily available, and very few models have been validated. Thus, all existing clinical models to predict cirrhosis in CHC patients have limitations.…”

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confidence: 99%

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Predicting cirrhosis in patients with hepatitis C based on standard laboratory tests: Results of the HALT-C cohort

Lok

Ghany

Goodman³

et al. 2005

Hepatology

298

229

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Knowledge of the presence of cirrhosis is important for the management of patients with chronic hepatitis C (CHC). Most models for predicting cirrhosis were derived from small numbers of patients and included subjective variables or laboratory tests that are not readily available. The aim of this study was to develop a predictive model of cirrhosis in patients with CHC based on standard laboratory tests. Data from 1,141 CHC patients including 429 with cirrhosis were analyzed. All biopsies were read by a panel of pathologists (blinded to clinical features), and fibrosis stage was determined by consensus. The cohort was divided into a training set (n ‫؍‬ 783) and a validation set (n ‫؍‬ 358). Variables that were significantly different between patients with and without cirrhosis in univariate analysis were entered into logistic regression models, and the performance of each model was com-

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“…[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Our model has several notable advantages over those published previously.…”

Section: Discussionmentioning

confidence: 78%

mentioning

confidence: 99%

Predicting cirrhosis in patients with hepatitis C based on standard laboratory tests: Results of the HALT-C cohort

Lok

Ghany

Goodman³

et al. 2005

Hepatology

298

229

View full text Add to dashboard Cite

show abstract

“…Since then, other extracellular matrix (ECM) polypeptides that derive from laminin, procollagen type IV, procollagen type I, procollagen type III, as well as hyaluronan were assessed with regard to their ability to predict the stage or the evolution of liver fibrosis (10). On the other hand, biochemical markers of liver function have also been evaluated as predictors of histological stage (11)(12)(13)(14)(15)(16)(17). Despite these efforts throughout 30 years, none of these serum markers has received universal acceptance, in part due to the study of heterogeneous populations and the use of insufficiently validated assays.…”

Section: Introductionmentioning

confidence: 99%

Serum connective tissue markers as predictors of advanced fibrosis in patients with chronic hepatitis B and D

Seven

Karatayli²,

Sk³

et al. 2011

Turk J Gastroenterol

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“…Liver biopsies, used to diagnose cirrhosis, were not available for the majority of our cohort. Thus, platelet counts of o100 000 cells/mL served as a surrogate marker for advanced fibrosis or cirrhosis [22,23], but this marker may be nonspecific in HIV-infected patients. …”

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confidence: 99%

Hepatitis C is associated with type 2 diabetes mellitus in HIV‐infected persons without traditional risk factors

et al. 2007

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ObjectivesHepatitis C virus (HCV) monoinfection has been linked to type 2 diabetes mellitus (DM). We evaluated the effect of HCV on risk of DM in relation to traditional risk factors such as age, body mass index (BMI) and family history of DM in an HIV-infected population. MethodsThis was a retrospective, cross-sectional study of 1529 HIV-infected out-patients. An adjusted multivariate logistic regression was performed to assess the effect of HCV seropositivity on DM stratified by low and high propensity for DM based on age, BMI and family history. ResultsRace, age, BMI, family history and HCV were associated with DM. Use of protease inhibitors (PIs) was not associated with DM, but HIV/HCV-coinfected patients were less likely to be on PIs than those with HIV infection alone. In a multivariate analysis controlled for race, the association between HCV and DM was stronger in lean, young patients without a family history of DM; the low-risk group. No association between HCV and type 2 DM was seen in patients who were older or overweight or had a family history of DM; the high-risk group. PI use did not affect the association between HCV and DM. ConclusionsHepatitis C is an independent risk factor for type 2 diabetes in young, lean, HIV-infected patients. HIV-infected patients with HCV infection, regardless of whether they are on PIs, should be carefully screened for DM even if traditional risk factors for DM are not present.Keywords: diabetes mellitus, hepatitis C virus, HIV, protease inhibitors, risk factors IntroductionType 2 diabetes mellitus (DM) is a common comorbid condition in those coinfected with HIV and the hepatitis C virus (HCV). Multiple factors may lead to the development of DM in HIV-infected persons. First, patients infected with HIV but not HCV who are taking protease inhibitors (PIs) are at increased risk for developing DM [1][2][3]. Secondly, longer duration of HIV-positive survival as a result of highly active antiretroviral therapy (HAART) leads to an older population which may contribute to the higher prevalence of DM, especially in those with HIV/HCV coinfection [4]. HCV itself has been linked to type 2 DM [5][6][7][8][9][10][11], and the higher prevalence of HCV in HIV-infected persons may also contribute to the increased prevalence of DM in the HIV-infected population [12].The association of HCV and type 2 DM is complex, with some studies suggesting that the higher prevalence of DM is a result of more severe liver disease in both the HCV-and hepatitis B virus (HBV)-infected groups [7,9,[13][14][15][16]. However, other studies have suggested that HCV may be directly involved in the development of type 2 DM or insulin resistance even in those without cirrhosis [8,[17][18][19] 491 HCV-infected persons over the age of 40 years in a nationwide cross-sectional study [11] and then in a longitudinal cohort study found that those with HCV infection were at increased risk for developing DM with increasing age and body mass index (BMI). Another nationwide crosssectional study dividing patients into yo...

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Development and validation of a model to diagnose cirrhosis in patients with hepatitis C

Abstract: In patients with hepatitis C, four readily available variables together predict cirrhosis accurately. Successful validation in hepatitis C patients at another hospital with lower prevalence of cirrhosis suggests this model's potential for broad applicability.

Cited by 51 publications

References 22 publications

Predicting cirrhosis in patients with hepatitis C based on standard laboratory tests: Results of the HALT-C cohort

Predicting cirrhosis in patients with hepatitis C based on standard laboratory tests: Results of the HALT-C cohort

Serum connective tissue markers as predictors of advanced fibrosis in patients with chronic hepatitis B and D

Hepatitis C is associated with type 2 diabetes mellitus in HIV‐infected persons without traditional risk factors

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