Effect of Detoxification on Liver Stiffness Assessed by Fibroscan® in Alcoholic Patients

Gelsi, Ève; Dainese, Raphaella; Truchi, Régine; Mariné-Barjoan, Eugènia; Anty, Rodolphe; Autuori, Michèle; Burroni, Sonia; Vanbiervliet, Geoffroy; Evesque, Ludovic; Chérikh, Faredj; Tran, Albert

doi:10.1111/j.1530-0277.2010.01374.x

Cited by 67 publications

(36 citation statements)

References 32 publications

(37 reference statements)

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“…They demonstrated that an AST level >100 U/L was associated with a lack of reliable diagnosis of fibrosis, whereas levels of AST lower than 100 and 50 U/L were related to high accuracy detection of F3 (only AST level < 50 U/L) and F4 fibrosis, respectively. These results have also been confirmed by other studies, in which alcohol withdrawal was associated with a significant decrease in LSM. The influence of AST in LSM might be explained by inflammation, which has been identified as a confounding factor, and by the direct relationship (except in the setting of cirrhosis) between AST levels and the amount of alcohol consumed .…”

Section: The Clinical Problem: Who and How To Evaluate And Follow Forsupporting

confidence: 89%

Noninvasive diagnosis in alcohol‐related liver disease

Hadefi

Degré

Trépo

et al. 2020

Health Science Reports

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Background Alcohol‐related liver disease (ALD) represents a major cause of death worldwide, and unfortunately, most patients are diagnosed at an advanced stage of the disease, which is related to poorer outcomes. Liver biopsy has historically been the gold standard for identifying advanced hepatic fibrosis, but this approach has several limitations, including invasiveness, low applicability, sampling variability, and cost. Main Text In order to detect earlier features of advanced liver fibrosis, surrogate biomarkers and techniques have been developed. While these were initially developed for chronic liver diseases such as viral hepatitis and nonalcoholic fatty liver disease (NAFLD), their performance in ALD has also been recently studied. Among the noninvasive surrogate markers and techniques used to detect liver fibrosis, the Enhanced Liver Fibrosis test, FibroTest, and Transient Elastography are the most accurate and validated techniques. In this review, we summarize the current status of the noninvasive assessment of liver disease in ALD and provide a synthesis of how these noninvasive tools can be used in clinical practice. Finally, we briefly outline novel biomarkers that are currently being investigated and discuss future directions and new opportunities in the noninvasive diagnosis of ALD.

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Section: The Clinical Problem: Who and How To Evaluate And Follow Forsupporting

confidence: 89%

Noninvasive diagnosis in alcohol‐related liver disease

Hadefi

Degré

Trépo

et al. 2020

Health Science Reports

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“…In patients with ALD, liver stiffness correlates with the stage of fibrosis,84 but elevated values need to be interpreted with caution in patients with ALD and AST serum levels >100 U/L due to the possibility of falsely elevated liver stiffness as a result of inflammation-related liver congestion. Moreover, recent alcohol consumption can also increase liver stiffness, perhaps related to the vasodilatory effects of alcohol 85. Imaging techniques can also be used to assess the severity of ALD.…”

Section: Clinical Management Of Aldmentioning

confidence: 99%

Pathophysiology and Management of Alcoholic Liver Disease: Update 2016

et al. 2017

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Alcoholic liver disease (ALD) is a leading cause of cirrhosis, liver cancer, and acute and chronic liver failure and as such causes significant morbidity and mortality. While alcohol consumption is slightly decreasing in several European countries, it is rising in others and remains high in many countries around the world. The pathophysiology of ALD is still incompletely understood but relates largely to the direct toxic effects of alcohol and its main intermediate, acetaldehyde. Recently, novel putative mechanisms have been identified in systematic scans covering the entire human genome and raise new hypotheses on previously unknown pathways. The latter also identify host genetic risk factors for significant liver injury, which may help design prognostic risk scores. The diagnosis of ALD is relatively easy with a panel of well-evaluated tests and only rarely requires a liver biopsy. Treatment of ALD is difficult and grounded in abstinence as the pivotal therapeutic goal; once cirrhosis is established, treatment largely resembles that of other etiologies of advanced liver damage. Liver transplantation is a sound option for carefully selected patients with cirrhosis and alcoholic hepatitis because relapse rates are low and prognosis is comparable to other etiologies. Still, many countries are restrictive in allocating donor livers for ALD patients. Overall, few therapeutic options exist for severe ALD. However, there is good evidence of benefit for only corticosteroids in severe alcoholic hepatitis, while most other efforts are of limited efficacy. Considering the immense burden of ALD worldwide, efforts of medical professionals and industry partners to develop targeted therapies in ALF has been disappointingly low.

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“…Of note, elevated liver stiffness values in patients with ALD and AST serum levels >100 U/L should be interpreted with caution because of the possibility of falsely elevated liver stiffness as a result of superimposed ASH [58]. Moreover, recent alcohol consumption can also elevate liver stiffness, perhaps related to the vasodilatory effects of alcohol [59]. Imaging techniques can also be used to assess the severity of ALD.…”

Section: Diagnosis Of Alcoholic Liver Diseasementioning

confidence: 99%

Trends in the management and burden of alcoholic liver disease

Mathurin

Bataller

2015

Journal of Hepatology

263

197

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SummaryAlcoholic liver disease (ALD) is the most prevalent cause of advanced liver disease in Europe and is the leading cause of death among adults with excessive alcohol consumption. There is a dose-response relationship between the amount of alcohol consumed and the risk of ALD. The relative risk of cirrhosis increases in subjects who consume more than 25 g/day. The burden of alcohol-attributable liver cirrhosis and liver cancer is high and is entirely preventable. Health agencies should develop population-based policies to reduce the prevalence of harmful and/or hazardous alcohol consumption and foster research in this field to provide new diagnostic and therapeutic tools. Disease progression of patients with ALD is heavily influenced by both genetic and environmental factors. Non-invasive methods for the diagnosis of fibrosis have opened new perspectives in the early detection of advanced ALD in asymptomatic patients. Alcoholic hepatitis, the most severe form of ALD, carries a high short-term mortality (around 30–50% at 3 months). Corticosteroids improve short-term survival in patients with severe alcoholic hepatitis but duration of therapy should be adapted to early response. Liver transplantation is the best option for patients with severe liver dysfunction. However, alcohol relapse after transplantation remains a critical issue and drinking habits of transplanted patients need to be routinely screened.

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Effect of Detoxification on Liver Stiffness Assessed by Fibroscan® in Alcoholic Patients

Abstract: TE in alcoholics is influenced by major variations in the biochemical activity of the disease. The kinetics of variation of TE suggest that this method may be useful to assess alcohol abuse and control.

Cited by 67 publications

References 32 publications

Noninvasive diagnosis in alcohol‐related liver disease

Noninvasive diagnosis in alcohol‐related liver disease

Pathophysiology and Management of Alcoholic Liver Disease: Update 2016

Trends in the management and burden of alcoholic liver disease

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