Evaluation of fibrosis with noninvasive biochemical tests in chronic viral hepatitis B

Barutçu, Sezgin

doi:10.14744/hf.2022.2022.0025

Cited by 4 publications

(6 citation statements)

References 22 publications

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“…Therefore, the ULN of the new staging method for ALT was selected from the relatively recognized domestic and international 30 IU/mL for males and 19 IU/mL for females ( 17 ). There are various non-invasive alternative indicators for liver fibrosis, among which FIB-4 is easy to use and widely recognized for its evaluation efficacy ( 18 ). FIB-4, in addition to evaluating the degree of liver fibrosis, is also useful in predicting HCC risk and even liver disease-related death ( 19 ).…”

Section: Discussionmentioning

confidence: 99%

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eALT-F: A New Non-Invasive Staging Method to Identify Medium to High-Risk Patients with HCC from Ultra-High HBV Viral Load Population — China, 2010–2023

Zheng,

Wang,

Wang

et al. 2023

China CDC Weekly

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Background The objective of this study was to examine the clinical characteristics of individuals with ultra-high hepatitis B virus (HBV) viral load and develop a novel staging method for chronic hepatitis B (CHB) that can more effectively identify patients with medium to high hepatocellular carcinoma (HCC) risk. Methods A total of 2,118 patients with HBV DNA >1×10 7 IU/mL who visited Peking University People’s Hospital between January 2010 and March 2023 were enrolled retrospectively. Clinical data from the first visit were obtained and analyzed. The traditional phases and new ‘eALT-F’ stages were compared to evaluate the risk of HCC. Results In the overall patients, more than one-third of the patients were under 30 years old. Additionally, a small proportion of older people (>60 years) also had ultra-high HBV viral load (4.3%). 9.1% and 6.7% of individuals with ultra-high HBV viral load showed FIB-4>3.25 and aMAP≥50, respectively. In the traditional stages of CHB, which are based on HBeAg and alanine aminotransferase (ALT) [the upper limit of normal (ULN) ALT level at 40 IU/L for both men and women], regardless of phase, a certain proportion of patients were at risk of developing HCC (4.1%, 6.4%, 25.0%, and 20.3%). However, in the new ‘eALT-F’ stages, which are based on HBeAg, ALT (the ULN of ALT level at 30 IU/L for men and 19 IU/L for women), and/or FIB-4 levels (>1.45), aMAP≥50 was only observed in chronic hepatitis patients with positive or negative HBeAg (6.4% and 22.1%, respectively). Conclusions The ‘eALT-F’ staging method, based on HBeAg, ALT (males: the ULN of ALT was 30 IU/L, females: 19 IU/L) and/or FIB-4 levels, was more effective in identifying medium to high-risk patients with HCC from patients with ultra-high HBV viral load than the traditional staging methods.

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Section: Discussionmentioning

confidence: 99%

“…>3.25 IU/mL for females (17). There are various non-invasive alternative indicators for liver fibrosis, among which FIB-4 is easy to use and widely recognized for its evaluation efficacy (18).…”

Section: Discussionmentioning

confidence: 99%

eALT-F: A New Non-Invasive Staging Method to Identify Medium to High-Risk Patients with HCC from Ultra-High HBV Viral Load Population — China, 2010–2023

Zheng,

Wang,

Wang

et al. 2023

China CDC Weekly

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“…Guidelines on the use of non-invasive tests have been published by the European Association for the Study of the Liver [ 47 ], emphasising their value in diagnosing and classifying chronic liver disease. Numerous studies have demonstrated the accuracy with which non-invasive models, such as the FIB-4 and APRI indices [ 45 ], the ALT, Age, PLT, and LS model [ 48 ], the AAR, API, APRI, KING, Zeugma scores, and Hudu’s score [ 49 , 50 ], can evaluate liver histology and forecast substantial liver injury. It has been discovered that these non-invasive models exhibit remarkable accuracy, with values of the area under the curve ranging from 0.595 to 0.870 [ 51 , 52 ].…”

Section: Prognostic Markersmentioning

confidence: 99%

A critical review of diagnostic and prognostic markers of chronic hepatitis B infection

Hudu,

Shinkafi,

Jimoh

2024

Medical Review

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A major worldwide health concern, chronic hepatitis B necessitates precise prognostic and diagnostic indicators for clinical guidance. This article highlights the clinical importance and current issues of the major markers used in both the detection and prognosis of chronic hepatitis B. An important indicator of an ongoing and persistent infection is the hepatitis B surface antigen. Hepatitis B virus DNA quantification monitoring aids in assessing viral load and hepatic cancer risk. While limited evidence of liver damage is provided by alanine aminotransferase levels, the hepatitis B core antibody verifies acute infection. Seroconversion to the hepatitis B e antibody is linked to a lower risk of disease development, and the hepatitis B e antigen status is a critical prognostic factor. Treatment choices are guided by a biopsy of the liver or minimally invasive liver fibrosis detection. Genotypes of the hepatitis B virus and host variables influence the prognosis by adding to the disease’s variability. Noninvasive techniques to evaluate the severity of the disease are provided by serum markers of fibrosis, such as the fibrosis score based on four criteria and the aspartate aminotransferase-to-platelet ratio index. The requirement for indicators that distinguish between distinct viral phases and increase specificity in evaluating liver damage is one of the challenges facing chronic hepatitis B research. Even though it is quite difficult to find reliable biomarkers for resistance especially when it comes to hepatocellular cancer risk estimation, there are advanced methods, which include imaging and omics that can help in improving the accuracy of the diagnostics and prognosis. Interventions early point that improve patient outcomes are made possible using diagnostics and prognostics as they are quite effective in managing the complicated landscape of chronic hepatitis B. Key in addressing these challenges today and improving the diagnostic and prognostic markers in the future, particularly those that would support the development of successful treatment plans for people living with chronic hepatitis B virus (HBV), are scientific research, technological advances and collaborations.

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“…Recently, studies also have shown that miRNAs, the single-stranded, non-coding RNAs containing 21 to 23 nucleotides, are involved in the pathogenesis of liver fibrosis, which are potential biomarkers for diagnosing liver fibrosis and therapeutic targets for liver fibrosis treatment[ 92 ]. The methods for liver fibrosis diagnosis have been reviewed in some recent publications[ 93 - 96 ]. Here, we will not discuss more details and will focus on the treatment options for liver fibrosis.…”

Section: Current Diagnosis For Liver Fibrosismentioning

confidence: 99%

Treatment of liver fibrosis: Past, current, and future

Zhang¹,

Liu²,

Yang³

2023

World J Hepatol

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Liver fibrosis accompanies the progression of chronic liver diseases independent of etiologies, such as hepatitis viral infection, alcohol consumption, and metabolic-associated fatty liver disease. It is commonly associated with liver injury, inflammation, and cell death. Liver fibrosis is characterized by abnormal accumulation of extracellular matrix components that are expressed by liver myofibroblasts such as collagens and alpha-smooth actin proteins. Activated hepatic stellate cells contribute to the major population of myofibroblasts. Many treatments for liver fibrosis have been investigated in clinical trials, including dietary supplementation ( e.g. , vitamin C), biological treatment ( e.g. , simtuzumab), drug ( e.g. , pegbelfermin and natural herbs), genetic regulation ( e.g. , non-coding RNAs), and transplantation of stem cells ( e.g. , hematopoietic stem cells). However, none of these treatments has been approved by Food and Drug Administration. The treatment efficacy can be evaluated by histological staining methods, imaging methods, and serum biomarkers, as well as fibrosis scoring systems, such as fibrosis-4 index, aspartate aminotransferase to platelet ratio, and non-alcoholic fatty liver disease fibrosis score. Furthermore, the reverse of liver fibrosis is slowly and frequently impossible for advanced fibrosis or cirrhosis. To avoid the life-threatening stage of liver fibrosis, anti-fibrotic treatments, especially for combined behavior prevention, biological treatment, drugs or herb medicines, and dietary regulation are needed. This review summarizes the past studies and current and future treatments for liver fibrosis.

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Evaluation of fibrosis with noninvasive biochemical tests in chronic viral hepatitis B

Cited by 4 publications

References 22 publications

eALT-F: A New Non-Invasive Staging Method to Identify Medium to High-Risk Patients with HCC from Ultra-High HBV Viral Load Population — China, 2010–2023

eALT-F: A New Non-Invasive Staging Method to Identify Medium to High-Risk Patients with HCC from Ultra-High HBV Viral Load Population — China, 2010–2023

A critical review of diagnostic and prognostic markers of chronic hepatitis B infection

Treatment of liver fibrosis: Past, current, and future

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