Factors Associated With Hepatic Fibrosis In Patients With Chronic Hepatitis C

Hu, Shirley X; Kyulo, Namgyal L.; Xia, Victor W.; Hillebrand, Donald J.; Hu, Ke–Qin

doi:10.1097/mcg.0b013e31818be17c

Cited by 41 publications

(34 citation statements)

References 48 publications

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“…The progression of chronic hepatitis is highly variable among individuals as a result of several factors including quasispecies diversity, viral genotype, gender, age at infection, alcohol intake, diabetes, and duration of infection [48,49]. However, these viral, demographic, and environmental factors account for only a small proportion of the variability [50,51].…”

Section: Discussionmentioning

confidence: 99%

Combined effect of pro- and anti-inflammatory cytokine gene polymorphisms on susceptibility to liver cirrhosis in Tunisian HCV-infected patients

et al. 2011

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Section: Discussionmentioning

confidence: 99%

Combined effect of pro- and anti-inflammatory cytokine gene polymorphisms on susceptibility to liver cirrhosis in Tunisian HCV-infected patients

et al. 2011

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“…3,25,26 One study has suggested that antioxidant defense mechanism deteriorates with age, and leaves the liver vulnerable to oxidative stress. 27 Our finding was consistent with the literature.…”

Section: Discussionmentioning

confidence: 99%

Predictors of Liver Fibrosis in Patients with Chronic HCV Infection

Ceylan¹,

Yardimci²,

Fincancı³

et al. 2012

Turkiye Klinikleri J Med Sci

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A AB BS ST TR RA AC CT T O Ob bj je ec ct ti iv ve e: : The aim of this study was to investigate the independent variables for the degree of liver fibrosis in patients with chronic hepatitis C virus (HCV) infection. M Ma at te er ri ia al l a an nd d M Me et th ho od ds s: : In this cross-sectional retrospective study, the patients were divided in two groups as Group A (patients with fibrosis score 0-2) and Group B (patients with fibrosis score 3-4) and they were compared in terms of age, gender, body mass index, alcohol consumption, presence of diabetes, serum HCV RNA, alanine aminotransferase, gamma-glutamyl transferase, and aspartate aminotransferase, total bilirubin, albumin, globulin and alkaline phosphatase levels, prothrombin time, blood thrombocyte count, splenomegaly in ultrasonographic examination, HCV genotype and liver steatosis. R Re es su ul lt ts s: : Of 201 patients, 93 (46.3%) were males; the median age was 51 (range: 18-77) years. It was found that serum gamma-glutamyl transferase and aspartate aminotransferase levels, age, prothrombin time and the presence of splenomegaly were independent variables predictive of advanced liver fibrosis. Odds ratio and p values were 1.984 and 0.013 for gamma-glutamyl transferase, 1.633 and 0.018 for aspartate aminotransferase, 1.861 and 0.003 for age, 5.598 and 0.008 for splenomegaly and 0.541 and 0.007 for prothrombin time, respectively. C Co on nc cl lu us si io on n: : The results of this study suggested that advanced age, elevated serum gamma-glutamyl transferase and, aspartate aminotransferase levels, prolonged prothrombin time and the presence of splenomegaly are independent variables determining severe liver fibrosis. K Ke ey y W Wo or rd ds s: : Liver cirrhosis; hepacivirus Ö ÖZ ZE ET T A Am ma aç ç: : Bu çalışmanın amacı kronik hepatit C virüsü (HCV) enfeksiyonlu olgularda karaciğer fibrozunun derecesini belirleyen bağımsız değişkenleri araştırmaktı. G Ge er re eç ç v ve e Y Yö ön nt te em ml le er r: : Bu geriye dönük kesitsel çalışmada hastalar Grup A (fibroz skoru 0-2 olanlar) ve Grup B (fibroz skoru 3-4 olanlar) olarak iki gruba ayrıldı ve gruplar yaş, cinsiyet, beden kitle indeksi, alkol kullanımı, diyabet varlığı, serum HCV RNA, alanin aminotransferaz, gama-glutamil transferaz, aspartat aminotransferaz, total bilirubin, albumin, globulin ve alkalen fosfataz seviyeleri, protrombin zamanı, kan trombosit sayısı, ultrasonografide splenomegali varlığı, HCV genotip ve karaciğer yağlanması açısın-dan karşılaştırıldı. B Bu ul lg gu ul la ar r: : İkiyüz bir hastadan 93 (%46,3)'ü erkekti ve ortanca yaş 51 (alt ve üst sınırlar: 18-77 yıl) idi. Serum gama-glutamil transferaz ve aspartat aminotransferaz düzeyleri, yaş, protrombin zamanı ve splenomegalinin ileri karaciğer fibrozunu belirleyen bağımsız değişkenler olduğu bulundu. Odds oranı ve p değerleri gamaglutamil transferaz için 1,984 ve 0,013; aspartat aminotransferaz için 1,633 ve 0,018; yaş için 1,861 ve 0,003; splenomegali için 5,598 ve 0,008 ve protrombin zamanı için 0,541 ve 0,007 idi. S So on nu uç ...

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“…In such patients, overt diabetes may develop earlier than in HCV negative persons [103] . Glucose metabolism is altered by HCV at early stages of the infection, leading to insulin resistance [86] which, when combined with type 2 diabetes, accelerates liver disease progression [86,88] and reduces the response to combined pegylated interferon (PEGIFN) with Ribavirin (RBV) [104,105] , although the res ponse to regimens containing directacting antiviral (DAA) does not seem to be affected by glucose metabolism alterations [106] . Other extrahepaticassociated diseases include porphyria cutanea tarda, lichen planus, necrolytic acral erythema, sialadenitis, sicca syndrome, and autoimmune thyroiditis [96] .…”

Section: Extrahepatic Manifestationsmentioning

confidence: 99%

“…Tobacco inhalation is associated with liver affection, and consequently with increased fibrosis score [82] , whereas coffee has a protective role against fibrosis [83] and HCC [84] . Steatosis [66,85] , insulin resistance [86,87] , and type 2 diabetes [88,89] are associated with disease progression and the possibility of HCC. Iron overload is related to severe fibrosis [90] .…”

Section: Chronic Hcv -Disease Progressionmentioning

confidence: 99%

Hepatitis C genotype 4: The past, present, and future

Abdel-Ghaffar

Sira

Naghi

2015

WJH

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Hepatitis C virus (HCV) genotype (GT) 4 represents 12%-15% (15-18 million) of total global HCV infection. It is prevalent in Northern and Equatorial Africa and the Middle East, and is also present in some countries in Europe. GT-4 (and subtype 4a in particular) dominates the HCV epidemic in Egypt. In underdeveloped countries, risk factors associated with HCV infection may be due to unsafe medical practices or other factors such as familial transmission, mother's HCV status, or illiteracy. HCV prevention and control programs should include health education, increased community awareness towards the disease, controlling infection distribution in healthcare centers, proper sterilization of medical and dental instruments, and ensuring safe supply of blood and blood-products. Response rates to a 48-wk combined pegylated-interferon (PEG-IFN) and ribavirin (RBV) treatment range from 40%-69%, and HCV-GT-4 has been considered better than GT-1 but worse than GT-2 and GT-3 in treatment with PEG-IFN/RBV. However, with the introduction of the HCV-GT-1 effective protease inhibitors boceprevir and telaprevir in 2011, HCV-GT-4 became the "most difficult (GT) to treat". Recently, the direct-acting antivirals (DAAs) with pan-genotypic activities simeprevir, sofosbuvir, and daclatasvir have been recommended in triple regimens with PEG-IFN/RBV for the treatment of HCV-GT-4. An IFN-free regimen will be available for treatment of all genotypes of HCV in the near future. To date, several DAAs have been developed and are currently being evaluated in various combinations in clinical trials. As new regimens and new agents are being approved by the Food and Drug Administration, we can expect the guidelines for HCV treatment to be changed. The availability of shorter, simpler, and more tolerable treatment regimens can reduce the morbidity and mortality associated with HCV infection. With such a large number of therapeutic agents available, we can end up with a range of choices that we can select from to treat patients.

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Factors Associated With Hepatic Fibrosis In Patients With Chronic Hepatitis C

Cited by 41 publications

References 48 publications

Combined effect of pro- and anti-inflammatory cytokine gene polymorphisms on susceptibility to liver cirrhosis in Tunisian HCV-infected patients

Combined effect of pro- and anti-inflammatory cytokine gene polymorphisms on susceptibility to liver cirrhosis in Tunisian HCV-infected patients

Predictors of Liver Fibrosis in Patients with Chronic HCV Infection

Hepatitis C genotype 4: The past, present, and future

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