FibroMeter scores for the assessment of liver fibrosis in patients with autoimmune liver diseases

Zachou, Kalliopi; Lygoura, Vasiliki; Arvaniti, Pinelopi; Giannoulis, Georgios; Gatselis, Nikolaos; Koukoulis, George Κ.; Dalekos, George Ν.

doi:10.1016/j.aohep.2020.10.013

Cited by 16 publications

(13 citation statements)

References 33 publications

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“…Studies and guidelines have confirmed that there is no available evidence to validate the complete resolution of histologic inflammation. 8,34,42 While transient elastography has gained traction in the community, [43][44][45] there is currently little evidence to advocate its use in AIH currently other than as a monitoring tool. We interrogated the Delphi panel about the role of transient elastography in AIH based on data that show that transient elastography separates severe from non-severe fibrosis after 6 months or longer of immunosuppressive treatment, 30 but it was rated as less appropriate to identify a remission, and failed to gain consensus.…”

Section: Discussionmentioning

confidence: 99%

Systematic review of response criteria and endpoints in autoimmune hepatitis by the International Autoimmune Hepatitis Group

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Snijders

Gevers

et al. 2022

Journal of Hepatology

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Section: Discussionmentioning

confidence: 99%

Systematic review of response criteria and endpoints in autoimmune hepatitis by the International Autoimmune Hepatitis Group

Pape

Snijders

Gevers

et al. 2022

Journal of Hepatology

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“…A second liver biopsy before complete immunosuppression discontinuation was desirable but was not accepted by all patients. As we and others have described (29)(30)(31), in these cases, serial liver stiffness measurements (LSMs) using Fibroscan ® 502 (Echosens, Paris, France) equipped with the standard M probe performed to follow up changes of histological characteristics without liver biopsy.…”

Section: Patientsmentioning

confidence: 99%

First Results From a Propensity Matching Trial of Mycophenolate Mofetil vs. Azathioprine in Treatment-Naive AIH Patients

et al. 2022

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Background/AimsAs previous real-world studies and meta-analyses have shown that mycophenolate mofetil (MMF) might have better efficacy than azathioprine (AZA) in autoimmune hepatitis (AIH), we conducted a propensity matching study to assess the efficacy and safety of MMF vs. AZA.MethodsAll 126 consecutive treatment-naive adult AIH patients, diagnosed and followed in our department since 2016, were included. Patients received prednisolone 0.5–1 mg/kg/day plus either AZA 1–2 mg/kg/day or 1.5–2 g/day MMF. The tapering of prednisolone was identical between groups.ResultsAfter propensity matching score and adjustment for known factors affecting response to treatment and outcome, 64 patients were included in the study (MMF = 32 and AZA = 32). Rates of non-response, complete biochemical response (CBR) at 6 and 12 months, and prednisolone withdrawal (6 months, 12 months, and end of follow-up) were identical between groups. However, MMF treatment was significantly associated with CBR at the end of follow-up [odds ratio (OR) 11.259; 95% CI: 1.3–97.4, p = 0.028]. AZA patients were more prone to stop treatment due to AZA intolerance/insufficient response (p = 0.0001). At the end of follow-up, the overall efficacy of each schedule was also significantly higher in the MMF group compared to the AZA group (p = 0.0001).ConclusionWe showed for the first time in a propensity matching study that MMF can be used as first-line therapy in AIH as attested by the significantly higher CBR at end of follow-up compared to AZA. Whether this better efficacy is also associated with higher histological remission rates and sustained CBR off immunosuppression needs further evaluation.

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“…Three of 12 patients with acute HEV infection (25%) were already cirrhotic at the time of the episode of acute hepatitis. The diagnosis of cirrhosis was based on clinical or laboratory findings, including transient elastography performed after the convalescence from acute hepatitis, as we have described previously [ 34 - 37 ]. In 2 patients the cirrhosis was due to alcoholic liver disease, while the third patient was diagnosed during follow up with primary biliary cholangitis (PBC) based on persistent cholestasis that existed before the acute HEV infection and the presence of anti-mitochondrial antibodies (AMA).…”

Section: Resultsmentioning

confidence: 99%

Acute non-A, non-B, non-C hepatitis differences and similarities between hepatitis E virus infection and autoimmune hepatitis, with phylogenetic analysis of hepatitis E virus in humans and wild boars

Zachou

Azariadis

Sofia

et al. 2022

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Background Hepatitis E virus (HEV) infection incidence is increasing in Europe, accounting for the majority of acute hepatitis cases. We investigated the prevalence and clinical characteristics of acute hepatitis E (AHE) in patients with acute non-A/B/C hepatitis from central Greece, their differences from acute autoimmune hepatitis (AIH) patients and the molecular similarity of human strains to local HEV strains in wild boars. Methods Sera from 20 patients with non-A/B/C acute hepatitis (2015-2017) were tested prospectively for anti-HEV IgM, IgG antibodies and HEV-RNA. Sera from patients diagnosed with acute AIH (2000-2015; n=56) were tested retrospectively. Liver tissue samples from 40 wild boars were tested for HEV-RNA. Positive wild boar and patients’ samples were sequenced and phylogenetically analyzed. Results Twelve of the 76 (16%) patients were diagnosed with AHE: HEV-RNA 11.5x10 4 (38.7-39.7x10 6 ) IU/mL; 11/20 (55%) acute non-A/B/C hepatitis and 1/56 (2%) AIH patients. Patients with AHE were older than those without, predominately men, with higher alanine aminotransferase but lower IgG levels (P=0.005 and P=0.002, respectively), and had high titers of smooth muscle antibodies. Liver biopsies, performed in 6/12 patients with HEV infection, revealed histology compatible with AIH. HEV strains from both patients and wild boars belonged to genotype 3. Conclusions Approximately one sixth of patients with acute non-A/B/C hepatitis had autochthonous HEV infection with AIH features. Therefore, a careful workup to exclude HEV should be carried out in all acute hepatitis cases before a definite diagnosis of AIH is established. Wild boars seem to be an important reservoir of HEV in Greece.

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FibroMeter scores for the assessment of liver fibrosis in patients with autoimmune liver diseases

Cited by 16 publications

References 33 publications

Systematic review of response criteria and endpoints in autoimmune hepatitis by the International Autoimmune Hepatitis Group

Systematic review of response criteria and endpoints in autoimmune hepatitis by the International Autoimmune Hepatitis Group

First Results From a Propensity Matching Trial of Mycophenolate Mofetil vs. Azathioprine in Treatment-Naive AIH Patients

Acute non-A, non-B, non-C hepatitis differences and similarities between hepatitis E virus infection and autoimmune hepatitis, with phylogenetic analysis of hepatitis E virus in humans and wild boars

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