Fibrosis and other histological features in chronic hepatitis C virus infection: a statistical model.

Wong, Voi Shim; Wight, D. G. D.; Palmer, C.; Alexander, Graeme

doi:10.1136/jcp.49.6.465

Cited by 67 publications

(52 citation statements)

References 22 publications

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“…7,36,37 This leads to the second important observation made by Hourigan et al, that hepatic steatosis is an independent risk factor for fibrosis in HCV patients. This is consistent with previous statistical modeling data, 38 as well as with evidence that fibrosis in HCV patients correlates with lipid peroxidation, 39 a process that stimulates fibrogenesis. [40][41][42] The clinical importance of the association between fat mass, hepatic steatosis, and fibrosis is emphasized by the increasing prevalence of obesity.…”

supporting

confidence: 92%

Body composition and hepatic steatosis as precursors for fibrotic liver disease

McCullough

Falck‐Ytter

1999

Hepatology

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supporting

confidence: 92%

Body composition and hepatic steatosis as precursors for fibrotic liver disease

McCullough

Falck‐Ytter

1999

Hepatology

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“…Serum aminotransferase levels are surrogate markers of liver cell integrity [23]and the AST/ALT ratio may predict cirrhosis in patients with HCV-induced liver disease [27]. Fibrosis correlates with the prognosis of developing cirrhosis during chronic HCV infection [28]and is closely related to necroinflammatory activities in HCV infection [29]. Therefore, we suggest that the progression of HCV-induced liver cell injury deteriorates SI and not HCV infection per se.…”

Section: Discussionmentioning

confidence: 99%

Severity of HCV-Induced Liver Damage Alters Glucose Homeostasis in Noncirrhotic Patients with Chronic HCV Infection

Konrad

Zeuzem²,

Toffolo

et al. 2000

Digestion

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Background/Aims: To investigate the link between hepatitis C infection and glucose intolerance, we measured insulin sensitivity, glucose effectiveness and β-cell secretion in noncirrhotic HCV-infected patients with normal glucose tolerance according to WHO criteria as assessed by oral glucose tolerance tests. Methods: Glucose, insulin and C-peptide data from frequently sampled intravenous glucose tolerance tests were analyzed using the minimal modeling technique for glucose and C-peptide to determine insulin sensitivity, glucose effectiveness, first and second phase insulin secretion in noncirrhotic HCV-infected patients (n = 10) and in healthy control subjects (n = 10). Histological activity index (HAI) as well as the extent of fibrosis were evaluated by scoring liver biopsies. Results: Insulin sensitivity (2.72 ± 1.63 vs. 6.84 ± 1.20 10^–4 min^–1 per µU/ml, p < 0.01) and glucose effectiveness (2.29 ± 0.45 vs. 2.89 ± 0.39 10^–2 min^–1, p < 0.05) ere significantly lower in patients with HCV-induced liver disease. Insulin sensitivity was negatively related to serum alanine aminotransferase (r = –0.47, p < 0.05) and aspartate aminotransferase concentrations (r = –0.65, p < 0.05). Multiple linear regression analysis revealed a strong relation of insulin sensitivity with fibrosis score and HAI (r = –0.82, p < 0.02 for both). Second phase insulin secretion was significantly enhanced in HCV-infected patients (14.30 ± 2.04 vs. 8.29 ± 1.65 min^–1, p < 0.05). Conclusions: HCV-infected patients with normal glucose tolerance are insulin and glucose resistant. The impairment of glucose tolerance appears to be closely related with the severity of HCV-induced liver damage.

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“…This series of haemophiliac patients with chronic HCV infection who underwent liver biopsy are very typical of our overall practice (Wong et al, 1996). The majority of patients had very benign disease with stage 0, 1 or 2 fibrosis.…”

Section: Discussionmentioning

confidence: 91%

“…It is important that further longitudinal studies are performed and that factors associated with fibrosis in crosssectional analysis, e.g. piecemeal necrosis, fat and bile duct damage (Wong et al, 1996), are evaluated formally in longitudinal studies. These risk factors were rarely present in this series.…”

Section: Discussionmentioning

confidence: 99%

“…Necro-inflammatory changes (grade) and fibrosis (stage) were scored separately according to a modified scoring system (Ishak et al, 1995;Wong et al, 1996). In particular, the stage of fibrosis was zero ¼ 0; 1 ¼ confined to portal tract, 2 ¼ portal tracts plus spurs radiating into the parenchyma, 3 ¼ linkage of some portal tracts but with an intact architecture, 4 ¼ linkage of most portal tracts with architectural distortion, and 5 ¼ cirrhosis.…”

Section: Methodsmentioning

confidence: 99%

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The role for liver biopsy in haemophiliacs infected with the hepatitis C virus

et al. 1997

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Assessment of chronic hepatitis C virus infection requires a liver biopsy in most circumstances. There is a reluctance to perform liver biopsy in haemophiliacs because of a perceived risk of haemorrhage, although with adequate factor concentrate replacement in patients without factor concentrate inhibitors it should be safe. We report a 4‐year experience of liver biopsy in patients with haemophilia infected with chronic hepatitis C virus. Of 55 patients seropositive for anti‐HCV, 35 have undergone liver biopsy; the median age of this group was 33 years (range 13–68). Seven patients had a normal liver. 22 had portal tract inflammation, four with lymphoid aggregates. Mild piecemeal necrosis was observed in only two and no bile duct injury was found. 11 patients had mild mixed micro‐ and macro‐vesicular fat. 19 patients had no evidence of fibrosis despite an estimated median duration of disease of 20 years (range 8–43). In the remaining 16 patients the maximum degree of fibrosis achieved was stage III. Patients with more significant fibrosis could not be identified on the basis of ALT or HCV RNA. There were no complications of liver biopsy in this series. Liver biopsy following a well‐defined protocol in chronic hepatitis C virus haemophiliac carriers is safe in the absence of factor concentrate inhibitors. In this young group of patients without HIV infection there was no evidence of significant liver disease despite a considerable duration of disease. Performing liver biopsy allows accurate information to be given to the patient and avoids unnecessary therapy. The relative youth of this group may be important in the light of the benign histology.

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Fibrosis and other histological features in chronic hepatitis C virus infection: a statistical model.

Cited by 67 publications

References 22 publications

Body composition and hepatic steatosis as precursors for fibrotic liver disease

Body composition and hepatic steatosis as precursors for fibrotic liver disease

Severity of HCV-Induced Liver Damage Alters Glucose Homeostasis in Noncirrhotic Patients with Chronic HCV Infection

The role for liver biopsy in haemophiliacs infected with the hepatitis C virus

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