Fibrosis assessment in patients with chronic hepatitis B virus (HBV) infection

Parikh, Pathik; Ryan, John D.; Tsochatzis, Emmanuel

doi:10.21037/atm.2017.01.28

Cited by 85 publications

(65 citation statements)

References 120 publications

(94 reference statements)

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“…31 Moreover, performance of the APRI and FIB-4 in HDV in the current study is similar to prior studies evaluating their performance in chronic HBV. 44 Thus, our findings may represent a "regression to the mean." Meanwhile, the poor performance of AAR in our study is consistent with those prior studies and the RPR score has never been investigated in HDV.…”

Section: Discussionmentioning

confidence: 83%

Vibration‐controlled transient elastography for the detection of cirrhosis in chronic hepatitis D infection

Surana

Takyar

et al. 2019

Journal of Viral Hepatitis

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Noninvasive detection of cirrhosis via vibration‐controlled transient elastography (VCTE) has revolutionized the management of chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. However, VCTE has not been studied in chronic hepatitis D virus (HDV) infection and accuracy remains in question due to the significant hepatic inflammation associated with this infection. Consecutive HBV, HCV and HDV patients who underwent VCTE (2006‐2019) were evaluated. Diagnosis of cirrhosis was made via liver biopsy or clinical findings. VCTE was compared with other noninvasive serum fibrosis tests using AUROC curves. The performance of VCTE in HBV/HCV/HDV was also compared. We evaluated 319 patients (HBV‐112; HCV‐132; HDV‐75), 278(87%) patients had histology for evaluation. HDV patients had evidence of higher hepatic inflammation as evidence by aspartate aminotransferase, alanine aminotransferase and histology activity index. Cirrhotic HDV patients had higher mean liver stiffness measurements compared with noncirrhotic patients (29.0 vs 8.3 kPa, P < .0001). VCTE demonstrated excellent diagnostic accuracy for the detection of cirrhosis with an AUROC of 0.90 compared with APRI (0.83), FIB‐4 (0.88), AAR (0.73) and RPR (0.85). Performance of VCTE in HDV was comparable with HBV (0.93) and HCV (0.94). At the optimized cut‐off value of ≥14.0 kPa for determining cirrhosis in HDV, VCTE had a sensitivity of 0.78, specificity of 0.86, NPV of 0.93 and PPV of 0.64. Hence, VCTE is a useful noninvasive test in HDV for determining cirrhosis despite the presence of significant hepatic inflammation.

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Section: Discussionmentioning

confidence: 83%

Vibration‐controlled transient elastography for the detection of cirrhosis in chronic hepatitis D infection

Surana

Takyar

et al. 2019

Journal of Viral Hepatitis

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“…Patients with smoking history (n = 1002) had higher median LSM (6.6 vs 6.3 kPa, P < 0.001) than never smokers (n = 1142). Using APRI or FIB‐4 as alternative liver fibrosis prediction markers, those with smoking history had similar median APRI score (0.36 vs 0.35, P = 0.11) but higher FIB‐4 score (1.88 vs 1.56, P < 0.001) compared to those without. As determined by LSM, significantly higher prevalence of advanced fibrosis (24.4% vs 16.5%, P = 0.001) was found in smokers than those non‐smokers.…”

Section: Resultsmentioning

confidence: 97%

Impacts of cigarette smoking on liver fibrosis and its regression under therapy in male patients with chronic hepatitis B

Xiong

Yang

et al. 2019

Liver International

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Background & Aims:The role of cigarette smoking in the development of chronic hepatitis B (CHB) remains poorly understood. We assessed the potential contributions of cigarette smoking to liver fibrosis and its regression after starting antiviral therapy in CHB patients. Methods:In this cohort study, 2144 consecutive male CHB patients under no antiviral therapy were evaluated and 206 patients with significant liver fibrosis (≥F2) initiating antiviral therapy had longitudinal follow-up. Liver fibrosis was measured by liver stiffness measurement using transient elastography. To adjust for imbalances between smoking history and never smoking groups, propensity score (PS) matching model with 1:1 ratios were performed. Cigarette smoking history and intensity (packyears) were collected and documented using a standardized questionnaire.Results: Before PS matching, 432/2144 patients had advanced fibrosis in prevalence cohort. Patients with smoking history (n = 1002) had a greater prevalence of advanced fibrosis than those without (n = 1142) (24.4% vs 16.5%, P = 0.001). Multivariate logistic regression analysis demonstrated that smoking contributed to advanced fibrosis (OR, 1.458; 95% CI, 1.114-1.908). In longitudinal cohort, multivariate logistic regression analysis demonstrated retarded fibrosis regression in patients with history of smoking ≥10 pack-years (OR, 0.288; 95% CI, 0.1-0.825). After PS matching, patients with smoking history had higher prevalence of advanced fibrosis (22.8% vs 18%, P = 0.024) than those non-smokers. In post-PS-matching logistic regression, the effect of smoking on advanced fibrosis persisted (OR, 1.415; 95% CI, 1.047-1.912; P = 0.024). Conclusions: Cigarette smoking in male CHB patients aggravated liver fibrosis prior to and delayed fibrosis regression under antiviral therapy. K E Y W O R D S advanced liver fibrosis, cigarette smoking, fibrosis regression, hepatitis B virus infection | 1429 XIONG et al.

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“…Globally, it has been estimated that 54% of HCC cases can be attributed to HBV infection [4]. HBV infection has a complex natural history, centered on the liver, where the interaction between viral proteins and the immune system leads to a cycle of hepatocyte damage and tissue repair [5]. The X protein (HBx) encoded by HBV is believed to be the major player in HBV-induced oncogenesis [6, 7].…”

Section: Introductionmentioning

confidence: 99%

Serum from Chronic Hepatitis B Patients Promotes Growth and Proliferation via the IGF-II/IGF-IR/MEK/ERK Signaling Pathway in Hepatocellular Carcinoma Cells

Ji¹,

Wang²,

Chen³

et al. 2018

Cell Physiol Biochem

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Background/Aims: Chronic hepatitis B virus (HBV) infection (CHB) plays a central role in the etiology of hepatocellular carcinoma (HCC). Emerging evidence implicates insulin-like growth factor (IGF)-II as a major risk factor for the growth and development of HCC. However, the relationship between HBV infection and IGF-II functions remains to be elucidated. Methods: Levels of circulating IGF-II and IGF-I receptor (IGF-IR) in healthy donors (HDs) and CHB patients were tested by ELISA. Human HCC cell lines (HepG-2, SMMC-7721, MHCC97-H) were incubated with serum from HDs and CHB patients at various concentrations for 24, 48, and 72 h. MTT and plate colony formation assays, BrdU ELISA, ELISA, small-interfering RNA (siRNA) transfection, quantitative real-time PCR, and western blot were applied to assess the functional and molecular mechanisms in HCC cell lines. Results: Serum levels of IGF-II and IGF-IR were significantly higher in CHB patients than in HDs. Additionally, serum from CHB patients directly induced cell growth, proliferation, IGF-II secretion, and HDGF-related protein-2 (HRP-2) and nuclear protein 1 (NUPR1) mRNA and protein expression in HCC cells. Moreover, serum from CHB patients increased IGF-II–induced cell growth, proliferation, and HRP-2 and NUPR1 mRNA and protein expression in HCC cells. Blockade of IGF-IR clearly inhibited the above effects. Most importantly, interference with IGF-II function markedly repressed the cell proliferation and HRP-2 and NUPR1 mRNA and protein expression induced by serum from CHB patients. Furthermore, serum from CHB patients induced ERK phosphorylation via IGF-IR, with the MEK inhibitor PD98059 significantly decreasing CHB patient serum-induced IGF-II secretion, cell proliferation, and HRP-2 and NUPR1 mRNA and protein expression. Conclusion: Serum from CHB patients increases cell growth and proliferation and enhances HRP-2 and NUPR1 expression in HCC cells via the IGF-II/IGF-IR/MEK/ERK signaling pathway. These findings help to explain the molecular mechanisms underlying HBV-related HCC and may lead to the development of effective therapies.

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Fibrosis assessment in patients with chronic hepatitis B virus (HBV) infection

Cited by 85 publications

References 120 publications

Vibration‐controlled transient elastography for the detection of cirrhosis in chronic hepatitis D infection

Vibration‐controlled transient elastography for the detection of cirrhosis in chronic hepatitis D infection

Impacts of cigarette smoking on liver fibrosis and its regression under therapy in male patients with chronic hepatitis B

Serum from Chronic Hepatitis B Patients Promotes Growth and Proliferation via the IGF-II/IGF-IR/MEK/ERK Signaling Pathway in Hepatocellular Carcinoma Cells

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