Modeling hepatic fibrosis in African American and Caucasian American patients with chronic hepatitis C virus infection

Fontana, Robert J.; Kleiner, David E.; Bilonick, Richard A.; Terrault, Norah A.; Afdhal, Nezam H.; Belle, Steven H.; Jeffers, Lennox J.; Ramcharran, Darmendra; Ghany, Marc G.; Hoofnagle, Jay H.

doi:10.1002/hep.21335

Cited by 52 publications

(40 citation statements)

References 48 publications

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“…In support of this, our model performed better in subjects without fragmented biopsies and in patients with larger biopsy samples (Table 4). 35,36 The serum fibrosis markers also correlated with the log-hepatic collagen content as determined by computerized morphometry. Prior studies have shown that morphometry is more sensitive for detecting changes in total hepatic fibrosis during antiviral therapy compared to light microscopy and strongly correlates with chemical determination of liver hydroxyproline content.…”

Section: Discussionmentioning

confidence: 92%

Relationship of serum fibrosis markers with liver fibrosis stage and collagen content in patients with advanced chronic hepatitis C

Fontana¹,

Goodman²,

Dienstag³

et al. 2008

Hepatology

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162

117

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This study determined the utility of a panel of serum fibrosis markers along with routine laboratory tests in estimating the likelihood of histological cirrhosis in a cohort of prior nonresponders with chronic hepatitis C. The relationship between serum markers and quantitative hepatic collagen content was also determined. Liver biopsy samples from 513 subjects enrolled in the HALT-C trial were assigned Ishak fibrosis scores. The collagen content of 386 sirius-red stained, nonfragmented biopsy samples was quantified using computerized morphometry. Serum tissue inhibitor of matrix metalloproteinase-1 (TIMP-1), amino-terminal peptide of type III procollagen (PIIINP), hyaluronic acid (HA), and YKL-40 levels were determined using commercially available assays.Sixty-two percent of patients had noncirrhotic fibrosis (Ishak stage 2-4) whereas 38% had cirrhosis (

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Section: Discussionmentioning

confidence: 92%

Relationship of serum fibrosis markers with liver fibrosis stage and collagen content in patients with advanced chronic hepatitis C

Fontana¹,

Goodman²,

Dienstag³

et al. 2008

Hepatology

Self Cite

162

117

View full text Add to dashboard Cite

show abstract

“…The series that did not demonstrate differences by ethnicity tended to be prospective studies of patients being evaluated for treatment. Among the latter group of studies, two are from the same overall patient population [15,18]. Treatment populations often exclude patients with decompensated liver disease, therefore excluding the population of patients with the most aggressive disease.…”

Section: Hcv Progression and Disease Severitymentioning

confidence: 99%

Ethnic and Racial Differences in the Natural History of Hepatitis C

Kallwitz

2010

Curr Hepatitis Rep

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Hepatitis C virus (HCV) infection is common in the UnitedStates and affects all ethnic groups. Important ethnic disparities exist in HCV severity, response to treatment, and progression after liver transplantation. Among patients with chronic HCV, African Americans tend to have less severe disease histologically, whereas Hispanics appear to have a more aggressive disease course compared with non-Hispanic Whites. In contrast, new data suggest that African Americans have more rapid HCV progression after liver transplantation relative to other ethnic groups. African Americans and Hispanics have lower sustained virologic response rates to pegylated interferon and ribavirin compared with non-Hispanic Whites. Awareness of these differences will help clinicians counsel diverse populations of patients on risk of progression, treatment outcome, and expectations after liver transplant. Future investigations of these differences should help in identifying mechanisms behind observed disparities and interventions to improve outcomes.

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“…These data were used to calculate the following, previously validated fibrosis scores: aminotransferase to platelet ratio index (APRI), [10] Forns, [11] Vira-HepC, [12] Fibroindex, [13] Lok Index, [14] Göteborg University Cirrhosis Index (GUCI), [15] and Fib-4. [16] The upper limits of normal for AST and ALT used in the calculations were 19IU/ml for women and 30IU/ml for men.…”

Section: Calculation Of Fibrosis Scoresmentioning

confidence: 99%

Utility of electronic medical recordbased fibrosis scores in predicting advanced cirrhosis in patients with hepatitic C virus infection

Khan

Anand

Hessefort

et al. 2017

Journal of Translational Internal Medicine

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Objective: To determine whether advanced cirrhosis -defined by the detection of nodular liver contours or portal venous collaterals on imaging studies -could be predicted by fibrosis algorithms, calculated using laboratory and demographic features extracted from patients' electronic medical records. To this end, we compared seven EMR-based fibrosis scores with liver imaging studies in a cohort of HCV patients. Methods: A search of our health system's patient data warehouse identified 867 patients with chronic HCV infection. A total of 565 patients had undergone at least one liver imaging study and had no confounding medical condition affecting the imaging features or fibrosis scores. Demographic and laboratory data were used to calculate APRI, Fib4, Fibrosis Index, Forns, GUCI, Lok Index and Vira-HepC scores for all viremic patients who had undergone liver imaging. Data points selected for the calculation of these scores were based on laboratory results obtained within the shortest possible time from the imaging study. Areas under the receiver operating curves (AUROC), optimum cut-offs, sensitivities, specificities and positive and negative predictive values were calculated for each score. Results: Seven algorithms were performed similarly in predicting cirrhosis. Sensitivities ranged from 0.65 to 1.00, specificities from 0.67 to 0.90, positive predictive values from 0.33 to 0.38, and negative predictive values from 0.93 to 1.00. No individual test was superior, as the confidence intervals of all AUROCs overlapped. Conclusions: EMR-based scoring systems performed relatively well in ruling out advanced, radiologically-defined cirrhosis. However, their moderate sensitivity and positive predictive values limit their reliability for EMR-based diagnosis.

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Modeling hepatic fibrosis in African American and Caucasian American patients with chronic hepatitis C virus infection

Abstract: Assessment of histological stage is an integral part of disease management in patients infected with the hepatitis C virus (HCV).

Cited by 52 publications

References 48 publications

Relationship of serum fibrosis markers with liver fibrosis stage and collagen content in patients with advanced chronic hepatitis C

Relationship of serum fibrosis markers with liver fibrosis stage and collagen content in patients with advanced chronic hepatitis C

Ethnic and Racial Differences in the Natural History of Hepatitis C

Utility of electronic medical recordbased fibrosis scores in predicting advanced cirrhosis in patients with hepatitic C virus infection

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