Noninvasive Markers of Liver Fibrosis Are Highly Predictive of Liver-Related Death in a Cohort of HCV-Infected Individuals With and Without HIV Infection

Nunes, David; Fleming, Catherine; Offner, Gwynneth D.; Craven, Donald E.; Fix, Oren K.; Heeren, Timothy; Koziel, Margaret James; Graham, Camilla S.; Tumilty, Sheila; Skolnik, Paul R.; Stuver, Sherri O.; Horsburgh, C. Robert; Cotton, Deborah

doi:10.1038/ajg.2009.746

Cited by 136 publications

(125 citation statements)

References 41 publications

(22 reference statements)

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“…If APRI was not enrolled in the multivariate analysis, the degree of hepatic fibrosis was still an independent risk factor to predict survival. It may be attributed to the following: APRI not only serves as a surrogate for assessing the degree of hepatic fibrosis, but also reflects liver functional reserve [28] causing minimal fibrosis, which was excluded by multivariate analysis. Accordingly, APRI is a simple and powerful predictor of prognosis for patients with small HCC who underwent resection surgery.…”

Section: Discussionmentioning

confidence: 99%

Fibrosis and AST to platelet ratio index predict post-operative prognosis for solitary small hepatitis B-related hepatocellular carcinoma

Hung

Lai

et al. 2010

Hepatol Int

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Purpose Although advanced liver fibrosis is crucial in the development of hepatocellular carcinoma (HCC) for patients with chronic hepatitis B, whether it is associated with the recurrence of HCC after resection remains obscure. This study was aimed to compare the outcomes for patients with minimal or advanced fibrosis in solitary small hepatitis B virus (HBV)-related HCC.Methods This study enrolled 76 patients with small (\5 cm) solitary HBV-related HCC who underwent resection. The outcomes of patients with minimal and advanced fibrosis in non-tumor areas were compared. Serum markers were tested to assess the stage of hepatic fibrosis and to predict prognosis. Results Fourteen patients with an Ishak fibrosis score of 0 or 1 were defined as having minimal fibrosis; the remaining 62 patients were defined as having advanced fibrosis. During a follow-up period of 77.0 ± 50.7 months, 41 patients died. The overall survival rate was significantly higher (P = 0.018) and recurrence rate was lower

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Section: Discussionmentioning

confidence: 99%

Fibrosis and AST to platelet ratio index predict post-operative prognosis for solitary small hepatitis B-related hepatocellular carcinoma

Hung

Lai

et al. 2010

Hepatol Int

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“…30 Moreover, HCC has been found to occur in patients with alcohol-induced liver disease in the absence of cirrhosis 11,12 at rates as high as 19%, 11 and liver fibrosis without cirrhosis has been histologically found in HCC cases with pure alcoholic liver disease. 19 Because underlying liver fibrosis is implicated by elevated FIB-4 levels, 15,18 there is biological plausibility for FIB-4's association with HCC incidence among alcoholics. Elevated FIB-4 values may represent both LC and fibrosis without cirrhosis, which are both major risk factors for HCC.…”

Section: Discussionmentioning

confidence: 99%

Prediction of future hepatocellular carcinoma incidence in moderate to heavy alcohol drinkers with the FIB‐4 liver fibrosis index

Suh

Yun

Park³

et al. 2015

Cancer

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BACKGROUND: Although heavy alcoholics are at heightened risk for hepatocellular carcinoma (HCC), there are no guidelines that recommend HCC screening for heavy alcoholics. This study investigated FIB-4, a noninvasive and easily applicable liver fibrosis index, as a risk factor for HCC incidence among alcohol drinkers without viral hepatitis. METHODS: This retrospective cohort study included 6661 generally healthy adults who were 30 years old or older, did not have chronic viral hepatitis, and visited Seoul National University Hospital for a general, routine health evaluation. The future HCC incidence was determined from National Health Insurance medical service claims data (median follow-up, 6.2 years). RESULTS: With adjustments for age, sex, body mass index, smoking, and alcohol, compared with subjects with FIB-4 values less 1.00, subjects with FIB-4 values greater than or equal to 1.75 and less than 2.10 and subjects with FIB-4 values greater than or equal to 2.10 had adjusted hazard ratios (aHRs) of 5.18 (95% confidence interval [CI], 1.12-24.00) and 13.63 (95% CI, 3.77-49.33), respectively, for HCC incidence. This was heightened in subjects who drank more 30 g of alcohol per day: the aHRs were 8.39 (95% CI, 1.28-54.87) and 16.58 (95% CI, 3.87-71.04), respectively. FIB-4 was shown to have a higher predictive value for HCC incidence than ultrasonographically detected liver cirrhosis (C-index, 0.665 vs 0.527; P 5.044). CON-CLUSIONS: High FIB-4 is a risk factor with a high predictive value for HCC incidence, especially among moderate to heavy alcoholics (>30 g/d). FIB-4 is a readily available and probably cost-effective clinical tool with potential value for identifying subpopulations of alcoholics at particularly high risk who would benefit from regular HCC screening. Further investigations are warranted to validate our results; nonetheless, our study suggests that FIB-4 may be useful in HCC screening among alcoholics. Cancer 2015;121:3818-25.

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“…We found a small number of reports about the relationship between NILFT and SVR/non-SVR (23)(24)(25)(26)(27)(28). Absence of EVR, nonwhite race, AST/ALT ratio ≥1.0, and presence of steatosis ≥5% in liver biopsy are independent predictors of absence of SVR in patients with chronic HCV infection receiving PEG-IFN and ribavirin combination treatment (23).…”

Section: Discussionmentioning

confidence: 99%

Simple non-invasive markers as a predictor of fibrosis and viral response in chronic hepatitis C patients

Arabul

Aslan²,

Alper³

et al. 2012

Turk J Gastroenterol

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Noninvasive Markers of Liver Fibrosis Are Highly Predictive of Liver-Related Death in a Cohort of HCV-Infected Individuals With and Without HIV Infection

Abstract: Noninvasive markers of liver fibrosis are highly predictive of liver outcome in HCV-infected individuals with and without HIV coinfection. These markers seem to have a prognostic value independent of CPT and MELD.

Cited by 136 publications

References 41 publications

Fibrosis and AST to platelet ratio index predict post-operative prognosis for solitary small hepatitis B-related hepatocellular carcinoma

Fibrosis and AST to platelet ratio index predict post-operative prognosis for solitary small hepatitis B-related hepatocellular carcinoma

Prediction of future hepatocellular carcinoma incidence in moderate to heavy alcohol drinkers with the FIB‐4 liver fibrosis index

Simple non-invasive markers as a predictor of fibrosis and viral response in chronic hepatitis C patients

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