18Feb 2017

THE PREDICTIVE VALUE OF HEPATIC ELASTOGRAPHY IN DIAGNOSIS OF HEPATIC FIBROSIS IN PATIENTS WITH CHRONIC HEPATITIS C VIRUS INFECTION.

  • Department of Internal Medicine, Faculty of Medicine, Zagazig University, Egypt.
  • Department of Diagnostic Radiology, Faculty of Medicine, Zagazig University, Egypt.
  • Department of Radiology, Faculty of Medicine, Ain Shams University, Egypt.
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Introduction: Hepatic elastography (HE) is a noninvasive technique that measures liver stiffness and is used to diagnose hepatic fibrosis. It can help patients who are thought to have early-stage disease avoid a staging liver biopsy, but only when confounding variables that increase liver stiffness are excluded. Chronic inflammation from hepatitis C virus (HCV) infection is not considered to be one of these variables. Aim of the study: To detect whether histologic and biochemical inflammation could confound the predictive value of hepatic elastography in patients with chronic hepatitis C virus infection. Patients and methods: Study population included 68 patients with HCV and METAVIR fibrosis scores of 0 – 2 in 288 patients with chronic liver disease, patients were 49.6 ± 9.0 years old, 64.3 % were male, and they had an average body mass index of 26.7 ± 4.1 kg/m2. Results: Inflammation (based on histologic analysis) and level of alanine aminotransferase (ALT) were associated with liver stiffness. The chances of a patient having a level of stiffness that indicates cirrhosis increased with grade of inflammation and level of ALT. By using a conservative 14.5-kPa cutoff for the diagnosis of cirrhosis, grade 3 inflammation had an odds ratio of 9.10 (95% confidence interval, 2.49 –33.4). Likewise, levels of ALT greater than 80 and 120 IU/L had odds ratios of 3.84 (95% confidence interval, 2.10 –7.00) and 4.10 (95% confidence interval, 2.18 –7.69), respectively. The effect of the level of ALT persisted when analysis was restricted to patients with fibrosis scores of F0 to F1. Conclusions: Patients with HCV infection and early-stage fibrosis, increased levels of ALT correlate with liver stiffness among patients in the lowest stages of fibrosis (METAVIR scores 0–2). Patients without fibrosis but high levels of ALT could have liver stiffness within the range for cirrhosis. Inflammation should be considered a confounding variable in analysis of liver stiffness.


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[Ahmed Hamouda Arnaout, Hussein Mohammed Hussein, Ahmed Abdel Aziz Elsammak and Ahmad Mohammad Ghandour. (2017); THE PREDICTIVE VALUE OF HEPATIC ELASTOGRAPHY IN DIAGNOSIS OF HEPATIC FIBROSIS IN PATIENTS WITH CHRONIC HEPATITIS C VIRUS INFECTION. Int. J. of Adv. Res. 5 (Feb). 470-476] (ISSN 2320-5407). www.journalijar.com


Ahmed Hamouda Ali Arnaout
Department of Internal Medicine, Faculty of Medicine, Zagazig University, Egypt

DOI:


Article DOI: 10.21474/IJAR01/3173      
DOI URL: http://dx.doi.org/10.21474/IJAR01/3173