To forestall complications such as cirrhosis and hepatocellular cancer, prompt diagnosis and treatment of chronic hepatitis B (CHB) are vital. An invasive, sophisticated, and costly method, liver biopsy, holds the distinction of being the gold standard for fibrosis identification. Through this study, the aim was to determine the impact of these examinations in forecasting liver fibrosis and determining subsequent treatment procedures.
A retrospective review of patient data from the Gastroenterology Department at Gaziantep University, encompassing 1051 cases diagnosed with CHB between 2010 and 2020, was performed. To establish the diagnosis, AAR, API, APRI, FIB-4, KING score, and FIBROQ score calculations were completed at the time of onset. Additionally, the formula known as the Zeugma score, believed to display superior sensitivity and specificity, was determined. Patients' biopsy results were correlated with their noninvasive fibrosis scores.
This study observed area under the curve values of 0.648 for API, 0.711 for APRI, 0.716 for FIB-4, 0.723 for KING, 0.595 for FIBROQ, and 0.701 for Zeugma (p < 0.005). The AAR score showed no statistically meaningful change. The KING, FIB-4, APRI, and Zeugma scores emerged as the most reliable indicators of advanced fibrosis. In predicting advanced fibrosis, cutoff values for KING, FIB-4, APRI, and Zeugma scores were 867, 094, 1624, and 963, demonstrating sensitivities of 5052%, 5677%, 5964%, and 5234%, and specificities of 8726%, 7496%, 7361%, and 7811%, respectively, achieving statistical significance (p<0.005). Our study examined the relationship between globulin and GGT levels and fibrosis, which is part of the Zeugma score formula. Fibrosis patients demonstrated significantly higher mean values for globulin and GGT (p<0.05). Globulin and GGT levels were statistically significantly correlated with the presence of fibrosis, with p-values less than 0.005 (r=0.230 and r=0.305, respectively).
The KING score stood out as the most trustworthy noninvasive approach for the identification of hepatic fibrosis in chronic HBV patients. Evaluation of liver fibrosis effectiveness was also observed with the use of FIB-4, APRI, and Zeugma scores. Hepatic fibrosis detection exceeded the capacity of the AAR score, as demonstrated. NSC 167409 supplier The Zeugma score, a novel and noninvasive test for liver fibrosis, is a practical and easy-to-use tool, offering improved accuracy over AAR, API, and FIBROQ in chronic HBV patients.
The KING score's effectiveness in non-invasively detecting hepatic fibrosis in individuals with chronic hepatitis B was conclusively established. Significant in the assessment of liver fibrosis were the FIB-4, APRI, and Zeugma scores. Evidence suggests that the AAR score was insufficient to reliably identify the presence of hepatic fibrosis. A useful and easily applicable noninvasive test, the Zeugma score, evaluates liver fibrosis in patients with chronic HBV, achieving superior accuracy compared to the AAR, API, and FIBROQ methods.
Characterized by hypersplenism, portal hypertension, and splenomegaly, heptoportal sclerosis, or HPS, is an idiopathic form of non-cirrhotic portal hypertension, or INCPH. The most widespread type of liver cancer is, without a doubt, hepatocellular carcinoma (HCC). In exceedingly uncommon cases, non-cirrhotic portal hypertension is a contributing factor to the onset of hepatocellular carcinoma. Esophageal varices in a 36-year-old woman prompted a referral to our hospital for further evaluation. The etiology was investigated through serological tests, all of which were negative. Normal serum ceruloplasmin and serum immunoglobulin A, M, and G concentrations were observed. A triple-phase computer scan, conducted as a follow-up, indicated the presence of two liver lesions. Despite arterial enhancement in the lesions, no washout was noted in the venous phase. During the magnetic resonance imaging procedure, a lesion exhibited characteristics suggestive of hepatocellular carcinoma (HCC). Initial application of radiofrequency ablation therapy targeted a patient exhibiting no evidence of metastatic spread. A living donor liver transplant was successfully carried out on the patient within the two months. Well-differentiated hepatocellular carcinoma (HCC) and hepatic progenitor cell sarcoma (HPS) were identified in explant pathology studies as the underlying causes of non-cirrhotic portal hypertension. The patient, under observation for three years, exhibited no recurrence of the ailment. Whether HCC develops in INCPH patients is a point of ongoing debate. Liver cell atypia and pleomorphism are observed in nodular regenerative hyperplasia liver samples, but a causative association between these and hepatocellular carcinoma remains to be established.
To ensure favorable long-term outcomes post-liver transplant, HBV reinfection prevention is crucial. Hepatitis B immunoglobulin (HBIG) is utilized for (i) those with pre-existing hepatitis B disease, (ii) those with positive hepatitis B core antibodies (HBcAb), or (iii) those who received organs with a positive hepatitis B core antibody (HBcAb) status. Nucleos(t)ide analogue (NA) single-agent therapy is increasingly employed for patients in this clinical situation. There's no widespread consensus regarding the ideal HBIG dosage level. This study sought to assess the effectiveness of a low dosage of HBIG (1560 international units [IU]) in preventing HBV infection following liver transplantation.
A comprehensive analysis of HBcAb-positive patients who received either HBcAb-positive or hepatitis B core antibody-negative (HBcAb-negative) organs and HBcAb-negative patients receiving HBcAb-positive organs was conducted from January 2016 to December 2020. Prior to LT, samples for hepatitis B virus serology were collected. Prophylactic measures against hepatitis B virus (HBV) involved the administration of nucleotide/nucleoside analogues (NAs), optionally supplemented by hepatitis B immune globulin (HBIG). The criteria for HBV recurrence, established by the one-year post-liver transplant (LT) follow-up, was HBV deoxyribonucleic acid (DNA) positivity. There was no assessment of HBV surface antibody titer levels.
The study encompassed a total of 103 patients, with a median age of 60 years. The most prevalent cause of the condition was Hepatitis C virus. For 37 recipients lacking HBcAb and 11 recipients positive for HBcAb but with undetectable HBV DNA, HBcAb-positive organs were procured. Prophylaxis involved four doses of low-dose HBIG and NA. Within one year, none of the recipients in our cohort showed a return of HBV.
Low-dose HBIG, administered at 1560 IU over four days, appears to effectively prevent HBV reinfection in HBcAb-positive recipients and donors during the post-LT period, alongside NA. Additional trials are needed for the validation of this observation.
Post-LT, the administration of low-dose HBIG (1560 IU) over four days, in conjunction with NA, seems to prevent HBV reinfection in recipients and donors who test positive for HBcAb. To validate this observation, additional trials are necessary.
Chronic liver disease (CLD) is a pervasive and devastating health concern worldwide, impacting individuals with various underlying causes. A FibroScan scan to measure liver stiffness.
To assess the evolution of fibrosis and steatosis, this is employed. This study, focused on a single center, aims to assess the varied justifications for FibroScan referrals.
.
CLD etiologies, demographic characteristics, and FibroScan findings are significant facets to consider in comprehensive analyses.
Patient parameters for those directed to our tertiary care center between 2013 and 2021 were subject to a retrospective evaluation.
Of the 9345 patients, 4946 were male, comprising 52.93% of the total, with a median age of 48 years, ranging from 18 to 88 years. Nonalcoholic fatty liver disease (NAFLD) had the highest count, at 4768 (51.02%), and was the most common indication. Hepatitis B followed closely, comprising 3194 (34.18%) cases. Finally, hepatitis C showed the lowest frequency, with 707 (7.57%) cases. Controlling for age, sex, and the cause of chronic liver disease, the study indicated a higher likelihood of advanced liver fibrosis in patients with advanced age (Odds Ratio (OR)=2908; Confidence Interval (CI)=2597-3256; p<0.0001) and those with hepatitis C (OR=2582; CI=2168-3075; p<0.0001), alcoholic liver disease (OR=2019; CI=1524-2674, p<0.0001), and autoimmune hepatitis (OR=2138; CI=1360-3660; p<0.0001) relative to patients with non-alcoholic fatty liver disease (NAFLD).
FibroScan was most often requested due to the presence of NAFLD.
.
FibroScan referrals were most frequently driven by the presence of NAFLD.
In the context of kidney transplant recipients (KTRs), metabolic dysfunction-associated fatty liver disease (MAFLD) is projected to be quite common. We sought to determine the prevalence of MAFLD among KTRs, a clinical metric yet to be scrutinized in previous studies.
We prospectively and consecutively recruited 52 KTRs, along with 53 age-, sex-, and BMI-matched individuals, to serve as the control group. The controlled attenuation parameter (CAP) and liver stiffness measurement (LSM) from FibroScan indicated hepatic steatosis and liver fibrosis.
A considerable portion of KTRs, namely 18 (346%), were diagnosed with metabolic syndrome. NSC 167409 supplier In the KTR population, the MAFLD prevalence was 423%, whereas in the control group it stood at 519% (p=0.375). The KTR and control groups showed no notable differences in CAP and LSM measurements, with statistically insignificant results (p=0.222 and p=0.119). NSC 167409 supplier Patients with MAFLD within the KTR population exhibited statistically significant elevations in age, BMI, waist circumference, LDL, and total cholesterol (p<0.0001, p=0.0011, p=0.0033, p=0.0022, and p=0.0029, respectively). In a multivariate analysis of KTRs, age was identified as the sole independent factor associated with MAFLD, possessing an odds ratio of 1120 and a 95% confidence interval of 1039 to 1208.
KTRs did not exhibit a significantly elevated rate of MAFLD when compared with the normal population. More extensive clinical trials involving larger patient groups are required.