July 10, 2011

Noninvasive tests predicted survival in chronic hepatitis C

Posted on HemOncToday.com July 8, 2011

Vergniol J. Gastroenterology. 2011;140:1970-1979.

Noninvasive tests for fibrosis and liver stiffness predicted 5-year survival in patients with chronic hepatitis C, according to researchers from CHU Bordeaux in France.

“The evaluation of liver fibrosis is a key step to manage a chronic liver disease and to assess its prognosis, as complications mainly occur in patients with advanced stages,” the researchers wrote. “Early assessment of the risk of bad prognosis helps the physician to manage patients with cirrhosis and to make decisions about liver transplantation.”

The researchers prospectively collected data from a cohort of 1,457 consecutive patients who presented with chronic hepatitis C from April 2003 to February 2009. The patients’ fibrosis and liver stiffness were measured using the FibroTest, the aspartate aminotransferase-to-platelet ratio index and the FIB-4. Some patients also received liver biopsies. During the follow-up period, the researchers analyzed data on death, liver-related death and liver transplantation.

At 5 years, the overall survival was 91.7%, and survival without liver-related death was 94.4%. Among patients diagnosed with severe fibrosis at baseline, the survival was significantly decreased. Although all methods used were able to predict shorter survival, liver stiffness and the FibroTest had higher predictive values. After adjustment for treatment response, patient age and estimates of necroinflammatory grade, the prognostic value of liver stiffness (P<.0001) and FibroTest results (P<.0001) remained.

“In this prospective study, we confirmed the prognostic value of liver stiffness and FibroTest on survival,” the researchers wrote. “This information is of major importance, helping us to sharpen our various tools for the follow-up of our patients.”

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