Addition of neutrophil-to-lymphocyte ratio to Pre-DAA FIB-4 does not increase prediction value for de novo liver complications in hepatitis C.

Autor:	Hong CM; Division of Hospital Medicine, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan., Su TH; Division of Gastroenterology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan., Hsu SJ; Division of Gastroenterology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan., Tseng TC; Department of Medicine Research, National Taiwan University Hospital, Taipei, Taiwan., Liu CH; Division of Gastroenterology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan., Yang HC; Division of Gastroenterology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan., Kao JH; Division of Gastroenterology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan., Chen PJ; Division of Gastroenterology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taipei, Taiwan., Cheng PN; Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan., Hung CH; Division of Hepatogastroenterology, Department of Internal Medicine, ChiaYi Chang Gung Memorial Hospital, Taiwan; Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taiwan., Peng CY; Center for Digestive Medicine, Department of Internal Medicine, China Medical University Hospital, School of Medicine, China Medical University, Taichung, Taiwan., Chen CH; Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taiwan., Lin CY; Department of Gastroenterology and Hepatology, Chang Gung Memorial Hospital, Linkou Branch, Taiwan., Kuo HT; Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chi Mei Medical Center, Taiwan., Lin HC; Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan., Huang YH; Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan., Chen CY; Division of Gastroenterology and Hepatology, Department of Medicine, Ditmanson Medical Foundation Chiayi Christian Hospital, Taiwan., Lin CL; Department of Gastroenterology, Renai Branch, Taipei City Hospital, Taipei, Taiwan., Tsai PC; Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan., Zeng YS; Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan., Dai CY; Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan., Chuang WL; Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan., Huang JF; Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan., Huang CF; Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan., Yeh ML; Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan., Yu ML; Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan., Liu CJ; Division of Gastroenterology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: cjliu@ntu.edu.tw.
Jazyk:	angličtina
Zdroj:	Journal of the Formosan Medical Association = Taiwan yi zhi [J Formos Med Assoc] 2024 Nov 01. Date of Electronic Publication: 2024 Nov 01.
DOI:	10.1016/j.jfma.2024.10.024
Abstrakt:	Background and Aims: Direct-acting antiviral agents (DAAs) achieve high sustained virologic response (SVR) in chronic hepatitis C patients; yet a proportion of patients still experience de novo liver complications after SVR. Identification of risk factors is clinically important. FIB-4 index is a useful noninvasive tool to assess fibrosis, while neutrophil-to-lymphocyte ratio (NLR) is a biomarker for systemic inflammation. Our study aimed to investigate whether the addition of NLR can increase the prediction power of pre-DAA FIB-4 for de novo liver complications after SVR. Methods: We recruited patients via The Taiwan HCV Registry (TACR) and National Health Insurance Registry Database. The inclusion criteria were patients who achieved SVR12 after DAA and were followed for at least 24 months after SVR12. Liver complications included ascites, hepatic encephalopathy, variceal bleeding, and HCC. Results: Totally 7657 patients were recruited from 2013 to 2018. Among them, 3674 patients (48.0%) had a FIB-4 value > 3.25 and 491 patients (6.4%) had a NLR >4 before DAA. After two-year of follow-up after SVR 12, 214 patients (2.8%) developed de novo liver complications. Factors associated with liver complications included male gender, diabetes mellitus, hyperlipidemia, chronic kidney disease, and pre-DAA FIB-4 >3.25 in multivariate analyses. Addition of NLR slightly did not increase the power of predicting liver complications. Conclusions: The overall incidence of de novo liver complications after SVR is low during short-term follow-up. Elevated pre-DAA FIB-4 is associated with de novo liver complications after SVR, whereas the addition of pre-DAA NLR does not increase the prediction power. Competing Interests: Declaration of competing interest A conflict of interest occurs when an individual's objectivity is potentially compromised by a desire for financial gain, prominence, professional advancement or a successful outcome. JFMA Editors strive to ensure that what is published in the Journal is as balanced, objective and evidence-based as possible. Since it can be difficult to distinguish between an actual conflict of interest and a perceived conflict of interest, the Journal requires authors to disclose all and any potential conflicts of interest. (Copyright © 2024 Formosan Medical Association. Published by Elsevier B.V. All rights reserved.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu