Liver Fibrosis Evaluated With Transient Elastography in 35 Children With Chronic Hepatitis C Virus Infection
| Autor: | Maria Pokorska-Śpiewak, Małgorzata Aniszewska, Anna Dobrzeniecka, Magdalena Marczyńska, Anna Tomasik, Marta Lipińska |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Liver Cirrhosis
Male Microbiology (medical) medicine.medical_specialty Cirrhosis Adolescent Liver fibrosis Gastroenterology Virus 03 medical and health sciences 0302 clinical medicine Fibrosis 030225 pediatrics Internal medicine Humans Medicine 030212 general & internal medicine Child Prospective cohort study Receiver operating characteristic business.industry Hepatitis C Chronic medicine.disease Confidence interval Fatty Liver Cross-Sectional Studies Infectious Diseases Pediatrics Perinatology and Child Health Elasticity Imaging Techniques Female business Transient elastography Biomarkers |
| Zdroj: | Pediatric Infectious Disease Journal. 40:103-108 |
| ISSN: | 0891-3668 |
| DOI: | 10.1097/inf.0000000000002913 |
| Popis: | Background The aim of this prospective study was to analyze liver fibrosis in teenagers with chronic hepatitis C (CHC) using noninvasive methods. Methods Thirty-five patients with CHC, 12-17 years of age (mean 14.2 ± 1.8 years; 22/35, 63% male) were included. Most of them (29/35, 83%) were infected vertically, 21/35 (60%) were treatment-naive, 30/35 (86%) were infected with genotype 1 and 5/35 (14%) were infected with genotype 4 HCV. In all patients, evaluation of liver fibrosis was performed using transient elastography (TE) and measurement of the following serum biomarkers: aspartate transaminase-to-platelet ratio index (APRI) and Fibrosis-4 index (FIB-4). Using liver stiffness measurement (LSM) results as a reference, the diagnostic performance of APRI and FIB-4 was assessed by calculating area under the receiver operating characteristics curve. Results Transient elastography results revealed no or mild fibrosis (F0/1 in METAVIR scale) in 31/35 (89%) patients. In 4/35 (11%) patients, significant fibrosis was observed (F ≥ 2), including 3/35 (9%) with cirrhosis (F4). The median APRI was 0.32, and the median FIB-4 was 0.32. LSM was associated with both APRI and FIB-4 [r = 0.61, 95% confidence interval (CI) 0.35-0.79, P = 0.0001; and r = 0.60, 95% CI 0.32-0.78, P = 0.0002, respectively]. For the diagnosis of significant fibrosis, the area under the receiver operating characteristics (95% CI) for both APRI and FIB-4 was 0.855 (0.695-0.951). APRI, with a cutoff >0.374, predicted significant fibrosis, with 100% sensitivity and 67.7% specificity, whereas FIB-4, with a cutoff >0.402, predicted significant fibrosis, with 75.0% sensitivity and 90.3% specificity. Conclusions Significant fibrosis, including cirrhosis, may occur in teenagers with CHC. Serum biomarkers (APRI, FIB-4) correlate positively with LSM. |
| Databáze: | OpenAIRE |
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