The importance of early diagnosis and treatment for chronic hepatitis B (CHB) lies in its ability to prevent complications like cirrhosis and hepatocellular cancer. For precisely diagnosing fibrosis, the gold standard remains the liver biopsy, an invasive, complicated, and expensive diagnostic method. This research aimed to analyze the contribution of these tests in anticipating liver fibrosis and guiding treatment protocols.
In a retrospective study, the Gastroenterology Department at Gaziantep University examined 1051 patients who had been diagnosed with CHB between 2010 and 2020. Diagnosis onset coincided with the calculation of AAR, API, APRI, FIB-4, KING score, and FIBROQ score. Moreover, a new formula, the Zeugma score, was established, anticipated to be more sensitive and specific. Patients' biopsy results were correlated with their noninvasive fibrosis scores.
The following area under the curve values were reported in this study: 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, all showing statistical significance (p < 0.005). There was no statistically important difference found in the assessment of the AAR score. The KING, FIB-4, APRI, and Zeugma scores served as the strongest indicators for the presence of advanced fibrosis. For KING, FIB-4, APRI, and Zeugma scores, cutoff values for predicting advanced fibrosis were determined as 867, 094, 1624, and 963, with corresponding sensitivities of 5052%, 5677%, 5964%, and 5234% and specificities of 8726%, 7496%, 7361%, and 7811%, respectively, all yielding statistical significance (p<0.005). Fibrosis, as part of the Zeugma score, was compared to globulin and GGT values in our investigation. The fibrosis group displayed a substantial increase in the average levels of globulin and GGT, a statistically significant difference (p<0.05). A statistical significance was found in the correlation between fibrosis and globulin, and independently between fibrosis and GGT values, with respective p-values less than 0.005 and correlation coefficients of 0.230 and 0.305.
For the noninvasive identification of hepatic fibrosis in patients with chronic HBV, the KING score proved to be the most dependable method. The FIB-4, APRI, and Zeugma scores, in addition to other factors, were found to effectively determine liver fibrosis. Hepatic fibrosis detection exceeded the capacity of the AAR score, as demonstrated. GDC-0973 manufacturer Evaluating liver fibrosis in chronic HBV patients, the Zeugma score, a novel and noninvasive test, proves to be a helpful and straightforward instrument, surpassing AAR, API, and FIBROQ in accuracy.
The KING score's reliability in non-invasive detection of hepatic fibrosis in chronic HBV patients was notably superior to other methods. The FIB-4, APRI, and Zeugma scores demonstrated effectiveness in assessing liver fibrosis. It was determined that the AAR score fell short of adequately identifying hepatic fibrosis. Evaluating liver fibrosis in patients with chronic HBV, the Zeugma score, a novel, noninvasive test, proves a useful and straightforward tool, significantly outperforming AAR, API, and FIBROQ in accuracy.
Hepatoportal sclerosis (HPS) is an idiopathic non-cirrhotic portal hypertension (INCPH) condition, clinically evident through hypersplenism, portal hypertension, and splenomegaly. Liver cancer's most prevalent form is hepatocellular carcinoma (HCC). In exceedingly uncommon cases, non-cirrhotic portal hypertension is a contributing factor to the onset of hepatocellular carcinoma. Our hospital was informed of a 36-year-old woman requiring treatment for esophageal varices. The serological tests for the cause of the ailment all came back negative. Normal serum ceruloplasmin and serum immunoglobulin A, M, and G concentrations were observed. Two liver lesions were observed during the triple-phase computer scan follow-up. While arterial enhancement was present in the lesions, no venous washout occurred. In the course of the magnetic resonance imaging examination, the possibility of hepatocellular carcinoma (HCC) was raised with respect to one of the lesions. A patient without any indication of metastasis served as the initial recipient of radiofrequency ablation therapy. Within the span of two months, the patient underwent a life-saving living donor liver transplant. 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's health was meticulously monitored for three years, showing no relapse or progression of the initial condition. The question of whether INCPH patients develop HCC continues to be debated. Liver specimens with nodular regenerative hyperplasia, demonstrating atypical and pleomorphic liver cells, do not definitively establish a cause-and-effect relationship with hepatocellular carcinoma.
Hepatitis B virus (HBV) reinfection prevention is a vital factor in determining long-term post-liver transplantation outcomes. Recipients of Hepatitis B immunoglobulin (HBIG) are identified as those (i) with native HBV disease, (ii) having positive hepatitis B core antibodies (HBcAb), or (iii) having received organs positive for hepatitis B core antibodies (HBcAb). In this specific clinical setting, nucleo(s)tide analogue (NA) monotherapy is currently an emerging therapeutic choice for patients. There's no widespread agreement on the best amount of HBIG to administer. The research undertaken sought to establish the utility of 1560 international units [IU] of low-dose HBIG in averting HBV post-liver transplantation.
Patients with HBcAb positivity who received either HBcAb-positive or hepatitis B core antibody-negative (HBcAb-negative) organs, and HBcAb-negative recipients of HBcAb-positive organs, were examined in the timeframe between January 2016 and December 2020. Prior to LT, samples for hepatitis B virus serology were collected. A component of the HBV prophylaxis approach was the use of nucleoside/nucleotide analogues (NAs), which may have been administered in conjunction with hepatitis B immune globulin (HBIG). During the year following liver transplantation (LT), HBV recurrence was characterized by the detection of HBV deoxyribonucleic acid (DNA). The HBV surface antibody titer levels were not tracked.
A cohort of 103 patients, averaging 60 years of age, took part in the investigation. In terms of etiology, Hepatitis C virus was most commonly observed. Thirty-seven recipients without HBcAb and 11 recipients positive for HBcAb, exhibiting undetectable HBV DNA, were furnished with HBcAb-positive organs. They underwent a prophylaxis treatment encompassing four doses of low-dose HBIG and NA. A one-year follow-up of our cohort's recipients revealed no HBV recurrences.
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. Further studies are indispensable for confirming this observation.
Four days of low-dose HBIG (1560 IU) and NA appear to be effective in preventing HBV reinfection in HBcAb-positive recipients and donors following liver transplantation. Confirmation of this observation necessitates further experimentation.
Chronic liver disease (CLD) is a significant cause of illness and death across the world, with a diverse array of origins. FibroScan, a crucial step in assessing liver health.
For monitoring fibrosis and steatosis, this is the recommended approach. FibroScan referrals are subject to a review of the distribution of indications, based on this single-center study.
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Chronic liver disease etiologies, coupled with demographic attributes and FibroScan results, offer valuable insights.
A retrospective analysis was performed on the characteristics of patients referred to our tertiary care center between 2013 and 2021.
Considering a sample size of 9345 patients, 4946, which accounts for 52.93%, were male, and the median age was 48 years, with a range of 18 to 88 years. The prevalence of nonalcoholic fatty liver disease (NAFLD) was highest, with 4768 cases (51.02%). Hepatitis B demonstrated the second highest frequency with 3194 cases (34.18%). The lowest frequency was observed in hepatitis C, with 707 cases (7.57%). Results demonstrated that, after controlling for age, sex, and chronic liver disease (CLD) etiology, patients with older 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) had significantly greater odds of developing advanced liver fibrosis compared to those with NAFLD.
FibroScan referrals were most frequently prompted by NAFLD diagnoses.
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FibroScan referrals were most frequently driven by the presence of NAFLD.
Kidney transplant recipients (KTRs) are anticipated to experience a high prevalence of metabolic dysfunction-associated fatty liver disease (MAFLD). The present study evaluated the incidence of MAFLD in the KTR cohort, a topic untouched by prior clinical research.
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. GDC-0973 manufacturer In the KTR population, the MAFLD prevalence was 423%, whereas in the control group it stood at 519% (p=0.375). There were no considerable disparities in CAP and LSM values between the KTR and control groups, as evidenced by the insignificant p-values (p=0.222 and p=0.119). GDC-0973 manufacturer Statistically significant increases were found in age, BMI, waist circumference, LDL, and total cholesterol among KTR patients with MAFLD (p<0.0001, p=0.0011, p=0.0033, p=0.0022, and p=0.0029, respectively). Among the KTRs, multivariable analysis revealed age as the only independent variable significantly associated with MAFLD, yielding an odds ratio of 1120 (95% CI: 1039-1208).
Compared to the general population, there was no appreciable difference in the prevalence of MAFLD among KTRs. Subsequent clinical research, encompassing more patients, is essential.