Ben L Da1, Pallavi Surana1, David E Kleiner2, Theo Heller1, Christopher Koh3. 1. Liver Diseases Branch, National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, Bethesda, MD, USA. 2. Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA. 3. Liver Diseases Branch, National Institute of Diabetes & Digestive & Kidney Diseases, National Institutes of Health, Bethesda, MD, USA. Electronic address: Christopher.koh@nih.gov.
Abstract
BACKGROUND: Chronic Hepatitis D virus (HDV) infection results in the most severe form of viral hepatitis with a rapid progression to cirrhosis. However, non-invasive fibrosis tests that can accurately predict cirrhosis have not been adequately validated. We aimed to develop a clinically useful non-invasive score that can accurately detect cirrhosis. MATERIAL AND METHODS: Patients with chronic HDV diagnosed by liver histology or serum PCR were evaluated. Data regarding demographics, laboratory, imaging, vibration-controlled transient elastography (VCTE), and liver biopsy were collected. The total cohort was randomized into a training and validation cohort. The training cohort was used to develop a novel score, the Delta-4 fibrosis score (D4FS) which was then compared to other non-invasive tests in the validation cohort by area under receiver operating characteristics (AUROC). RESULTS: 77 patients with chronic HDV were evaluated: mean age 42.6 (SD:11.1) years, 59.7% male, and 57.1% Asian. The total cohort was then separated into a training (n = 45) and validation (n = 32) cohort with no significant differences in terms of clinical characteristics between the two. From the training cohort, the D4FS was derived from variables of statistical and clinical interest (gamma-glutamyl transpeptidase (GGT), platelet count, alanine aminotransferase (ALT), and liver stiffness measurement (LSM)). The D4FS demonstrated the best AUROC in the validation cohort (0.94) followed by VCTE (0.90), FIB-4 (0.86), APRI (0.81), and AAR (0.71). DISCUSSION: The D4FS is a clinically useful non-invasive fibrosis score that can accurately detect cirrhosis in patients with chronic HDV infection. Further studies should be performed to further validate clinical utility. Published by Elsevier B.V.
BACKGROUND:Chronic Hepatitis D virus (HDV) infection results in the most severe form of viral hepatitis with a rapid progression to cirrhosis. However, non-invasive fibrosis tests that can accurately predict cirrhosis have not been adequately validated. We aimed to develop a clinically useful non-invasive score that can accurately detect cirrhosis. MATERIAL AND METHODS:Patients with chronic HDV diagnosed by liver histology or serum PCR were evaluated. Data regarding demographics, laboratory, imaging, vibration-controlled transient elastography (VCTE), and liver biopsy were collected. The total cohort was randomized into a training and validation cohort. The training cohort was used to develop a novel score, the Delta-4fibrosis score (D4FS) which was then compared to other non-invasive tests in the validation cohort by area under receiver operating characteristics (AUROC). RESULTS: 77 patients with chronic HDV were evaluated: mean age 42.6 (SD:11.1) years, 59.7% male, and 57.1% Asian. The total cohort was then separated into a training (n = 45) and validation (n = 32) cohort with no significant differences in terms of clinical characteristics between the two. From the training cohort, the D4FS was derived from variables of statistical and clinical interest (gamma-glutamyl transpeptidase (GGT), platelet count, alanine aminotransferase (ALT), and liver stiffness measurement (LSM)). The D4FS demonstrated the best AUROC in the validation cohort (0.94) followed by VCTE (0.90), FIB-4 (0.86), APRI (0.81), and AAR (0.71). DISCUSSION: The D4FS is a clinically useful non-invasive fibrosis score that can accurately detect cirrhosis in patients with chronic HDV infection. Further studies should be performed to further validate clinical utility. Published by Elsevier B.V.
Authors: F Bonino; F Negro; M Baldi; M R Brunetto; E Chiaberge; M Capalbo; E Maran; C Lavarini; N Rocca; G Rocca Journal: Prog Clin Biol Res Date: 1987
Authors: Grazia Anna Niro; Antonina Smedile; Antonio Massimo Ippolito; Alessia Ciancio; Rosanna Fontana; Antonella Olivero; Maria Rosa Valvano; Maria Lorena Abate; Domenica Gioffreda; Gian Paolo Caviglia; Mario Rizzetto; Angelo Andriulli Journal: J Hepatol Date: 2010-07-29 Impact factor: 25.083
Authors: Carla Osiowy; Ken Swidinsky; Sarah Haylock-Jacobs; Matthew D Sadler; Scott Fung; David Wong; Gerald Y Minuk; Karen E Doucette; Philip Wong; Edward Tam; Curtis Cooper; Alnoor Ramji; Mang Ma; Carmine Nudo; Keith Tsoi; Carla S Coffin Journal: JHEP Rep Date: 2022-02-22