Prevalence and predictors for compensated Advanced Chronic Liver Disease infection

Objective The study aimed to evaluate the prevalence and predictor factors for compensated advanced chronic liver disease (c-ACLD) in patients with hepatitis Delta virus (HDV) infection. Methods This cross-sectional study included consecutive HDV-infected patients defined by positive anti-HDV. Patie...

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Veröffentlicht in:PloS one 2017-03, Vol.12 (3), p.e0174453
Hauptverfasser: Couto, Ingrid, Victoria, Marilu, Veloso, Valdiléa G, Rodrigues, Lorena, Grinsztejn, Beatriz, Lacerda, Marcus, Victoria, Flamir, Perazzo, Hugo
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container_title PloS one
container_volume 12
creator Couto, Ingrid
Victoria, Marilu
Veloso, Valdiléa G
Rodrigues, Lorena
Grinsztejn, Beatriz
Lacerda, Marcus
Victoria, Flamir
Perazzo, Hugo
description Objective The study aimed to evaluate the prevalence and predictor factors for compensated advanced chronic liver disease (c-ACLD) in patients with hepatitis Delta virus (HDV) infection. Methods This cross-sectional study included consecutive HDV-infected patients defined by positive anti-HDV. Patients with hepatitis C coinfection, liver transplantation or presence of conditions that limit liver (LSM) or spleen stiffness measurement (SSM) were excluded. Blood tests, abdominal ultrasound, SSM and LSM by transient elastography (FibroScan.sup.®) were performed at the same day. Alcohol consumption was quantified using the AUDIT score and c-ACLD was defined by LSM [greater than or equal to] 15 kPa performed by an experimented operator blinded for clinical and laboratory data. Results 101 patients were eligible and few patients were excluded due to negative anti-HDV (n = 7), hepatitis C coinfection (n = 2), liver transplantation (n = 10) and limitation for LSM or SSM (n = 5). Therefore, 77 patients [61% male, age = 43 (IQR,36-52) years] were included. The prevalence of c-ACLD was 57% (n = 44/77). Patients with c-ACLD had a higher rate of detectable HBV viral load (p = 0.039), higher levels of transaminases, GGT, alkaline phosphatases, total bilirubin and INR (p0.001 for both) compared to those without c-ACLD. Patients with c-ACLD had higher SSM [65.2 (IQR,33.8-75.0) vs 21.8 (16.5-32.0) kPa; p
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Methods This cross-sectional study included consecutive HDV-infected patients defined by positive anti-HDV. Patients with hepatitis C coinfection, liver transplantation or presence of conditions that limit liver (LSM) or spleen stiffness measurement (SSM) were excluded. Blood tests, abdominal ultrasound, SSM and LSM by transient elastography (FibroScan.sup.®) were performed at the same day. Alcohol consumption was quantified using the AUDIT score and c-ACLD was defined by LSM [greater than or equal to] 15 kPa performed by an experimented operator blinded for clinical and laboratory data. Results 101 patients were eligible and few patients were excluded due to negative anti-HDV (n = 7), hepatitis C coinfection (n = 2), liver transplantation (n = 10) and limitation for LSM or SSM (n = 5). Therefore, 77 patients [61% male, age = 43 (IQR,36-52) years] were included. The prevalence of c-ACLD was 57% (n = 44/77). Patients with c-ACLD had a higher rate of detectable HBV viral load (p = 0.039), higher levels of transaminases, GGT, alkaline phosphatases, total bilirubin and INR (p0.001 for both) compared to those without c-ACLD. Patients with c-ACLD had higher SSM [65.2 (IQR,33.8-75.0) vs 21.8 (16.5-32.0) kPa; p&lt;0.001] and higher splenic volume [475 (IQR,311-746) vs 154 (112-283) cm.sup.3 ; p10 UI/ml), alkaline phosphatase (per IU/L) and GGT levels (per IU/L) were independently associated with c-ACLD in all multivariate models. Splenic volume [per cm.sup.3,OR = 1.01 (95%CI,1.01-1.02);p = 0.002], SSM [per kPa, OR = 1.04 (1.01-1.07);p = 0.012] and splenomegaly [yes vs no,OR = 28.45 (4.42-182.95);p&lt;0.001] were independently associated with c-ACLD. Conclusions The prevalence of c-ACLD was high in patients with chronic HDV infection in western Amazon basin. HBV viral load, liver enzymes and splenic features can be used to predict severe liver disease in HDV-infected patients.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0174453</identifier><language>eng</language><publisher>Public Library of Science</publisher><subject>Analysis ; Hepatitis delta virus ; Liver diseases ; Prevalence studies (Epidemiology) ; Risk factors</subject><ispartof>PloS one, 2017-03, Vol.12 (3), p.e0174453</ispartof><rights>COPYRIGHT 2017 Public Library of Science</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,864,27924,27925</link.rule.ids></links><search><creatorcontrib>Couto, Ingrid</creatorcontrib><creatorcontrib>Victoria, Marilu</creatorcontrib><creatorcontrib>Veloso, Valdiléa G</creatorcontrib><creatorcontrib>Rodrigues, Lorena</creatorcontrib><creatorcontrib>Grinsztejn, Beatriz</creatorcontrib><creatorcontrib>Lacerda, Marcus</creatorcontrib><creatorcontrib>Victoria, Flamir</creatorcontrib><creatorcontrib>Perazzo, Hugo</creatorcontrib><title>Prevalence and predictors for compensated Advanced Chronic Liver Disease infection</title><title>PloS one</title><description>Objective The study aimed to evaluate the prevalence and predictor factors for compensated advanced chronic liver disease (c-ACLD) in patients with hepatitis Delta virus (HDV) infection. Methods This cross-sectional study included consecutive HDV-infected patients defined by positive anti-HDV. Patients with hepatitis C coinfection, liver transplantation or presence of conditions that limit liver (LSM) or spleen stiffness measurement (SSM) were excluded. Blood tests, abdominal ultrasound, SSM and LSM by transient elastography (FibroScan.sup.®) were performed at the same day. Alcohol consumption was quantified using the AUDIT score and c-ACLD was defined by LSM [greater than or equal to] 15 kPa performed by an experimented operator blinded for clinical and laboratory data. Results 101 patients were eligible and few patients were excluded due to negative anti-HDV (n = 7), hepatitis C coinfection (n = 2), liver transplantation (n = 10) and limitation for LSM or SSM (n = 5). Therefore, 77 patients [61% male, age = 43 (IQR,36-52) years] were included. The prevalence of c-ACLD was 57% (n = 44/77). Patients with c-ACLD had a higher rate of detectable HBV viral load (p = 0.039), higher levels of transaminases, GGT, alkaline phosphatases, total bilirubin and INR (p0.001 for both) compared to those without c-ACLD. Patients with c-ACLD had higher SSM [65.2 (IQR,33.8-75.0) vs 21.8 (16.5-32.0) kPa; p&lt;0.001] and higher splenic volume [475 (IQR,311-746) vs 154 (112-283) cm.sup.3 ; p10 UI/ml), alkaline phosphatase (per IU/L) and GGT levels (per IU/L) were independently associated with c-ACLD in all multivariate models. Splenic volume [per cm.sup.3,OR = 1.01 (95%CI,1.01-1.02);p = 0.002], SSM [per kPa, OR = 1.04 (1.01-1.07);p = 0.012] and splenomegaly [yes vs no,OR = 28.45 (4.42-182.95);p&lt;0.001] were independently associated with c-ACLD. Conclusions The prevalence of c-ACLD was high in patients with chronic HDV infection in western Amazon basin. HBV viral load, liver enzymes and splenic features can be used to predict severe liver disease in HDV-infected patients.</description><subject>Analysis</subject><subject>Hepatitis delta virus</subject><subject>Liver diseases</subject><subject>Prevalence studies (Epidemiology)</subject><subject>Risk factors</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid/><recordid>eNptkE1LAzEQhoMoWKv_wEPA866ZJpvZPZb6CQVFei8xmdSUNinJ2t9vQA89yBzeYXhm3plh7BZECxLhfpu-czS79pAitQJQqU6esQkMctbomZDnJ_kluyplK0Qne60n7OM909HsKFriJjp-yOSCHVMu3KfMbdofKBYzkuNzdzQVc3zxlVMMli_DkTJ_CIVMIR6iJzuGFK_ZhTe7Qjd_OmWrp8fV4qVZvj2_LubLZqOxbzx4kqg-STgxKACtnerQG4veeRCdpwE1OJSWUGgLAhF6KxSCBgmEcsrufsdu6vrr6p7GbOw-FLueq3rbbBigr1T7D1XD0T7Y-i8fav2k4QcVw2PD</recordid><startdate>20170322</startdate><enddate>20170322</enddate><creator>Couto, Ingrid</creator><creator>Victoria, Marilu</creator><creator>Veloso, Valdiléa G</creator><creator>Rodrigues, Lorena</creator><creator>Grinsztejn, Beatriz</creator><creator>Lacerda, Marcus</creator><creator>Victoria, Flamir</creator><creator>Perazzo, Hugo</creator><general>Public Library of Science</general><scope/></search><sort><creationdate>20170322</creationdate><title>Prevalence and predictors for compensated Advanced Chronic Liver Disease infection</title><author>Couto, Ingrid ; Victoria, Marilu ; Veloso, Valdiléa G ; Rodrigues, Lorena ; Grinsztejn, Beatriz ; Lacerda, Marcus ; Victoria, Flamir ; Perazzo, Hugo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-g678-f1fe374be0d0941166d457fac7fdf105fe9761d73ce706c107718c04716131e73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Analysis</topic><topic>Hepatitis delta virus</topic><topic>Liver diseases</topic><topic>Prevalence studies (Epidemiology)</topic><topic>Risk factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Couto, Ingrid</creatorcontrib><creatorcontrib>Victoria, Marilu</creatorcontrib><creatorcontrib>Veloso, Valdiléa G</creatorcontrib><creatorcontrib>Rodrigues, Lorena</creatorcontrib><creatorcontrib>Grinsztejn, Beatriz</creatorcontrib><creatorcontrib>Lacerda, Marcus</creatorcontrib><creatorcontrib>Victoria, Flamir</creatorcontrib><creatorcontrib>Perazzo, Hugo</creatorcontrib><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Couto, Ingrid</au><au>Victoria, Marilu</au><au>Veloso, Valdiléa G</au><au>Rodrigues, Lorena</au><au>Grinsztejn, Beatriz</au><au>Lacerda, Marcus</au><au>Victoria, Flamir</au><au>Perazzo, Hugo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prevalence and predictors for compensated Advanced Chronic Liver Disease infection</atitle><jtitle>PloS one</jtitle><date>2017-03-22</date><risdate>2017</risdate><volume>12</volume><issue>3</issue><spage>e0174453</spage><pages>e0174453-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Objective The study aimed to evaluate the prevalence and predictor factors for compensated advanced chronic liver disease (c-ACLD) in patients with hepatitis Delta virus (HDV) infection. Methods This cross-sectional study included consecutive HDV-infected patients defined by positive anti-HDV. Patients with hepatitis C coinfection, liver transplantation or presence of conditions that limit liver (LSM) or spleen stiffness measurement (SSM) were excluded. Blood tests, abdominal ultrasound, SSM and LSM by transient elastography (FibroScan.sup.®) were performed at the same day. Alcohol consumption was quantified using the AUDIT score and c-ACLD was defined by LSM [greater than or equal to] 15 kPa performed by an experimented operator blinded for clinical and laboratory data. Results 101 patients were eligible and few patients were excluded due to negative anti-HDV (n = 7), hepatitis C coinfection (n = 2), liver transplantation (n = 10) and limitation for LSM or SSM (n = 5). Therefore, 77 patients [61% male, age = 43 (IQR,36-52) years] were included. The prevalence of c-ACLD was 57% (n = 44/77). Patients with c-ACLD had a higher rate of detectable HBV viral load (p = 0.039), higher levels of transaminases, GGT, alkaline phosphatases, total bilirubin and INR (p0.001 for both) compared to those without c-ACLD. Patients with c-ACLD had higher SSM [65.2 (IQR,33.8-75.0) vs 21.8 (16.5-32.0) kPa; p&lt;0.001] and higher splenic volume [475 (IQR,311-746) vs 154 (112-283) cm.sup.3 ; p10 UI/ml), alkaline phosphatase (per IU/L) and GGT levels (per IU/L) were independently associated with c-ACLD in all multivariate models. Splenic volume [per cm.sup.3,OR = 1.01 (95%CI,1.01-1.02);p = 0.002], SSM [per kPa, OR = 1.04 (1.01-1.07);p = 0.012] and splenomegaly [yes vs no,OR = 28.45 (4.42-182.95);p&lt;0.001] were independently associated with c-ACLD. Conclusions The prevalence of c-ACLD was high in patients with chronic HDV infection in western Amazon basin. HBV viral load, liver enzymes and splenic features can be used to predict severe liver disease in HDV-infected patients.</abstract><pub>Public Library of Science</pub><doi>10.1371/journal.pone.0174453</doi></addata></record>
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subjects Analysis
Hepatitis delta virus
Liver diseases
Prevalence studies (Epidemiology)
Risk factors
title Prevalence and predictors for compensated Advanced Chronic Liver Disease infection
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