Noninvasive Tests for Fibrosis and Liver Stiffness Predict 5-Year Outcomes of Patients With Chronic Hepatitis C
Background & Aims Liver stiffness can be measured noninvasively to assess liver fibrosis in patients with chronic hepatitis C. In patients with chronic liver diseases, level of fibrosis predicts liver-related complications and survival. We evaluated the abilities of liver stiffness, results from...
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| Veröffentlicht in: | Gastroenterology (New York, N.Y. 1943) N.Y. 1943), 2011-06, Vol.140 (7), p.1970-1979.e3 |
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| creator | Vergniol, Julien Foucher, Juliette Terrebonne, Eric Bernard, Pierre–Henri le Bail, Brigitte Merrouche, Wassil Couzigou, Patrice de Ledinghen, Victor |
| description | Background & Aims Liver stiffness can be measured noninvasively to assess liver fibrosis in patients with chronic hepatitis C. In patients with chronic liver diseases, level of fibrosis predicts liver-related complications and survival. We evaluated the abilities of liver stiffness, results from noninvasive tests for fibrosis, and liver biopsy analyses to predict overall survival or survival without liver-related death with a 5-year period. Methods In a consecutive cohort of 1457 patients with chronic hepatitis C, we assessed fibrosis and, on the same day, liver stiffness, performed noninvasive tests of fibrosis (FibroTest, the aspartate aminotransferase to platelet ratio index, FIB-4), and analyzed liver biopsy samples. We analyzed data on death, liver-related death, and liver transplantation collected during a 5-year follow-up period. Results At 5 years, 77 patients had died (39 liver-related deaths) and 16 patients had undergone liver transplantation. Overall survival was 91.7% and survival without liver-related death was 94.4%. Survival was significantly decreased among patients diagnosed with severe fibrosis, regardless of the noninvasive method of analysis. All methods were able to predict shorter survival times in this large population; liver stiffness and results of FibroTest had higher predictive values. Patient outcomes worsened as liver stiffness and FibroTest values increased. Prognostic values of stiffness ( P < .0001) and FibroTest results ( P < .0001) remained after they were adjusted for treatment response, patient age, and estimates of necroinflammatory grade. Conclusions Noninvasive tests for liver fibrosis (measurement of liver stiffness or FibroTest) can predict 5-year survival of patients with chronic hepatitis C. These tools might help physicians determine prognosis at earlier stages and discuss specific treatments, such as liver transplantation. |
| doi_str_mv | 10.1053/j.gastro.2011.02.058 |
| format | Article |
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In patients with chronic liver diseases, level of fibrosis predicts liver-related complications and survival. We evaluated the abilities of liver stiffness, results from noninvasive tests for fibrosis, and liver biopsy analyses to predict overall survival or survival without liver-related death with a 5-year period. Methods In a consecutive cohort of 1457 patients with chronic hepatitis C, we assessed fibrosis and, on the same day, liver stiffness, performed noninvasive tests of fibrosis (FibroTest, the aspartate aminotransferase to platelet ratio index, FIB-4), and analyzed liver biopsy samples. We analyzed data on death, liver-related death, and liver transplantation collected during a 5-year follow-up period. Results At 5 years, 77 patients had died (39 liver-related deaths) and 16 patients had undergone liver transplantation. Overall survival was 91.7% and survival without liver-related death was 94.4%. Survival was significantly decreased among patients diagnosed with severe fibrosis, regardless of the noninvasive method of analysis. All methods were able to predict shorter survival times in this large population; liver stiffness and results of FibroTest had higher predictive values. Patient outcomes worsened as liver stiffness and FibroTest values increased. Prognostic values of stiffness ( P < .0001) and FibroTest results ( P < .0001) remained after they were adjusted for treatment response, patient age, and estimates of necroinflammatory grade. Conclusions Noninvasive tests for liver fibrosis (measurement of liver stiffness or FibroTest) can predict 5-year survival of patients with chronic hepatitis C. These tools might help physicians determine prognosis at earlier stages and discuss specific treatments, such as liver transplantation.</description><identifier>ISSN: 0016-5085</identifier><identifier>EISSN: 1528-0012</identifier><identifier>DOI: 10.1053/j.gastro.2011.02.058</identifier><identifier>PMID: 21376047</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Aspartate Aminotransferases - blood ; Biomarkers - blood ; Biopsy ; Chi-Square Distribution ; Cirrhosis ; Clinical Enzyme Tests ; Elasticity Imaging Techniques ; Female ; FibroScan ; FibroTest ; France ; Gastroenterology and Hepatology ; Hepatitis C ; Hepatitis C, Chronic - blood ; Hepatitis C, Chronic - complications ; Hepatitis C, Chronic - diagnosis ; Hepatitis C, Chronic - mortality ; Hepatitis C, Chronic - therapy ; Humans ; Liver Cirrhosis - blood ; Liver Cirrhosis - diagnosis ; Liver Cirrhosis - mortality ; Liver Cirrhosis - therapy ; Liver Cirrhosis - virology ; Liver Transplantation ; Male ; Middle Aged ; Platelet Count ; Predictive Value of Tests ; Prognosis ; Proportional Hazards Models ; Prospective Studies ; Risk Assessment ; Risk Factors ; Severity of Illness Index ; Survival ; Survival Analysis ; Survival Rate ; Time Factors</subject><ispartof>Gastroenterology (New York, N.Y. 1943), 2011-06, Vol.140 (7), p.1970-1979.e3</ispartof><rights>AGA Institute</rights><rights>2011 AGA Institute</rights><rights>Copyright © 2011 AGA Institute. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c462t-b6d8525bc875a96ac446e339c8ae3ec2e0569b3762655cc7b0783dd83a4d138f3</citedby><cites>FETCH-LOGICAL-c462t-b6d8525bc875a96ac446e339c8ae3ec2e0569b3762655cc7b0783dd83a4d138f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1053/j.gastro.2011.02.058$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21376047$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Vergniol, Julien</creatorcontrib><creatorcontrib>Foucher, Juliette</creatorcontrib><creatorcontrib>Terrebonne, Eric</creatorcontrib><creatorcontrib>Bernard, Pierre–Henri</creatorcontrib><creatorcontrib>le Bail, Brigitte</creatorcontrib><creatorcontrib>Merrouche, Wassil</creatorcontrib><creatorcontrib>Couzigou, Patrice</creatorcontrib><creatorcontrib>de Ledinghen, Victor</creatorcontrib><title>Noninvasive Tests for Fibrosis and Liver Stiffness Predict 5-Year Outcomes of Patients With Chronic Hepatitis C</title><title>Gastroenterology (New York, N.Y. 1943)</title><addtitle>Gastroenterology</addtitle><description>Background & Aims Liver stiffness can be measured noninvasively to assess liver fibrosis in patients with chronic hepatitis C. In patients with chronic liver diseases, level of fibrosis predicts liver-related complications and survival. We evaluated the abilities of liver stiffness, results from noninvasive tests for fibrosis, and liver biopsy analyses to predict overall survival or survival without liver-related death with a 5-year period. Methods In a consecutive cohort of 1457 patients with chronic hepatitis C, we assessed fibrosis and, on the same day, liver stiffness, performed noninvasive tests of fibrosis (FibroTest, the aspartate aminotransferase to platelet ratio index, FIB-4), and analyzed liver biopsy samples. We analyzed data on death, liver-related death, and liver transplantation collected during a 5-year follow-up period. Results At 5 years, 77 patients had died (39 liver-related deaths) and 16 patients had undergone liver transplantation. Overall survival was 91.7% and survival without liver-related death was 94.4%. Survival was significantly decreased among patients diagnosed with severe fibrosis, regardless of the noninvasive method of analysis. All methods were able to predict shorter survival times in this large population; liver stiffness and results of FibroTest had higher predictive values. Patient outcomes worsened as liver stiffness and FibroTest values increased. Prognostic values of stiffness ( P < .0001) and FibroTest results ( P < .0001) remained after they were adjusted for treatment response, patient age, and estimates of necroinflammatory grade. Conclusions Noninvasive tests for liver fibrosis (measurement of liver stiffness or FibroTest) can predict 5-year survival of patients with chronic hepatitis C. These tools might help physicians determine prognosis at earlier stages and discuss specific treatments, such as liver transplantation.</description><subject>Adult</subject><subject>Aged</subject><subject>Aspartate Aminotransferases - blood</subject><subject>Biomarkers - blood</subject><subject>Biopsy</subject><subject>Chi-Square Distribution</subject><subject>Cirrhosis</subject><subject>Clinical Enzyme Tests</subject><subject>Elasticity Imaging Techniques</subject><subject>Female</subject><subject>FibroScan</subject><subject>FibroTest</subject><subject>France</subject><subject>Gastroenterology and Hepatology</subject><subject>Hepatitis C</subject><subject>Hepatitis C, Chronic - blood</subject><subject>Hepatitis C, Chronic - complications</subject><subject>Hepatitis C, Chronic - diagnosis</subject><subject>Hepatitis C, Chronic - mortality</subject><subject>Hepatitis C, Chronic - therapy</subject><subject>Humans</subject><subject>Liver Cirrhosis - blood</subject><subject>Liver Cirrhosis - diagnosis</subject><subject>Liver Cirrhosis - mortality</subject><subject>Liver Cirrhosis - therapy</subject><subject>Liver Cirrhosis - virology</subject><subject>Liver Transplantation</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Platelet Count</subject><subject>Predictive Value of Tests</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Prospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Severity of Illness Index</subject><subject>Survival</subject><subject>Survival Analysis</subject><subject>Survival Rate</subject><subject>Time Factors</subject><issn>0016-5085</issn><issn>1528-0012</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkUFvEzEQhS0EoqHwDxDyjdMuY3u961yQUERppYhWahHiZHm9s9QhWQfbG6n_nonScuDCaST7vTd63zD2VkAtQKsPm_qnyyXFWoIQNcgatHnGFkJLUwEI-ZwtaLSVBqPP2KucNwCwVEa8ZGdSqK6Fpluw-DVOYTq4HA7I7zCXzMeY-EXoU8whczcNfE1_id-WMI4T5sxvEg7BF66rH-gSv56LjzvMPI78xpWAE4V8D-Wer-4TpXt-iXt6LxS3es1ejG6b8c3jPGffLj7frS6r9fWXq9WndeWbVpaqbwejpe696bRbts43TYtKLb1xqNBLBN0ueyohW62973rojBoGo1wzCGVGdc7en3L3Kf6eqZfdhexxu3UTxjlb04Fuuk4pUjYnpafGOeFo9ynsXHqwAuyRtN3YE2l7JG1BWiJNtnePC-Z-h8Nf0xNaEnw8CZBqHgImmz2x8cQuoS92iOF_G_4N8NtAON32Fz5g3sQ5TYTQCpvJYG-P1z4eWwgA2YFRfwABnqY3</recordid><startdate>20110601</startdate><enddate>20110601</enddate><creator>Vergniol, Julien</creator><creator>Foucher, Juliette</creator><creator>Terrebonne, Eric</creator><creator>Bernard, Pierre–Henri</creator><creator>le Bail, Brigitte</creator><creator>Merrouche, Wassil</creator><creator>Couzigou, Patrice</creator><creator>de Ledinghen, Victor</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20110601</creationdate><title>Noninvasive Tests for Fibrosis and Liver Stiffness Predict 5-Year Outcomes of Patients With Chronic Hepatitis C</title><author>Vergniol, Julien ; Foucher, Juliette ; Terrebonne, Eric ; Bernard, Pierre–Henri ; le Bail, Brigitte ; Merrouche, Wassil ; Couzigou, Patrice ; de Ledinghen, Victor</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c462t-b6d8525bc875a96ac446e339c8ae3ec2e0569b3762655cc7b0783dd83a4d138f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aspartate Aminotransferases - blood</topic><topic>Biomarkers - blood</topic><topic>Biopsy</topic><topic>Chi-Square Distribution</topic><topic>Cirrhosis</topic><topic>Clinical Enzyme Tests</topic><topic>Elasticity Imaging Techniques</topic><topic>Female</topic><topic>FibroScan</topic><topic>FibroTest</topic><topic>France</topic><topic>Gastroenterology and Hepatology</topic><topic>Hepatitis C</topic><topic>Hepatitis C, Chronic - blood</topic><topic>Hepatitis C, Chronic - complications</topic><topic>Hepatitis C, Chronic - diagnosis</topic><topic>Hepatitis C, Chronic - mortality</topic><topic>Hepatitis C, Chronic - therapy</topic><topic>Humans</topic><topic>Liver Cirrhosis - blood</topic><topic>Liver Cirrhosis - diagnosis</topic><topic>Liver Cirrhosis - mortality</topic><topic>Liver Cirrhosis - therapy</topic><topic>Liver Cirrhosis - virology</topic><topic>Liver Transplantation</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Platelet Count</topic><topic>Predictive Value of Tests</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Prospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Severity of Illness Index</topic><topic>Survival</topic><topic>Survival Analysis</topic><topic>Survival Rate</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Vergniol, Julien</creatorcontrib><creatorcontrib>Foucher, Juliette</creatorcontrib><creatorcontrib>Terrebonne, Eric</creatorcontrib><creatorcontrib>Bernard, Pierre–Henri</creatorcontrib><creatorcontrib>le Bail, Brigitte</creatorcontrib><creatorcontrib>Merrouche, Wassil</creatorcontrib><creatorcontrib>Couzigou, Patrice</creatorcontrib><creatorcontrib>de Ledinghen, Victor</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Gastroenterology (New York, N.Y. 1943)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Vergniol, Julien</au><au>Foucher, Juliette</au><au>Terrebonne, Eric</au><au>Bernard, Pierre–Henri</au><au>le Bail, Brigitte</au><au>Merrouche, Wassil</au><au>Couzigou, Patrice</au><au>de Ledinghen, Victor</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Noninvasive Tests for Fibrosis and Liver Stiffness Predict 5-Year Outcomes of Patients With Chronic Hepatitis C</atitle><jtitle>Gastroenterology (New York, N.Y. 1943)</jtitle><addtitle>Gastroenterology</addtitle><date>2011-06-01</date><risdate>2011</risdate><volume>140</volume><issue>7</issue><spage>1970</spage><epage>1979.e3</epage><pages>1970-1979.e3</pages><issn>0016-5085</issn><eissn>1528-0012</eissn><abstract>Background & Aims Liver stiffness can be measured noninvasively to assess liver fibrosis in patients with chronic hepatitis C. In patients with chronic liver diseases, level of fibrosis predicts liver-related complications and survival. We evaluated the abilities of liver stiffness, results from noninvasive tests for fibrosis, and liver biopsy analyses to predict overall survival or survival without liver-related death with a 5-year period. Methods In a consecutive cohort of 1457 patients with chronic hepatitis C, we assessed fibrosis and, on the same day, liver stiffness, performed noninvasive tests of fibrosis (FibroTest, the aspartate aminotransferase to platelet ratio index, FIB-4), and analyzed liver biopsy samples. We analyzed data on death, liver-related death, and liver transplantation collected during a 5-year follow-up period. Results At 5 years, 77 patients had died (39 liver-related deaths) and 16 patients had undergone liver transplantation. Overall survival was 91.7% and survival without liver-related death was 94.4%. Survival was significantly decreased among patients diagnosed with severe fibrosis, regardless of the noninvasive method of analysis. All methods were able to predict shorter survival times in this large population; liver stiffness and results of FibroTest had higher predictive values. Patient outcomes worsened as liver stiffness and FibroTest values increased. Prognostic values of stiffness ( P < .0001) and FibroTest results ( P < .0001) remained after they were adjusted for treatment response, patient age, and estimates of necroinflammatory grade. Conclusions Noninvasive tests for liver fibrosis (measurement of liver stiffness or FibroTest) can predict 5-year survival of patients with chronic hepatitis C. These tools might help physicians determine prognosis at earlier stages and discuss specific treatments, such as liver transplantation.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>21376047</pmid><doi>10.1053/j.gastro.2011.02.058</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Aspartate Aminotransferases - blood Biomarkers - blood Biopsy Chi-Square Distribution Cirrhosis Clinical Enzyme Tests Elasticity Imaging Techniques Female FibroScan FibroTest France Gastroenterology and Hepatology Hepatitis C Hepatitis C, Chronic - blood Hepatitis C, Chronic - complications Hepatitis C, Chronic - diagnosis Hepatitis C, Chronic - mortality Hepatitis C, Chronic - therapy Humans Liver Cirrhosis - blood Liver Cirrhosis - diagnosis Liver Cirrhosis - mortality Liver Cirrhosis - therapy Liver Cirrhosis - virology Liver Transplantation Male Middle Aged Platelet Count Predictive Value of Tests Prognosis Proportional Hazards Models Prospective Studies Risk Assessment Risk Factors Severity of Illness Index Survival Survival Analysis Survival Rate Time Factors |
| title | Noninvasive Tests for Fibrosis and Liver Stiffness Predict 5-Year Outcomes of Patients With Chronic Hepatitis C |
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