Outreach screening of drug users for cirrhosis with transient elastography
ABSTRACT Aims Transient elastography (TE) is a non‐invasive sensitive tool for diagnosing cirrhosis in hospital‐based cohorts. This study aimed to evaluate TE as a screening tool for cirrhosis among drug users. Design Cross‐sectional study. Setting All treatment centres in the county of Funen, De...
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creator | Moessner, Belinda K. Jørgensen, Tina R. Skamling, Merete Vyberg, Mogens Junker, Peter Pedersen, Court Christensen, Peer B. |
description | ABSTRACT
Aims Transient elastography (TE) is a non‐invasive sensitive tool for diagnosing cirrhosis in hospital‐based cohorts. This study aimed to evaluate TE as a screening tool for cirrhosis among drug users.
Design Cross‐sectional study.
Setting All treatment centres in the county of Funen, Denmark.
Participants Drug users attending treatment centres during the presence of the study team.
Measurements Liver stiffness measurements (LSM) by transient elastography using the Fibroscan device; blood tests for viral hepatitis, HIV infection and hyaluronic acid (HA) levels; and routine liver tests. Individuals with LSM ≥ 8 kPa were referred to the hospital for treatment evaluation. Individuals with LSM ≥ 12 kPa were recommended a liver biopsy.
Findings Among 175 drug users negative for hepatitis C, 13% had LSM = 8–11.9 kPa and 4% had LSM ≥ 12 kPa; elevated LSM was associated with a body mass index (BMI) > 30. Among 128 drug users with chronic hepatitis C, 19.5% had LSM = 8–11.9 kPa and 21.1% had LSM ≥ 12 kPa (P |
doi_str_mv | 10.1111/j.1360-0443.2010.03246.x |
format | Article |
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Aims Transient elastography (TE) is a non‐invasive sensitive tool for diagnosing cirrhosis in hospital‐based cohorts. This study aimed to evaluate TE as a screening tool for cirrhosis among drug users.
Design Cross‐sectional study.
Setting All treatment centres in the county of Funen, Denmark.
Participants Drug users attending treatment centres during the presence of the study team.
Measurements Liver stiffness measurements (LSM) by transient elastography using the Fibroscan device; blood tests for viral hepatitis, HIV infection and hyaluronic acid (HA) levels; and routine liver tests. Individuals with LSM ≥ 8 kPa were referred to the hospital for treatment evaluation. Individuals with LSM ≥ 12 kPa were recommended a liver biopsy.
Findings Among 175 drug users negative for hepatitis C, 13% had LSM = 8–11.9 kPa and 4% had LSM ≥ 12 kPa; elevated LSM was associated with a body mass index (BMI) > 30. Among 128 drug users with chronic hepatitis C, 19.5% had LSM = 8–11.9 kPa and 21.1% had LSM ≥ 12 kPa (P < 0.001). Repeat LSM at liver biopsy performed a median 3 months after screening showed a significant decrease (<12 kPa) among 30% (six of 20), and this was independent of alcohol consumption, BMI, age and gender. In 29 patients where liver biopsy was performed a LSM ≥ 16 kPa predicted cirrhosis with 88.9% sensitivity and 90% specificity.
Conclusions Transient elastography is a feasible screening tool for cirrhosis among drug users. Transient elastography identifies severe liver fibrosis in a significant proportion of drug users with hepatitis C infections but management should not be based on a single elevated liver stiffness measurement.</description><identifier>ISSN: 0965-2140</identifier><identifier>EISSN: 1360-0443</identifier><identifier>DOI: 10.1111/j.1360-0443.2010.03246.x</identifier><identifier>PMID: 21182552</identifier><identifier>CODEN: ADICE5</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject>Addictive behaviors ; Adult ; Adult and adolescent clinical studies ; AIDS ; Biological and medical sciences ; Biomarkers - blood ; Biopsy ; Cirrhosis ; Cross-sectional analysis ; Cross-Sectional Studies ; Denmark ; Denmark - epidemiology ; Drug abuse ; Drug addiction ; Drug use ; Drug users ; Elasticity Imaging Techniques ; Evaluation ; Female ; Fibrosis ; Gastroenterology. Liver. Pancreas. Abdomen ; hepatitis C ; Hepatitis C, Chronic - complications ; Hepatitis C, Chronic - diagnosis ; Hepatitis C, Chronic - epidemiology ; HIV ; Humans ; hyaluronic acid ; Hyaluronic Acid - blood ; Liver ; Liver - pathology ; Liver cirrhosis ; Liver Cirrhosis - diagnosis ; Liver Cirrhosis - epidemiology ; Liver Cirrhosis - pathology ; Liver. Biliary tract. Portal circulation. Exocrine pancreas ; Male ; Mass Screening - methods ; Medical imaging ; Medical sciences ; Medical screening ; Middle Aged ; Other diseases. Semiology ; Patients ; Prevention and actions ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Public health. Hygiene ; Public health. Hygiene-occupational medicine ; screening ; Sensitivity and Specificity ; street-based ; Substance Abuse, Intravenous - complications ; Substance Abuse, Intravenous - epidemiology ; transient elastography</subject><ispartof>Addiction (Abingdon, England), 2011-05, Vol.106 (5), p.970-976</ispartof><rights>2010 The Authors, Addiction © 2010 Society for the Study of Addiction</rights><rights>2015 INIST-CNRS</rights><rights>2010 The Authors, Addiction © 2010 Society for the Study of Addiction.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4956-7359ead178d607e335c5b726e64f419f99b03d6c850b49e8011e8cbda8e5520f3</citedby><cites>FETCH-LOGICAL-c4956-7359ead178d607e335c5b726e64f419f99b03d6c850b49e8011e8cbda8e5520f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1360-0443.2010.03246.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1360-0443.2010.03246.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24073001$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21182552$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Moessner, Belinda K.</creatorcontrib><creatorcontrib>Jørgensen, Tina R.</creatorcontrib><creatorcontrib>Skamling, Merete</creatorcontrib><creatorcontrib>Vyberg, Mogens</creatorcontrib><creatorcontrib>Junker, Peter</creatorcontrib><creatorcontrib>Pedersen, Court</creatorcontrib><creatorcontrib>Christensen, Peer B.</creatorcontrib><title>Outreach screening of drug users for cirrhosis with transient elastography</title><title>Addiction (Abingdon, England)</title><addtitle>Addiction</addtitle><description>ABSTRACT
Aims Transient elastography (TE) is a non‐invasive sensitive tool for diagnosing cirrhosis in hospital‐based cohorts. This study aimed to evaluate TE as a screening tool for cirrhosis among drug users.
Design Cross‐sectional study.
Setting All treatment centres in the county of Funen, Denmark.
Participants Drug users attending treatment centres during the presence of the study team.
Measurements Liver stiffness measurements (LSM) by transient elastography using the Fibroscan device; blood tests for viral hepatitis, HIV infection and hyaluronic acid (HA) levels; and routine liver tests. Individuals with LSM ≥ 8 kPa were referred to the hospital for treatment evaluation. Individuals with LSM ≥ 12 kPa were recommended a liver biopsy.
Findings Among 175 drug users negative for hepatitis C, 13% had LSM = 8–11.9 kPa and 4% had LSM ≥ 12 kPa; elevated LSM was associated with a body mass index (BMI) > 30. Among 128 drug users with chronic hepatitis C, 19.5% had LSM = 8–11.9 kPa and 21.1% had LSM ≥ 12 kPa (P < 0.001). Repeat LSM at liver biopsy performed a median 3 months after screening showed a significant decrease (<12 kPa) among 30% (six of 20), and this was independent of alcohol consumption, BMI, age and gender. In 29 patients where liver biopsy was performed a LSM ≥ 16 kPa predicted cirrhosis with 88.9% sensitivity and 90% specificity.
Conclusions Transient elastography is a feasible screening tool for cirrhosis among drug users. Transient elastography identifies severe liver fibrosis in a significant proportion of drug users with hepatitis C infections but management should not be based on a single elevated liver stiffness measurement.</description><subject>Addictive behaviors</subject><subject>Adult</subject><subject>Adult and adolescent clinical studies</subject><subject>AIDS</subject><subject>Biological and medical sciences</subject><subject>Biomarkers - blood</subject><subject>Biopsy</subject><subject>Cirrhosis</subject><subject>Cross-sectional analysis</subject><subject>Cross-Sectional Studies</subject><subject>Denmark</subject><subject>Denmark - epidemiology</subject><subject>Drug abuse</subject><subject>Drug addiction</subject><subject>Drug use</subject><subject>Drug users</subject><subject>Elasticity Imaging Techniques</subject><subject>Evaluation</subject><subject>Female</subject><subject>Fibrosis</subject><subject>Gastroenterology. Liver. Pancreas. Abdomen</subject><subject>hepatitis C</subject><subject>Hepatitis C, Chronic - complications</subject><subject>Hepatitis C, Chronic - diagnosis</subject><subject>Hepatitis C, Chronic - epidemiology</subject><subject>HIV</subject><subject>Humans</subject><subject>hyaluronic acid</subject><subject>Hyaluronic Acid - blood</subject><subject>Liver</subject><subject>Liver - pathology</subject><subject>Liver cirrhosis</subject><subject>Liver Cirrhosis - diagnosis</subject><subject>Liver Cirrhosis - epidemiology</subject><subject>Liver Cirrhosis - pathology</subject><subject>Liver. Biliary tract. Portal circulation. Exocrine pancreas</subject><subject>Male</subject><subject>Mass Screening - methods</subject><subject>Medical imaging</subject><subject>Medical sciences</subject><subject>Medical screening</subject><subject>Middle Aged</subject><subject>Other diseases. Semiology</subject><subject>Patients</subject><subject>Prevention and actions</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Public health. Hygiene</subject><subject>Public health. Hygiene-occupational medicine</subject><subject>screening</subject><subject>Sensitivity and Specificity</subject><subject>street-based</subject><subject>Substance Abuse, Intravenous - complications</subject><subject>Substance Abuse, Intravenous - epidemiology</subject><subject>transient elastography</subject><issn>0965-2140</issn><issn>1360-0443</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkU-P0zAQxS0EYsvCV0AWEuKUMv6b-MBh1WULaJe9gDhajjNpU9Kk2Im2_fY4tBSJC_hia_x7o5n3CKEM5iydt5s5ExoykFLMOaQqCC71fP-IzM4fj8kMjFYZZxIuyLMYNwCQF0Y-JRecsYIrxWfk0_04BHR-TaMPiF3TrWhf0yqMKzpGDJHWfaC-CWHdxybSh2ZY0yG4LjbYDRRbF4d-FdxufXhOntSujfjidF-Srzfvvyw-ZLf3y4-Lq9vMS6N0lgtl0FUsLyoNOQqhvCpzrlHLWjJTG1OCqLQvFJTSYAGMYeHLyhWYJoZaXJI3x7670P8YMQ5220SPbes67MdoDQdQhvP8n2ShmTLMGEjkq7_ITT-GLq2RIDCgpRIJKo6QD32MAWu7C83WhYNlYKdc7MZO9tvJfjvlYn_lYvdJ-vLUfyy3WJ2Fv4NIwOsT4KJ3bZ0c9k38w0nIBQBL3Lsj99C0ePjvAezV9fX0SvrsqG_igPuz3oXvVuciV_bb56VVZnF3o--WloufQxW19A</recordid><startdate>201105</startdate><enddate>201105</enddate><creator>Moessner, Belinda K.</creator><creator>Jørgensen, Tina R.</creator><creator>Skamling, Merete</creator><creator>Vyberg, Mogens</creator><creator>Junker, Peter</creator><creator>Pedersen, Court</creator><creator>Christensen, Peer B.</creator><general>Blackwell Publishing Ltd</general><general>Blackwell</general><scope>BSCLL</scope><scope>IQODW</scope><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>7QG</scope><scope>7TK</scope><scope>8BJ</scope><scope>FQK</scope><scope>JBE</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>201105</creationdate><title>Outreach screening of drug users for cirrhosis with transient elastography</title><author>Moessner, Belinda K. ; Jørgensen, Tina R. ; Skamling, Merete ; Vyberg, Mogens ; Junker, Peter ; Pedersen, Court ; Christensen, Peer B.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4956-7359ead178d607e335c5b726e64f419f99b03d6c850b49e8011e8cbda8e5520f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Addictive behaviors</topic><topic>Adult</topic><topic>Adult and adolescent clinical studies</topic><topic>AIDS</topic><topic>Biological and medical sciences</topic><topic>Biomarkers - blood</topic><topic>Biopsy</topic><topic>Cirrhosis</topic><topic>Cross-sectional analysis</topic><topic>Cross-Sectional Studies</topic><topic>Denmark</topic><topic>Denmark - epidemiology</topic><topic>Drug abuse</topic><topic>Drug addiction</topic><topic>Drug use</topic><topic>Drug users</topic><topic>Elasticity Imaging Techniques</topic><topic>Evaluation</topic><topic>Female</topic><topic>Fibrosis</topic><topic>Gastroenterology. Liver. Pancreas. Abdomen</topic><topic>hepatitis C</topic><topic>Hepatitis C, Chronic - complications</topic><topic>Hepatitis C, Chronic - diagnosis</topic><topic>Hepatitis C, Chronic - epidemiology</topic><topic>HIV</topic><topic>Humans</topic><topic>hyaluronic acid</topic><topic>Hyaluronic Acid - blood</topic><topic>Liver</topic><topic>Liver - pathology</topic><topic>Liver cirrhosis</topic><topic>Liver Cirrhosis - diagnosis</topic><topic>Liver Cirrhosis - epidemiology</topic><topic>Liver Cirrhosis - pathology</topic><topic>Liver. Biliary tract. Portal circulation. Exocrine pancreas</topic><topic>Male</topic><topic>Mass Screening - methods</topic><topic>Medical imaging</topic><topic>Medical sciences</topic><topic>Medical screening</topic><topic>Middle Aged</topic><topic>Other diseases. Semiology</topic><topic>Patients</topic><topic>Prevention and actions</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Public health. Hygiene</topic><topic>Public health. Hygiene-occupational medicine</topic><topic>screening</topic><topic>Sensitivity and Specificity</topic><topic>street-based</topic><topic>Substance Abuse, Intravenous - complications</topic><topic>Substance Abuse, Intravenous - epidemiology</topic><topic>transient elastography</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Moessner, Belinda K.</creatorcontrib><creatorcontrib>Jørgensen, Tina R.</creatorcontrib><creatorcontrib>Skamling, Merete</creatorcontrib><creatorcontrib>Vyberg, Mogens</creatorcontrib><creatorcontrib>Junker, Peter</creatorcontrib><creatorcontrib>Pedersen, Court</creatorcontrib><creatorcontrib>Christensen, Peer B.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Animal Behavior Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>International Bibliography of the Social Sciences (IBSS)</collection><collection>International Bibliography of the Social Sciences</collection><collection>International Bibliography of the Social Sciences</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Addiction (Abingdon, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Moessner, Belinda K.</au><au>Jørgensen, Tina R.</au><au>Skamling, Merete</au><au>Vyberg, Mogens</au><au>Junker, Peter</au><au>Pedersen, Court</au><au>Christensen, Peer B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Outreach screening of drug users for cirrhosis with transient elastography</atitle><jtitle>Addiction (Abingdon, England)</jtitle><addtitle>Addiction</addtitle><date>2011-05</date><risdate>2011</risdate><volume>106</volume><issue>5</issue><spage>970</spage><epage>976</epage><pages>970-976</pages><issn>0965-2140</issn><eissn>1360-0443</eissn><coden>ADICE5</coden><abstract>ABSTRACT
Aims Transient elastography (TE) is a non‐invasive sensitive tool for diagnosing cirrhosis in hospital‐based cohorts. This study aimed to evaluate TE as a screening tool for cirrhosis among drug users.
Design Cross‐sectional study.
Setting All treatment centres in the county of Funen, Denmark.
Participants Drug users attending treatment centres during the presence of the study team.
Measurements Liver stiffness measurements (LSM) by transient elastography using the Fibroscan device; blood tests for viral hepatitis, HIV infection and hyaluronic acid (HA) levels; and routine liver tests. Individuals with LSM ≥ 8 kPa were referred to the hospital for treatment evaluation. Individuals with LSM ≥ 12 kPa were recommended a liver biopsy.
Findings Among 175 drug users negative for hepatitis C, 13% had LSM = 8–11.9 kPa and 4% had LSM ≥ 12 kPa; elevated LSM was associated with a body mass index (BMI) > 30. Among 128 drug users with chronic hepatitis C, 19.5% had LSM = 8–11.9 kPa and 21.1% had LSM ≥ 12 kPa (P < 0.001). Repeat LSM at liver biopsy performed a median 3 months after screening showed a significant decrease (<12 kPa) among 30% (six of 20), and this was independent of alcohol consumption, BMI, age and gender. In 29 patients where liver biopsy was performed a LSM ≥ 16 kPa predicted cirrhosis with 88.9% sensitivity and 90% specificity.
Conclusions Transient elastography is a feasible screening tool for cirrhosis among drug users. Transient elastography identifies severe liver fibrosis in a significant proportion of drug users with hepatitis C infections but management should not be based on a single elevated liver stiffness measurement.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>21182552</pmid><doi>10.1111/j.1360-0443.2010.03246.x</doi><tpages>7</tpages></addata></record> |
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subjects | Addictive behaviors Adult Adult and adolescent clinical studies AIDS Biological and medical sciences Biomarkers - blood Biopsy Cirrhosis Cross-sectional analysis Cross-Sectional Studies Denmark Denmark - epidemiology Drug abuse Drug addiction Drug use Drug users Elasticity Imaging Techniques Evaluation Female Fibrosis Gastroenterology. Liver. Pancreas. Abdomen hepatitis C Hepatitis C, Chronic - complications Hepatitis C, Chronic - diagnosis Hepatitis C, Chronic - epidemiology HIV Humans hyaluronic acid Hyaluronic Acid - blood Liver Liver - pathology Liver cirrhosis Liver Cirrhosis - diagnosis Liver Cirrhosis - epidemiology Liver Cirrhosis - pathology Liver. Biliary tract. Portal circulation. Exocrine pancreas Male Mass Screening - methods Medical imaging Medical sciences Medical screening Middle Aged Other diseases. Semiology Patients Prevention and actions Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Public health. Hygiene Public health. Hygiene-occupational medicine screening Sensitivity and Specificity street-based Substance Abuse, Intravenous - complications Substance Abuse, Intravenous - epidemiology transient elastography |
title | Outreach screening of drug users for cirrhosis with transient elastography |
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