Non-Invasive Tests for Fibrosis and Liver Stiffness Predict 5-Year Outcomes of Patients with Chronic Hepatitis C.

March 14, 2011

Gastroenterology. 2011 Mar 1. [Epub ahead of print]

Non-Invasive Tests for Fibrosis and Liver Stiffness Predict 5-Year Outcomes of

Patients with Chronic Hepatitis C.

Vergniol J, Foucher J, Terrebonne E, Bernard PH, Le Bail B, Merrouche W,

Couzigou P, de Lédinghen V.

Centre d'Investigation de la Fibrose hépatique, Hôpital Haut-Lévêque, CHU

Bordeaux, Pessac, France.

Abstract

BACKGROUND & AIMS: Liver stiffness can be measured, non-invasively, 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

non-invasive 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 the

non-invasive tests of fibrosis (FibroTest, the platelet ratio index, FIB-4), and

analyzed liver biopsy samples. We analyzed data on death, liver-related death,

and liver transplantation collected over 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

non-invasive method of analysis. All methods were able to predict shorter

survival times in this large population; liver stiffness and results of the

FibroTest had higher predictive values. Patient outcomes worsened as liver

stiffness and FibroTest values increased. The prognostic values of stiffness

(P<0.0001) and FibroTest results (P<0.0001) remained after they were adjusted

for treatment response, patient age, and estimates of necroinflammatory grade.

CONCLUSION: Non-invasive 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 to determine prognosis at earlier

stages and discuss specific treatments, such as liver transplantation.Copyright

PMID: 21376047 [PubMed - as supplied by publisher]

March 14, 2011