Albumin- bilirubin score as a non-invasive serum biomarker for advanced liver fibrosis and cirrhosis in Egyptian patients with chronic hepatitis C infection: A case-control study

Background: In many health systems, primary care is the main source of health care services. Liver cirrhosis is a silent disease that causes no signs or symptoms until decompensation occurs. Therefore, a simple and readily accessible tool for predicting advanced liver fibrosis and cirrhosis is needed to aid general practitioners in primary care settings. Aim: To explore the predictive performance of Albumin Bilirubin (ALBI) score as a non-invasive serum biomarker for advanced liver fibrosis and cirrhosis. Methods: This case-control study was conducted at Zagazig University Hospitals, Egypt, and comprised 400 participants divided into two equal groups. Group (I): 200 chronic HCV patients with advanced liver fibrosis and cirrhosis [F3-F4] and Group (II): 200 healthy controls. ALBI score was calculated for all study participants. Results: The AUROC for the ALBI score was 0.832 (95% CI: 0.787-0.872) (p-value) Conclusion: ALBI score is reliable for predicting advanced liver fibrosis and cirrhosis and could be valuable in primary care

Fibrofast and fibrosis-4 versus fibroscan as indicators of hepatic fibrosis in non-alcoholic fatty liver disease patients: A cross sectional Study

Aims: Non-alcoholic fatty liver disease (NAFLD) is a broad category for a disease spectrum that includes simple steatosis, which can proceed to non-alcoholic steatohepatitis, cirrhosis, and, finally, hepatocellular carcinoma. Owing to the invasive nature of liver biopsy, the need for non-invasive tools were required for diagnosis. Objective: To compare the performance of simple biochemical scores (fibroblast) FIB-5 and (fibrosis-4) FIB-4 with fibroscan to differentiate mild to moderate fibrosis (MF; F0 to F2) from advanced fibrosis (AF; F3 to F4) in patients with NAFLD. Patients and methods: This cross-sectional study was done on 116 NAFLD patients. All patients were scanned with the FibroScan examination. FIB-5 and FIB-4 were calculated for all patients. Results: The mean kPa score (liver stiffness measurement score) of the patients belonging to advanced fibrosis [9.53 ± 1.05]. The FIB-4 score was significantly higher in patients with advanced fibrosis (1.54 ± 0.38) compared with patients with mild to moderate fibrosis (1.18 ± 0.44), p-value = 0.001, whereas the FIB-5 score was insignificant between patients. Conclusion: FIB-4 is superior to FIB-5 as a non-invasive simple marker in diagnosing advanced fibrosis in NAFLD patients.

Acoustic radiation force impulse elastography and liver fibrosis risk scores in severe obesity

ABSTRACT Objective: Identifying significant fibrosis is crucial to evaluate the prognosis and therapeutic interventions in patients with nonalcoholic fatty liver disease (NAFLD). We assessed the performance of acoustic radiation force impulse (ARFI) elastography, APRI, FIB-4, Forns, NFS and BARD scores in determining liver fibrosis in severe obesity. Subjects and methods: A prospective study included 108 patients undergoing bariatric surgery. Liver biopsy specimens were obtained intraoperatively and classified according to the NAFLD Activity Score. Patients were assessed with serological markers and shear wave velocity of the liver was measured with the Siemens S2000 ultrasound system preoperatively. Optimal cut-off values were determined using the area under the receiver operating characteristic curves (AUROC). Results: In the entire cohort prevalence of NAFLD was 80.6%, steatohepatitis 25.9% and significant fibrosis 19.4%. The best tests for predicting significant fibrosis were FIB-4 and Forns scores (both AUROC 0.78), followed by APRI (AUROC 0.74), NFS (AUROC 0.68), BARD (AUROC 0.64) and ARFI (AUROC 0.62). ARFI elastography was successful in 73% of the patients. Higher body mass index (BMI) correlated with invalid ARFI measurements. In patients with BMI < 42 kg/m2, ARFI showed 92.3% sensitivity and 82,6% specificity for the presence of significant fibrosis, with AUROC 0.86 and cut-off 1.32 m/s. Conclusions: FIB-4 and Forns scores were the most accurate for the prediction of significant fibrosis in bariatric patients. Applicability and accuracy of ARFI was limited in individuals with severe obesity. In patients with BMI < 42 kg/m2, ARFI elastography was capable for predicting significant fibrosis with relevant accuracy.

Non-invasive markers for staging fibrosis in patients with chronic hepatitis Delta / Монголын Анагаах Ухаан

Introduction@#Determining stages of liver fibrosis in chronic liver disease is essential for clinical practice such as decision making on medical treatment, setting the interval of follow-up examination for its complication, screening intervals for hepatocellular carcinoma. @*Goal@#We compared non-invasive fibrosis markers among the patients with chronic hepatitis Delta. @*Materials and Methods@#Totally 70 patients with chronic hepatitis D enrolled into this study. The blood samples were examined for complete blood count, liver function test and serum M2BPGi level. Non-invasive markers such as AAR, APRI, Fib-4 scores were calculated. Those with AAR >1, APRI >0.7, FIB-4 >1.45 were considered with advanced fibrosis. All patients underwent liver stiffness measurement using FibroScan M2 probe. The cutoff values of FibroScan for advanced fibrosis were 9 kPa for patient with normal transaminase level and 11 kPa for patients with elevated transaminase. @*Results@#Advanced fibrosis was observed in 25.7%, 38.6% and 38.6% by AAR, APRI and Fib-4 score, respectively. When cut-off levels of serum M2BPGi for advanced fibrosis was 2.2 COI, 35.7% had advanced fibrosis. FibroScan tests showed 34.4% had advanced fibrosis. The AUROC of M2BPGi were 0.894 and 0.827 for predicting advanced fibrosis and liver cirrhosis. @*Conclusion@#Serum M2BPGi and FibroScan would be reliable diagnostic tool for identifying liver fibrosis in Mongolian patients with chronic hepatitis D.