Accepted Article
Received Date : 08-Dec-2014 Revised Date : 10-Jan-2015 Accepted Date : 31-Jan-2015 Article type : Original Articles
Occult cirrhosis diagnosed by transient elastography is a frequent and under-monitored clinical entity
Tianyan Chen1, Remy Wong1, Philip Wong1, Kathleen C Rollet-Kurhajec2, Rasha Alshaalan1,
Marc Deschenes1, Peter Ghali1, Giada Sebastiani1,2
1
Division of Gastroenterology and Hepatology, Royal Victoria Hospital, McGill University
Health Centre, Montreal, Canada 2
Chronic Viral Illness Service, McGill University Health Centre, Montreal, Canada
Financial support: the study was not funded. GS holds a Chercheur-Boursier career award from the Fonds de la Recherche en Santé du Quebéc (FRSQ).
Contact information: Dr Giada Sebastiani Department of Medicine, Division of Gastroenterology and Hepatology McGill University Health Center Royal Victoria Hospital 687 Pine Avenue West, Ross 2.28 This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/liv.12802 This article is protected by copyright. All rights reserved.
Accepted Article
Montreal, QC H3A 1A1, Canada Email: [email protected]
List of abbreviations CLD, chronic liver disease; SBP, spontaneous bacterial peritonitis; HCC, hepatocellular carcinoma; LSM, liver stiffness measurement; AUC, area under the curve; AST, aspartate aminotransferase; APRI, aspartate aminotransferase/platelet ratio index; SC, subclinical cirrhosis; IQR, interquartile range; ALT, alanine aminotransferase; BMI, body mass index; INR, international normalized ratio; γGT, gamma glutamyl transpeptidase; kPa, kilopascals; NASH, nonalcoholic steatohepatitis; CI, confidence interval.
Potential conflict of interest: GS has acted as speaker for Merck, Vertex, Gilead, Echosens, served as an advisory board member for Boheringer Ingelheim and Novartis and has received research funding from Vertex, ViiV and Merck. PG has acted as consultant for Merck, Vertex and Gilead. PW has served as consultant for Bristol Myers Squibb, Gilead, Merck, Novartis, Roche, Vertex. MD has served as an advisory board member for Roche, Merck, Janssen, Vertex, Gilead. TC, RW, RA and KCR have nothing to disclose.
Abstract Background & Aims: Diagnosis of preclinical compensated cirrhosis (occult cirrhosis, OC) is challenging due to lack of clinical findings. We evaluated prevalence and outcomes of OC by transient elastography (TE, Fibroscan®).
This article is protected by copyright. All rights reserved.
Accepted Article
representing 17% of the cases; 15 to the non-cirrhotic CLD group, representing 3% of the cases; and 16 to the clinically evident cirrhosis group, representing 10% of the cases. The median length of liver biopsy specimen was 1.8cm (IQR 1.6-2.2). In the OC group, 11 out of 17 (65%) patients had F3 or F4 on liver biopsy. In the clinically evident cirrhosis group, 11 out of 16 (69%) had F3 or F4. In the non-cirrhotic CLD group, 1 out of 15 (6%) had F3, and this figure was significantly lower than the other two groups (p3.25 suggesting advanced fibrosis. These figures were significantly lower than in the clinically evident cirrhosis group, where 72 (43%) patients had APRI ≥2 and 110 patients (65%) had FIB-4 >3.25 (p
Received Date : 08-Dec-2014 Revised Date : 10-Jan-2015 Accepted Date : 31-Jan-2015 Article type : Original Articles
Occult cirrhosis diagnosed by transient elastography is a frequent and under-monitored clinical entity
Tianyan Chen1, Remy Wong1, Philip Wong1, Kathleen C Rollet-Kurhajec2, Rasha Alshaalan1,
Marc Deschenes1, Peter Ghali1, Giada Sebastiani1,2
1
Division of Gastroenterology and Hepatology, Royal Victoria Hospital, McGill University
Health Centre, Montreal, Canada 2
Chronic Viral Illness Service, McGill University Health Centre, Montreal, Canada
Financial support: the study was not funded. GS holds a Chercheur-Boursier career award from the Fonds de la Recherche en Santé du Quebéc (FRSQ).
Contact information: Dr Giada Sebastiani Department of Medicine, Division of Gastroenterology and Hepatology McGill University Health Center Royal Victoria Hospital 687 Pine Avenue West, Ross 2.28 This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1111/liv.12802 This article is protected by copyright. All rights reserved.
Accepted Article
Montreal, QC H3A 1A1, Canada Email: [email protected]
List of abbreviations CLD, chronic liver disease; SBP, spontaneous bacterial peritonitis; HCC, hepatocellular carcinoma; LSM, liver stiffness measurement; AUC, area under the curve; AST, aspartate aminotransferase; APRI, aspartate aminotransferase/platelet ratio index; SC, subclinical cirrhosis; IQR, interquartile range; ALT, alanine aminotransferase; BMI, body mass index; INR, international normalized ratio; γGT, gamma glutamyl transpeptidase; kPa, kilopascals; NASH, nonalcoholic steatohepatitis; CI, confidence interval.
Potential conflict of interest: GS has acted as speaker for Merck, Vertex, Gilead, Echosens, served as an advisory board member for Boheringer Ingelheim and Novartis and has received research funding from Vertex, ViiV and Merck. PG has acted as consultant for Merck, Vertex and Gilead. PW has served as consultant for Bristol Myers Squibb, Gilead, Merck, Novartis, Roche, Vertex. MD has served as an advisory board member for Roche, Merck, Janssen, Vertex, Gilead. TC, RW, RA and KCR have nothing to disclose.
Abstract Background & Aims: Diagnosis of preclinical compensated cirrhosis (occult cirrhosis, OC) is challenging due to lack of clinical findings. We evaluated prevalence and outcomes of OC by transient elastography (TE, Fibroscan®).
This article is protected by copyright. All rights reserved.
Accepted Article
representing 17% of the cases; 15 to the non-cirrhotic CLD group, representing 3% of the cases; and 16 to the clinically evident cirrhosis group, representing 10% of the cases. The median length of liver biopsy specimen was 1.8cm (IQR 1.6-2.2). In the OC group, 11 out of 17 (65%) patients had F3 or F4 on liver biopsy. In the clinically evident cirrhosis group, 11 out of 16 (69%) had F3 or F4. In the non-cirrhotic CLD group, 1 out of 15 (6%) had F3, and this figure was significantly lower than the other two groups (p3.25 suggesting advanced fibrosis. These figures were significantly lower than in the clinically evident cirrhosis group, where 72 (43%) patients had APRI ≥2 and 110 patients (65%) had FIB-4 >3.25 (p
