Inflammation-adapted liver stiffness values for improved fibrosis staging in patients with hepatitis C virus and alcoholic liver disease.

摘要: Background & Aims It is well known that inflammation increases liver stiffness (LS) in patients with chronic hepatitis C (HCV) and alcoholic disease (ALD) independent of fibrosis stage, but no inflammation-adapted cut-off values have been settled so far. An early identification rapid fibrosers, however, essential to decide whom treat first the novel expensive antiviral drugs. Methods Liver stiffness, biopsy-proven stages F0–F4 (METAVIR or Kleiner score) routine laboratory parameters were studied 2068 HCV (n = 1391) ALD (n = 677). Results Among for damage, AST correlated best LS (HCV: r = 0.54, P < 0.0001 ALD: r = 0.34, P < 0.0001). In absence elevated transaminases, almost identical between F1–2, F3 F4 5.1, 9.0 11.9 kPa vs 4.9, 8.1 10.5 kPa). These increased exponentially as a function median level. The impact on was higher lobular-pronounced compared portal tract-localized HCV. Most notably, Cohen's weighted Kappa displayed an improved agreement AST-dependent histological stage both (0.68 0.65) (0.80 0.76). Conclusions The AST-adapted improve non-invasive staging may be also applied other diseases. Especially in HCV, they could help drugs.