Staging chronic hepatitis C in seven categories using fibrosis biomarker (FibroTest™) and transient elastography (FibroScan®)

Thierry Poynard, Julien Vergniol, Yen Ngo, Juliette Foucher, Mona Munteanu, Wassil Merrouche, Massimo Colombo, Vincent Thibault, Eugene R Schiff, Clifford A. Brass, Janice K. Albrecht, Marika Rudler, Olivier Deckmyn, Pascal Lebray, Dominique Thabut, Vlad Ratziu, Victor De Ledinghen

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

Background & Aims FibroTest™ (FT) and Transient Elastography (TE) have been validated as non-invasive markers of METAVIR fibrosis stages from F0 to F4 using biopsy, and as prognostic markers of liver related mortality in patients with chronic hepatitis C. The aim was to extend the validation of FT and TE as markers of critical steps defined by occurrence of cirrhosis without complications (F4.1), esophageal varices (F4.2), and severe complications (F4.3): primary liver cancer, variceal bleeding, or decompensation (ascites, encephalopathy, or jaundice). Methods The updated individual data of 3927 patients (1046 cirrhotics) without complications at baseline were pooled from three prospective cohorts called "EPIC", "Paris", and "Bordeaux" cohorts. Results At 5 years, among 501 patients without varices at baseline (F4.1) varices occurred in 19 patients [F4.2 incidence of 4.0% (95% CI 2.2-5.8)]. The predictive performance (AUROC) of FT was 0.77 (0.66-0.84; p <0.001). At 10 years severe complications occurred in 203 patients, [F4.3 incidence of 13.4% (9.6-17.1)], including primary liver cancer in 84 patients [6.4% (3.5-9.3)]. FT was predictive (Cox adjusted on treatment) of severe complications [AUROC 0.79 (76-82); p <0.0001], including primary liver cancer [AUROC 0.84 (80-87); p <0.0001]. Similarly TE was predictive of severe complications [AUROC 0.77 (72-81); p <0.0001], including primary liver cancer [AUROC 0.86 (81-90); p <0.0001]. Conclusions FibroTest™ and TE increase were associated with the occurrence of all severe complications including hepatocellular carcinoma, hepatic insufficiency, and variceal bleeding. FibroTest™ increase was also associated with the occurrence of esophageal varices.

Original languageEnglish
Pages (from-to)706-714
Number of pages9
JournalJournal of Hepatology
Volume60
Issue number4
DOIs
StatePublished - Jan 1 2014

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Elasticity Imaging Techniques
Chronic Hepatitis C
Fibrosis
Biomarkers
Liver Neoplasms
Esophageal and Gastric Varices
Varicose Veins
Hemorrhage
Hepatic Insufficiency
Incidence
Brain Diseases
Paris
Jaundice
Ascites
Hepatocellular Carcinoma
Biopsy
Mortality
Liver

Keywords

  • Cirrhosis complications
  • Elastography
  • Fibrosis stages
  • FibroTest™
  • Hepatocellular carcinoma
  • Prognostic factors
  • Surrogate markers

ASJC Scopus subject areas

  • Hepatology

Cite this

Staging chronic hepatitis C in seven categories using fibrosis biomarker (FibroTest™) and transient elastography (FibroScan®). / Poynard, Thierry; Vergniol, Julien; Ngo, Yen; Foucher, Juliette; Munteanu, Mona; Merrouche, Wassil; Colombo, Massimo; Thibault, Vincent; Schiff, Eugene R; Brass, Clifford A.; Albrecht, Janice K.; Rudler, Marika; Deckmyn, Olivier; Lebray, Pascal; Thabut, Dominique; Ratziu, Vlad; De Ledinghen, Victor.

In: Journal of Hepatology, Vol. 60, No. 4, 01.01.2014, p. 706-714.

Research output: Contribution to journalArticle

Poynard, T, Vergniol, J, Ngo, Y, Foucher, J, Munteanu, M, Merrouche, W, Colombo, M, Thibault, V, Schiff, ER, Brass, CA, Albrecht, JK, Rudler, M, Deckmyn, O, Lebray, P, Thabut, D, Ratziu, V & De Ledinghen, V 2014, 'Staging chronic hepatitis C in seven categories using fibrosis biomarker (FibroTest™) and transient elastography (FibroScan®)', Journal of Hepatology, vol. 60, no. 4, pp. 706-714. https://doi.org/10.1016/j.jhep.2013.11.016
Poynard, Thierry ; Vergniol, Julien ; Ngo, Yen ; Foucher, Juliette ; Munteanu, Mona ; Merrouche, Wassil ; Colombo, Massimo ; Thibault, Vincent ; Schiff, Eugene R ; Brass, Clifford A. ; Albrecht, Janice K. ; Rudler, Marika ; Deckmyn, Olivier ; Lebray, Pascal ; Thabut, Dominique ; Ratziu, Vlad ; De Ledinghen, Victor. / Staging chronic hepatitis C in seven categories using fibrosis biomarker (FibroTest™) and transient elastography (FibroScan®). In: Journal of Hepatology. 2014 ; Vol. 60, No. 4. pp. 706-714.
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T1 - Staging chronic hepatitis C in seven categories using fibrosis biomarker (FibroTest™) and transient elastography (FibroScan®)

AU - Poynard, Thierry

AU - Vergniol, Julien

AU - Ngo, Yen

AU - Foucher, Juliette

AU - Munteanu, Mona

AU - Merrouche, Wassil

AU - Colombo, Massimo

AU - Thibault, Vincent

AU - Schiff, Eugene R

AU - Brass, Clifford A.

AU - Albrecht, Janice K.

AU - Rudler, Marika

AU - Deckmyn, Olivier

AU - Lebray, Pascal

AU - Thabut, Dominique

AU - Ratziu, Vlad

AU - De Ledinghen, Victor

PY - 2014/1/1

Y1 - 2014/1/1

N2 - Background & Aims FibroTest™ (FT) and Transient Elastography (TE) have been validated as non-invasive markers of METAVIR fibrosis stages from F0 to F4 using biopsy, and as prognostic markers of liver related mortality in patients with chronic hepatitis C. The aim was to extend the validation of FT and TE as markers of critical steps defined by occurrence of cirrhosis without complications (F4.1), esophageal varices (F4.2), and severe complications (F4.3): primary liver cancer, variceal bleeding, or decompensation (ascites, encephalopathy, or jaundice). Methods The updated individual data of 3927 patients (1046 cirrhotics) without complications at baseline were pooled from three prospective cohorts called "EPIC", "Paris", and "Bordeaux" cohorts. Results At 5 years, among 501 patients without varices at baseline (F4.1) varices occurred in 19 patients [F4.2 incidence of 4.0% (95% CI 2.2-5.8)]. The predictive performance (AUROC) of FT was 0.77 (0.66-0.84; p <0.001). At 10 years severe complications occurred in 203 patients, [F4.3 incidence of 13.4% (9.6-17.1)], including primary liver cancer in 84 patients [6.4% (3.5-9.3)]. FT was predictive (Cox adjusted on treatment) of severe complications [AUROC 0.79 (76-82); p <0.0001], including primary liver cancer [AUROC 0.84 (80-87); p <0.0001]. Similarly TE was predictive of severe complications [AUROC 0.77 (72-81); p <0.0001], including primary liver cancer [AUROC 0.86 (81-90); p <0.0001]. Conclusions FibroTest™ and TE increase were associated with the occurrence of all severe complications including hepatocellular carcinoma, hepatic insufficiency, and variceal bleeding. FibroTest™ increase was also associated with the occurrence of esophageal varices.

AB - Background & Aims FibroTest™ (FT) and Transient Elastography (TE) have been validated as non-invasive markers of METAVIR fibrosis stages from F0 to F4 using biopsy, and as prognostic markers of liver related mortality in patients with chronic hepatitis C. The aim was to extend the validation of FT and TE as markers of critical steps defined by occurrence of cirrhosis without complications (F4.1), esophageal varices (F4.2), and severe complications (F4.3): primary liver cancer, variceal bleeding, or decompensation (ascites, encephalopathy, or jaundice). Methods The updated individual data of 3927 patients (1046 cirrhotics) without complications at baseline were pooled from three prospective cohorts called "EPIC", "Paris", and "Bordeaux" cohorts. Results At 5 years, among 501 patients without varices at baseline (F4.1) varices occurred in 19 patients [F4.2 incidence of 4.0% (95% CI 2.2-5.8)]. The predictive performance (AUROC) of FT was 0.77 (0.66-0.84; p <0.001). At 10 years severe complications occurred in 203 patients, [F4.3 incidence of 13.4% (9.6-17.1)], including primary liver cancer in 84 patients [6.4% (3.5-9.3)]. FT was predictive (Cox adjusted on treatment) of severe complications [AUROC 0.79 (76-82); p <0.0001], including primary liver cancer [AUROC 0.84 (80-87); p <0.0001]. Similarly TE was predictive of severe complications [AUROC 0.77 (72-81); p <0.0001], including primary liver cancer [AUROC 0.86 (81-90); p <0.0001]. Conclusions FibroTest™ and TE increase were associated with the occurrence of all severe complications including hepatocellular carcinoma, hepatic insufficiency, and variceal bleeding. FibroTest™ increase was also associated with the occurrence of esophageal varices.

KW - Cirrhosis complications

KW - Elastography

KW - Fibrosis stages

KW - FibroTest™

KW - Hepatocellular carcinoma

KW - Prognostic factors

KW - Surrogate markers

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