Tuesday, August 26, 2014

Chronic hepatitis C and liver fibrosis

Chronic hepatitis C and liver fibrosis

Good afternoon folks, today on the blog the focus in on liver fibrosis and noninvasive methods to estimate liver fibrosis in chronic hepatitis C infection.

An article published online in the August issue of World Journal of Gastroenterology offers an updated review of liver fibrosis associated with HCV, with an in-depth look at noninvasive testing used currently in clinical practice to assess liver fibrosis.

The clinical article is written using medical terminology that only a professional in the industry could understand, after five minutes of reading I was on ARRP's website researching ways to improve my brain function. Which is so hypocritical, considering I refuse to join any organization for people fifty and over. However, I did read an article about Cher while I was there, which by the way is highly entertaining.

In any event, after reading the entire article; Chronic hepatitis C and liver fibrosisyou should come away understanding the importance of using noninvasive testing to manage chronic hepatitis C, and the likely course of the disease. In addition, as noted by the authors; to monitor the regression of liver fibrosis in response to antiviral therapy.

FibroScan® Noninvasive test to measure liver inflammation and fibrosis

Essentially, most people are familiar with FibroScan®, FDA approved in 2013, with that said, before you read the article, Stuart Gordon, M.D., Director of Hepatology at Henry Ford Hospital explains FibroScan® in simple terms;

Using FibroScan ®, the skin in the area of the liver is first coated with a water-based gel. The doctor then passes an ultrasound sensor over the area to take 10 consecutive readings. The sensor produces vibrations that create a low-frequency seismic wave sent between the ribs and into the liver. The speed of the wave as it passes through the liver is used to determine the hardness or stiffness of the organ – the faster the wave, the harder the tissue.
The data collected during the readings are collected and analyzed in the console connected to the sensor, and provides immediate results on the presence and severity of liver fibrosis.

For people who have utilized the test, information understanding results or stage of fibrosis can be confusing. On the website, a scoring card is available, making it easier to convert test results into grading systems that are used to determine "liver biopsy" results. 

What is liver fibrosis?

HCV Advocate has an array of current fact sheets at your disposal explaining liver fibrosis, please consider reading; What is liver fibrosis and Use of Fibroscan in medical practice, both updated within the last two months. Lucinda K. Porter, RN., who writes for HCV Advocate and hepmag.com., recently published; Hepatitis C: Some Good News for a Change, which offers a few facts about fibrosis.

Role of magnetic resonance elastography in compensated and decompensated liver disease

Research into the natural history of HCV suggest the disease usually evolves slowly, how quickly liver damage develops depends on a number of factors; older age at infection, gender, diabetes, obesity, hepatic steatosis, alcohol use, and co-infection with HBV or HIV. 

For example, a 50-year old who has been infected with HCV for 30 years is likely to have a higher HCV-related morality risk, even when the above cofactors are not present, in relation to a 30-year old with 5 to 10 years of infection and several cofactors. 

Therefore people who did not achieve SVR,  ( never treatednatural history of HCV) and were infected with HCV in the 1970s and 1980s, also a time before Direct-acting antiviral therapies were available, are at a greatest risk for disease progression, including cirrhosis and liver cancer.

This brings us to another noninvasive test for accessing liver damage in persons with cirrhosis called magnetic resonance elastography or MRE. In the article; Role of magnetic resonance elastography in compensated and decompensated liver disease, by Dr. Sumeet Asrani from Baylor University, the good doctor discusses the role of MRE used to predict the progression of cirrhosis from compensated to decompensated disease. View a video summarizing the article, here, or the article found in May 2014 issue of Journal of Hepatology.

Finally, check out the article published online in World Journal of Gastroenterology

See you soon, stay well.


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