Primary care screening for fibrosis in hepatitis C

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Accepted Manuscript

Journal of Hepatology

September 2018

Volume 69, Issue 3, Pages 575–583 

Liver stiffness measurement in the primary care setting detects high rates of advanced fibrosis and predicts liver related events in hepatitis C

Stephen Bloom , William Kemp, Amanda Nicoll, Stuart K. Roberts, Paul Gow, Anouk Dev, Sally Bell, Siddharth Sood, Ian Kronborg, Virginia Knight, Diana Lewis, John Lubel

Lay Summary
The prevalence of advanced liver disease in primary care managed hepatitis C is unknown. Our data suggests that rates of advanced fibrosis in the community are significant (16.5%), often underdiagnosed and comparable to rates seen in specialist referral centres. Liver stiffness measurement is a feasible community screening tool prior to hepatitis C therapy and can predict liver-related adverse events.

Highlights
•The rate of advanced fibrosis in community hepatitis C is significant at 16.5%.
•No laboratory features of active disease were seen in 8.5% at risk of cirrhosis.
•Rates of advanced fibrosis were comparable between a hospital and community groups.
•Older age, high BMI, ALT and alcohol use were linked to elevated liver stiffness.

•A liver stiffness greater than 24 kPa predicted liver related events in this cohort.

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