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Fibrosis regression following hepatitis C antiviral therapy

World Journal of Hepatology 2022年第6期14卷 1120-1130页

作者： aisha elsharkawy Reham Samir Mohamed El-Kassas Department of Endemic Medicine and Hepatogastroenterology Faculty of MedicineCairo UniversityCairo 11566Egypt Department of Endemic Medicine Faculty of MedicineHelwan UniversityCairo 11795Egypt

Hepatitis C virus(HCV)infection is one of the most common causes of liver *** is a major etiological factor of continuous liver injury by triggering an uncontrolled inflammatory response,causing liver fibrosis and *** fibrosis is a dynamic process that can be reversible upon timely cessation of the injurious agent,which in cases of HCV is represented by the sustained virological response(SVR)following antiviral ***-acting antiviral therapy has recently revolutionized HCV therapy and minimized *** fibrosis can be assessed with variable invasive and non-invasive methods,with certain *** the broad validation of the diagnostic and prognostic value of non-invasive modalities of assessment of liver fibrosis in patients with HCV,the proper interpretation of liver stiffness measurement in patients after SVR remains *** is also still a debate whether this regression is caused by the resolution of liver injury following treatment of HCV,rather than true fibrosis *** of liver fibrosis can possess a positive impact on patient's quality of life reducing the incidence of ***,fibrosis regression does not abolish the risk of developing hepatocellular carcinoma,which mandates regular screening of patients with advanced fibrosis.

关键词： Fibrosis regression Hepatitis C virus Direct-acting antivirals Hepatocellular carcinoma Liver fibrosis Cirrhosis

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Coinfection with hepatitis C virus and schistosomiasis:Fibrosis and treatment response

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World Journal of Gastroenterology 2013年第17期19卷 2691-2696页

作者： Mahasen Abdel-Rahman Mohammad El-Sayed Maissa El Raziky aisha elsharkawy Wafaa El-Akel Hossam Ghoneim Hany Khattab Gamal Esmat Department of Endemic Medicine and Hepatology Faculty of Medicine Cairo University Department of Endemic Medicine and Hepatology Faculty of Medicine Beni-Suef University Department of Pathology Faculty of MedicineCairo University

AIM:To assess whether schistosomiasis coinfection with chronic hepatitis C virus (HCV) influences hepatic fibrosis and pegylated-interferon/ribavirin (PEG-IFN/ RIB) therapy response. METHODS:This study was designed as a retrospective analysis of 3596 chronic HCV patients enrolled in the Egyptian National Program for HCV treatment with PEG-IFN/RIB. All patients underwent liver biopsy and anti-schistosomal antibodies testing prior to HCV treatment. The serology results were used to categorize the patients into group A (positive schistosomal serology) or group B (negative schistosomal serology). Patients in group A were given oral antischistosomal treatment(praziquantel, single dose) at four weeks prior to PEG-IFN/RIB. All patients received a 48-wk course of PEG-IFN (PEG-IFNα2a or PEG-IFNα2b)/RIB therapy. Clinical and laboratory follow-up examinations were carried out for 24 wk after cessation of therapy (to week 72). Correlations of positive schistosomal serology with fibrosis and treatment response were assessed by multiple regression analysis. RESULTS:Schistosomal antibody was positive in 27.3% of patients (15.9% females and 84.1% males). The patients in group A were older (P = 0.008) and had a higher proportion of males (P = 0.002) than the patients in group B. There was no significant association between fibrosis stage and positive schistosomal serology (P = 0.703). Early virological response was achieved in significantly more patients in group B than in group A (89.4% vs 86.5%, P = 0.015). However, significantly more patients in group A experienced breakthrough at week 24 than patients in group B (36.3% vs 32.3%, P = 0.024). End of treatment response was achieved in more patients in group B than in group A (62.0% vs 59.1%) but the difference did not reach statistical significance (P = 0.108). Sustained virological response occurred in significantly more patients in group B than in group A (37.6% vs 27.7%, P = 0.000). Multivariate logistic regression analysis of p

关键词： Hepatitis C virus Schistosomiasis Coinfection Fibrosis Treatment response

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Use of ultrasonic transient elastography (Fibroscan) in the assessment of hepatic focal lesion stiffness

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Open Journal of Gastroenterology 2013年第2期3卷 107-112页

作者： Mohamed Yousef aisha elsharkawy Mohammad El Beshlawy Gamal Esmat Zakaria Salama Department of Endemic Medicine and Hepatology Faculty of Medicine Cairo University Cairo Egypt

Background and Aim: Hepatic focal lesions differ in their tissue composition and in the degree of stiffness, so our aim was to evaluate the role of Ultrasonic Transient Elastography (Fibroscan) in the measurement of hepatic focal lesions stiffness in order to differentiate hepatocellular carcinoma (HCC) focal lesions from other non HCC focal lesions. Methods: The study was conducted on 34 patients with hepatic focal lesion(s) in the right lobe located near the liver surface and more than or equal4 cmin diameter, detected by imaging studies and diagnosed by CT and histopathology. Stiffness over the focal lesions was measured by the fibroscan. Results: The median value of stiffness was 72.5 kPa over HCC focal lesions, 17.2 kPa over lymphoma focal lesions, 6.5 kPa over metastatic focal lesions and 10.5 kPa over the sarcoidosis focal lesion. Conclusions: Hepatocellular carcinoma focal lesions are much stiffer than lymphoma, metastasis or sarcoidosis focal lesions. Fibroscan may be a useful non-invasive method in the prediction of hepatocellular carcinoma in the future.

关键词： Hepatic Focal Lesions Hepatocellular Carcinoma Fibroscan Stiffness

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Use of the urinary trypsinogen-2 dipstick test in early diagnosis of pancreatitis after endoscopic retrograde cholangiopancreatography (ERCP)

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Open Journal of Gastroenterology 2013年第6期3卷 289-294页

作者： Hasan El-Garem Enas Hamdy Sherif Hamdy Mohammad El-Sayed aisha elsharkawy Azmi Mohammed Saleh Department of Clinical Pathology Faculty of Medicine Cairo University Cairo Egypt Department of Endemic Medicine and Hepatology Faculty of Medicine Cairo University Cairo Egypt

Background: Acute pancreatitis is one of the most serious complications of ERCP. Early diagnosis of post ERCP pancreatitis helps physicians to provide intensive care and possible medical treatment as early as possible. Trypsinogen-2 in urine is a good diagnostic and prognostic marker of acute pancreatitis. Objectives: To evaluate the diagnostic value of urinary trypsinogen-2 dipstick test for early diagnosis of post ERCP pancreatitis. Methods: A total of 37 patients with obstructive jaundice were tested with the urinary trypsinogen-2 dipstick test and serum levels of amylase and lipase before ERCP and 6 hours after ERCP. Results: Post ERCP pancreatitis was diagnosed in 6 (16%) of 37 patients. The sensitivity, specificity, positive predictive value and negative predictive value of urinary trypsinogen-2 dipstick test at 6 hours after ERCP were 100%, 97%, 86%, 100% respectively. At the cutoff level (130 U/L) for lipase, the positive predictive value and negative predictive value all were (100%), however, the positive predictive value and negative predictive value for amylase levels at cutoff (122 U/L) were 60%, 100% respectively. Serum lipase level was the best test for diagnosing post ERCP pancreatitis followed by the urinary trypsinogen-2 dipstick test. Conclusions: The urinary trypsinogen-2 dipstick test can be used as a rapid and easy test for early diagnosis of post ERCP pancreatitis with high sensitivity and specificity.

关键词： ERCP Pancreatitis Urinary Trypsinogen-2 Dipstick Test

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