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Improved Hepascore in hepatitis C predicts reversal in risk of adverse outcome

World Journal of Hepatology 2017年第19期9卷 850-856页

作者： Angus W Jeffrey Yi Huang W bastiaan de boer Leon A Adams Gerry MacQuillan David Speers John Joseph Gary P Jeffrey School of Medicine University of Notre Dame School of Medicine and Pharmacology University of Western Australia department of Hepatology Sir Charles Gairdner Hospital department of Anatomical Pathology Path West QEII Medical Centre department of Microbiology Path West QEII Medical Centre department of Biochemistry Path West QEII Medical Centre

AIM To establish if serial Hepascore tests(referred to as delta Hepascore) in those with chronic hepatitis C(CHC) correlate with the increase and/or decrease in risk of liver related *** Three hundred and forty-six CHC patients who had two Hepascore tests performed were studied. During 1944 patient years follow-up 28(8.1%) reached an endpoint. The Hepascore is a serum test that provides clinically useful data regarding the stage of liver fibrosis andsubsequent clinical outcomes in chronic liver *** Patients with a baseline Hepascore > 0.75 had a significantly increased rate of reaching a composite endpoint consisting of hepatocellular carcinoma, liver death, and/or decompensation(P 0.75, a subsequent improved Hepascore showed a significantly decreased risk for the composite endpoint(P = 0.004). There were no negative outcomes in those with a stable or improved delta Hepascore. The minimum time between tests that was found to give a statically significant result was in those greater than one year(P = 0.03).CONCLUSION In conclusion, Hepascore is an accurate predictor of liver related mortality and liver related morbidity in CHC patients. Of note, we have found that there is a decreased risk of mortality and morbidity in CHC patients when the patient has an improving delta Hepascore. Repeat Hepascore tests, when performed at a minimum one-year interval, may be of value in routine clinical practice to predict liver related clinical outcomes and to guide patient management.

关键词： Chronic Prognosis Direct acting antivirals Serum Hepatitis C

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Predictors of survival in autoimmune liver disease overlap syndromes

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World Journal of Hepatology 2024年第9期16卷 1269-1277页

作者： Dujinthan Jayabalan Yi Huang Luis Calzadilla-Bertot Malik Janjua bastiaan de boer John Joseph Wendy Cheng Simon Hazeldine Briohny W Smith Gerry C MacQuillan Michael C Wallace George Garas Leon A Adams Gary P Jeffrey Medical School University of Western AustraliaNed-lands 6009Western AustraliaAustralia department of Hepatology Sir Charles Gairdner HospitalNedlands 6009Western AustraliaAustralia department of Anatomical Pathology PathWest Laboratory MedicineNedlands 6009Western AustraliaAustralia department of Gastroenterology and Hepatology Royal Perth HospitalPerth 6000Western AustraliaAustralia department of Gastroenterology and Hepatology Fiona Stanley HospitalMurdoch 6150Western AustraliaAustralia Medical School University of Western AustraliaNedl-ands 6009Western AustraliaAustralia

BACKGROUND Survival in patients with autoimmune liver disease overlap syndromes(AILDOS)compared to those with single autoimmune liver disease is *** To investigate the survival of patients with AILDOS and assess the accuracy of non-invasive serum models for predicting liver-related *** Patients with AILDOS were defined as either autoimmune hepatitis and primary biliary cholangitis overlap(AIH-PBC)or autoimmune hepatitis and primary sclerosing cholangitis overlap(AIH-PSC)and were identified from three tertiary centres for this cohort ***-related death or transplantation(liver-related mortality)was determined using a population-based data linkage *** scores for liver-related death were compared for accuracy[including liver outcome score(LOS),Hepascore,Mayo Score,model for end-stage liver disease(MELD)score and MELD incorporated with serum sodium(MELD-Na)score].RESULTS Twenty-two AILDOS patients were followed for a median of 3.1 years(range,0.35-7.7).Fourteen were female,the median age was 46.7 years(range,17.8 to 82.1)and median Hepascore was 1(range,0.07-1).At five years post enrolment,57%of patients remained free from liver-related mortality(74%AIH-PBC,27%AIH-PSC).There was no significant difference in survival between AIH-PBC and *** was a significant predictor of liver-related mortality(P<0.05)in patients with AIH-PBC(n=14)but not AIH-PSC(n=8).A LOS cut-point of 6 discriminated liver-related mortality in AIH-PBC patients(P=0.012,log-rank test,100%sensitivity,77.8%specificity)(Harrell's C-statistic 0.867).The MELD score,MELD-Na score and Mayo Score were not predictive of liver-related mortality in any *** Survival in the rare,AILDOS is *** current study supports the LOS as a predictor of liver-related mortality in AIH-PBC *** trials investigating predictors of survival in AILDOS are required.

关键词： Autoimmune liver disease overlap syndromes Liver outcome score Liver-related death Hepascore Autoimmune hepatitis Primary biliary cholangitis Primary sclerosing cholangitis

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