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Applicability and variability of liver stiffness measurements according to probe position

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World Journal of Gastroenterology 2009年第27期15卷 3398-3404页

作者： Patrick Ingiliz Kim Pav Chhay Mona Munteanu Pascal Lebray Yen Ngo dominique Roulot Yves Benhamou dominique thabut Vlad Ratziu Thierry Poynard dominique thabut Vlad Ratziu Thierry Poynard AP-HP Hospital Group Pitié-Salpêtrière Hepatology Department47-83 Hospital Boulevard Paris 75651 France BioPredictive 40 Bac street Paris 75007 France AP-HP Hepatology Department Avicenne hospitalBobigny 93000France AP-HP Hospital Group Pitié-Salpêtrière Hepatology Department47-83 Hospital Boulevard Paris 75651 France

AIM: To investigate the liver stiffness measurement (LSM) applicability and variability with reference to three probe positions according to the region of liver biopsy. METHODS: The applicability for LSM was defined as at least 10 valid measurements with a success rate greater than 60% and an interquartile range/median LSM < 30%. The LSM variability compared the inter-position concordance and the concordance with FibroTest. RESULTS: Four hundred and forty two consecutive patients were included. The applicability of the anterior position (81%) was significantly higher than that of the reference (69%) and lower positions (68%), (both P = 0.0001). There was a signif icant difference (0.5 kPa, 95% CI 0.13-0.89; P < 0.0001) between mean LSM estimated at the reference position (9.3 kPa) vs the anterior position (8.8 kPa). Discordance between positions was associated with thoracic fold (P = 0.008). The discordance rate between the reference position result and FibroTest was higher when the 7.1 kPa cutoff was used to define advanced fibrosis instead of 8.8 kPa (33.6% vs 23.5%, P = 0.03).CONCLUSION: The anterior position of the probe should be the fi rst choice for LSM using Fibroscan, as it has a higher applicability without higher variability compared to the usual liver biopsy position.

关键词： Fibroscan Fibrotest Liver fibrosis Variability Concordance

Protein-S-100-beta is increased in patients with decompensated cirrhosis admitted to ICU

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Journal of Intensive Medicine 2024年第2期4卷 222-230页

作者： Nicolas Weiss Simona Tripon Maxime Mallet Françoise Imbert-Bismut Mehdi Sakka dominique Bonnefont-Rousselot Philippe Sultanik Sarah Mouri Marika Rudler dominique thabut Sorbonne Université AP-HP.Sorbonne UniversitéHôpital de la Pitié-SalpêtrièreDépartement de NeurologieUnitéde Médecine Intensive RéanimationàOrientation NeurologiqueParisFrance Brain Liver Pitié-Salpêtrière(BLIPS)Study Group INSERM UMR_S 938Centre de recherche Saint-AntoineMaladies métaboliquesBiliaires et Fibro-Inflammatoire du FoieInstitute of Cardiometabolism and Nutrition(ICAN)ParisFrance Groupe de Recherche Clinique en REanimation et Soins intensifs du Patient en Insuffisance Respiratoire aiguE(GRC-RESPIRE)Sorbonne Université ParisFrance Assistance Publique-Hôpitaux de Paris AP-HP.Sorbonne UniversitéHôpital de la Pitié-SalpêtrièreService d'hépato-GastroentérologieUnitéde Soins Intensifs d'HépatologieParisFrance Assistance Publique-Hôpitaux de Paris AP-HP.Sorbonne UniversitéService de Biochimie MétaboliqueHôpitaux Universitaires Pitié-Salpêtrière-Charles FoixDMU BioGeMParis F-75013France UniversitéParis Cité UFR de PharmacieCNRSInsermUTCBSParisFrance

Background Hepatic encephalopathy(HE)is highly prevalent in patients with liver *** pathophysiology of HE is centered on the synergic role of hyperammonemia and systemic ***,some data suggest altered functioning of the blood–brain barrier(BBB).Assessing BBB function is challenging in clinical practice and at the ***-S-100 Beta(PS100-Beta)could be a useful peripheral marker of BBB permeability in *** study aimed to assess plasmatic PS100-Beta levels in a prospective cohort of patients admitted to the intensive care unit(ICU)with decompensated cirrhosis with and without overt *** We retrospectively evaluated a prospective cohort of cirrhotic patients admitted to the ICU from October 2013 to September 2015 that had an available plasmatic PS100-Beta *** with previous neurological impairment or limitation of intensive or resuscitative measures were *** HE was defined as West-Haven grades 2 to *** patients were compared to a control cohort of outpatient clinic cirrhotic and non-cirrhotic patients explored for isolated elevation of liver *** ICU discharge,the patients were followed for at least 3 months for the occurrence of overt *** outcomes(liver transplantation or death)were *** ability of PS100-Beta–in combination with other factors–to predict overt HE was evaluated in a multivariate analysis using logistic *** ratios were used to determine the effects and calculate odds ratios(OR).Survival analysis was performed by using the Kaplan–Meier method and survival between groups was compared using a Log-rank *** A total of 194 ICU patients and 207 outpatients were included in the *** levels of plasmatic PS100-Beta were detected in the ICU decompensated cirrhotic patients compared with the outpatients([0.15±0.01]mg/L vs.[0.08±0]mg/L,P<0.001).ICU patients with overt HE had higher levels of PS100-Beta([0.19±0.03]mg/L)compared with the

关键词： Cirrhosis Hepatic encephalopathy Blood-brain barrier PS100-Beta Liver disease

Daclatasvir vs telaprevir plus peginterferon alfa/ribavirin for hepatitis C virus genotype 1

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World Journal of Gastroenterology 2016年第12期22卷 3418-3431页

作者： Ira Jacobson Stefan Zeuzem Robert Flisiak Brygida Knysz Stefan Lueth Dorota Zarebska-Michaluk Ewa Janczewska Peter Ferenci Moises Diago Anna Linda Zignego Rifaat Safadi Yaacov Baruch Dzhamal Abdurakhmanov Stephen Shafran dominique thabut Rafael Bruck Adrian Gadano Alexander James Thompson Justin Kopit Fiona Mc Phee Tracy Michener Eric A Hughes Philip D Yin Stephanie Noviello Weill Cornell Medical College New YorkNY 10029United States Icahn School of Medicine at Mount Sinai New YorkNY 10029United States JW Goethe University Hospital 60323 FrankfurtGermany Uniwersytet Medyczny w Bialymstoku 15-089 BialystokPoland EMC and Medical University 50-220 WroclawPoland Universitatsklinikum Hamburg-Eppendorf 20246 HamburgGermany Wojewodzki Szpital Zespolony w Kielcach 25-736 KielcePoland ID Clinic 41-400 MyslowicePoland Medizinische Universitat Wien 1090 ViennaAustria Clinica Quiron 46010 ValenciaSpain Universita degli Studi di Firenze 50121 FlorenceItaly Holy Family Hospital Nazareth 6004Israel Rambam Medical Center Haifa 31096Israel 1st Moscow State Medical University N.A.I.M.Sechenov 119991 MoscowRussia University of Alberta Hospital EdmontonAlberta T6G 2B7Canada Groupe Hospitalier Pitie-Salpetriere 75013 ParisFrance Tel Aviv Sourasky Medical Center and Tel Aviv University Tel Aviv 64239Israel Hospital Italiano de Buenos Aires Buenos Aires C1181ACHArgentina St.Vincents Hospital and the University of Melbourne Melbourne 3065Australia Fiona McPhee Bristol-Myers Squibb Research and DevelopmentWallingfordCT 06492United States Bristol-Myers Squibb Research and Development PrincetonNJ 08450United States

AIM: To evaluate daclatasvir vs telaprevir, each combined with peginterferon alfa-2a/ribavirin(peg IFN/RBV), in treatment-naive hepatitis C virus(HCV) genotype(GT) 1-infected ***: In this phase 3, randomized, open-label, noninferiority study, 602 patients were randomly assigned(2:1) to daclatasvir vs telaprevir, stratified by IL28 B rs12979860 host genotype(CC vs non-CC), cirrhosis status(compensated cirrhosis vs no cirrhosis), and HCV GT1 subtype(GT1a vs GT1b). Patients were selected by study inclusion criteria from a total of 793 enrolled patients. Patients received daclatasvir 60 mg once daily or telaprevir 750 mg 3 times daily plus peg IFN/RBV. Daclatasvir recipients received 24 wk of daclatasvir plus peg IFN/RBV; those without an extended rapid virologic response(e RVR; undetectable HCV-RNA at weeks 4 and 12) received an additional 24 wk of peg IFN/RBV. Telaprevir-treated patients received 12 wk of telaprevir plus peg IFN/RBV followed by 12(with e RVR) or 36(no e RVR) wk of peg IFN/RBV. The primary objective was to compare for noninferiority of sustained virologic response rates at posttreatment week 12(SVR12) in GT1b-infected patients. Key secondary objectives were to demonstrate that the rates of anemia(hemoglobin < 10 g/d L) and rashrelated events, through week 12, were lower with daclatasvir + peg IFN/RBV than with telaprevir + peg IFN/RBV among GT1b-infected patients. Resistance testing was performed using population-based sequencing of the NS5 A region for all patients at baseline, and for patients with virologic failure or relapse and HCV-RNA ≥ 1000 IU/m L, to investigate any link between NS5 A polymorphisms associated with daclatasvir resistance and virologic outcome. RESULTS: Patient demographics and disease characteristics were generally balanced across treatment arms; however, there was a higher proportion of black/African Americans in the daclatasvir groups(6.0% and 8.2% in the GT1 b and GT1 a groups, respectively) than in the telaprevi

关键词： Direct-acting antiviral Chronic hepatitis C Daclatasvir Genotype 1b NS5A inhibitor Liver disease

Subclinical proximal tubulopathy in hepatitis B:The roles of nucleot(s)ide analogue treatment and the hepatitis B virus

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World Journal of Hepatology 2020年第12期12卷 1326-1340页

作者： Anais Brayette Marie Essig Paul Carrier Marilyne Debette-Gratien Anais Labrunie Sophie Alain Marianne Maynard Nathalie Ganne-Carrie Eric Nguyen-Khac Pauline Pinet Victor De Ledinghen Christophe Renou Philippe Mathurin Claire Vanlemmens Vincent Di Martino Anne Gervais Juliette Foucher Fouchard-Hubert Isabelle Julien Vergniol Isabelle Hourmand-Ollivier Daniel Cohen Xavier Duval Thierry Poynard Marc Bardou Armand Abergel Manh-Thong Dao Thierry Thevenot Jean-Baptiste Hiriart Valerie Canva Guillaume Lassailly Christine Aurières Nathalie Boyer dominique thabut Pierre-Henri Bernard Matthieu Schnee dominique Larrey Bertrand Hanslik Severine Hommel Jeremie Jacques Veronique Loustaud-Ratti U1248 INSERM Department of Hepatology and GastroenterologyUniv.LimogesCHU LimogesLimoges F-87000France U1248 INSERM Department of Nephrology and TransplantationCHU LimogesLimoges F-87000France Department of Center of Epidemiology Biostatistics and Research MethodologyCHU LimogesLimoges F-87000France U1092 INSERM Department of VirologyCHU LimogesLimoges F-87000France Department of Hepatology Croix-Rousse University Hospital of LyonLyon 69004France Department of Hepatology Jean Verdier University Hospital of BondyBondy 93140France Department of Hepato-Gastroenterology Amiens University HospitalAmiens 80054France Department of Infectious Diseases CHU LimogesLimoges F-87000France Department of Hepatology Haut Leveque HospitalBordeaux University HospitalPessac 33604France Department of Gastroenterology Hyeres HospitalHyeres 83407France Department of Hepato-Gastroenterology Claude Huriez University HospitalLille 59037France Department of Hepatology Jean Minjoz University HospitalBesançon 25030France Department of Infectious Diseases Bichat University HospitalParis 75018France Department of Hepatology University Hospital of AngersAngers 49933France Department of Hepato-Gastroenterology and Nutrition University Hospital of CaenCaen 14033France Department of General Medecine University Hospital of CaenCaen 14000France Department of Hepatology La Pitié-Salpêtrière University HospitalParis 75651France Department of Hepatology and Gastroenterology Dijon University HospitalDijon 21079France Department of Hepatology and Gastroenterology Estaing University HospitalClermont Ferrand 63003France Department of Hepatology Beaujon University HospitalClichy 92110France Department of Hepatology Saint-AndréUniversity HospitalBordeaux 33000France Department of Hepatology and Gastroenterology La Roche-Sur-Yon Hospital CenterLa Roche-Sur-Yon 85000France Department of Hepatology and Gastroenterology University Hospital of MontpellierMontpellier 34295France Department of Addictology Hospita

BACKGROUND The recommended monitoring tools for evaluating nucleot(s)ide analogue renal toxicity,such as estimated glomerular filtration rate(eGFR)and phosphatemia,are late markers of proximal *** early markers are available,but no consensus exists on their *** To determine the 24 mo prevalence of subclinical proximal tubulopathy(SPT),as defined with early biomarkers,in treated vs untreated hepatitis B virus(HBV)-monoinfected *** A prospective,non-randomized,multicenter study of HBV-monoinfected patients with a low number of renal comorbidities was *** patients were separated into three groups:Naïve,starting entecavir(ETV)treatment,or starting tenofovir disoproxil(TDF)*** on the early markers of SPT,the eGFR and phosphatemia,were collected *** was defined as a maximal tubular reabsorption of phosphate/eGFR below 0.8 mmoL/L and/or uric acid fractional excretion above 10%.The prevalence and cumulative incidence of SPT at month 24(M24)were *** data were analyzed using analyses of variance or Kruskal-Wallis tests,whereas chi-squared or Fisher’s exact tests were used to analyze qualitative *** analyses were used to adjust for any potential confounding *** Of the 196 patients analyzed,138(84 naïve,28 starting ETV,and 26 starting TDF)had no SPT at *** M24,the prevalence of SPT was not statistically different between naïve and either treated group(21.1%vs 30.7%,P<0.42 and 50.0%vs 30.7%,P=0.32 for ETV and TDF,respectively);no patient had an eGFR lower than 50 mL/min/1.73 m²or phosphatemia less than 0.48 mmoL/*** the multivariate analysis,no explanatory variables were identified after *** cumulative incidence of SPT over 24 mo(25.5%,13.3%,and 52.9%in the naïve,ETV,and TDF groups,respectively)tended to be higher in the TDF group vs the naïve group(hazard ratio:2.283,P=0.05).SPT-free survival at M24 was 57.6%,68.8%,and 23.5%for the naïve,ETV,and TD

关键词： Hepatitis B virus Proximal tubulopathy Biomarkers Renal insufficiency Nucleoside analogues