Hyaluronic acid and aspartate aminotransferase levels normalized by liver function can reflect sinusoidal impairment in chronic liver disease

Early changes in dynamic biomarkers of liver fibrosis in hepatitis C virus-infected patients treated with sofosbuvir

BACKGROUND

Chronic hepatitis C is a major cause of liver-associated mortality caused by decompensated cirrhosis and hepatocellular carcinoma. With the approval of sofosbuvir, therapeutic efficacy has markedly increased. Early changes in non-invasive biomarkers of liver fibrosis under effective antiviral therapy are widely unknown.

AIM

To evaluate early changes of fibrosis markers determined by enhanced liver fibrosis (ELF) scores and liver stiffness measurement (FibroScan(®)) in patients treated with sofosbuvir.

METHODS

A total of 32 hepatitis C patients treated prospectively with sofosbuvir were included. The ELF-panel and FibroScan measurements were performed at baseline, week 4, end-of-treatment and 12 weeks thereafter.

RESULTS

Antiviral therapy resulted in a biochemical and virological response within 4 weeks. Sustained virological response rate at 12-week follow-up (SVR12) was 93.8%; there was a significantly decrease from baseline to 12-week post-treatment follow-up in ELF (10.00 vs. 9.37; p=0.007) and FibroScan (8.0 vs. 6.8 kPa; p=0.016) measurements, indicating improvement of the dynamics of liver fibrosis.

CONCLUSION

We observed a rapid decrease in non-invasive fibrosis markers measured by ELF-scores and FibroScan in hepatitis C-infected patients receiving sofosbuvir treatment. These initial results need to be histologically confirmed by liver biopsy in the future.

13C-methacetin breath test for evaluation of liver functional reserve and treatment effectiveness in patients with liver cirrhosis

AIM: To evaluate the value of ¹³C-methacetin breath test in diagnosis and treatment of liver cirrhosis and the association between Child-Pugh score and ¹³C-MBT, and to analyze their advantages and disadvantages.

METHODS: Eighty-eight inpatients and 10 healthy volunteers were enrolled. All of them received ¹³C-MBT and Child-Pugh scoring. According to ¹³C-MBT levels, 88 patients with liver cirrhosis were divided into three subgroups: levelsⅠ(n = 21), Ⅱ(n = 36), and Ⅲ (n = 31). According to Child-Pugh score, the patients were also divided into three subgroups: grade A in 16 cases, grade B in 41 cases and grade C in 31 cases. Liver function changes between before and after treatment were assessed. Sensitivity, specificity and time required to achieve efficacy between two groups were compared.

RESULTS: There was a good consistency (Kappa = 0.84, P < 0.05) between ¹³C-MBT levels (levels Ⅰ, Ⅱ and Ⅲ) and Child-Pugh score (grades A, B and C). Sensitivity and specificity of 13C-MBT were similar to those of Child-Pugh score (93.8%, 75.6%, 87.1% vs 91.7%, 89.4%, 93.0%). Concerning the time required to achieve efficacy, according to Child-Pugh score, there was no statistic significance among three subgroups of patients (P > 0.05), while according to ¹³C-MBT levels, a statistic significance was observed among the three subgroups of patients (P < 0.05). The higher the ¹³C-MBT level, the shorter the time required to achieve efficacy.

CONCLUSION: ¹³C-MBT is a simple, safe and reliable technique, representing a complementary method for Child-Pugh scoring.