Study determines the diagnostic utility of liver stiffness measurement

Study determines the diagnostic utility of liver stiffness measurement

Even after cure of chronic hepatitis C, portal hypertension remains the main factor in the development of complications in advanced liver disease. A team of researchers led by Georg Semmler and Mattias Mandorfer from the Clinical Department of Gastroenterology and Hepatology at the University Clinic for Internal Medicine III at MedUni Vienna, in collaboration with researchers from Spain, showed that the non-invasive tests examined in their previous studies accurately estimate the likelihood of subsequent damage. Their study, published in the prestigious Journal of Hepatology, refutes concerns about the accuracy of these tests and recommends follow-up measures for individual diseases.

In their latest study, the research group analyzed all published data on non-invasive tests and minimally invasive hepatic venous pressure gradient measurements performed on patients before and after treatment for hepatitis C. Working closely with colleagues from Spain, they evaluated paired measurements from 418 patients, confirming the accuracy of two non-invasive tests: the US liver stiffness measurement and platelet count, a simple blood test. Based on these findings, a risk stratification for patients after hepatitis C recovery could be developed and already implemented in the Baveno VII consensus, ie the international recommendations for the management of portal hypertension.

The results of the study are already contributing to the personalized follow-up care of these patients worldwide, which means that unnecessary, sometimes stressful examinations are eliminated and, if necessary, preventative measures can be initiated at an early stage.”

Georg Semmler, lead author of the study, Medical University of Vienna

Accurate prediction after non-invasive testing

Hepatitis C is a viral infection common worldwide. It has been successfully treated with direct antiviral drugs for several years and can be cured in over 95% of cases. However, patients with advanced scarring of the liver (“advanced liver disease”) are still at risk of developing secondary disease. With the exception of hepatocellular carcinoma, these complications are directly caused by the presence of portal hypertension. This refers to high blood pressure in the large vein that carries blood from the intestines to the liver. For follow-up care after hepatitis C, it is important that portal hypertension can be accurately detected using non-invasive tests. “Our study made it possible to accurately predict the individual risk after healing from hepatitis C. While it is possible to stop monitoring in a large proportion of patients, it is strongly recommended to initiate or continue preventive drug treatment in others,” adds study leader Matthias Mandorfer.

Source:

Medical University of Vienna

Reference:

Semmler, G., et al. (2022) Non-invasive testing for clinically significant portal hypertension after HCV cure. Journal of Hepatology. doi.org/10.1016/j.jhep.2022.08.025.

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