geoscience.net logo
+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Quantitative tests detect impaired hepatic function in a high proportion of chronic hepatitis C patients with fibrosis or compensated cirrhosis and may predict risk of cirrhosis, splenomegaly, and varices


, : Quantitative tests detect impaired hepatic function in a high proportion of chronic hepatitis C patients with fibrosis or compensated cirrhosis and may predict risk of cirrhosis, splenomegaly, and varices. Hepatology 38(4 Suppl 1): 304A-305A, October

Background: Conventional clinical blood tests (bilirubin, albumin, prothrombin, platelets) are insensitive measures of hepatic function and do not adequately define risk for cirrhosis and portal hypertensive complications, such as varices. Liver biopsy may be inaccurate due to sampling variability. QLFTs measure the liver's ability to metabolize or extract test compounds, may identify patients with impaired hepatic function at earlier stages of disease, and possibly define risk for cirrhosis, splenomegaly, and varices. Specific Aims: 1. Use 7 QLFTs to define hepatic impairment in patients with chronic hepatitis C and bridging fibrosis or compensated cirrhosis enrolled in the Hepatitis Antiviral Long-Term Treatment to Prevent Cirrhosis Trial (HALT C). 2. Compare test results between those with or without biopsy-proven cirrhosis, splenomegaly on ultrasonography, and varices at endoscopy. Patients: The mean age of the 248 enrolled patients was 49.9+-7.3 yr and 75% were male. Mean BMI was 29.6+-5.3, 40% had cirrhosis, 60% had bridging fibrosis, 93% were infected with HCV genotype 1, and mean serum HCV RNA was 4.39+-4.66X106 copies/ml. 30% had platelet count <140,000/ul, 25% had albumin <3.5 g/dl, 25% had INR >1.1, 10% had bilirubin >1.2 mg/dl, and 25% had AST:ALT >1. Analytical Methods: 13C-methionine (MBT), caffeine (Caf), antipyrine (AP), and 2,2,4,4-2H-cholate (CA) were taken orally and 24-13C-cholate, galactose (Gal), and lidocaine were administered intravenously. These compounds or their metabolites were measured from timed serial samples of blood, saliva, and breath using standard techniques. Elimination rate (kelim), volume of distribution (Vd), clearance (Cl), elimination capacity (Elim), and shunt were calculated from measured analytes. Perfused hepatic mass (PHM) was determined from SPECT liver scan. Mean test results were compared by T statistic and area under the receiver operator curve (ROC) by C statistic. Table results are ordered by T statistic for association with cirrhosis PHM had the highest area under ROC with cirrhosis (C statistic.87), splenomegaly (C statistic.75), and varices (C statistic.832) and correlated best with platelet count, billrubin, prothrombin time, and albumin. Conclusions: QLFTs uncover hepatic impairment in a high proportion of fibrotic patients with chronic hepatitis C, and some tests, particularly CA Cloral, PHM, and CAshunt, identify patients with chronic hepatitis C with cirrhosis, splenomegaly or varices. Long-term followup, as planned in HALT C, will determine whether hepatic impairment as defined by QLFTs predicts risk for clinical deterioration.

US$29.90


Other references

Rossi, U.G.; Rigamonti, P.; Torcia, P.; Mauri, G.; Brunini, F.; Rossi, M.; Gallieni, M.; Cariati, M., 2016: Congenital anomalies of superior vena cava and their implications in central venous catheterization. Congenital anomalies of superior vena cava (SVC) are generally discovered incidentally during central venous catheter (CVC) insertion, pacemaker electrode placement, and cardiopulmonary bypass surgery. Persistent left SVC (PLSVC) is a rare (0.3%)...

Case, D.B., 1988: Survey of expectations among clients of three small animal clinics. A questionnaire completed by 319 clients of 3 small animal clinics asked what clients expected and what they received in their interaction with the veterinarian. The survey emphasized communication and rapport established by the veterinarian. Clie...

Austin, D.M., 1984: Program design issues in the improved administration of human services programs. Current changes in the role of the federal government in human service programs are forcing states and local communities to deal with issues of administrative and program design. This involves making explicit choices among a number of alternatives...

Saakadze, V.P.; Metreveli, M.V.; Teliia, A.Z., 2007: Derivative allergens as predictors of allergic predisposition in next generations. Through studding of statistical data was performed the analysis of allergosis sickness rate in Georgia during the last ten years (1998-2004) and was determined the steady rise of allergic illnesses with prevailing bronchial asthma in allergology....

Hofer, M.A., 1980: Effects of reserpine and amphetamine on the development of hyperactivity in maternally deprived rat pups. Maternal deprivation for 24 hr is known to produce hyperactivity in 2-week-old infant rats kept at nest temperature. Pretreatment with reserpine (0.5 mg/kg), at the time of separation, prevented the development of hyperactivity over the ensuing 24...

Gunella, G.; Serafini, F.; Melica, A., 1973: Effects of trazodone in subjects with partial or total ventilatory insufficiency. Giornale di Clinica Medica 54(4): 174-182

Pichardo-Geisinger, R.; Muñoz-Ali, D.; Arcury, T.A.; Blocker, J.N.; Grzywacz, J.G.; Mora, D.C.; Chen, H.; Schulz, M.R.; Feldman, S.R.; Quandt, S.A., 2014: Dermatologist-diagnosed skin diseases among immigrant Latino poultry processors and other manual workers in North Carolina, USA. Immigrant Latino workers represent an expanding workforce in rural areas of the USA, where their employment is concentrated in occupations such as poultry processing that entail chemical, infectious, and mechanical skin exposures. Occupation-relat...

Garcia Soto, E.M.; Raymond, G.V.; Gilmore, H.; Moser, A.B.; Watkins, P.; Mihalik, S., 2000: Peroxisomal mosaicism as a diagnostic dilemma. American Journal of Human Genetics 67(4 Supplement 2): 280, October

Erinchek P.T., 1987: Sampling deposits with anomalously high formation pressure in areas in north of West Siberia. Trudy Vsesoyuznogo Neftyanogo Nauchno-Issledovatel'skogo Geologorazvedochnogo Instituta 467: 138-143

Talitskii V.G. (Talitskiy V.G.; Galkin V.A., 1998: Structural organization of geologic medium and some regularities of its dynamic rearrangements. Moscow University Geology Bulletin 52(2): 12-17