Cohort study: Apparent redundancy of fibrosis assessment in young persons with HCV; development of realistic approaches to break the paradigm

Annals of Hepatology

Robinson Emma¹  Cartlidge Peter²  Amarthingalam Asthika³  Dillon John Francis⁴  Brennan Paul Noel⁵ 

[1]Corresponding author.

[2]University of Dundee, Ninewells Hospital and Medical School, Dundee DD1 9SY, United Kingdom

[3]NHS Tayside, Ninewells Hospital and Medical School, Dundee DD1 9SY, United Kingdom

[4]University of Dundee, Ninewells Hospital and Medical School, Dundee DD1 9SY, United Kingdom

[5]University of Edinburgh, Edinburgh BioQuarter, 5 Little France Drive, EH16 4UU United Kingdom

关键词: Hepatitis C Virus (HCV);    Fibrosis assessment;    Transient elastography;    Non-invasive fibrosis markers;   

DOI  :  

来源: DOAJ

【 摘 要 】

Introduction and Objectives: Hepatitis C Virus (HCV) is a blood-borne, hepatotropic RNA virus causing both acute and chronic infection. Chronic HCV infection predisposes individuals to liver fibrosis, cirrhosis and hepatocellular carcinoma. Staging of fibrosis prior to treatment to determine either treatment choice or required follow up, is standard practice. However, this often acts as a barrier to treatment initiation. We sought to validate the hypothesis that those individuals; mono-infected with HCV, ≤35 years of age; with no additional hepatic insult were unlikely to have significant fibrosis. Methods: We performed a retrospective analysis of a Hepatitis C Virus database; with collation of relevant basic demographics including age, sex and baseline Transient Elastography measurements pre-treatment. Additionally, we compared the reliability of biochemical fibrosis scores with corresponding transient elastography scores. Results: Our results support the hypothesis that those individuals with chronic HCV ≤35 years old, with no additional risk for fibrogenesis did not have significant liver fibrosis within our cohort. Conclusion: Patients ≤35 years old likely do not necessitate fibrosis assessment prior to Direct Acting Antiviral (DAA) treatment in the absence of other significant risk factors for fibrosis. Given the emerging evidence that DAA treatment results in a significant decrease in all-cause mortality and hepatocellular carcinoma development, treatment of those with chronic HCV represents a global priority.

【 授权许可】

Unknown