Biomarkers of fibrosis and impaired liver function in chronic hepatitis C: how well do they predict clinical outcomes?

TY - JOUR

T1 - Biomarkers of fibrosis and impaired liver function in chronic hepatitis C: how well do they predict clinical outcomes?

AU - Peters, L.

AU - Rockstroh, J.K.

PY - 2010/11

Y1 - 2010/11

N2 - PURPOSE OF REVIEW: To review the recent literature on the prognostic value of biomarkers of liver fibrosis and impaired liver function in patients with chronic hepatitis C with or without HIV coinfection. RECENT FINDINGS: A combination of standard blood tests seems to be useful in identifying patients at risk of liver-related complications. Findings from studies investigating the validity of the Model for End-Stage Liver Disease (MELD) score in HIV-infected liver transplant candidates are conflicting. Two large studies of HIV/hepatitis C virus (HCV) coinfected patients have shown that plasma levels of the fibrosis marker hyaluronic acid are a strong predictor of clinical complications. A smaller study found hyaluronic acid and two other fibrosis tests, aspartate aminotransferase-to-platelet ratio index (APRI) and Fib-4, to be independent predictors of mortality when included in models with the MELD or the Child-Pugh-Turcotte scores. SUMMARY: Although the data are still limited, recent findings from large studies of the prognostic ability of fibrosis markers in hepatitis C patients provides hope that fibrosis markers, together with other noninvasive methods, one day, will replace liver biopsy as the gold standard for the prognostic evaluation of liver disease. The MELD score, and other prognostic factors, need further evaluation in HIV/HCV coinfected patients with end-stage liver disease

AB - PURPOSE OF REVIEW: To review the recent literature on the prognostic value of biomarkers of liver fibrosis and impaired liver function in patients with chronic hepatitis C with or without HIV coinfection. RECENT FINDINGS: A combination of standard blood tests seems to be useful in identifying patients at risk of liver-related complications. Findings from studies investigating the validity of the Model for End-Stage Liver Disease (MELD) score in HIV-infected liver transplant candidates are conflicting. Two large studies of HIV/hepatitis C virus (HCV) coinfected patients have shown that plasma levels of the fibrosis marker hyaluronic acid are a strong predictor of clinical complications. A smaller study found hyaluronic acid and two other fibrosis tests, aspartate aminotransferase-to-platelet ratio index (APRI) and Fib-4, to be independent predictors of mortality when included in models with the MELD or the Child-Pugh-Turcotte scores. SUMMARY: Although the data are still limited, recent findings from large studies of the prognostic ability of fibrosis markers in hepatitis C patients provides hope that fibrosis markers, together with other noninvasive methods, one day, will replace liver biopsy as the gold standard for the prognostic evaluation of liver disease. The MELD score, and other prognostic factors, need further evaluation in HIV/HCV coinfected patients with end-stage liver disease

KW - Biological Markers

KW - blood

KW - Hepatitis C,Chronic

KW - HIV Infections

KW - Humans

KW - Liver Cirrhosis

KW - Liver Function Tests

KW - pathology

KW - physiopathology

KW - Predictive Value of Tests

KW - Prognosis

KW - virology

U2 - 10.1097/coh.0b013e32833e3ee6

DO - 10.1097/coh.0b013e32833e3ee6

M3 - Journal article

C2 - 20978395

SN - 1746-630X

VL - 5

SP - 517

EP - 523

JO - Current Opinion in HIV and AIDS

JF - Current Opinion in HIV and AIDS

IS - 6

ER -