AIM: To construct a noninvasive assessment model consisting of routine laboratory data to predict significant fibrosis and cirrhosis in patients with chronic hepatitis B (CHB). METHODS: A total of 137 consecutive ...AIM: To construct a noninvasive assessment model consisting of routine laboratory data to predict significant fibrosis and cirrhosis in patients with chronic hepatitis B (CHB). METHODS: A total of 137 consecutive patients with CriB who underwent percutaneous liver biopsy were retrospectively analyzed. These patients were divided into two groups according to their aminotransferase (ALT) level. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), the likelihood ratio (LR) of aminotransferase/platelet ratio index (APRI) ≥ 1.5 or 〈 1.5 in combination with different hyaluronic acid (HA) cut-off points were calculated for the presence of moderate to severe fibrosis/cirrhosis (fibrosis stages 2 and 4) and no to mild fibrosis/cirrhosis (fibrosis stages 0 and 1). RESULTS: The APRI correlated with fibrosis stage in CriB patients. The APRI ≥1.5 in combination with a cut-off HA cut-off point 〉 300 ng/mL could detect moderate to severe fibrosis (stages 2-4) in Crib patients. The PPV was 93.7%, the specificity was 98.9%. The APRI 〈 1.5 in combination with different HA cut-off points could not detect no to mild fibrosis in CHB patients. CONCLUSION: The APRI ≥ 1.5 in combination with a HA cut-off point 〉 300 ng/mL can detect moderate to severe fibrosis (stages 2-4) in Crib patients.展开更多
AIM: To determine whether alteration of the mito- chondria DNA (mtDNA) copy number and its oxidative damage index (mtDNA△CT) can be detected by analysis of peripheral blood cells in hepatitis C virus (HCV)- in...AIM: To determine whether alteration of the mito- chondria DNA (mtDNA) copy number and its oxidative damage index (mtDNA△CT) can be detected by analysis of peripheral blood cells in hepatitis C virus (HCV)- infected patients. METHODS: This study enrolled two groups of pa- tients aged 40-60 years: a control group and an HCV- infected group in Department of Gastroenterology and Hepatology in Changhua Christian Hospital. Patients with co-infection with hepatitis B virus or human im- munodeficiency virus, autoimmune disease, malignant neoplasia, pregnancy, thyroid disease, or alcohol con- sumption 〉 40 g/d were excluded. HCV-infected pa- tients who met the following criteria were included: (1) positive HCV antibodies for 〉 6 mo; (2) alanine aminotransferase (ALT) levels more than twice the upper lim- it of normal on at least two occasions during the past 6 mo; and (3) histological fibrosis stage higher than F1. The mtDNA copy number and oxidative damage index of HCV mtDNA (mtDNA△CT) were measured in periph- eral blood leukocytes. The association between mtDNA copy number and mtDNA△CT was further analyzed using clinical data. RESULTS: Forty-seven normal controls (male/female: 26/21, mean age 50.51 ± 6.15 years) and 132 HCV- infected patients (male/female: 76/61, mean age 51.65 ± 5.50 years) were included in the study. The geno- types of HCV-infected patients include type 1a (n = 3), type 1b (n = 83), type 2a (n = 32), and type 2b (n = 14). Liver fibrosis stages were distributed as follows: F1/F2/F3/F4 = 1/61/45/25 and activity scores were A0/ A1/A2/A3 = 7/45/55/25. There were no age or gender differences between the two groups. HCV-infected pa- tients had higher hepatitis activity (aspartate transami- nase levels 108.77 ± 60.73 vs 23.19 ± 5.47, P 〈 0.01; ALT levels 168.69 ± 93.12 vs 23.15 ± 9.45, P 〈 0.01) and lower platelet count (170.40±58.00 vs 251.24 ± 63.42, P 〈 0.01) than controls. The mtDNA copy num- ber was lower in HCV-infected patients than in controls (173.49 vs 247.93, P 〈 0.05). The mtDNA△CT was higher in HCV-infected patients than in controls (2.92 vs 0.64, P 〈 0.05). To clarify the clinical significance of these results in HCV-infected patients, their association with different clinical parameters among HCV-infected pa- tients was analyzed. A negative association was found between mtDNA copy number and elevated aspartate transaminase levels (r = -0.17, P 〈 0.05). Changes in mtDNA copy number were not associated with HCV RNA levels, HCV genotypes, liver fibrosis severity, or inflammatory activity in the liver biopsy specimen. How- ever, a correlation was observed between mtDNA△CT and platelet count (r = -0.22, P 〈 0.01), HCV RNA level (r = 0.36, P 〈 0.01), and hepatitis activity (r = 0.20, P = 0.02). However, no difference in the change in mtDNA△CT was observed between different fibrosis stages or HCV CONCLUSION: Oxidative stress and mtDNA dam- age are detectable in patient's peripheral leukocytes. Increased leukocyte mtDNA△CT correlates with higher HCV viremia, increased hepatitis activity, and lower platelet count.展开更多
文摘AIM: To construct a noninvasive assessment model consisting of routine laboratory data to predict significant fibrosis and cirrhosis in patients with chronic hepatitis B (CHB). METHODS: A total of 137 consecutive patients with CriB who underwent percutaneous liver biopsy were retrospectively analyzed. These patients were divided into two groups according to their aminotransferase (ALT) level. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), the likelihood ratio (LR) of aminotransferase/platelet ratio index (APRI) ≥ 1.5 or 〈 1.5 in combination with different hyaluronic acid (HA) cut-off points were calculated for the presence of moderate to severe fibrosis/cirrhosis (fibrosis stages 2 and 4) and no to mild fibrosis/cirrhosis (fibrosis stages 0 and 1). RESULTS: The APRI correlated with fibrosis stage in CriB patients. The APRI ≥1.5 in combination with a cut-off HA cut-off point 〉 300 ng/mL could detect moderate to severe fibrosis (stages 2-4) in Crib patients. The PPV was 93.7%, the specificity was 98.9%. The APRI 〈 1.5 in combination with different HA cut-off points could not detect no to mild fibrosis in CHB patients. CONCLUSION: The APRI ≥ 1.5 in combination with a HA cut-off point 〉 300 ng/mL can detect moderate to severe fibrosis (stages 2-4) in Crib patients.
基金Supported by Changhua Christian Hospital,99-CCH-IPR-12
文摘AIM: To determine whether alteration of the mito- chondria DNA (mtDNA) copy number and its oxidative damage index (mtDNA△CT) can be detected by analysis of peripheral blood cells in hepatitis C virus (HCV)- infected patients. METHODS: This study enrolled two groups of pa- tients aged 40-60 years: a control group and an HCV- infected group in Department of Gastroenterology and Hepatology in Changhua Christian Hospital. Patients with co-infection with hepatitis B virus or human im- munodeficiency virus, autoimmune disease, malignant neoplasia, pregnancy, thyroid disease, or alcohol con- sumption 〉 40 g/d were excluded. HCV-infected pa- tients who met the following criteria were included: (1) positive HCV antibodies for 〉 6 mo; (2) alanine aminotransferase (ALT) levels more than twice the upper lim- it of normal on at least two occasions during the past 6 mo; and (3) histological fibrosis stage higher than F1. The mtDNA copy number and oxidative damage index of HCV mtDNA (mtDNA△CT) were measured in periph- eral blood leukocytes. The association between mtDNA copy number and mtDNA△CT was further analyzed using clinical data. RESULTS: Forty-seven normal controls (male/female: 26/21, mean age 50.51 ± 6.15 years) and 132 HCV- infected patients (male/female: 76/61, mean age 51.65 ± 5.50 years) were included in the study. The geno- types of HCV-infected patients include type 1a (n = 3), type 1b (n = 83), type 2a (n = 32), and type 2b (n = 14). Liver fibrosis stages were distributed as follows: F1/F2/F3/F4 = 1/61/45/25 and activity scores were A0/ A1/A2/A3 = 7/45/55/25. There were no age or gender differences between the two groups. HCV-infected pa- tients had higher hepatitis activity (aspartate transami- nase levels 108.77 ± 60.73 vs 23.19 ± 5.47, P 〈 0.01; ALT levels 168.69 ± 93.12 vs 23.15 ± 9.45, P 〈 0.01) and lower platelet count (170.40±58.00 vs 251.24 ± 63.42, P 〈 0.01) than controls. The mtDNA copy num- ber was lower in HCV-infected patients than in controls (173.49 vs 247.93, P 〈 0.05). The mtDNA△CT was higher in HCV-infected patients than in controls (2.92 vs 0.64, P 〈 0.05). To clarify the clinical significance of these results in HCV-infected patients, their association with different clinical parameters among HCV-infected pa- tients was analyzed. A negative association was found between mtDNA copy number and elevated aspartate transaminase levels (r = -0.17, P 〈 0.05). Changes in mtDNA copy number were not associated with HCV RNA levels, HCV genotypes, liver fibrosis severity, or inflammatory activity in the liver biopsy specimen. How- ever, a correlation was observed between mtDNA△CT and platelet count (r = -0.22, P 〈 0.01), HCV RNA level (r = 0.36, P 〈 0.01), and hepatitis activity (r = 0.20, P = 0.02). However, no difference in the change in mtDNA△CT was observed between different fibrosis stages or HCV CONCLUSION: Oxidative stress and mtDNA dam- age are detectable in patient's peripheral leukocytes. Increased leukocyte mtDNA△CT correlates with higher HCV viremia, increased hepatitis activity, and lower platelet count.