Liver fibrosis progression rates and risk factors in chronic liver diseases have not been compared. This would enable better organization of screening strategies.
In this study, an international team of researchers retrospectively studied 4852 patients. Of these, 2313 had chronic hepatitis C (HCV), 180 HIV-HCV co-infection, 777 hepatitis B (HBV), 701 alcoholic liver disease (ALD), 406 primary biliary cirrhosis (PBC), 383 genetic hemochromatosis (GH), 57 auto-immune hepatitis (AIH), and 35 delta hepatitis.
The research team estimated fibrosis progression rates from birth and from the date of exposure, when known, to the first biopsy.
|Highly significant differences were found in the rates of fibrosis progression.|
|Journal of Hepatology|
The team found highly significant differences in the rates of fibrosis progression.
The most rapid was in patients with HIV-HCV co-infection, and the slowest in patients with PBC.
The team found that fibrosis progression accelerated with aging.
Furthermore, fibrosis progression was slower in females, compared with males for HCV, HBV, GH, and PBC.
In contrast, in ALD, the fibrosis progression was more rapid in females.
Dr Thierry Poynard’s team concluded, “Rates of fibrosis progression differ markedly between the predominant causes of chronic liver disease, and according to age and gender”.
“Patients with HIV-HCV co-infection are at particularly high risk of fibrosis progression.”
In a related editorial in the same publication, Dr William Rosenberg discusses the rating of fibrosis progression in liver disease.
He discusses the difficulty of accurately measuring fibrosis progression.
Dr Rosenberg concludes by stressing the need for “reliable, reproducible, non-invasive surrogate indicators”, possibly serum markers.