Background: Bleeding esophageal varices (OVs) due to portal hypertension are one of the major complications with high mortality in liver cirrhosis. So, early detection and management are mandatory. Aim: To evaluate th...Background: Bleeding esophageal varices (OVs) due to portal hypertension are one of the major complications with high mortality in liver cirrhosis. So, early detection and management are mandatory. Aim: To evaluate the role of Von Willebrand factor (VWF) in predicting the presence of OVs. Patients and Methods: 62 patients with liver cirrhosis representing different Child-Pugh classes were included. The diagnosis of liver cirrhosis was based on the combination of clinical, laboratory and US examinations. All included patients underwent the following investigations: complete blood count, liver function tests (ALT, AST, serum bilirubin, albumin and total protein, prothrombin time (PT) and concentration (PC), INR and serum alkaline phosphatase), serum creatinine, Von Willebrand factor antigen (VWF-Ag) measurement and abdominal US. Upper endoscopic evaluation was done to detect presence or absence of varices (esophageal or gastric) and/or PHG. Results: 38 males and 24 females with their mean age (46 ± 12 years old) were included. Plasma Von Willebrand factor-Ag level was significantly higher in patients with OVs than those without varices (P value = 0.000). Also, its level was significantly higher in patients with higher grade of OVs, G3 than those with G1 or G2 (P value = 0.000). Patients with large OVs including those with G2 and G3 showed significantly higher values of VWF than those with small OVs (NO and G1) (P value = 0.000). VWF was independent predictor for detecting the presence of OVs with good sensitivity (90), specificity (77.3) and accuracy (85.5) at a cutoff value of 1.74 U/ml. Also it was an independent predictor for detecting the presence of large OVs with good sensitivity (91.2), specificity (85.7) and accuracy (88.7) at a cutoff value of 2.16 U/ml. Conclusion: VWF-Ag could be used as a non invasive laboratory independent predictor for the detection of OVs.展开更多
Background: Hepatitis B virus and Hepatitis C virus infection is one of the public health problems in Egypt. So we aimed to evaluate the efficacy of serum osteopontin as predictor of hepatic fibrosis regression and vi...Background: Hepatitis B virus and Hepatitis C virus infection is one of the public health problems in Egypt. So we aimed to evaluate the efficacy of serum osteopontin as predictor of hepatic fibrosis regression and virological response in patients with chronic HBV or HCV infection. Methods: This study has been conducted on 74 HBeAg + ve chronic HBV infection, 74 chronic HCV infection and 74 healthy controls. HBV patients treated with Entecavir. HCV patients treated with sofosbuvir, daclatasvir with or without ribavirin. One year post HBeAg seroconversion and 3 months after end of regular antiviral treatment for patients with chronic HBV and chronic HCV infection respectively, hepatic condition was reevaluated. Results: 14.9% of patients with HBV, failed to achieve undetectable HBV DNA or HBeAg seroconversion and 2.7% of patients with HCV infection, failed to achieve SVR. In chronic HBV, pretreatment high serum osteopontin predict failure of virological response and hepatic fibrosis regression at a cutoff > 115.5, with 90.91% sensitivity, 82.54% specificity. Also high degree of liver stiffness predicts failure of hepatic fibrosis regression at a cutoff > 8.7, with 81.8% sensitivity, 73% specificity. Conclusions: In chronic HBV infection low osteopontin predicts good virological response and hepatic fibrosis regression. But it has no role in predicting SVR or hepatic fibrosis regression in chronic HCV infected patients.展开更多
Purpose: Chronic hepatitis B virus infection affects more than 3 million people worldwide. The present study aimed to evaluate the role of pretreatment factor IV collagen as predictor of post treatment virological res...Purpose: Chronic hepatitis B virus infection affects more than 3 million people worldwide. The present study aimed to evaluate the role of pretreatment factor IV collagen as predictor of post treatment virological response with hepatic fibrosis regression. Materials and Methods: This prospective cohort study has been conducted on 74 naieve patients with chronic HBV infection with variable degree of hepatic fibrosis (F2, F3, ≥F4), viral load, and variable degree of abnormality in laboratory parameters of liver functions. All patients treated with Entecavir 0.5 mg/day or 1 mg/day according to severity of hepatic condition for 1 year. Liver fibrosis assessed using fibroscan, factor IV collagen, (APRI) and (FIB-4) scores evaluation. Results: All included patients in our study achieve post treatment Virological response with undetectable HBV DNA PCR ( Conclusion: Low pretreatment factor IV collagen is significantly correlated with virologial response and hepatic fibrosis regression post Entecavir therapy in patients with chronic HBV infection.展开更多
文摘Background: Bleeding esophageal varices (OVs) due to portal hypertension are one of the major complications with high mortality in liver cirrhosis. So, early detection and management are mandatory. Aim: To evaluate the role of Von Willebrand factor (VWF) in predicting the presence of OVs. Patients and Methods: 62 patients with liver cirrhosis representing different Child-Pugh classes were included. The diagnosis of liver cirrhosis was based on the combination of clinical, laboratory and US examinations. All included patients underwent the following investigations: complete blood count, liver function tests (ALT, AST, serum bilirubin, albumin and total protein, prothrombin time (PT) and concentration (PC), INR and serum alkaline phosphatase), serum creatinine, Von Willebrand factor antigen (VWF-Ag) measurement and abdominal US. Upper endoscopic evaluation was done to detect presence or absence of varices (esophageal or gastric) and/or PHG. Results: 38 males and 24 females with their mean age (46 ± 12 years old) were included. Plasma Von Willebrand factor-Ag level was significantly higher in patients with OVs than those without varices (P value = 0.000). Also, its level was significantly higher in patients with higher grade of OVs, G3 than those with G1 or G2 (P value = 0.000). Patients with large OVs including those with G2 and G3 showed significantly higher values of VWF than those with small OVs (NO and G1) (P value = 0.000). VWF was independent predictor for detecting the presence of OVs with good sensitivity (90), specificity (77.3) and accuracy (85.5) at a cutoff value of 1.74 U/ml. Also it was an independent predictor for detecting the presence of large OVs with good sensitivity (91.2), specificity (85.7) and accuracy (88.7) at a cutoff value of 2.16 U/ml. Conclusion: VWF-Ag could be used as a non invasive laboratory independent predictor for the detection of OVs.
文摘Background: Hepatitis B virus and Hepatitis C virus infection is one of the public health problems in Egypt. So we aimed to evaluate the efficacy of serum osteopontin as predictor of hepatic fibrosis regression and virological response in patients with chronic HBV or HCV infection. Methods: This study has been conducted on 74 HBeAg + ve chronic HBV infection, 74 chronic HCV infection and 74 healthy controls. HBV patients treated with Entecavir. HCV patients treated with sofosbuvir, daclatasvir with or without ribavirin. One year post HBeAg seroconversion and 3 months after end of regular antiviral treatment for patients with chronic HBV and chronic HCV infection respectively, hepatic condition was reevaluated. Results: 14.9% of patients with HBV, failed to achieve undetectable HBV DNA or HBeAg seroconversion and 2.7% of patients with HCV infection, failed to achieve SVR. In chronic HBV, pretreatment high serum osteopontin predict failure of virological response and hepatic fibrosis regression at a cutoff > 115.5, with 90.91% sensitivity, 82.54% specificity. Also high degree of liver stiffness predicts failure of hepatic fibrosis regression at a cutoff > 8.7, with 81.8% sensitivity, 73% specificity. Conclusions: In chronic HBV infection low osteopontin predicts good virological response and hepatic fibrosis regression. But it has no role in predicting SVR or hepatic fibrosis regression in chronic HCV infected patients.
文摘Purpose: Chronic hepatitis B virus infection affects more than 3 million people worldwide. The present study aimed to evaluate the role of pretreatment factor IV collagen as predictor of post treatment virological response with hepatic fibrosis regression. Materials and Methods: This prospective cohort study has been conducted on 74 naieve patients with chronic HBV infection with variable degree of hepatic fibrosis (F2, F3, ≥F4), viral load, and variable degree of abnormality in laboratory parameters of liver functions. All patients treated with Entecavir 0.5 mg/day or 1 mg/day according to severity of hepatic condition for 1 year. Liver fibrosis assessed using fibroscan, factor IV collagen, (APRI) and (FIB-4) scores evaluation. Results: All included patients in our study achieve post treatment Virological response with undetectable HBV DNA PCR ( Conclusion: Low pretreatment factor IV collagen is significantly correlated with virologial response and hepatic fibrosis regression post Entecavir therapy in patients with chronic HBV infection.
