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Human liver           

Learning About Liver Fibrosis

Fibrosis and Cirrhosis / Slides of Different Stages of Fibrosis

2009

 Main Fibrosis Page

 


Nov-Oct


Symptoms and Complications of Cirrhosis

Oct 1 09

 


Sept


A Potential Therapeutic Agent For Hepatic Fibrosis

Fibrotest or Fibroscan for evaluation of liver fibrosis in haemophilia patients infected with hepatitis C
Summary. Non-invasive modalities to estimate fibrosis stage are desirable in hepatitis C-infected haemophilia patients. Previous studies found a high ...
View Full Story »

Sept 01

Interferon-based Therapy Reduces or Reverses Liver Fibrosis over the Long-term in Chronic Hepatitis C Patients


AUG


Aug 29

Novel Treatment Reduces Swollen Livers

Blood Pressure Drug Losartan Associated with Liver Fibrosis Regression in Small Study

Drug Reverses Liver Scarring From HCV"


June

Complete blood count reflects the degree of oesophageal varices and liver fibrosis in virus-related chronic liver disease patients

Study Finds Noninvasive Blood Test For Liver Fibrosis May Alleviate Need For Liver Biopsies For Some Patients With Chronic Hepatitis C


 

Interferon-based Therapy Reduces or Reverses Liver Fibrosis over the Long-term in Chronic Hepatitis C Patients

By Liz Highleyman

http://www.hivandhepatitis.com/2009icr/ddw/docs/070709_a.html

Interferon-based therapy reduced liver fibrosis progression over 5 years in hepatitis C patients who achieved sustained virological response, and most of those with advanced liver damage prior to treatment experienced fibrosis regression, according to findings presented at the 2009 Digestive Disease Week meeting (DDW 2009) last month in Chicago.

Research on the long-term effects of interferon-based therapy for chronic hepatitis C virus (HCV) infection have produced conflicting results. Several studies have shown that fibrosis progression may be slowed, halted, or even reversed in individuals who achieve sustained virological response (SVR). Outcomes in non-responders are less clear.

Mitchell Shiffman and colleagues from Virginia Commonwealth University Medical Center reported follow-up findings from a prospective cohort study (initiated in 1998) looking at long-term histological outcomes in chronic hepatitis C patients treated with conventional or pegylated interferon, with or without ribavirin.

A total of 755 patients underwent a baseline liver biopsy and received a single course of interferon-based therapy or no treatment. Of this initial group, 230 were followed without additional treatment for 5 years before undergoing a repeat biopsy. This group included 41 patients who declined therapy and 189 who received treatment but did not achieve SVR (continued undetectable HCV viral load 24 weeks after completion of therapy). Participants with no evidence of fibrosis at baseline who achieved SVR did not receive a repeat biopsy.

 

At baseline, untreated patients, treated patients without SVR, and treated patients who achieved SVR were not significantly different with respect to age (average 46 years), sex (55% male), and baseline HCV RNA (5.7 IU/ml).

However, inflammation, fibrosis, and serum ALT were lower in the untreated group (i.e., these patients were least likely to be deemed to require therapy). The SVR group had fewer African-Americans and people with HCV genotype 1 (i.e., these individuals were less likely to achieve sustained response). The analysis did not include patients with other causes of liver disease besides HCV, HIV-HCV coinfection, chronic kidney failure, or prior organ transplants.

Results

 Patients who achieved SVR continued to have undetectable HCV RNA throughout the 5 year follow-up period.

 After 5 years, inflammation and fibrosis scores increased significantly in the untreated group (by 2.1 and 1.1, respectively) and the treated group without SVR (by 1.6 and 0.5, respectively).

 More patients with no fibrosis at baseline and no treatment experienced liver disease progression (28% vs 11%).

Liver histology improved significantly in treated patients who achieved SVR.

 After 5 years, all treated SVR patients with portal fibrosis and 80% with bridging fibrosis at baseline had no fibrosis.

 20% of sustained responders experienced resolution of cirrhosis.

"Interferon treatment reduces the rate of histologic progression over 5 years compared to [no treatment], even in HCV patients with [no fibrosis]," the investigators concluded.

"Patients with HCV who achieve SVR, including those with [cirrhosis], resolve fibrosis, and after 5 years liver histology returns to normal in most patients without pre-existing [cirrhosis]," they added.

Hepatology Section, Virginia Commonwealth University Medical Center, Richmond, VA; Department of Pathology, Virginia Commonwealth University Medical Center, Richmond, VA.

7/7/09

Reference
ML Shiffman, SB Hubbard, A Long, and others. The Long Term Effects of Interferon Based (IFNTx) Therapy on Hepatic Histology in Patients with Chronic Hepatitis C Virus. Results of a Five Year Prospective Evaluation on Fibrosis Progression and Fibrosis Regression. Digestive Disease Week (DDW 2009). Chicago. May 30-June 4, 2009. Abstract 7.

 


June-May


Is P90RSK A New Therapeutic Target For Liver Fibrosis?
Cirrhosis is a world wide, bad prognosis liver disease and characterized by excessive collagen deposition and liver function damage. In our previous work, p90RSK is observed significantly up-regulated in association with...

Hyperferritinemia Is Another Surrogate Marker Of Advanced Liver Disease

 Histologic Outcomes in Hepatitis C-Infected Patients With Breakthrough or Relapse to Interferon-Based Treatments: there was a positive correclation between viral response and improved fibrosis -

New Non-invasive Liver Fibrosis Index Reduces Need For Biopsies In Children


April-March


Interferon-based Therapy for Hepatitis C Improves Fibrosis Even in Individuals without Virological Response

Fibrosis Improves with Interferon Treatment

Smoking is associated with steatosis and severe fibrosis in chronic hepatitis C but not B

The Role Of The Omentum In Regenerating The Liver

How Inflammatory Disease Causes Fatigue

Transient elastography and other noninvasive tests to assess hepatic fibrosis in patients with viral hepatitis

Liver fibrosis staging with contrast-enhanced ultrasonography: prospective multicenter study compared with METAVIR scoring

Study may lead to new tests for liver toxicity

A new type of MRI of the liver developed at Mayo Clinic called MRE can reduce the need for liver biopsy in some patients with liver disease. Dr. Jayant Talwalkar, a hepatologist from the Mayo Clinic, discusses the types of patients that may benefit from this scan and how it may decrease the need for liver biopsy.

http://www.videomd.com/featured_video_category.aspx?cid=27

 


February-January

KineMed Describes Innovative Approach To Discover And Develop Drugs To Treat Fibrosis And Identifies Potential Drug For Lung And Liver Fibrosis
01 February 2009

Scientists at KineMed, Inc., describe a new way to measure changes in the rates of deposition and breakdown of connective tissue applicable in animals and man. The methods described fill a critical need for better approaches...
[read article]

 

Histological changes in HCV antibody-positive, HCV RNA-negative subjects suggest persistent virus infection

HealthWise: Cirrhosis


 

Magnetic resonance elastography (MRE)

 

New diagnostic technique to detect liver fibrosis

 

Magnetic resonance elastography (MRE) can accurately measure the extent and severity of hepatic fibrosis, US researchers have announced during ‘Liver Week 2008’ – the annual meeting of the American Association for the Study of Liver Disease. 

Results of a study designed to assess the performance of MRE from the Mayo Clinic and Foundation in Rochester, Minnesota, presented by principal investigator Dr. Jayant A. Talwalker, showed that MRE is accurate in detecting fibrosis caused by a broad spectrum of liver diseases.
 

The study involved 113 patients who had had liver biopsies within the previous year. MRE was performed and liver stiffness measured in all subjects.
 

Etiology of disease was non-alcoholic fatty liver disease (NAFLD) in 42%, hepatitis C virus infection in 24%, primary biliary cirrhosis (PBC) in 7%, primary sclerosing cholangitis (PSC) in 6% and alcoholic liver disease in 3%.
 

There was no fibrosis visible in 20% of patients, stage I fibrosis was found in 22%, stage II fibrosis in 13%, stage III in fibrosis in 13% and stage IV fibrosis was found in 28% of patients.
 

"Hepatic stiffness increased systematically with fibrosis stage," Dr. Talwalker noted.
 

"MRE shows a bigger picture [of the liver] than biopsy," he said. "Early fibrosis, especially, is a patchy disease. The biopsy can greatly underestimate or overestimate disease, depending on whether or not the biopsy takes tissue from a fibrotic area. Biopsy is restricted to the right lobe," he added, "MRE visualizes the whole liver."
 

"MRE can guide treatment decisions," concluded the Mayo Clinic investigators.
 

Reuters Health
 

Interferon Maintenance Therapy and Liver Disease Progression

Ursodiol Lowers Liver Enzymes in HCV Study

Researchers Show that Fibrosis can be Stopped, Cured and Reversed
 


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