Liver Tests may Predict Hepatitis C Survival

According to a new study, noninvasive tests for liver fibrosis—such as liver stiffness measurement or the FibroTest—may predict the survival of patients suffering from chronic hepatitis C.

"Liver stiffness measurement and/or the FibroTest could replace liver biopsy for the evaluation of hepatitis C, regardless of the stage of the disease," said lead author of the study Victor de Lédinghen, MD, PhD, of the Centre d' Investigation de la Fibrose Hépatique. "These tools may help physicians assess prognosis early and discuss specific treatments."

Lédinghen and fellow doctors assessed the five-year prognostic value of liver stiffness, non-invasive tests of liver fibrosis, and liver biopsy to predict overall survival as well as survival without liver-related death in patients with chronic hepatitis C.

The researchers studied 1,457 patients with chronic hepatitis C. At the five year mark, seventy-seven patients were deceased—thirty-nine from liver-related deaths—and sixteen patients had liver transplantation.

Overall survival was 91.7%. Survival without liver-related death was 94.4%.

The researchers discovered that survival was notably decreased in patients diagnosed with severe fibrosis, no matter which non-invasive method was used.

Every method used in the study was able to predict shorter survival times, though the doctors noted that liver stiffness measurement and results of the FibroTest had higher predictive values.

On the same day, the doctors assessed fibrosis and liver stiffness, performed noninvasive tests of fibrosis (FibroTest, the aspartate aminotransferase to platelet ratio index, FIB-4), and examined liver biopsy samples.

"To our knowledge, this study is the first showing that liver stiffness has a prognostic value for overall survival and survival without liver-related death in patients with chronic hepatitis C virus infection," stated Dr. Lédinghen. "The present study independently validated the prognostic value of the FibroTest and showed that liver stiffness and FibroTest can predict survival."

The findings of this study carry a great amount of significance, as liver stiffness is a known predictive factor of survival for hepatitis C patients. In chronic liver diseases, fibrosis assessment can predict liver-related complications, as well as a patient’s chances for survival.

These noninvasive tests performed in the study may aid physicians in the future; detecting the severity of liver disease in patients earlier would enable doctors to decide with more certainty whether to proceed with a liver transplant, a portosystemic shun, or to pursue surgery.

This study is published in Gastroenterology, the official journal of the American Gastroenterological Association Institute.