NON-INVASIVE TOOLS TO ASSESS THE RISK OF VARICES-NEEDING-TREATMENT IN CIRRHOSIS SECONDARY TO HCV

Objective: To assess the non-invasive biomarkers of fibrosis for predicting varices-needing-treatment in patients with cirrhosis secondary to chronic-hepatitis-C. Study Design: Cross sectional comparative study. Place and Duration of Study: Department of Gastroenterology, Pak Emirates Military...

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Autores principales:	Laima Alam, Farrukh Saeed
Formato:	article
Lenguaje:	EN
Publicado:	Army Medical College Rawalpindi 2021
Materias:	cirrhosis hcv non-invasive biomarkers varices varices-needing-treatment Medicine R Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/ee05b4264b49454d8ea788f0367104fa
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spelling	oai:doaj.org-article:ee05b4264b49454d8ea788f0367104fa2021-12-02T18:01:28ZNON-INVASIVE TOOLS TO ASSESS THE RISK OF VARICES-NEEDING-TREATMENT IN CIRRHOSIS SECONDARY TO HCV0030-96482411-884210.51253/pafmj.v71i1.6352https://doaj.org/article/ee05b4264b49454d8ea788f0367104fa2021-02-01T00:00:00Zhttps://pafmj.org/index.php/PAFMJ/article/view/6352https://doaj.org/toc/0030-9648https://doaj.org/toc/2411-8842Objective: To assess the non-invasive biomarkers of fibrosis for predicting varices-needing-treatment in patients with cirrhosis secondary to chronic-hepatitis-C. Study Design: Cross sectional comparative study. Place and Duration of Study: Department of Gastroenterology, Pak Emirates Military Hospital Rawalpindi, from Jan 2017 to Dec 2017. Methodology: A total of 153 patients aged 18-79 with cirrhosis, whether compensated or decompensated, secondary to chronic-hepatitis-C were enrolled. Relevant serum tests were used to calculate non-invasive fibrosis indices and their diagnostic performance to predict the presence of varices and varices-needing-treatment was calculated. Results: King’s score showed the best performance in detecting varices due to high positive predictive value of 96.4% and positive likelihood ratio of 2.4. Overall, all the non-invasive fibrosis indices exhibited good performance with positive predictive value >85% but none could rule out the presence of varices with adequate reliability due to low negative-predictive-value (<65%). King’s score exhibited relatively higher positive-predictivevalue (70%) and negative predictive value (51.1%) and the lowest negative-likelihood-ratio (0.6) for predicting varices needing treatment. Taken together, none of the non-invasive biomarkers of fibrosis could predict the presence of varices-needing-treatment with adequate accuracy due to low positive-predictive-value (<85%) and low negative-predictive-value (<65%). Conclusion: The calculated non-invasive biomarkers of fibrosis and their optimum cutoff values showed modest accuracy for predicting varices and varices-needing-treatment. These indices may be used as first-line screening method for segregation of clinically significant portal hypertension and high risk esophageal varices-needingtreatment but may not be able to replace the gold standards like Fibroscan liver and Hepatic Venous Pressure Gradient measurements.Laima AlamFarrukh SaeedArmy Medical College Rawalpindiarticlecirrhosishcvnon-invasive biomarkersvaricesvarices-needing-treatmentMedicineRMedicine (General)R5-920ENPakistan Armed Forces Medical Journal, Vol 71, Iss 1, Pp 12-17 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	cirrhosis hcv non-invasive biomarkers varices varices-needing-treatment Medicine R Medicine (General) R5-920
spellingShingle	cirrhosis hcv non-invasive biomarkers varices varices-needing-treatment Medicine R Medicine (General) R5-920 Laima Alam Farrukh Saeed NON-INVASIVE TOOLS TO ASSESS THE RISK OF VARICES-NEEDING-TREATMENT IN CIRRHOSIS SECONDARY TO HCV
description	Objective: To assess the non-invasive biomarkers of fibrosis for predicting varices-needing-treatment in patients with cirrhosis secondary to chronic-hepatitis-C. Study Design: Cross sectional comparative study. Place and Duration of Study: Department of Gastroenterology, Pak Emirates Military Hospital Rawalpindi, from Jan 2017 to Dec 2017. Methodology: A total of 153 patients aged 18-79 with cirrhosis, whether compensated or decompensated, secondary to chronic-hepatitis-C were enrolled. Relevant serum tests were used to calculate non-invasive fibrosis indices and their diagnostic performance to predict the presence of varices and varices-needing-treatment was calculated. Results: King’s score showed the best performance in detecting varices due to high positive predictive value of 96.4% and positive likelihood ratio of 2.4. Overall, all the non-invasive fibrosis indices exhibited good performance with positive predictive value >85% but none could rule out the presence of varices with adequate reliability due to low negative-predictive-value (<65%). King’s score exhibited relatively higher positive-predictivevalue (70%) and negative predictive value (51.1%) and the lowest negative-likelihood-ratio (0.6) for predicting varices needing treatment. Taken together, none of the non-invasive biomarkers of fibrosis could predict the presence of varices-needing-treatment with adequate accuracy due to low positive-predictive-value (<85%) and low negative-predictive-value (<65%). Conclusion: The calculated non-invasive biomarkers of fibrosis and their optimum cutoff values showed modest accuracy for predicting varices and varices-needing-treatment. These indices may be used as first-line screening method for segregation of clinically significant portal hypertension and high risk esophageal varices-needingtreatment but may not be able to replace the gold standards like Fibroscan liver and Hepatic Venous Pressure Gradient measurements.
format	article
author	Laima Alam Farrukh Saeed
author_facet	Laima Alam Farrukh Saeed
author_sort	Laima Alam
title	NON-INVASIVE TOOLS TO ASSESS THE RISK OF VARICES-NEEDING-TREATMENT IN CIRRHOSIS SECONDARY TO HCV
title_short	NON-INVASIVE TOOLS TO ASSESS THE RISK OF VARICES-NEEDING-TREATMENT IN CIRRHOSIS SECONDARY TO HCV
title_full	NON-INVASIVE TOOLS TO ASSESS THE RISK OF VARICES-NEEDING-TREATMENT IN CIRRHOSIS SECONDARY TO HCV
title_fullStr	NON-INVASIVE TOOLS TO ASSESS THE RISK OF VARICES-NEEDING-TREATMENT IN CIRRHOSIS SECONDARY TO HCV
title_full_unstemmed	NON-INVASIVE TOOLS TO ASSESS THE RISK OF VARICES-NEEDING-TREATMENT IN CIRRHOSIS SECONDARY TO HCV
title_sort	non-invasive tools to assess the risk of varices-needing-treatment in cirrhosis secondary to hcv
publisher	Army Medical College Rawalpindi
publishDate	2021
url	https://doaj.org/article/ee05b4264b49454d8ea788f0367104fa
work_keys_str_mv	AT laimaalam noninvasivetoolstoassesstheriskofvaricesneedingtreatmentincirrhosissecondarytohcv AT farrukhsaeed noninvasivetoolstoassesstheriskofvaricesneedingtreatmentincirrhosissecondarytohcv
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NON-INVASIVE TOOLS TO ASSESS THE RISK OF VARICES-NEEDING-TREATMENT IN CIRRHOSIS SECONDARY TO HCV

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