Staging liver fibrosis after severe yellow fever with ultrasound elastography in Brazil: A six-month follow-up study.

<h4>Background</h4>Yellow fever (YF) is a hemorrhagic disease caused by an arbovirus endemic in South America, with recent outbreaks in the last years. Severe cases exhibit fulminant hepatitis, but there are no studies regarding its late-term effects on liver parenchyma. Thus, the aim of...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Yuri Costa Sarno Neves, Victor Augusto Camarinha de Castro-Lima, Davi Jorge Fontoura Solla, Vivian Simone de Medeiros Ogata, Fernando Linhares Pereira, Jordana Machado Araujo, Ana Catharina Seixas Nastri, Yeh-Li Ho, Maria Cristina Chammas
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/f389c53a7d304214ba97c847f78bc197
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:f389c53a7d304214ba97c847f78bc197
record_format	dspace
spelling	oai:doaj.org-article:f389c53a7d304214ba97c847f78bc1972021-11-25T06:33:29ZStaging liver fibrosis after severe yellow fever with ultrasound elastography in Brazil: A six-month follow-up study.1935-27271935-273510.1371/journal.pntd.0009594https://doaj.org/article/f389c53a7d304214ba97c847f78bc1972021-07-01T00:00:00Zhttps://doi.org/10.1371/journal.pntd.0009594https://doaj.org/toc/1935-2727https://doaj.org/toc/1935-2735<h4>Background</h4>Yellow fever (YF) is a hemorrhagic disease caused by an arbovirus endemic in South America, with recent outbreaks in the last years. Severe cases exhibit fulminant hepatitis, but there are no studies regarding its late-term effects on liver parenchyma. Thus, the aim of this study was to determine the frequency and grade of liver fibrosis in patients who recovered from severe YF and to point out potential predictors of this outcome.<h4>Methodology/principal findings</h4>We followed-up 18 patients who survived severe YF during a recent outbreak (January-April 2018) in Brazil using ultrasound (US) with shear-wave elastography (SWE) at 6 months after symptoms onset. No patient had previous history of liver disease. Median liver stiffness (LS) was 5.3 (4.6-6.4) kPa. 2 (11.1%) patients were classified as Metavir F2, 1 (8.3%) as F3 and 1 (8.3%) as F4; these two last patients had features of cardiogenic liver congestion on Doppler analysis. Age and cardiac failure were associated with increased LS (p = 0.036 and p = 0.024, respectively). SAPS-3 at ICU admission showed a tendency of association with significant fibrosis (≥ F2; p = 0.053). 7 patients used sofosbuvir in a research protocol, of which none showed liver fibrosis (p = 0.119).<h4>Conclusions/significance</h4>We found a low frequency of liver fibrosis in severe YF survivors. US with SWE may have a role in the follow up of patients of age and / or with comorbidities after hospital discharge in severe YF, a rare but reemergent disease.Yuri Costa Sarno NevesVictor Augusto Camarinha de Castro-LimaDavi Jorge Fontoura SollaVivian Simone de Medeiros OgataFernando Linhares PereiraJordana Machado AraujoAna Catharina Seixas NastriYeh-Li HoMaria Cristina ChammasPublic Library of Science (PLoS)articleArctic medicine. Tropical medicineRC955-962Public aspects of medicineRA1-1270ENPLoS Neglected Tropical Diseases, Vol 15, Iss 7, p e0009594 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
spellingShingle	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Yuri Costa Sarno Neves Victor Augusto Camarinha de Castro-Lima Davi Jorge Fontoura Solla Vivian Simone de Medeiros Ogata Fernando Linhares Pereira Jordana Machado Araujo Ana Catharina Seixas Nastri Yeh-Li Ho Maria Cristina Chammas Staging liver fibrosis after severe yellow fever with ultrasound elastography in Brazil: A six-month follow-up study.
description	<h4>Background</h4>Yellow fever (YF) is a hemorrhagic disease caused by an arbovirus endemic in South America, with recent outbreaks in the last years. Severe cases exhibit fulminant hepatitis, but there are no studies regarding its late-term effects on liver parenchyma. Thus, the aim of this study was to determine the frequency and grade of liver fibrosis in patients who recovered from severe YF and to point out potential predictors of this outcome.<h4>Methodology/principal findings</h4>We followed-up 18 patients who survived severe YF during a recent outbreak (January-April 2018) in Brazil using ultrasound (US) with shear-wave elastography (SWE) at 6 months after symptoms onset. No patient had previous history of liver disease. Median liver stiffness (LS) was 5.3 (4.6-6.4) kPa. 2 (11.1%) patients were classified as Metavir F2, 1 (8.3%) as F3 and 1 (8.3%) as F4; these two last patients had features of cardiogenic liver congestion on Doppler analysis. Age and cardiac failure were associated with increased LS (p = 0.036 and p = 0.024, respectively). SAPS-3 at ICU admission showed a tendency of association with significant fibrosis (≥ F2; p = 0.053). 7 patients used sofosbuvir in a research protocol, of which none showed liver fibrosis (p = 0.119).<h4>Conclusions/significance</h4>We found a low frequency of liver fibrosis in severe YF survivors. US with SWE may have a role in the follow up of patients of age and / or with comorbidities after hospital discharge in severe YF, a rare but reemergent disease.
format	article
author	Yuri Costa Sarno Neves Victor Augusto Camarinha de Castro-Lima Davi Jorge Fontoura Solla Vivian Simone de Medeiros Ogata Fernando Linhares Pereira Jordana Machado Araujo Ana Catharina Seixas Nastri Yeh-Li Ho Maria Cristina Chammas
author_facet	Yuri Costa Sarno Neves Victor Augusto Camarinha de Castro-Lima Davi Jorge Fontoura Solla Vivian Simone de Medeiros Ogata Fernando Linhares Pereira Jordana Machado Araujo Ana Catharina Seixas Nastri Yeh-Li Ho Maria Cristina Chammas
author_sort	Yuri Costa Sarno Neves
title	Staging liver fibrosis after severe yellow fever with ultrasound elastography in Brazil: A six-month follow-up study.
title_short	Staging liver fibrosis after severe yellow fever with ultrasound elastography in Brazil: A six-month follow-up study.
title_full	Staging liver fibrosis after severe yellow fever with ultrasound elastography in Brazil: A six-month follow-up study.
title_fullStr	Staging liver fibrosis after severe yellow fever with ultrasound elastography in Brazil: A six-month follow-up study.
title_full_unstemmed	Staging liver fibrosis after severe yellow fever with ultrasound elastography in Brazil: A six-month follow-up study.
title_sort	staging liver fibrosis after severe yellow fever with ultrasound elastography in brazil: a six-month follow-up study.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/f389c53a7d304214ba97c847f78bc197
work_keys_str_mv	AT yuricostasarnoneves stagingliverfibrosisaftersevereyellowfeverwithultrasoundelastographyinbrazilasixmonthfollowupstudy AT victoraugustocamarinhadecastrolima stagingliverfibrosisaftersevereyellowfeverwithultrasoundelastographyinbrazilasixmonthfollowupstudy AT davijorgefontourasolla stagingliverfibrosisaftersevereyellowfeverwithultrasoundelastographyinbrazilasixmonthfollowupstudy AT viviansimonedemedeirosogata stagingliverfibrosisaftersevereyellowfeverwithultrasoundelastographyinbrazilasixmonthfollowupstudy AT fernandolinharespereira stagingliverfibrosisaftersevereyellowfeverwithultrasoundelastographyinbrazilasixmonthfollowupstudy AT jordanamachadoaraujo stagingliverfibrosisaftersevereyellowfeverwithultrasoundelastographyinbrazilasixmonthfollowupstudy AT anacatharinaseixasnastri stagingliverfibrosisaftersevereyellowfeverwithultrasoundelastographyinbrazilasixmonthfollowupstudy AT yehliho stagingliverfibrosisaftersevereyellowfeverwithultrasoundelastographyinbrazilasixmonthfollowupstudy AT mariacristinachammas stagingliverfibrosisaftersevereyellowfeverwithultrasoundelastographyinbrazilasixmonthfollowupstudy
_version_	1718413655423320064

Staging liver fibrosis after severe yellow fever with ultrasound elastography in Brazil: A six-month follow-up study.

Ejemplares similares