Noninvasive Assessment of Hepatitis C Virus Infected Patients Using Vibration-Controlled Transient Elastography.
Mira FloreaTeodora SerbanGeorge Razvan TirpeAlexandru TirpeMonica Lupsor-PlatonPublished in: Journal of clinical medicine (2021)
Chronic infection with hepatitis C virus (HCV) is one of the leading causes of cirrhosis and hepatocellular carcinoma (HCC). Surveillance of these patients is an essential strategy in the prevention chain, including in the pre/post-antiviral treatment states. Ultrasound elastography techniques are emerging as key methods in the assessment of liver diseases, with a number of advantages such as their rapid, noninvasive, and cost-effective characters. The present paper critically reviews the performance of vibration-controlled transient elastography (VCTE) in the assessment of HCV patients. VCTE measures liver stiffness (LS) and the ultrasonic attenuation through the embedded controlled attenuation parameter (CAP), providing the clinician with a tool for assessing fibrosis, cirrhosis, and steatosis in a noninvasive manner. Moreover, standardized LS values enable proper staging of the underlying fibrosis, leading to an accurate identification of a subset of HCV patients that present a high risk for complications. In addition, VCTE is a valuable technique in evaluating liver fibrosis prior to HCV therapy. However, its applicability in monitoring fibrosis regression after HCV eradication is currently limited and further studies should focus on extending the boundaries of VCTE in this context. From a different perspective, VCTE may be effective in identifying clinically significant portal hypertension (CSPH). An emerging prospect of clinical significance that warrants further study is the identification of esophageal varices. Our opinion is that the advantages of VCTE currently outweigh those of other surveillance methods.
Keyphrases
- hepatitis c virus
- liver fibrosis
- end stage renal disease
- human immunodeficiency virus
- newly diagnosed
- ejection fraction
- chronic kidney disease
- public health
- peritoneal dialysis
- prognostic factors
- randomized controlled trial
- blood pressure
- magnetic resonance imaging
- adipose tissue
- stem cells
- patient reported outcomes
- risk factors
- pet ct
- mass spectrometry
- brain injury
- computed tomography
- high frequency
- antiretroviral therapy
- high resolution
- current status
- cerebral ischemia
- high fat diet induced
- clinical evaluation