¹³C-Aminopyrine breath test accurately predicts long-term outcome of chronic hepatitis C

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• 作者：Alba Rocco¹ ; Germana de Nucci¹ ; Giovanna Valente¹ ; Debora Compare¹ ; Agesilao D&rsquo ; Arienzo¹ ; Lucia Cimino¹ ; Francesco Perri² ; Gerardo Nardone¹ ; ^{nardone@unina.it}
• 关键词：Fibrosis progression ; 13C-ABT ; HCV-related chronic disease outcome
• 刊名：Journal of Hepatology
• 出版年：2012
• 期刊代码：162_01688278
• 类别：med
• 出版时间：April, 2012
• 卷：56
• 期：4
• 页码：782-787
• 文件大小：579 K

摘要

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Background & Aims

Although numerous non-invasive tests are currently available to explore liver function and disease activity in patients with HCV-related chronic diseases, none of these indicate the likelihood of disease progression in the individual patient.

We aimed at assessing the prognostic ability of ¹³C₂-aminopyrine breath test (¹³C-ABT) in the prediction of liver fibrosis progression in patients with HCV chronic hepatitis who prospectively entered a long-term follow-up.

Methods

Fifty patients with HCV-related chronic disease who underwent paired liver biopsy (at baseline and after a mean period of 86 months) were included in the study. ¹³C-ABT was carried out at baseline and every 3 years. Histological progression was defined as increase of at least 2 fibrosis units according to Ishak score.

Results

Fourteen patients progressed of at least 2 fibrosis units during the follow-up. These patients were more frequently infected with a HCV-1b genotype and had, at baseline, a significantly older age, higher BMI, AST levels, and AST to platelet ratio index (APRI). ¹³C-ABT was altered in 57%of cases at baseline and in 100%of the cases at 3-year follow-up. In the univariate analysis, age (p = 0.005), BMI (p = 0.006), platelet count (p = 0.03), AST (p = 0.012) and ALT (p = 0.04) levels, APRI (p = 0.03), and baseline ¹³C-ABT results (p <0.0001) were all independently associated with progression of liver fibrosis. By Cox鈥檚 multiple regression analysis, the ¹³C-ABT was the only covariate that significantly predicted liver fibrosis progression (HR 6.7; 95%CI 2.3-20.1; p <0.001).

Conclusions

¹³C-ABT accurately predicts the risk of disease progression in patients with HCV-related chronic hepatitis.