Clinical and Molecular Hepatology

"Advanced fibrosis"

Letter to the Editor

Steatotic liver disease

Prevalence of steatotic liver disease and associated fibrosis in the general population: An epidemiological survey: Letter to the editor on “Epidemiology of metabolic dysfunction-associated steatotic liver disease”: Lin Guan, Xinhe Zhang, Shanghao Liu, Xiaolong Qi, Yiling Li; Clin Mol Hepatol 2025;31(2):e145-e148.
Published online October 29, 2024; DOI: https://doi.org/10.3350/cmh.2024.0921

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Correspondence

Steatotic liver disease

Correspondence to editorial on “Optimal cutoffs of vibration-controlled transient elastography and magnetic resonance elastography in diagnosing advanced liver fibrosis in patients with nonalcoholic fatty liver disease: A systematic review and meta-analysis”: Jung Hwan Yu, Seung Up Kim; Clin Mol Hepatol 2025;31(1):e52-e54.
Published online September 24, 2024; DOI: https://doi.org/10.3350/cmh.2024.0815

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Original Articles

Steatotic liver disease

Optimal cut-offs of vibration-controlled transient elastography and magnetic resonance elastography in diagnosing advanced liver fibrosis in patients with nonalcoholic fatty liver disease: A systematic review and meta-analysis: Young Eun Chon, Young-Joo Jin, Jihyun An, Hee Yeon Kim, Miyoung Choi, Dae Won Jun, Mi Na Kim, Ji Won Han, Han Ah Lee, Jung Hwan Yu, Seung Up Kim; Clin Mol Hepatol 2024;30(Suppl):S117-S133.
Published online August 21, 2024; DOI: https://doi.org/10.3350/cmh.2024.0392

Background/aims
Opinions differ regarding vibration-controlled transient elastography and magnetic resonance elastography (VCTE/MRE) cut-offs for diagnosing advanced fibrosis (AF) in patients with non-alcoholic fatty liver disease (NAFLD). We investigated the diagnostic performance and optimal cut-off values of VCTE and MRE for diagnosing AF.
Methods
Literature databases, including Medline, EMBASE, Cochrane Library, and KoreaMed, were used to identify relevant studies published up to June 13, 2023. We selected studies evaluating VCTE and MRE regarding the degree of liver fibrosis using liver biopsy as the reference. The sensitivity, specificity, and area under receiver operating characteristics curves (AUCs) of the pooled data for VCTE and MRE for each fibrosis stage and optimal cut-offs for AF were investigated.
Result
s: A total of 19,199 patients from 63 studies using VCTE showed diagnostic AUC of 0.83 (95% confidence interval: 0.80–0.86), 0.83 (0.80–0.86), 0.87 (0.84–0.90), and 0.94 (0.91–0.96) for ≥F1, ≥F2, ≥F3, and F4 stages, respectively. Similarly, 1,484 patients from 14 studies using MRE showed diagnostic AUC of 0.89 (0.86–0.92), 0.92 (0.89–0.94), 0.89 (0.86–0.92), and 0.94 (0.91–0.96) for ≥F1, ≥F2, ≥F3, and F4 stages, respectively. The diagnostic AUC for AF using VCTE was highest at 0.90 with a cut-off of 7.1–7.9 kPa, and that of MRE was highest at 0.94 with a cut-off of 3.62–3.8 kPa.
Conclusions
VCTE (7.1–7.9 kPa) and MRE (3.62–3.8 kPa) with the suggested cut-offs showed favorable accuracy for diagnosing AF in patients with NAFLD. This result will serve as a basis for clinical guidelines for non-invasive tests and differential diagnosis of AF.

Citations

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Young Eun Chon, Jung Hwan Yu, Seung Up Kim
Clinical and Molecular Hepatology.2025; 31(1): e61. CrossRef
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Crossref

Viral hepatitis

Advanced fibrosis is not a negative pretreatment predictive factor for genotype 2 or 3 chronic hepatitis C patients: Hyun Seok Lee, Young Oh Kweon, Won Young Tak, Soo Young Park, Eun Jung Kang, Yu Lim Lee, Hae Min Yang, Hyun Woo Park; Clin Mol Hepatol 2013;19(2):148-155.
Published online June 27, 2013; DOI: https://doi.org/10.3350/cmh.2013.19.2.148

Abstract
PDF

Background/Aims

Chronic hepatitis C patients with advanced fibrosis have unsatisfactory sustained virological response (SVR) rates. Few data demonstrating the efficacy of combination therapy in chronic hepatitis C patients with advanced fibrosis in South Korea are available. The purpose of this study was to assess whether the stage of fibrosis impacts the efficacy of combination therapy for chronic hepatitis C.

Methods

We retrospectively reviewed data for a total of 109 patients with chronic hepatitis C, treated with peginterferon alfa and ribavirin. SVR according to the stage of liver fibrosis assessed by pretreatment liver biopsy and genotype results were analyzed.

Results

Data from 66 genotype 1 patients (60.6%) and 43 genotype 2 or 3 patients (39.4%) among the 109 patients were analyzed. SVR rates for the genotype 1 patients were significantly lower for the stage 3-4 group (32.1%) than the stage 0-2 group (78.9%; P<0.001). SVR rates (92.0% for stage 0-2, 77.8% for stage 3-4, P=0.184) of genotype 2 or 3 patients were not significantly different according to fibrosis stage. Likewise, the frequency of adverse events was not significantly different according to fibrosis stage.

Conclusions

Compared to patients without advanced fibrosis, we can anticipate good SVR rates for genotype 2 or 3 patients with advanced fibrosis and they did not show an inferior tolerability for peginterferon and ribavirin combination therpy. Our results suggest that active treatment is needed for genotype 2 or 3 patients with advanced fibrosis.

Citations

Citations to this article as recorded by

Thrombocytopenia in Virus Infections
Matthijs Raadsen, Justin Du Toit, Thomas Langerak, Bas van Bussel, Eric van Gorp, Marco Goeijenbier
Journal of Clinical Medicine.2021; 10(4): 877. CrossRef
Real-world single-center experience with direct-acting antivirals for improvement of the liver fibrosis after chronic hepatitis C treatment
Sun Hee Lee, Hyun Phil Shin, Joung Il Lee
Antiviral Chemistry and Chemotherapy.2020; 28: 204020662097483. CrossRef
Hepatitis C in infection with recombinant strain RF2k/1b of the virus: clinical course and therapy
L. I Nikolaeva, G. V Sapronov, A. V Kolotvin, E. I Samokhvalov, E. A Leybman, L. M Samokhodskaya
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