Background And Aims: Direct-acting antiviral agents (DAAs) achieve high sustained virologic response (SVR) in chronic hepatitis C patients; yet a proportion of patients still experience de novo liver complications after SVR. Identification of risk factors is clinically important. FIB-4 index is a useful noninvasive tool to assess fibrosis, while neutrophil-to-lymphocyte ratio (NLR) is a biomarker for systemic inflammation. Our study aimed to investigate whether the addition of NLR can increase the prediction power of pre-DAA FIB-4 for de novo liver complications after SVR.
Methods: We recruited patients via The Taiwan HCV Registry (TACR) and National Health Insurance Registry Database. The inclusion criteria were patients who achieved SVR12 after DAA and were followed for at least 24 months after SVR12. Liver complications included ascites, hepatic encephalopathy, variceal bleeding, and HCC.
Results: Totally 7657 patients were recruited from 2013 to 2018. Among them, 3674 patients (48.0%) had a FIB-4 value > 3.25 and 491 patients (6.4%) had a NLR >4 before DAA. After two-year of follow-up after SVR 12, 214 patients (2.8%) developed de novo liver complications. Factors associated with liver complications included male gender, diabetes mellitus, hyperlipidemia, chronic kidney disease, and pre-DAA FIB-4 >3.25 in multivariate analyses. Addition of NLR slightly did not increase the power of predicting liver complications.
Conclusions: The overall incidence of de novo liver complications after SVR is low during short-term follow-up. Elevated pre-DAA FIB-4 is associated with de novo liver complications after SVR, whereas the addition of pre-DAA NLR does not increase the prediction power.
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http://dx.doi.org/10.1016/j.jfma.2024.10.024 | DOI Listing |
J Vasc Interv Radiol
December 2024
Department of Interventional Radiology, Zhongshan Hospital, Fudan University; National Clinical Research Center for Interventional Medicine, Zhongshan Hospital, Fudan University; Shanghai Institution of Medical Imaging, Fudan University. Electronic address:
Purpose: To evaluate the consistency and agreement between portal venous pressure measured by fine-needle (F), portal vein catheterization (D), and hepatic vein balloon-occlusion (W) in decompensated cirrhotic patients with intrahepatic venovenous shunts (IHVS).
Materials And Methods: 156 consecutive patients planning to receive transjugular intrahepatic portosystemic shunt in our center were screened for study participation. The F/D/W were assessed for consistency by Pearson coefficient (r), linear regression coefficient (R), and intraclass correlation coefficient (ICC), and for disagreement (error exceeding 20% of D) by Bland-Altman method.
J Med Case Rep
December 2024
Division of Hematology Medical Oncology, Dr. Kariadi General Hospital Semarang/Faculty of Medicine Diponegoro University, Semarang, Indonesia.
Introduction: Breast cancer liver metastasis presents a significant challenge in clinical oncology, with limited treatment options and poor prognosis. This case series study explores the extended survival achieved in breast cancer patients with liver metastases through a combination of surgical and medical interventions.
Case Presentation: We present three cases of Javanese female patients with breast cancer (51 years old, 42 years old, and 55 years old) with liver metastases who underwent hepatic resection followed by systemic therapy.
BMC Surg
December 2024
Department of Surgery, Transplantation and Gastroenterology, Semmelweis University, Budapest, Hungary.
Background: Biliary leakage is a serious complication of hepato-pancreato-biliary operations, increasing morbidity and mortality, and challenging clinicians.
Objective: This study aims to evaluate the incidence of bilioenteric anastomotic leakage, treatment options, and their outcomes at a high-volume tertiary referral center.
Methods: A retrospective cohort study was conducted to analyze the outcomes of patients who underwent biliary anastomosis formation between 2016 and 2021.
Dig Liver Dis
December 2024
Hospital Universitario del Tajo, Critical Care, Department, Universidad Alfonso X el Sabio, Spain. Electronic address:
Background: Gastrointestinal endoscopy is increasingly performed under sedation in older patients. Aging has implications in increasing the morbidity and the risk of complications related to sedation. The aim of this study is to assess the difference in complications between patients aged 65 to 74 years and those aged over 75 years.
View Article and Find Full Text PDFZhonghua Yu Fang Yi Xue Za Zhi
December 2024
Department of Clinical Laboratory Medicine, People's Hospital of Ningxia Hui Autonomous Region, Ningxia Medical University, Yinchuan750002, China.
In order to investigate the clinical manifestations and laboratory findings associated with brucellosis for the purpose of facilitating prompt clinical diagnosis and effective treatment, as well as to offer a laboratory reference for the prevention of brucellosis outbreaks. In this study, a retrospective cohort design was employed to gather epidemiological characteristics, clinical symptoms, and associated laboratory data from 391 patients diagnosed with bacterial culture-positive brucellosis at the People's Hospital of Ningxia Hui Autonomous Region between 2019 and 2023. The patients were categorized into four age groups, with each group representing a 20 years age interval.
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