Related Experiment Videos
Quantitative testing of liver function in patients with cirrhosis due to chronic hepatitis C to assess disease
C Herold1, R Heinz, M Radespiel-Tröger
1Dept of Medicine I, University of Erlangen-Nuernberg, Germany. christoph.herold@med1.med.uni-erlangen.de
Insights
Quantitative testing of liver function (QTLF) shows decreased metabolic function in hepatitis C cirrhosis patients, correlating with disease severity. These tests may predict prognosis in early-stage cirrhosis.
Area of Science:
- Hepatology
- Diagnostic Medicine
- Biomarkers
Background:
- Quantitative testing of liver function (QTLF) offers prognostic insights for liver diseases.
- Limited data exists on QTLF in hepatitis C-induced cirrhosis.
Purpose of the Study:
- To assess the utility of QTLF in patients with hepatitis C-related cirrhosis.
- To correlate QTLF results with Child-Pugh classification.
Main Methods:
- 86 patients with confirmed hepatitis C cirrhosis underwent liver biopsy.
- QTLF included aminopyrine breath test, galactose elimination capacity, sorbitol clearance, and indocyanine green clearance.
- Results were analyzed against Child-Pugh grades (A, B, C).
Main Results:
- QTLF values decreased progressively from Child-Pugh grade A to C.
- Metabolic liver function tests were significantly reduced, while hepatic perfusion tests were near the lower normal limit in Child-Pugh A.
- All QTLF were significantly lower in grades B and C compared to controls.
Conclusions:
- QTLF inversely correlates with Child-Pugh grades in hepatitis C cirrhosis.
- QTLF, particularly metabolic function tests, may predict prognosis and complications in early cirrhosis.
Background/Aims:
Quantitative testing of liver function (QTLF) may allow a prognostic assessment of patients with various liver diseases. However, there are insufficient data about patients with liver cirrhosis due to hepatitis C.
Patients/Methods:
86 consecutive patients (58 males, 28 females, age: 48.3 +/- 11.7 years) with chronic hepatitis C (HCV RNA pos.) underwent sonographically guided liver biopsy to confirm the diagnosis of cirrhosis. QTLF included aminopyrine breath test (microsomal liver function), galactose elimination capacity (cytosolic liver function), sorbitol clearance (liver plasma flow) and indocyanine green clearance (liver perfusion). Values were correlated with the Child-Pugh classification.
Results:
55% of the patients (n=47) had cirrhosis of Child-Pugh grade A, 28% of grade B (n=24) and 17% of grade C (n=15). QTLF showed a steady decrease from Child-Pugh grade A to grade B and to grade C. Contrary to markedly reduced tests of metabolic liver function in Child-Pugh grade patients, surrogate tests of hepatic perfusion were at the lower normal limit. All QTLF were significantly reduced in Child-Pugh grade B and C patients compared to healthy controls. Differences between the three Child grades were significant.
Conclusion:
In patients with cirrhosis due to hepatitis C, QTLF correlated inversely with Child-Pugh grades. Since in cirrhosis of grade A, surrogate tests of hepatic perfusion remained at the lower normal limit, whereas those of metabolic function were decreased, QTLF may be a tool to predict prognosis or complications in early cirrhosis due to chronic hepatitis C.