Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/25649
Title: Prevalence and predictors for compensated Advanced Chronic Liver Disease (c-ACLD) in patients with chronic Hepatitis Delta Virus (HDV) infection
Authors: Couto, Ingrid
Victoria, Marilu
Veloso, Valdiléa G
Rodrigues, Lorena
Grinsztejn, Beatriz
Lacerda, Marcus
Victoria, Flamir
Perazzo, Hugo
Affilliation: Fundação de Medicina Tropical Dr. Heitor Vieira Dourado. Manaus, AM, Brazil.
Fundação de Medicina Tropical Dr. Heitor Vieira Dourado. Manaus, AM, Brazil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brazil.
Fundação de Medicina Tropical Dr. Heitor Vieira Dourado. Manaus, AM, Brazil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brazil.
Fundação de Medicina Tropical Dr. Heitor Vieira Dourado. Manaus, AM, Brazil / Fundação Oswaldo Cruz. Instituto de Pesquisas Leônidas & Maria Deane. Manaus, AM, Brazil.
Fundação de Medicina Tropical Dr. Heitor Vieira Dourado. Manaus, AM, Brazil.
Fundação Oswaldo Cruz. Instituto Nacional de Infectologia Evandro Chagas. Rio de Janeiro, RJ, Brazil.
Abstract: The study aimed to evaluate the prevalence and predictor factors for compensated advanced chronic liver disease (c-ACLD) in patients with hepatitis Delta virus (HDV) infection. Methods This cross-sectional study included consecutive HDV-infected patients defined by positive anti-HDV. Patients with hepatitis C coinfection, liver transplantation or presence of conditions that limit liver (LSM) or spleen stiffness measurement (SSM) were excluded. Blood tests, abdominal ultrasound, SSM and LSM by transient elastography (FibroScan®) were performed at the same day. Alcohol consumption was quantified using the AUDIT score and c-ACLD was defined by LSM 15 kPa performed by an experimented operator blinded for clinical and laboratory data. Results 101 patients were eligible and few patients were excluded due to negative anti-HDV (n = 7), hepatitis C coinfection (n = 2), liver transplantation (n = 10) and limitation for LSM or SSM (n = 5). Therefore, 77 patients [61% male, age = 43 (IQR,36–52) years] were included. The prevalence of c-ACLD was 57% (n = 44/77). Patients with c-ACLD had a higher rate of detectable HBV viral load (p = 0.039), higher levels of transaminases, GGT, alkaline phosphatases, total bilirubin and INR (p<0.001 for all), as well as lower platelet count and albumin levels (p>0.001 for both) compared to those without c-ACLD. Patients with c-ACLD had higher SSM [65.2 (IQR,33.8–75.0) vs 21.8 (16.5–32.0) kPa; p<0.001] and higher splenic volume [475 (IQR,311–746) vs 154 (112–283) cm3 ; p<0.001] compared to those without. Detectable HBV viral load (>10 UI/ml), alkaline phosphatase (per IU/L) and GGT levels (per IU/L) were independently associated with c-ACLD in all multivariate models. Splenic volume [per cm3, OR = 1.01 (95%CI,1.01–1.02);p = 0.002], SSM [per kPa, OR = 1.04 (1.01–1.07); p = 0.012] and splenomegaly [yes vs no,OR = 28.45 (4.42–182.95);p<0.001] were independently associated with c-ACLD. Conclusions: The prevalence of c-ACLD was high in patients with chronic HDV infection in western Amazon basin. HBV viral load, liver enzymes and splenic features can be used to predict severe liver disease in HDV-infected patients.
Keywords: Advanced Chronic Liver Disease (c-ACLD)
Hepatitis Delta Virus (HDV) Infection
Patients
Issue Date: 2017
Citation: COUTO, Ingrid et al. Prevalence and predictors for compensated Advanced Chronic Liver Disease (c-ACLD) in patients with chronic Hepatitis Delta Virus (HDV) infection. PLOS One, v. 12, n. 3, p. 1-15, 22 March 2017.
DOI: 10.1371/journal.pone.0174453
ISSN: 1932-6203
Copyright: open access
Appears in Collections:AM - ILMD - Artigos de Periódicos
INI - Artigos de Periódicos

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