Population screening for liver fibrosis: toward early diagnosis and intervention for chronic liver diseases
Ginès, Pere Castera, Laurent Lammert, Frank Graupera, Isabel Serra-Burriel, Miquel Allen, Alina M Wong, Vincent Wai-Sun Hartmann, Phillipp Thiele, Maja Caballeria, Llorenç
Ginès, Pere
Castera, Laurent
Lammert, Frank
Graupera, Isabel
Serra-Burriel, Miquel
Allen, Alina M
Wong, Vincent Wai-Sun
Hartmann, Phillipp
Thiele, Maja
Caballeria, Llorenç
Abstract
Cirrhosis, highly prevalent worldwide, develops after years of hepatic inflammation triggering progressive fibrosis. Currently, the main etiologies of cirrhosis are non-alcoholic fatty liver disease and alcohol-related liver disease, although chronic hepatitis B and C infections are still major etiological factors in some areas of the world. Recent studies have shown that liver fibrosis can be assessed with relatively high accuracy noninvasively by serological tests, transient elastography, and radiological methods. These modalities may be utilized for screening for liver fibrosis in at-risk populations. Thus far, a limited number of population-based studies using noninvasive tests in different areas of the world indicate that a significant percentage of subjects without known liver disease (around 5% in general populations and a higher rate -18% to 27%-in populations with risk factors for liver disease) have significant undetected liver fibrosis or established cirrhosis. Larger international studies are required to show the harms and benefits before concluding that screening for liver fibrosis should be applied to populations at risk for chronic liver diseases. Screening for liver fibrosis has the potential for changing the current approach from diagnosing chronic liver diseases late when patients have already developed complications of cirrhosis to diagnosing liver fibrosis in asymptomatic subjects providing the opportunity of preventing disease progression.
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Date
2021-12-10
Type
Article
Subject
Collections
Citation
Ginès P, Castera L, Lammert F, Graupera I, Serra-Burriel M, Allen AM, Wong VW, Hartmann P, Thiele M, Caballeria L, de Knegt RJ, Grgurevic I, Augustin S, Tsochatzis EA, Schattenberg JM, Guha IN, Martini A, Morillas RM, Garcia-Retortillo M, de Koning HJ, Fabrellas N, Pich J, Ma AT, Diaz MA, Roulot D, Newsome PN, Manns M, Kamath PS, Krag A; LiverScreen Consortium Investigators. Population screening for liver fibrosis: Toward early diagnosis and intervention for chronic liver diseases. Hepatology. 2022 Jan;75(1):219-228. doi: 10.1002/hep.32163. Epub 2021 Dec 10.
Journal / Source Title
Hepatology
DOI
10.1002/hep.32163
PMID
34537988
Publisher
Wolters Kluwer Health
Publisher’s URL
https://journals.lww.com/hep/pages/default.aspx