Dr Nancy Reau speaks with Dr Richard Sterling, the lead author of new guidelines on noninvasive liver disease assessment about best practices surrounding their use.
Professor, Department of Internal Medicine, Rush University; Richard B. Capps Chair of Hepatology; Section Chief, Hepatology; Associate Director of Organ Transplantation, Rush University Medical Center, Chicago IllinoisServe as a director, officer, partner, employee, advisor, consultant, or trustee for: AbbVie; Gilead; Arbutus; Intercept; SalixChronic liver disease is responsible for significant morbidity and mortality.
Understanding the fibrosis stage is paramount to managing people with CLD. It not only can provide prognostic information but also identifies those who are at risk for developing complications of portal Proprietary, complex NILDA models have been developed to overcome this, because they can also include direct markers of fibrosis formation or degradation. However, they are much more expensive, are not as readily available, and may not add any value over simple, nonproprietary NILDAs.
Therefore, they may work differently in a primary care setting where the prevalence of advanced fibrosis is less than 5% compared with a hepatology referral setting where over 30% of patients may have advanced fibrosis. Is there risk to using one NILDA, such as the Fibrosis-4 index , and applying it to all liver disease across the board?
Therefore, all blood-based NILDAs need to be interpreted with clinical context of each patient to assess whether something other than fibrosis is driving the result. The guideline recommends applying two blood-based biomarkers for both untreated HCV and MASLD. Is this important for all such patients?It is very important to identify those with cirrhosis who may need hepatocellular carcinoma surveillance after cure for HCV.
Gallbladder Disease Nonalcoholic Fatty Liver Disease NAFLD Non-Alcoholic Fatty Liver Disease Non-Alcoholic Fatty Liver Disease (NAFLD) Liver Disease Hepatic Impairment Metabolic Syndrome Liver Hepatocellular Carcinoma HCC - Hepatocellular Carcinoma Liver Cancer HCC Hepatocellular Cancer Cancer Of The Liver Liver Carcinoma Carcinoma Of The Liver Aminotransferase Ast
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