Prognostic value of Ishak fibrosis stage: Findings from the hepatitis C antiviral long-term treatment against cirrhosis trial
dc.contributor.author | Everhart, James E. | en_US |
dc.contributor.author | Wright, Elizabeth C. | en_US |
dc.contributor.author | Goodman, Zachary D. | en_US |
dc.contributor.author | Dienstag, Jules L. | en_US |
dc.contributor.author | Hoefs, John C. | en_US |
dc.contributor.author | Kleiner, David E. | en_US |
dc.contributor.author | Ghany, Marc G. | en_US |
dc.contributor.author | Mills, A. Scott | en_US |
dc.contributor.author | Nash, S. Russell | en_US |
dc.contributor.author | Govindarajan, Sugantha | en_US |
dc.contributor.author | Rogers, Thomas E. | en_US |
dc.contributor.author | Greenson, Joel K. | en_US |
dc.contributor.author | Brunt, Elizabeth M. | en_US |
dc.contributor.author | Bonkovsky, Herbert L. | en_US |
dc.contributor.author | Morishima, Chihiro | en_US |
dc.contributor.author | Litman, Heather J. | en_US |
dc.date.accessioned | 2010-02-02T15:32:32Z | |
dc.date.available | 2011-03-01T16:26:45Z | en_US |
dc.date.issued | 2010-02 | en_US |
dc.identifier.citation | Everhart, James E.; Wright, Elizabeth C.; Goodman, Zachary D.; Dienstag, Jules L.; Hoefs, John C.; Kleiner, David E.; Ghany, Marc G.; Mills, A. Scott; Nash, S. Russell; Govindarajan, Sugantha; Rogers, Thomas E.; Greenson, Joel K.; Brunt, Elizabeth M.; Bonkovsky, Herbert L.; Morishima, Chihiro; Litman, Heather J. (2010). "Prognostic value of Ishak fibrosis stage: Findings from the hepatitis C antiviral long-term treatment against cirrhosis trial." Hepatology 51(2): 585-594. <http://hdl.handle.net/2027.42/64929> | en_US |
dc.identifier.issn | 0270-9139 | en_US |
dc.identifier.issn | 1527-3350 | en_US |
dc.identifier.uri | https://hdl.handle.net/2027.42/64929 | |
dc.description.abstract | Studies of the prognostic value of Ishak fibrosis stage are lacking. We used multi-year follow-up of the Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis (HALT-C) Trial to determine whether individual Ishak fibrosis stages predicted clinical outcomes in patients with chronic hepatitis C. Baseline liver biopsy specimens from 1050 patients with compensated chronic hepatitis C who had failed combination peginterferon and ribavirin were reviewed by a panel of expert hepatopathologists. Fibrosis was staged with the Ishak scale (ranging from 0 = no fibrosis to 6 = cirrhosis). Biopsy fragmentation and length as well as number of portal tracts were recorded. We compared rates of prespecified clinical outcomes of hepatic decompensation and hepatocellular carcinoma across individual Ishak fibrosis stages. Of 1050 biopsy specimens, 25% were fragmented, 63% longer than 1.5 cm, 69% larger than 10 mm 2 , and 75% had 10 or more portal tracts. Baseline laboratory markers of liver disease severity were worse and the frequency of esophageal varices higher with increasing Ishak stage ( P < 0.0001). The 6-year cumulative incidence of first clinical outcome was 5.6% for stage 2, 16.1% for stage 3, 19.3% for stage 4, 37.8% for stage 5, and 49.3% for stage 6. Among nonfragmented biopsy specimens, the predictive ability of Ishak staging was enhanced; however, no association was observed between Ishak stage and outcomes for fragmented biopsy specimens because of high rates of outcomes for patients with noncirrhotic stages. Similar results were observed with liver transplantation or liver-related death as the outcome. Conclusion : Ishak fibrosis stage predicts clinical outcomes, need for liver transplantation, and liver-related death in patients with chronic hepatitis C. Patients with fragmented biopsy specimens with low Ishak stage may be understaged histologically. (H EPATOLOGY 2010;51:585–594.) | en_US |
dc.format.extent | 485973 bytes | |
dc.format.extent | 3118 bytes | |
dc.format.mimetype | application/pdf | |
dc.format.mimetype | text/plain | |
dc.publisher | Wiley Subscription Services, Inc., A Wiley Company | en_US |
dc.subject.other | Life and Medical Sciences | en_US |
dc.subject.other | Hepatology | en_US |
dc.title | Prognostic value of Ishak fibrosis stage: Findings from the hepatitis C antiviral long-term treatment against cirrhosis trial | en_US |
dc.type | Article | en_US |
dc.rights.robots | IndexNoFollow | en_US |
dc.subject.hlbsecondlevel | Internal Medicine and Specialties | en_US |
dc.subject.hlbtoplevel | Health Sciences | en_US |
dc.description.peerreviewed | Peer Reviewed | en_US |
dc.contributor.affiliationum | Department of Pathology, University of Michigan Health System, Ann Arbor, MI | en_US |
dc.contributor.affiliationother | Division of Digestive Diseases and Nutrition, National Institutes of Health, Department of Health and Human Services, Bethesda, MD ; fax: 301-480-8300. ; Epidemiology and Clinical Trials Branch, Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases, 2 Democracy Plaza, Room 655, 6707 Democracy Boulevard, MSC 5450, Bethesda, MD 20892-5450 | en_US |
dc.contributor.affiliationother | Office of the Director, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, MD | en_US |
dc.contributor.affiliationother | Armed Forces Institute of Pathology, Division of Hepatic Pathology and Veterans Administration Special Reference Laboratory for Pathology, Washington, DC | en_US |
dc.contributor.affiliationother | Gastrointestinal Unit (Medical Services), Massachusetts General Hospital and the Department of Medicine, Harvard Medical School, Boston, MA | en_US |
dc.contributor.affiliationother | Division of Gastroenterology, University of California–Irvine, Irvine, CA | en_US |
dc.contributor.affiliationother | Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD | en_US |
dc.contributor.affiliationother | Liver Diseases Branch, National Institutes of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Department of Health and Human Services, Bethesda, MD | en_US |
dc.contributor.affiliationother | Department of Pathology, Virginia Commonwealth University Medical Center, Richmond, VA | en_US |
dc.contributor.affiliationother | Colorado GI Pathology, Centennial, CO | en_US |
dc.contributor.affiliationother | Department of Pathology, University of Southern California at Rancho Los Amigos Medical Center, Downey, CA | en_US |
dc.contributor.affiliationother | Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX | en_US |
dc.contributor.affiliationother | Department of Pathology and Immunology, Washington University, St. Louis, MO | en_US |
dc.contributor.affiliationother | Departments of Medicine and Molecular and Structural Biology and The Liver-Biliary-Pancreatic Center, University of Connecticut Health Center, Farmington, CT | en_US |
dc.contributor.affiliationother | Virology Division, Department of Laboratory Medicine, University of Washington, Seattle, WA | en_US |
dc.contributor.affiliationother | New England Research Institutes, Watertown, MA | en_US |
dc.identifier.pmid | 20101752 | en_US |
dc.description.bitstreamurl | http://deepblue.lib.umich.edu/bitstream/2027.42/64929/1/23315_ftp.pdf | |
dc.identifier.doi | 10.1002/hep.23315 | en_US |
dc.identifier.source | Hepatology | en_US |
dc.owningcollname | Interdisciplinary and Peer-Reviewed |
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