Noninvasive prediction of outcomes in autoimmune hepatitis-related cirrhosis

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  • dc.contributor.author Llovet, Laura-Patricia
  • dc.contributor.author Gratacós-Ginès, Jordi
  • dc.contributor.author Téllez, Luis
  • dc.contributor.author Gómez-Outomuro, Ana
  • dc.contributor.author Navascués, Carmen A.
  • dc.contributor.author Riveiro-Barciela, Mar
  • dc.contributor.author Vinuesa, Raquel
  • dc.contributor.author Gómez-Camarero, Judith
  • dc.contributor.author García-Retortillo, Montserrat
  • dc.contributor.author Díaz-Fontenla, Fernando
  • dc.contributor.author Salcedo, Magdalena
  • dc.contributor.author García-Eliz, María
  • dc.contributor.author Horta, Diana
  • dc.contributor.author Guerrero, Marta
  • dc.contributor.author Rodríguez-Perálvarez, Manuel
  • dc.contributor.author Fernández-Rodriguez, Conrado
  • dc.contributor.author Albillos, Agustín
  • dc.contributor.author Abraldes, Juan Gonzales
  • dc.contributor.author Parés Jiménez, Albert
  • dc.contributor.author Londoño, María-Carlota
  • dc.date.accessioned 2022-09-21T06:13:01Z
  • dc.date.available 2022-09-21T06:13:01Z
  • dc.date.issued 2022
  • dc.description.abstract The value of noninvasive tools in the diagnosis of autoimmune hepatitis (AIH)-related cirrhosis and the prediction of clinical outcomes is largely unknown. We sought to evaluate (1) the utility of liver stiffness measurement (LSM) in the diagnosis of cirrhosis and (2) the performance of the Sixth Baveno Consensus on Portal Hypertension (Baveno VI), expanded Baveno VI, and the ANTICIPATE models in predicting the absence of varices needing treatment (VNT). A multicenter cohort of 132 patients with AIH-related cirrhosis was retrospectively analyzed. LSM and endoscopies performed at the time of cirrhosis diagnosis were recorded. Most of the patients were female (66%), with a median age of 54 years. Only 33%-49% of patients had a LSM above the cutoff points described for the diagnosis of AIH-related cirrhosis (12.5, 14, and 16 kPa). Patients with portal hypertension (PHT) had significantly higher LSM than those without PHT (15.7 vs. 11.7 kPa; P = 0.001), but 39%-52% of patients with PHT still had LSM below these limits. The time since AIH diagnosis negatively correlated with LSM, with longer time being significantly associated with a lower proportion of patients with LSM above these cutoffs. VNT was present in 12 endoscopies. The use of the Baveno VI, expanded Baveno VI criteria, and the ANTICIPATE model would have saved 46%-63% of endoscopies, but the latter underpredicted the risk of VNT. Conclusions: LSM cutoff points do not have a good discriminative capacity for the diagnosis of AIH-related cirrhosis, especially long-term after treatment initiation. Noninvasive tools are helpful to triage patients for endoscopy.
  • dc.format.mimetype application/pdf
  • dc.identifier.citation Llovet LP, Gratacós-Ginès J, Téllez L, Gómez-Outomuro A, Navascués CA, Riveiro-Barciela M, Vinuesa R, Gómez-Camarero J, García-Retortillo M, Díaz-Fontenla F, Salcedo M, García-Eliz M, Horta D, Guerrero M, Rodríguez-Perálvarez M, Fernández-Rodriguez C, Albillos A, G-Abraldes J, Parés A, Londoño MC. Noninvasive prediction of outcomes in autoimmune hepatitis-related cirrhosis. Hepatol Commun. 2022 Jun;6(6):1392-402. DOI: 10.1002/hep4.1889
  • dc.identifier.doi http://dx.doi.org/10.1002/hep4.1889
  • dc.identifier.issn 2471-254X
  • dc.identifier.uri http://hdl.handle.net/10230/54127
  • dc.language.iso eng
  • dc.publisher Wiley
  • dc.relation.ispartof Hepatol Commun. 2022 Jun;6(6):1392-402
  • dc.rights © 2022 The Authors. Hepatology Communications published by Wiley Periodicals LLC on behalf of the American Association for the Study of Liver Diseases. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
  • dc.rights.accessRights info:eu-repo/semantics/openAccess
  • dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
  • dc.title Noninvasive prediction of outcomes in autoimmune hepatitis-related cirrhosis
  • dc.type info:eu-repo/semantics/article
  • dc.type.version info:eu-repo/semantics/publishedVersion

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