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
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Affiliation
Hospital Clínic of Barcelona; August Pi I Sunyer Biomedical Research Institute; Centro de Investigación En Red de Enfermedades Hepáticas Y Digestivas; University of Barcelona; Assistance Publique-Hôpitaux de Paris; Université de Paris; Centre de Recherche Sur L'inflammation; Saarland University Medical Center; Saarland University; Hannover Medical School; University of Zurich; Mayo Clinic College of Medicine and Science; The Chinese University of Hong Kong; University of California San Diego; Odense University Hospital; University of Southern Denmark; Catalan Health Institute; Erasmus MC University Medical Centre; University Hospital Dubrava; University of Zagreb School of Medicine; Hospital Universitari Vall d´Hebron; Universitat Autònoma de Barcelona; University College of London; University Medical Center of the Johannes Gutenberg-University Mainz; Nottingham University Hospitals NHS Trust; University of Nottingham; University-Teaching Hospital of Padova; Hospital Germans Trias i Pujol; Hospital del Mar; Hôpital Avicenne; European Association for the Study of the Liver; University Hospitals Birmingham NHS Foundation Trust; University of Birmingham
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Publication date
2021-12-10
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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.
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.
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Article