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Abstract
Introduction. L’hépatite chronique C et le syndrome métabolique entrainent une fibrose hépatique. L’évaluation de cette fibrose a une importance dans le suivi des hépatopathies chroniques. Le NAFLD Fibrosis Score permet d’évaluer la fibrose en cas de syndrome métabolique. Notre but était d’évaluer la fibrose chez les patients porteurs d’une hépatite virale C et d’un syndrome métabolique. Méthodes. Il s’agissait d’une étude transversale et analytique allant du 1er Juin 2015 au 31 mai 2019. Nous avons sélectionné les patients ayant une hépatite virale C chronique et un syndrome métabolique dans la ville de Douala. Le coefficient de Spearman a permis d’établir la corrélation entre l’élastométrie impulsionnelle et le NAFLD fibrosis score. Résultats. Nous avons inclus 85 patients. Leur âge moyen était de 62,08±9,27 ans. Le sexe féminin représentait 65,9% des patients. L’obésité était observée chez 63,5% des patients. Les génotypes 1, 2 et 4 étaient retrouvés respectivement chez 44%, 32% et 24% des patients. La prévalence de la fibrose significative était de 64%. Il existait une corrélation linéaire positive (r=0,439, p<0,001) entre le NAFLD score et l’élastométrie impulsionnelle. La valeur seuil du NAFLD Fibrosis Score pour la fibrose significative était de 1,542 et de – 0,346 pour la fibrose non significative. Conclusion. Il existe une corrélation entre la NAFLD Fibrosis Score et l’élastométrie impulsionnelle. Toutefois le NAFLD Fibrosis Score semble plus efficace pour prédire la fibrose non significative et la valeur seuil est de -0,346.
ABSTRACT
Introduction. Chronic Hepatitis C and metabolic syndrome lead to fibrosis independently. Assessment of hepatic fibrosis is therefore an important part of the management of chronic liver disease. The NAFLD Fibrosis Score was developed to assess fibrosis in metabolic syndrome. The aim of the study was to assess fibrosis in patients with viral hepatitis C and metabolic syndrome. Methods. This was a cross-sectional study from June 1, 2015 to May 31, 2019. We recruited patients with chronic viral hepatitis C and a metabolic syndrome in four health facilities in Douala. The Spearman coefficient was used to establish the correlation between transient elastographyy and the NAFLD score. We evaluated the cut-off of the NAFLD score for significant fibrosis and for non-significant fibrosis. Results. We included 85 patients. Their mean age was 62.08 ± 9.27 years. The female sex represented 65.9% of patients. Obesity was observed in 63.5% of patients. Genotypes 1, 2 and 4 were found in 44%, 32% and 24% of patients, respectively. The prevalence of significant fibrosis was 64%. There was a positive linear correlation (r = 0.439, p <0.001) between the NAFLD score and transient elastography. The cut-off value for the NAFLD Fibrosis Score for significant fibrosis was 1.542 and that for non-significant fibrosis was -0.346. Conclusion. There is a correlation between the NAFLD Fibrosis Score and transient elasgraphy. However, the NAFLD Fibrosis Score seems to be more effective in predicting non significant fibrosis and the cutoff value is -0.346.
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References
- RÉFÉRENCES
- Organisation Mondiale de la Santé. Résumé D’Orientation Rapport Mondial Sur L’Hépatite. Genève; 2017.
- Petruzziello A, Marigliano S, et al. Global epidemiology of hepatitis C virus infection: An up-date of the distribution and circulation of hepatitis C virus genotypes. World J Gastroenterol. 2016;22(34):7824–40.
- Bigna JJ, Amougou MA, et al. Seroprevalence of hepatitis C virus infection in Cameroon: A systematic review and meta-analysis. BMJ Open. 2017;7(8):1–11.
- Hourigan LF, Macdonald GA, et al. Fibrosis in chronic hepatitis C correlates significantly with body mass index and steatosis. Hepatology. 1999;29(4):1215–9.
- Orellana N I, Poniachik T J, Smok S G, Madrid S AM, Menéndez A A, Tobar A E, et al. Hepatitis crónica por virus C: Factores asociados a la severidad del daño histológico. Rev Med Chil. 2005;133(11):1311–6.
- Negro F, Seifari M. Hépatite C et résistance à l’insuline. Rev Med Suisse. 2008;4:1859–62.
- Mandob D, Judith E, Ngondi L, Inès G, Fomekong D, Agbor G, et al. Prediction and Prevalence of Metabolic Syndrome in Overweight and Obese Subjects in Cameroon. Int J Biomed Pharm Sci. 2008;2(2):117–21.
- Mandob DE, Marcel J, Sah S. Prevalence of metabolic syndrome among normal weight cameroonians. World J Pharm Pharm Sci. 2015;4(09):1569–78.
- Miyaaki H, Ichikawa T, Taura N, Miuma S, Shibata H, Isomoto H, et al. Predictive value of the fibrosis scores in patients with chronic hepatitis C associated with liver fibrosis and metabolic syndrome. InternMed. 2011;50(11):1137–41.
- Hwang SJ, Lee SD. Hepatic steatosis and hepatitis C: Still unhappy bedfellows? J Gastroenterol Hepatol. 2011;26(1):96–101.
- Leroy V, Hilleret MN. Évaluation De La Fibrose Hépatique. Hepato-Gastro. 2005;12(4):251–9.
- Recommandations AFEF sur la prise en charge de l’hépatite virale C. 2017.
- Association for the study of Liver EASL-ALEH. Clinical Practice Guidelines : Non-invasive tests for evaluation of liver disease severity and prognosis. J Hepatol. 2015;63:237–64.
- Angulo P, Hui JM, et al. The NAFLD fibrosis score: A noninvasive system that identifies liver fibrosis in patients with NAFLD. Hepatology. 2007;45(4):846–54.
- Luma HN, Eloumou SAFB, et al. Characteristics of anti-hepatitis C virus antibody-positive patients in a hospital setting in Douala, Cameroon. Int J Infect Dis. 2016;45:53–8.
- Yoon H, Lee JG, Yoo JH, Son MS, Kim DY, Hwang SG, et al. Effects of metabolic syndrome on fibrosis in chronic viral hepatitis. Gut Liver. 2013;7(4):469–74.
- Siddiqui MS, Yamada G, Vuppalanchi R, Natta M Van, Chalasani N, Neuschander-tetri B, et al. Diagnostic Accuracy of Noninvasive Fibrosis Models to Detect Change in Fibrosis Stage. Clin Gastroenterol Hepatol. 2019;(March).
- Mahady SE, Macaskill P, et al. Diagnostic Accuracy of Non-invasive Fibrosis Scores in a Population of individuals With a low Prevalence of Fibrosis. Clin Gastroenterol Hepatol [Internet]. 2017; Available from: http://dx.doi.org/10.1016/j.cgh.2017.02.031
- Tovo C V, Villela-nogueira CA, et al. Annals of Hepatology Transient hepatic elastography has the best performance to evaluate liver fibrosis in non-alcoholic fatty liver disease ( NAFLD ). 2019;18:445–9.
- Nakano M, Murohisa T, Hiraishi H. Validity of the NAFLD fibrosis score in a Japanese population. Japanese J Gastro-enterology. 2012;109(5):751.
References
RÉFÉRENCES
Organisation Mondiale de la Santé. Résumé D’Orientation Rapport Mondial Sur L’Hépatite. Genève; 2017.
Petruzziello A, Marigliano S, et al. Global epidemiology of hepatitis C virus infection: An up-date of the distribution and circulation of hepatitis C virus genotypes. World J Gastroenterol. 2016;22(34):7824–40.
Bigna JJ, Amougou MA, et al. Seroprevalence of hepatitis C virus infection in Cameroon: A systematic review and meta-analysis. BMJ Open. 2017;7(8):1–11.
Hourigan LF, Macdonald GA, et al. Fibrosis in chronic hepatitis C correlates significantly with body mass index and steatosis. Hepatology. 1999;29(4):1215–9.
Orellana N I, Poniachik T J, Smok S G, Madrid S AM, Menéndez A A, Tobar A E, et al. Hepatitis crónica por virus C: Factores asociados a la severidad del daño histológico. Rev Med Chil. 2005;133(11):1311–6.
Negro F, Seifari M. Hépatite C et résistance à l’insuline. Rev Med Suisse. 2008;4:1859–62.
Mandob D, Judith E, Ngondi L, Inès G, Fomekong D, Agbor G, et al. Prediction and Prevalence of Metabolic Syndrome in Overweight and Obese Subjects in Cameroon. Int J Biomed Pharm Sci. 2008;2(2):117–21.
Mandob DE, Marcel J, Sah S. Prevalence of metabolic syndrome among normal weight cameroonians. World J Pharm Pharm Sci. 2015;4(09):1569–78.
Miyaaki H, Ichikawa T, Taura N, Miuma S, Shibata H, Isomoto H, et al. Predictive value of the fibrosis scores in patients with chronic hepatitis C associated with liver fibrosis and metabolic syndrome. InternMed. 2011;50(11):1137–41.
Hwang SJ, Lee SD. Hepatic steatosis and hepatitis C: Still unhappy bedfellows? J Gastroenterol Hepatol. 2011;26(1):96–101.
Leroy V, Hilleret MN. Évaluation De La Fibrose Hépatique. Hepato-Gastro. 2005;12(4):251–9.
Recommandations AFEF sur la prise en charge de l’hépatite virale C. 2017.
Association for the study of Liver EASL-ALEH. Clinical Practice Guidelines : Non-invasive tests for evaluation of liver disease severity and prognosis. J Hepatol. 2015;63:237–64.
Angulo P, Hui JM, et al. The NAFLD fibrosis score: A noninvasive system that identifies liver fibrosis in patients with NAFLD. Hepatology. 2007;45(4):846–54.
Luma HN, Eloumou SAFB, et al. Characteristics of anti-hepatitis C virus antibody-positive patients in a hospital setting in Douala, Cameroon. Int J Infect Dis. 2016;45:53–8.
Yoon H, Lee JG, Yoo JH, Son MS, Kim DY, Hwang SG, et al. Effects of metabolic syndrome on fibrosis in chronic viral hepatitis. Gut Liver. 2013;7(4):469–74.
Siddiqui MS, Yamada G, Vuppalanchi R, Natta M Van, Chalasani N, Neuschander-tetri B, et al. Diagnostic Accuracy of Noninvasive Fibrosis Models to Detect Change in Fibrosis Stage. Clin Gastroenterol Hepatol. 2019;(March).
Mahady SE, Macaskill P, et al. Diagnostic Accuracy of Non-invasive Fibrosis Scores in a Population of individuals With a low Prevalence of Fibrosis. Clin Gastroenterol Hepatol [Internet]. 2017; Available from: http://dx.doi.org/10.1016/j.cgh.2017.02.031
Tovo C V, Villela-nogueira CA, et al. Annals of Hepatology Transient hepatic elastography has the best performance to evaluate liver fibrosis in non-alcoholic fatty liver disease ( NAFLD ). 2019;18:445–9.
Nakano M, Murohisa T, Hiraishi H. Validity of the NAFLD fibrosis score in a Japanese population. Japanese J Gastro-enterology. 2012;109(5):751.