La Fibrose Hépatique chez les Patients Porteurs d’une Hépatite Virale C Chronique et d’un Syndrome Métabolique : Élastométrie Impulsionnelle versus NAFLD Fibrosis Score

WT Bekolo Nga, AW Ndjitoyap Ndam, Gabin Kenfack, AL Nnang Olomo, SAF Eloumou Bagnaka, A Malongue, C Tzeuton, D Noah Noah, Namme Luma H, O Njoya, F Ankouane Andoulo

Abstract


RÉSUMÉ
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.

Keywords


NAFLD Fibrosis Score, élastométrie impulsionnelle, hépatite virale C, syndrome métabolique, fibrose.

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