Advertisement

An individualized cirrhosis screening strategy might be more cost-effective in the general population

  • Siru Zhao
    Affiliations
    State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
    Search for articles by this author
  • Xingmei Liao
    Affiliations
    State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
    Search for articles by this author
  • Rong Fan
    Correspondence
    Corresponding author. Address: Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, 510515, China. Tel.: 020-62787432, fax: 020-62786534.
    Affiliations
    State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
    Search for articles by this author
      We read with great interest the article by Labenz, Arslanow et al.
      • Labenz C.
      • Arslanow A.
      • Nguyen-Tat M.
      • Nagel M.
      • Worns M.A.
      • Reichert M.C.
      • et al.
      Structured early detection of asymptomatic liver cirrhosis: results of the population-based liver screening program SEAL.
      recently published in Journal of Hepatology. This article showed that the structured early detection of asymptomatic liver cirrhosis (SEAL) approach, involving assessment of elevated liver enzymes and calculation of the aspartate aminotransferase (AST)-to-platelet ratio index (APRI), has the potential to increase the detection of advanced liver fibrosis and cirrhosis in the general population. This prospective study is important and timely for guiding the detection of early cirrhosis in clinical practice. After careful consideration, we put forward the following suggestions.

      Keywords

      Linked Article

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Hepatology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Labenz C.
        • Arslanow A.
        • Nguyen-Tat M.
        • Nagel M.
        • Worns M.A.
        • Reichert M.C.
        • et al.
        Structured early detection of asymptomatic liver cirrhosis: results of the population-based liver screening program SEAL.
        J Hepatol. 2022; (S0168-8278(22)00244-00246. https://dx.doi.org/10.1016/j.jhep.2022.04.009)
        • Wang W.
        • Zhao X.
        • Li G.
        • Wang L.
        • Chen Y.
        • Ma K.
        • et al.
        Diagnostic thresholds and performance of noninvasive fibrosis scores are limited by age in patients with chronic hepatitis B.
        J Med Virol. 2019; 91: 1279-1287
        • McPherson S.
        • Hardy T.
        • Dufour J.F.
        • Petta S.
        • Romero-Gomez M.
        • Allison M.
        • et al.
        Age as a confounding factor for the accurate non-invasive diagnosis of advanced NAFLD fibrosis.
        Am J Gastroenterol. 2017; 112: 740-751
        • Bertot L.C.
        • Jeffrey G.P.
        • de Boer B.
        • MacQuillan G.
        • Garas G.
        • Chin J.
        • et al.
        Diabetes impacts prediction of cirrhosis and prognosis by non-invasive fibrosis models in non-alcoholic fatty liver disease.
        Liver Int: official J Int Assoc Study Liver. 2018; 38: 1793-1802
        • Boursier J.
        • Canivet C.M.
        • Costentin C.
        • Lannes A.
        • Delamarre A.
        • Sturm N.
        • et al.
        Impact of type 2 diabetes on the accuracy of noninvasive tests of liver fibrosis with resulting clinical implications.
        Clin Gastroenterol Hepatol. 2022; (S1542-3565(22)00248-8. https://dx.doi.org/10.1016/j.cgh.2022.02.059)
        • Xiao G.
        • Yang J.
        • Yan L.
        Comparison of diagnostic accuracy of aspartate aminotransferase to platelet ratio index and fibrosis-4 index for detecting liver fibrosis in adult patients with chronic hepatitis B virus infection: a systemic review and meta-analysis.
        Hepatology (Baltimore, Md). 2015; 61: 292-302
        • Harris R.
        • Harman D.J.
        • Card T.R.
        • Aithal G.P.
        • Guha I.N.
        Prevalence of clinically significant liver disease within the general population, as defined by non-invasive markers of liver fibrosis: a systematic review.
        Lancet Gastroenterol Hepatol. 2017; 2: 288-297