TY - JOUR
T1 - Population screening for liver fibrosis
T2 - Toward early diagnosis and intervention for chronic liver diseases
AU - for the LiverScreen Consortium Investigators
AU - Ginès, Pere
AU - Castera, Laurent
AU - Lammert, Frank
AU - Graupera, Isabel
AU - Serra-Burriel, Miquel
AU - Allen, Alina M.
AU - Wong, Vincent Wai Sun
AU - Hartmann, Phillipp
AU - Thiele, Maja
AU - Caballeria, Llorenç
AU - de Knegt, Robert J.
AU - Grgurevic, Ivica
AU - Augustin, Salvador
AU - Tsochatzis, Emmanuel A.
AU - Schattenberg, Jörn M.
AU - Guha, Indra Neil
AU - Martini, Andrea
AU - Morillas, Rosa M.
AU - Garcia-Retortillo, Montserrat
AU - de Koning, Harry J.
AU - Fabrellas, Núria
AU - Pich, Judit
AU - Ma, Ann T.
AU - Diaz, M. Alba
AU - Roulot, Dominique
AU - Newsome, Philip N.
AU - Manns, Michael
AU - Kamath, Patrick S.
AU - Krag, Aleksander
N1 - Funding Information:
LiverScreen Consortium and the European Commission under the H20/20 program (847989); AGAUR (2017SGR‐01281); Centro de Investigacion Biomedica en Enfermedades Hepaticas y Digestivas; Fundación de Investigación Sanitaria, cofunded by Instituto Carlos III–Subdirección General de Evaluación and the European Regional Development Fund (PI18/01330, PI18/00662, and PI18/00862); and Gilead’s Investigator–sponsored research program (IN‐ES‐989‐5309)
Funding Information:
Dr. Gines advises and received grants from Gilead, Grifols, and Mallinckrodt. He advises Novartis, Martin, and Ferring. Dr. Castera consults and is on the speakers’ bureau for Echosens, Gilead, Intercept, and Novo Nordisk. He consults Alexion, MSD, and Pfizer. Dr. Wong consults for Gilead, 3V‐Bio, AbbVie, Allergan, Boehringer Ingelheim, Echosens, Inventiva, Merck, Novartis, Novo Nordisk, Pfizer, Prosciento, Sagimet, TARGET, and Terns. Dr. de Knegt advises, is on the speakers’ bureau, and received grants from Gilead. He advises and is on the speakers’ bureau for AbbVie. He advises Bristol‐Myers Squibb and Merck. He is on the speakers’ bureau for Echosens and Philips. Dr. Thiele advises GE and is on the speakers’ bureau for Echosens, Norgine, and Siemens. Dr. Grgurevic is on the speakers’ bureau for Echosens. Dr. Augustin consults, is on the speakers’ bureau, and received grants from Gilead. He consults and is on the speakers’ bureau for Novartis. He consults and is employed by Boehringer Ingelheim. He consults for Intercept, Pfizer, Ferrer, and IQVIA. He is on the speakers’ bureau for Allergan, MSD, and Menarini. Dr. Tsochatzis consults for Gilead, Intercept, Pfizer, and Orphalan. Dr. Schattenberg consults and received grants from Gilead, Boehringer Ingelheim, and Siemens. He consults for Bristol‐Myers Squibb, Echosens, Genfit, Intercept, Madrigal, Nordic, Novartis, Pfizer, Roche, and Sanofi. He is on the speakers’ bureau for Falk Foundation. Dr. Guha received grants from Gilead. Dr. Krag advises, is on the speakers’ bureau, and received grants from Norgine and Siemens. He is on the speakers’ bureau for Nordic.
Funding Information:
LiverScreen Consortium and the European Commission under the H20/20 program (847989); AGAUR (2017SGR-01281); Centro de Investigacion Biomedica en Enfermedades Hepaticas y Digestivas; Fundaci?n de Investigaci?n Sanitaria, cofunded by Instituto Carlos III?Subdirecci?n General de Evaluaci?n and the European Regional Development Fund (PI18/01330, PI18/00662, and PI18/00862); and Gilead?s Investigator?sponsored research program (IN-ES-989-5309)
Publisher Copyright:
© 2021 The Authors. Hepatology published by Wiley Periodicals LLC on behalf of American Association for the Study of Liver Diseases.
PY - 2022/1
Y1 - 2022/1
N2 - 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.
AB - 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.
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U2 - 10.1002/hep.32163
DO - 10.1002/hep.32163
M3 - Review article
C2 - 34537988
AN - SCOPUS:85119260132
VL - 75
SP - 219
EP - 228
JO - Hepatology
JF - Hepatology
SN - 0270-9139
IS - 1
ER -