[Using transient elastography as a screening tool for liver fibrosis in addiction service]

2014 La Presse Médicale 43;3 (e17-31)

BACKGROUND: Most addictive behaviors are risk factors for chronic hepatitis. The level of liver fibrosis is the main prognostic factor of chronic hepatitis. Transient elastography is a valid and accessible tool for measuring the level of liver fibrosis. Its routine use in addiction service is however poorly documented. AIMS OF THE STUDY: To test the feasibility of a systematic use of transient elastography as a tool for screening and diagnosis of liver fibrosis in patients hospitalized in an addiction medicine ward and to determine the prevalence of hepatic fibrosis, its predictive factors and etiologies and appreciate its evolution during alcohol detoxification. PATIENTS AND METHODS: Two hundred and twenty-seven patients were included, hepatic elastography was measured by two operators according to the standards. Threshold of fibrosis (F1) was 8 kPa, threshold cirrhosis (F4) was 13 kPa. RESULTS: Hepatic elastography was performed in 208 (92%) patients. A body mass index greater than 30 was associated with the non-feasibility of transient elastography, anti-HCV positive serology was associated with a lower reproductibility of transient elastography. Of the 208 patients, 61 had liver stiffness >/= 8 kPa (prevalence of fibrosis of 29%), 25 had liver stiffness >/= 13 kPa, fibrosis was not known for 46 (75%) of the 61 patients with fibrosis. A fibrosis was independently associated with the following variables: time between last alcohol ingestion and transient elastography measurement65 UI/L and serum concentration of platelets

Pubmed : 24485827