Journal
HEPATOLOGY
Volume 75, Issue 1, Pages 219-228Publisher
WILEY
DOI: 10.1002/hep.32163
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Categories
Funding
- LiverScreen Consortium
- European Commission under the H20/20 program [847989]
- AGAUR [2017SGR-01281]
- Centro de Investigacion Biomedica en Enfermedades Hepaticas y Digestivas
- Fundacion de Investigacion Sanitaria
- European Regional Development Fund [PI18/01330, PI18/00662, PI18/00862]
- Gilead's Investigator-sponsored research program [IN-ES-989-5309]
- Instituto Carlos III-Subdireccion General de Evaluacion
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Cirrhosis is a highly prevalent global disease caused mainly by non-alcoholic fatty liver disease and alcohol-related liver diseases. Noninvasive methods can accurately assess liver fibrosis, and screening high-risk populations for liver fibrosis may have the potential to prevent disease progression.
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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