Article information
Resumen
La evaluación de la fibrosis hepática es esencial en los pacientes con hepatitis crónica C, ya que de su gravedad depende su pronóstico y la indicación de tratamiento antiviral. La combinación de marcadores serológicos de fibrosis en algoritmos o scores permite distinguir a un importante número de pacientes con fibrosis significativa y a la mayoría de pacientes con cirrosis hepática, evitando potencialmente un gran número de biopsias. Si bien la interpretación de estos algoritmos debe realizarse teniendo en cuenta sus posibles limitaciones, su alta reproducibilidad, aplicabilidad y disponibilidad hacen que sean métodos esenciales en la evaluación actual de los pacientes con hepatitis crónica C. En la recurrencia de la hepatitis C tras el trasplante hepático, los marcadores serológicos han mostrado una menor capacidad de diagnosticar la presencia de fibrosis. Sin embargo, un algoritmo de marcadores directos ha demostrado tener una excelente capacidad predictiva en pacientes con hepatitis C postrasplante hepático, lo cual lo convierte en una excelente herramienta para establecer el pronóstico de los pacientes e indicar el tratamiento antiviral.
Palabras clave:
ELF
APRI
Forns
FibroTest
Fibrosis significativa
Cirrosis
Abstract
Liver fibrosis must be evaluated in patients with chronic hepatitis C, since its severity will affect prognosis and the indication of antiviral therapy. Combining serological markers of fibrosis in algorithms or scores can identify a substantial number of patients with significant fibrosis and most patients with liver cirrhosis, thus potentially avoiding a large number of biopsies. Although these algorithms should be interpreted with caution, due to their possible limitations, their high reproducibility, applicability and availability make them an essential tool in the current evaluation of patients with chronic hepatitis C infection. In contrast, serological markers have been found to be less effective in the diagnosis of fibrosis in the context of recurrent hepatitis C infection after liver transplantation. However, an algorithm for direct markers has shown excellent predictive ability in liver transplant recipients with hepatitis C. Consequently, this algorithm seems to be an excellent tool to establish prognosis and indicate antiviral therapy.
Keywords:
ELF
APRI
Forns
FibroTest
Significant fibrosis
Cirrhosis
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