Search Results for Fibrosis

Deep learning: a more effective way to assess NAFLD progression?

The current gold standard for the diagnosis and assessment of non-alcoholic fatty liver disease (NAFLD) progression is liver biopsy, which is then followed by microscopic analysis by a pathologist.To assess disease progression, the Kleiner and Brunt scoring system is typically used. In short, this approach assesses three histological features of liver injury (ballooning, inflammation, and steatosis). Analyses of these features are then combined to generate a NAFLD activity score.

Update on prevalence and natural history of NASH / NAFLD

NASH with severe fibrosis is more prevalent than one may think. Hispanics and those with type 2 DM are at a higher risk, however other ethnic groups with risk factors should be screened. Simple steatosis (NAFL) and NASH without fibrosis are associated with increased risk of cirrhosis. CVD and non-hepatic cancer are major causes of mortality. Lastly, patients with fibrosis NASH remain at the highest risk for developing liver-related outcomes.

Natural history and clinical outcomes in adults with NAFLD – lessons from cohort studies and placebo arms of trials

Dr. K. Kowdley -USA

It was found that the natural history of NAFLD is variable. Whilst 31% of patients with NAFLD develop NASH, 29% of patients have been found to resolve it. The fibrosis progression rate in clinical trials stands at ~20%. The rate of improvement for fibrosis patients stands at ~22% and results are driven by factors such as regression to the mean, sampling variability and observer variability. The placebo response was also determined by the same variables mentioned above. Advanced fibrosis (F3 and F4) act as drivers for clinical outcomes. 10% IR was also found in the new decompensation in advanced NASH.

Non-Invasive Evaluation Of NAFLD Severity Slide

Liver fibrosis should be evaluated in all patients diagnosed with NAFLD. Non-invasive tests such as blood tests and liver elastography are now available for an accurate diagnosis of advanced liver fibrosis in NAFLD. The sequential use of non-invasive tests define patient pathways from primary care/diabetology clinics to liver specialists. Therefore, awareness about NAFLD and the use of such non-invasive tests should be reinforced to improve the case findings of patients with advanced liver fibrosis.

MAFLD-HCC in Italy: a rapidly increasing prevalence, a reduced cancer aggressiveness?

Non-alcoholic liver disease (NAFLD)’s current nomenclature supports an exclusionary diagnosis, i.e. based on the ruling out of other liver disease causes instead of active case-finding. As an alternative to NAFLD, an international panel of experts has recently proposed a new definition of NAFLD, termed metabolic dysfunction-associated fatty liver disease (MAFLD), based on active identification of its associated metabolic risk factors.