Browsing by Author "Colombo, Massimo"

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    Real-world evidence on non-invasive tests and associated cut-offs used to assess fibrosis in routine clinical practice
    (2023) Lazarus, Jeffrey, V; Castera, Laurent; Mark, Henry E.; Allen, Alina M.; Adams, Leon A.; Anstee, Quentin M.; Arrese, Marco; Alqahtani, Saleh A.; Bugianesi, Elisabetta; Colombo, Massimo; Cusi, Kenneth; Hagstrom, Hannes; Loomba, Rohit; Romero-Gomez, Manuel; Schattenberg, Jorn M.; Thiele, Maja; Valenti, Luca; Wong, Vincent Wai-Sun; Yilmaz, Yusuf; Younossi, Zobair M.; Francque, Sven M.; Tsochatzis, Emmanuel A.
    Background & Aims: Non-invasive tests (NITs) offer a practical solution for advanced fibrosis identification in non-alcoholic fatty liver disease (NAFLD). Despite increasing implementation, their use is not standardised, which can lead to inconsistent interpretation and risk stratification. We aimed to assess the types of NITs and the corresponding cut-offs used in a range of healthcare settings. Methods: A survey was distributed to a convenience sample of liver health experts who participated in a global NAFLD consensus statement. Respondents provided information on the NITs used in their clinic with the corresponding cut-offs and those used in established care pathways in their areas.Results: There were 35 respondents from 24 countries, 89% of whom practised in tertiary level settings. A total of 14 different NITs were used, and each respondent reported using at least one (median = 3). Of the respondents, 80% reported using FIB-4 and liver stiffness by vibration-controlled transient elastography (Fibroscan & REG;), followed by the NAFLD fibrosis score (49%). For FIB-4, 71% of respondents used a low cut-off of <1.3 (range <1.0 to <1.45) and 21% reported using age-specific cut-offs. For Fibroscan & REG;, 21% of respondents used a single liver stiffness cut-off: 8 kPa in 50%, while the rest used 7.2 kPa, 7.8 kPa and 8.7 kPa. Among the 63% of respondents who used lower and upper liver stiffness cut-offs, there were variations in both values (<5 to <10 kPa and >7.5 to >20 kPa, respectively).Conclusions: The cut-offs used for the same NITs for NAFLD risk stratification vary between clinicians. As cut-offs impact test performance, these findings underscore the heterogeneity in risk-assessment and support the importance of establishing consistent guidelines on the standardised use of NITs in NAFLD management. Lay summary: Owing to the high prevalence of non-alcoholic fatty liver disease (NAFLD) in the general population it is important to identify those who have more advanced stages of liver fibrosis, so that they can be properly treated. Non-invasive tests (NITs) provide a practical way to assess fibrosis risk in patients. However, we found that the cut-offs used for the same NITs vary between clinicians. As cut-offs impact test performance, these findings highlight the importance of establishing consistent guidelines on the standardised use of NITs to optimise clinical management of NAFLD.& COPY; 2022 The Author(s). Published by Elsevier B.V. on behalf of European Association for the Study of the Liver (EASL). This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
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    The case for simplifying and using absolute targets for viral hepatitis elimination goals
    (2021) Razavi, Homie; Blach, Sarah; Razavi-Shearers, Devin; Abaalkhail, Faisal; Abbas, Zaigham; Abdallah, Ayat; Ferreira, Paulo Abrao; Abu Raddad, Laith Jamal; Adda, Danjuma; Agarwal, Kosh; Aghemo, Alessio; Ahmed, Aijaz; Al-Busafi, Said A.; Al-hamoudi, Waleed; Al-Kaabi, Saad; Al-Romaihi, Hamad; Aljarallah, Badr; AlNaamani, Khalid; Alqahtani, Saleh; Alswat, Khalid; Altraif, Ibrahim; Asselah, Tarik; Bacon, Bruce; Bessone, Fernando; Bizri, Abdul Rahman; Block, Tim; Bonino, Ferruccio; BranclaoMello, Carlos Eduardo; Browny, Kimberly; Bruggmann, Philip; Brunetto, Maurizia Rossana; Buti, Maria; Cabezas, Joaquin; Calleja, Jose Luis; Batanjer, Erika Castro; Chan, Henry Lik-Yuen; Chang, Henry; Chen, Chien-Jen; Christensen, Peer Brehm; Chuang, Wan-Long; Cisneros, Laura; Cohen, Chari; Colombo, Massimo; Conway, Brian; Cooper, Curtis; Craxi, Antonio; Crespo, Javier; Croes, Esther; Cryer, Donna; de Barros, Fernando Passos Cupertino; Derbala, Moutaz; Dillon, John; Doss, Wahid; Dou, Xiaoguang; Doyle, Joseph; Duberg, Ann-Sofi; Dugan, Ellen; Dunn, Rick; Dusheiko, Geoffrey; El Khayat, Hisham; EI-Sayed, Manal H.; Eshraghian, Ahad; Esmat, Gamal; Mur, Rafael Esteban; Ezzat, Sameera; Falconer, Karolin; Fassio, Eduardo; Ferrinho, Paulo; Flamm, Steven; Flisiak, Robert; Foster, Graham; Fung, James; Garcia-Samaniego, Javier; Gish, Robert G.; Goncales, Fernando; Halota, Waldemar; Hamoudi, Waseem; Hassany, Mohamed; Hatzakis, Angelos; Hay, Susan; Himatt, Sayed; Hoepelman, I. M.; Hsu, Yao-Chun; Hui, Yee Tak; Hunyady, Bela; Jacobson, Ira; Janjua, Naveed; Janssen, Harry; Jarcuska, Peter; Kabagambe, Kenneth; Kanto, Tatsuya; Kao, Jia-Horng; Kaymakoglu, Sabahattin; Kershenobich, David; Khamis, Faryal; Kim, Dong Joon; Kim, Young; Kondili, Loreta A.; KottiliI, Shyamasundaran; Kramvis, Anna; Kugelmas, Marcelo; Kurosaki, Masayuki; Lacombe, Karine; Lagging, Martin; Lao, WaiCheung; Lavanchy, Daniel; Lazarus, Jeffrey, V; Lee, Alice; Lee, Samual S.; Levyl, Miriam; Liakina, Valentina; Lim, YoungSuk; Liu, Shuang; Maddrey, Willis; Malekzade, Reza; Marinho, Rui Tato; Mathur, Poonam; Maticic, Mojca; Mendes Correa, Maria Cassia; Mera, Jorge; Merat, Shahin; Mogawer, Sherif; Mohamed, Rosmawati; Muellhaupti, Beat; Muljono, David; Mostafa, Ibrahim; Nahum, Mendez Sanchez; Nawaz, Arif; Negro, Francesco; Ninburg, Michael; Ning, Qing; Ntiri-Reid, Boatemaa; Nymadawa, Pagbajabyn; Oevrehus, Anne; Ormeci, Necati; Orrego, Mauricio; Osman, Alaa; Oyunsuren, Tsendsuren; Pant, Calvin; Papaevangelou, Vassiliki; Papatheodoridis, George; Popping, Stephanie; Prasad, Papu; Prithiviputh, Rittoo; Qureshi, Huma; Ramji, Alnoor; Razavi-Shearer, Kathryn; Reddy, Rajender; Remak, William; Richter, Clemens; Ridruejo, Ezequiel; Robaeys, Geert; Robert, Stuart; Roberts, Lewis; Roudot-Thoraval, Francoise; Saab, Sammy; Said, Sanaa; Salamat, Amjad; Sanai, Faisal; Sanchez-Avila, Juan Francisco; Schiff, Eugene; Schinazi, Raymond; Sebastiani, Giada; Seguin-Devaux, Carole; Shanmugam, R. P.; Sharara, Ala; Shilton, Sonjelle; Shouval, Daniel; Sievert, William; Simonova, Marieta; Sohrabpour, Amir Ali; Sonderup, Mark; Soza, Alejandro; Spearman, C. Wendy; Steinfurth, Nancy; Sulkowski, Mark; Tan, Soek-Siam; Tanaka, Junko; Tashi, Dhondup; Thein, Hla-Hla; Thompson, Peyton; Tolmane, Ieva; Toy, Mehlika; Valantinas, Jonas; Van de Vijver, David; Velez-Moller, Patricia; Vince, Adriana; Waked, Imam; Wang, Su; Wedemeyer, Heiner; Wong, Vincent; Xie, Qing; Yamada, Seiji; Yang, Hwai-, I; Yesmembetov, Kakharman; Yilmaz, Yusuf; Younossi, Zobair; Yu, Ming-Lung; Yuen, Man-Fung; Yurdaydin, Cihan; Yusuf, Aasim; Zekry, Amany; Zeuzem, Stefan
    The 69th World Health Assembly endorsed the Global Health Sector Strategy for Viral Hepatitis, embracing a goal to eliminate hepatitis infection as a public health threat by 2030. This was followed by the World Health Organization's (WHO) global targets for the care and management of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections. These announcements and targets were important in raising awareness and calling for action; however, tracking countries' progress towards these elimination goals has provided insights to the limitations of these targets. The existing targets compare a country's progress relative to its 2015 values, penalizing countries who started their programmes prior to 2015, countries with a young population, or countries with a low prevalence. We recommend that (1) WHO simplify the hepatitis elimination targets, (2) change to absolute targets and (3) allow countries to achieve these disease targets with their own service coverage initiatives that will have the maximum impact. The recommended targets are as follows: reduce HCV new chronic cases to <= 5 per 100 000, reduce HBV prevalence among 1-year-olds to <= 0.1%, reduce HBV and HCV mortality to <= 5 per 100 000, and demonstrate HBV and HCV year-to-year decrease in new HCV- and HBV-related HCC cases. The objective of our recommendations is not to lower expectations or diminish the hepatitis elimination standards, but to provide clearer targets that recognize the past and current elimination efforts by countries, help measure progress towards true elimination, and motivate other countries to follow suit.