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18. Serum Fibrosis Marker Panels FIB-4 Index and Aspartate Aminotransferase (AST)-to-Platelet Ratio Index (APRI) Are Equivalent to AST Alone at Predicting Liver Fibrosis in a Cohort of 1731 Patients Infected with Hepatitis C Virus.

Author

Drees, Julia C., Wi, Soora, Ready, Joanna B., Dlott, Richard S., Fetterman, Barbara J., Seo, Suk I., Pauly, Mary Pat, Petrie, Matthew S., and Lorey, Thomas S.

Subjects
HEPATITIS C treatment, HEPATIC fibrosis, SERUM, ASPARTATE aminotransferase, ELASTOGRAPHY, LIVER biopsy
Abstract

Background: Efficient tools are needed to stage liver disease before treatment of patients infected with hepatitis C virus (HCV). Compared to biopsy, several studies demonstrated favorable performance of noninvasive multianalyte serum fibrosis marker panels [fibrosis-4 (FIB-4) index] and aspartate aminotransferase (AST)-to-platelet ratio index (APRI), but suggested cutoffs vary widely. Ourobjective was to evaluate FIB-4 index and APRI and their component tests for staging fibrosis in our HCV-infected population and to determine practical cutoffs to help triage an influx of patients requiring treatment. Methods: Transient elastography (TE) results from 1731 HCV-infected patients were mapped to an F0-F4 equivalent scale. Each patient's APRI and FIB-4 index were calculated. Areas under the receiver operator curve (AUROCs) and false positive and false-negative rates were calculated to retrospectively compare the performance of the indices and their component tests. Results: The highest AUROCs for distinguishing severe (F3-F4) from mild-to-moderate (F0 -F2) fibrosis had overlapping 95% CIs: APRI (0.77; 0.74-0.79), FIB-4 index (0.76; 0.73-0.78), and AST (0.74; 0.72-0.77). Cutoffs had false negative rates of 2.7%-2.8% and false-positive rates of 6.4%-7.4% for all 3 markers. Conclusions: AST was as effective as FIB-4 index and APRI at predicting fibrosis. Published cutoffs for APRI and FIB-4 index would have been inappropriate in our population, with false-negative rates as high as 11%. For our purposes, no serum fibrosis marker was sufficiently sensitive to rule-out significant fibrosis, but cutoffs developed for AST, FIB-4 index, and APRI all had specificities of 79.2%-80.3% for ruling-in severe fibrosis and could be used to triage 1/3 of our population for treatment without waiting for TE or liver biopsy. [ABSTRACT FROM AUTHOR]

Published
2017
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19. 450 Simeprevir/Sofosbuvir Therapy in Hepatitis C (HCV) Infected Patients With Child-Pugh Class B/C Cirrhosis Compared to Matched Untreated and Protease Inhibitor (PI)-Triple Therapy Treated Control

Author

Saxena, Varun, Nyberg, Lisa M., Pauly, Mary Patricia, Ready, Joanna, Szpakowski, Jean-Luc, Piasecki, Barbara, Nyberg, Anders H., Winston, Bradley J., Redd, Jacquelyn L., Catalli, Lisa, Dasgupta, Aditi, Straley, Stephanie, Sommer, Kali, Witt, Gayle, Rathbun, Robert, and Terrault, Norah A.

Published
2015
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20. The impact of lifetime drug use on hepatitis C treatment outcomes in insured members of an integrated health care plan.

Author

Russell, Marcia, Pauly, Mary Patricia, Moore, Charles Denton, Chia, Constance, Dorrell, Jennifer Mary, Cunanan, Renee Junko, and Witt, Gayle

Subjects
*HEPATITIS C treatment, *DRUG abuse, *INTEGRATED health care delivery, *STIMULANTS, *RIBAVIRIN, *HEALTH outcome assessment
Abstract

Abstract: Background: The relation of drug use to HCV treatment outcome in an insured household population has not been previously reported. Methods: Lifetime frequencies of marijuana use and non-medical use of stimulants, sedatives, and opioids; hallucinogens; and inhalants were retrospectively assessed in 259 privately insured members of an integrated health care plan treated for chronic hepatitis C virus infection (HCV+) with pegylated interferon alpha and ribavirin and examined with respect to rates of sustained virological response (SVR). Results: The majority of patients reported chronic use of multiple illegal drugs; 61.6% reported injection drug use (IDU); 79.5% abstained from drug use during the six months prior to HCV treatment. Total frequency of individual drugs, multiple drugs, and length of abstention from drugs prior to HCV treatment were not related to impaired SVR rates. Sustained viral responses were obtained in 80.2% of patients with HCV genotype 2/3 and 45.1% of patients with genotype 1/4/6. Marijuana use during HCV treatment, reported by 8.5% of patients, was associated with higher treatment adherence (95.5% compared with 78.9%, p =0.045), but lower SVR rates (40.9% compared with 62.5%, p =0.041). In addition, drug use during HCV treatment was associated with significantly higher relapse rates, 18.8% compared with 7.7% (p =0.053). Conclusion: A history of chronic illegal drug use should not be considered a deterrent to HCV treatment in members of an integrated health care plan who are motivated to seek treatment and closely monitored, but drug use during HCV treatment, including marijuana use, should be discouraged. [Copyright &y& Elsevier]

Published
2014
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21. Effect of Cigarette Smoking on Virologic Response in Patients Treated for Chronic Hepatitis C (CHC) in the IDEAL Study

Author

Pauly, Mary Pat, Poordad, Fred, Gibas, Alexandra L., Freilich, Bradley, Reindollar, Robert W., Box, Terry D., Strauss, Robert M., Nelson, Donald, Ravendhran, Natarajan, Smith, Coleman, Godofsky, Eliot, Goteti, Venkata S., Noviello, Stephanie, Brass, Clifford A., Pedicone, Lisa D., Albrecht, Janice K., McHutchison, John, and Sulkowski, Mark

Published
2011
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25. A CENTERING, OF SORTS: THE EVOLVING IDEA OF MINNESOTA CENTER FOR BOOK ARTS.

Author

Pauly, Mary Jo

Subjects
*ARTISTS' books, *CONCEPTUAL art, *20TH century art
Abstract

Focuses on the activities of the Minnesota Center for Book Arts. Background on the Community Youth Farm and Market Project for children; Background on the center's mission; Classes addressing conventional bookmarking crafts offered in its initial quarter and exhibits.

Published
2003

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