Liu Chen-Hua, Kao Jia-Horng
Department of Internal Medicine, National Taiwan University Hospital, Taipei 100225, Taiwan.
Hepatitis Research Center, National Taiwan University Hospital, Taipei 100225, Taiwan.
Diagnostics (Basel). 2022 Sep 21;12(10):2282. doi: 10.3390/diagnostics12102282.
Hepatitis C virus (HCV) is a major health problem in hemodialysis patients, which leads to significant morbidity and mortality through progressive hepatic fibrosis or cirrhosis. Percutaneous liver biopsy is the gold standard to stage hepatic fibrosis. However, it is an invasive procedure with postbiopsy complications. Because uremia may significantly increase the risk of fatal and nonfatal bleeding events, the use of noninvasive means to assess the severity of hepatic fibrosis is particularly appealing to hemodialysis patients. To date, researchers have evaluated the performance of various biochemical, serological, and radiological indices for hepatic fibrosis in hemodialysis patients with HCV infection. In this review, we will summarize the progress of noninvasive indices for assessing hepatic fibrosis and propose a pragmatic recommendation to diagnose the stage of hepatic fibrosis with a noninvasive index, in hemodialysis patients with HCV infection.
丙型肝炎病毒（HCV）是血液透析患者面临的一个主要健康问题，它通过进行性肝纤维化或肝硬化导致显著的发病率和死亡率。经皮肝活检是肝纤维化分期的金标准。然而，这是一种侵入性操作，存在活检后并发症。由于尿毒症可能显著增加致命和非致命出血事件的风险，因此使用非侵入性方法评估肝纤维化的严重程度对血液透析患者特别有吸引力。迄今为止，研究人员已经评估了各种生化、血清学和放射学指标在丙型肝炎病毒感染的血液透析患者中对肝纤维化的诊断价值。在这篇综述中，我们将总结评估肝纤维化的非侵入性指标的进展，并针对丙型肝炎病毒感染的血液透析患者，提出关于使用非侵入性指标诊断肝纤维化分期的实用建议。
