Method Description
The method is an interpretable logical model (QCA). To determine the degree of liver steatosis, the results of a routine clinical examination of the patient with determination of sex, age, height, weight, genotype of the hepatitis C virus and the results of ultrasound of the abdominal organs are sufficient.
Determination of the degree of liver steatosis using this method can be recommended for patients with chronic viral hepatitis C. The study should not be carried out on patients with acute hepatitis of any etiology, as well as patients with chronic HCV infection during an exacerbation of the disease. Currently, there are no other known absolute contraindications for this test.
Accuracy of the method
The «gold standard» for diagnosing hepatic steatosis is a pathomorphological examination of a liver biopsy and magnetic resonance imaging of the abdominal organs.
The accuracy of diagnosing grades 1-3 hepatic steatosis compared to liver biopsy in patients with chronic hepatitis C is 76.9% (sensitivity 80.0%, specificity 75.0%).
Interpretation of results
The test result is the calculated hepatic steatosis index. The index is a negative or positive number. An index value greater than zero corresponds to a positive test result (the patient has grades 1-3 hepatic steatosis). An index value less than zero corresponds to a negative test result (the patient does not have grades 1-3 hepatic steatosis). The probability of obtaining the correct test result depends on the index value. So the greater or less than zero the index value, the higher the probability of obtaining the correct positive or correct negative test results, respectively.
Publications
Lipid metabolism disorders in the liver in patients with chronic viral hepatitis
Authors: V.V. Tsvetkov, I.I. Tokin, O.E. Nikitina, D.A. Lioznov
Source: Bulletin of the North-West State Medical University named after I.I. Mechnikov. 2021; 13(2): 27-38.
https://doi.org/10.17816/mechnikov71418
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The review article is devoted to the problem of lipid metabolism disorders in the liver in patients with chronic hepatitis B and C. The article presents the results of modern biological, epidemiological and clinical studies aimed at studying the causes and mechanisms of liver steatosis and steatohepatitis, their prevalence and impact on the course of infectious pathology. Particular attention is paid to the generalization and systematization of data on the mechanisms of lipid metabolism disorders in the liver mediated by the molecular structures of hepatitis B and C viruses. In conclusion, the need for timely diagnosis and treatment of pathological conditions caused by lipid metabolism disorders in the liver is substantiated in order to improve the quality of medical care for patients with chronic hepatitis B and C.
Diagnostic markers of liver steatosis in patients with chronic viral hepatitis C
Authors: V.V. Tsvetkov, I.I. Tokin, O.E. Nikitina, D.A. Lioznov
Source: Scientific Notes of Pavlov State Medical University of St. Petersburg. 2022; 29(4): 31-42.
https://doi.org/10.24884/1607-4181-2022-29-4-31-42
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Aim – to conduct a comparative analysis of routine clinical and laboratory parameters in 2 groups of patients with chronic viral hepatitis C (CHC) depending on the presence or absence of liver steatosis.
Methods and materials. The observational retrospective cross-sectional study included 411 patients with CHC, which those with liver steatosis – 43.80%. The studied parameters were routine clinical and laboratory parameters, virus genotype, as well as formalized results of liver biopsy and ultrasound examination (US) of abdominal organs. To assess the differences between the 2 groups, the Pearson agreement criterion, two-sided Fisher exact test, Wilcoxon rank sum W-test, Spearman correlation coefficient, and partial correlation coefficient were calculated.
Results. It was found that patients with CHC with liver steatosis were older and had a higher body mass index (BMI) than patients without liver steatosis (p<0.01). Among patients with hepatic steatosis, genotype 3a of the virus was more often detected (p<0.001), advanced stages of liver fibrosis (p<0.01), higher activity of liver transaminases (p<= 0.001) and iron concentration (p<0.01) in the blood serum, as well as higher values of the size of the liver (p<0.001) and pancreas (p<0.001) in ultrasound than among patients without hepatic steatosis.
Conclusion. Age, BMI, virus genotype, stage of liver fibrosis, activity of ALT, AST, GGT and iron concentration, as well as the size of the liver and pancreas are potential predictors of the presence of hepatic steatosis in patients with CHC.
Qualitative Comparative Analysis of Medical and Epidemiological Data
Authors: V. Tsvetkov, I. Tokin
Source: Preprints 2023, 2023092111
https://www.preprints.org/manuscript/202309.2111
More details
Qualitative comparative analysis (QCA) was developed by Charles Ragin in 1987 for the comparative analysis of small data sets. The method has become widespread in sociological and economic research. There are examples of successful use of QCA in the field of medicine and epidemiology. The purpose of this review is to describe the key stages of QCA with a discussion of the application of this method to the analysis of medical and epidemiological data.
Patents
Results of examination of patients with chronic hepatitis C, including data from histological examination of the liver
Authors: D.A. Lioznov, I.I. Tokin, V.V. Tsvetkov, O.E. Nikitina
Source: Certificate of state registration of the database RU 2024620481. 2024.
More details
The database (DB) contains information on the results of examination of patients with chronic hepatitis C over 18 years of age, including: demographic and clinical data, results of laboratory and instrumental (ultrasound examination of abdominal organs) studies in combination with the results of histological studies of liver tissue (liver biopsy). The DB is intended to develop new methods for assessing the functional state of the liver in patients with chronic hepatitis C using machine learning algorithms (artificial intelligence), and can be used in the field of medical research. The DB provides storage and structuring of formalized medical data of patients with chronic hepatitis C. Computer type: IBM PC - compatible PC; OS: Windows 7/10.
Method for diagnosing liver steatosis in patients with chronic viral hepatitis C
Authors: D.A. Lioznov, I.I. Tokin, V.V. Tsvetkov, O.E. Nikitina
Source: Patent for invention No. 2830504. 2024.
Rules
The results of the study should be assessed by a specialist doctor taking into account other results of the clinical and laboratory examination of the patient.