Methods: 383 consecutive subjects were evaluated by means of TE and SSI. Reliable TE measurements were defined as: median value of 10LS measurements with a success rate≥60% and an interquartile range interval<30%, values expressed in kPa. Reliable LS measurements by means of SSI was definied as the median value of 5 LS measurements expressed in kPa. To discriminate between various stages of fibrosis by TE we used the liver stiffness (LS) cut-offs (kPa) proposed

in the most recently published meta-analysis (1): F1-6, F2-7.2, F3-9.6 and F4-14.5. Results: Our subjects were: healthy volunteers-14.6%; patients Belnacasan with chronic hepatitis B -17.6%; with chronic hepatitis C – 25.8%; with coinfection (B+C or B+D) – 1.6%; with non-viral chronic hepatopathies (most of them with non-alcholic fatty liver disease)-29.2%; and with liver cirrhosis diagnosed by means of clinical, biological, ultrasound and/or endoscopic criteria-11.2%. The rate of reliable

LS measurements was statistically similar for TE and SSI: 73.9% vs. 79.9%, p=0.06. Reliable LS measurements selleck kinase inhibitor by both elastographic methods were obtained in 65.2% of patients. The distribution of liver fibrosis in this cohort of patients, using TE prespecified cut-off values were: F0-40.8%, F1-14.8%, F2-19.2%, F3-12.8%, F4-12.4%. The best SSI cut-off value for predicting significant fibrosis was 7.8 kPa (AUROC=0.859 with 76.8% Se and 82.6% Sp), while the best SSI cut-off value for predicting liver cirrhosis was 11.5 kPa (AUROC=0.914 with 80.6% Se and 92.7% Sp). Conclusion: The best SSI cut-off values for predicting significant fibrosis

(F≥2) medchemexpress and cirrhosis were 7.8 kPa and 11.5 kPa, respectively. References 1. Tsochatzis et al:J Hepatol. 2011;54:650-9. Key Word(s): 1. liver fibrosis; 2. liver stiffness; 3. SSI; 4. Aixplorer; Presenting Author: IOAN SPOREA Additional Authors: OANA GRADINARU-TASCAU, SIMONA BOTA, ROXANA SIRLI, ALINA POPESCU, ANA JURCHIS, MADALINA POPESCU, MIRELA DANILA Corresponding Author: IOAN SPOREA Affiliations: Department of Gastroenterology and Hepatology, “Victor Babeș” University of Medicine and Pharmacy Timișoara, Romania Objective: to assess the feasibility (“intend to diagnose”) of the 3 shear waves elastographic methods (Transient Elastography-TE, Acoustic Radiation Force Impulse-ARFI and SuperSonic Shear Imaging-SSI) in chronic viral hepatitis patients.

Methods: 383 consecutive subjects were evaluated by means of TE and SSI. Reliable TE measurements were defined as: median value of 10LS measurements with a success rate≥60% and an interquartile range interval<30%, values expressed in kPa. Reliable LS measurements by means of SSI was definied as the median value of 5 LS measurements expressed in kPa. To discriminate between various stages of fibrosis by TE we used the liver stiffness (LS) cut-offs (kPa) proposed

in the most recently published meta-analysis (1): F1-6, F2-7.2, F3-9.6 and F4-14.5. Results: Our subjects were: healthy volunteers-14.6%; patients CX-5461 clinical trial with chronic hepatitis B -17.6%; with chronic hepatitis C – 25.8%; with coinfection (B+C or B+D) – 1.6%; with non-viral chronic hepatopathies (most of them with non-alcholic fatty liver disease)-29.2%; and with liver cirrhosis diagnosed by means of clinical, biological, ultrasound and/or endoscopic criteria-11.2%. The rate of reliable

LS measurements was statistically similar for TE and SSI: 73.9% vs. 79.9%, p=0.06. Reliable LS measurements DAPT by both elastographic methods were obtained in 65.2% of patients. The distribution of liver fibrosis in this cohort of patients, using TE prespecified cut-off values were: F0-40.8%, F1-14.8%, F2-19.2%, F3-12.8%, F4-12.4%. The best SSI cut-off value for predicting significant fibrosis was 7.8 kPa (AUROC=0.859 with 76.8% Se and 82.6% Sp), while the best SSI cut-off value for predicting liver cirrhosis was 11.5 kPa (AUROC=0.914 with 80.6% Se and 92.7% Sp). Conclusion: The best SSI cut-off values for predicting significant fibrosis

(F≥2) 上海皓元医药股份有限公司 and cirrhosis were 7.8 kPa and 11.5 kPa, respectively. References 1. Tsochatzis et al:J Hepatol. 2011;54:650-9. Key Word(s): 1. liver fibrosis; 2. liver stiffness; 3. SSI; 4. Aixplorer; Presenting Author: IOAN SPOREA Additional Authors: OANA GRADINARU-TASCAU, SIMONA BOTA, ROXANA SIRLI, ALINA POPESCU, ANA JURCHIS, MADALINA POPESCU, MIRELA DANILA Corresponding Author: IOAN SPOREA Affiliations: Department of Gastroenterology and Hepatology, “Victor Babeș” University of Medicine and Pharmacy Timișoara, Romania Objective: to assess the feasibility (“intend to diagnose”) of the 3 shear waves elastographic methods (Transient Elastography-TE, Acoustic Radiation Force Impulse-ARFI and SuperSonic Shear Imaging-SSI) in chronic viral hepatitis patients.

Results: NS3 polymorphisms

T54S (N = 2), Q80L (N = 2), S122G (N = 1), Q80L + D168E (N = 1) and V36I +Q80R (N = 1) were detected and mutation rate was 2.3% at pretreatment. The frequencies of the IL28B genotypes were major homozygotes (TT), 28; heterozygotes (TG), 6; and minor homozygotes (GG), 1. There were no significant differences between polymorphisms in NS3 region were independent factors. Twenty six of 31 (83.9%) patients showed a SVR. SVR was achieved in 88.9% of the patients with drug Deforolimus solubility dmso resistance mutations in NS3 region and also 81.9% of the patients without mutations. Achievement to SVR occurred more frequently in patients with IL28B major genotype (92%) than in those with minor genotype (50%), and there was significant difference in IL28B genotype (P = 0.0376). Conclusion: The identification of polymorphisms including drug resistance mutations in NS3 region at pretreatment was not associated with response to peginterferon, RBV and TPV or SMV therapy in patients with HCV genotype 1b. Key Word(s): 1. HCV IFN NS3 Presenting Author: MING LUNG YU Additional Authors: CHI CHIEH YANG, TSAI WEI-LUN,

WEI WEN SU, PIN NAN CHENG, CHING CHU LO, KUO CHIH TSENG, LEIN RAY MO, WANG CHUN-HSIANG, SHIH JER HSU, HSUEH CHOU LAI, CHIEN WEI SU, CHUN JEN LIU Corresponding Author: MING LUNG YU Affiliations: Show Chwan Memorial selleck chemicals llc Hospital, Kaohsiung Veterans General Hospital, Changhua Christian Hospital, National Cheng Kung University Hospital, St. Martin De Porres Hospital, Dalin Tzu Chi General Hospital, E-Da Hospital, Tainan Municipal Hospital, National Taiwan University Hospital Yun Lin Branch,China Medical University Hospital, Taipei Veterans General Hospital, National Taiwan University Hospital Objective: The combination of Boceprevir (BOC) with pegylated interferon (P)/ ribavirin (R) has greatly improved the sustained virological

response (SVR) in patients 上海皓元医药股份有限公司 with hepatitis C virus genotype 1 (HCV-1) infection. The efficacy and safety of the BOC containing triple therapy in Asian treatment experienced patients needs to be explored. Methods: A Boceprevir Named Patient program (NPP) for compassionate use prior to registration was conducted in Taiwan in 2013. HCV-1 treatment experienced patients were allocated in 14 participating hospitals. After 4 weeks of PR lead in therapy, patients with cirrhosis or previous null-response received triple therapy for 44 weeks; whereas others received 32 weeks of triple therapy followed by 12 weeks of PR therapy. Patients with HCV RNA >100 IU/mL at week 12 or with detectable HCV RNA at week 24 of treatment were viewed as futility. Results: One hundred and six-teen patients who started treatment before November 2013 were recruited in the current study. By the end of May 2014, twenty-three (19.

, Minneapolis, MN), according to the manufacturer’s instructions. Real-time polymerase chain reaction (PCR) was performed as described previously.13 The primers used are summarized in Supporting Table 2. Liver tissue content of malondialdehyde (MDA) was measured by the thiobarbituric acid reduction method using a commercially available kit (#10009055; Cayman Chemical, Ann Arbor, MI). Values were obtained after 30-minute incubation at 90°C under acidic conditions. Human umbilical vein endothelial cells (HUVECs) were

used at passages 3-6. For analysis of reactive oxygen species (ROS), H2O2 (Thermo Fisher Scientific, Waltham, MA) and N-acetylcysteine (NAC; Calbiochem, San Diego, CA) were used as an ROS inducer and an ROS this website scavenger, respectively. To examine the effects of H2O2 on TSP-1 expression, HUVECs were seeded on 0.1% gelatin-coated culture plates and incubated overnight. Without change of medium, H2O2 was applied at final concentrations of 0.01, 0.05, and 0.1 mM and incubated for 10 minutes. For immunocytochemistry (ICC), HUVECs were plated into Lab-Tek Permanox slides precoated with 0.1% gelatin and incubated overnight. Then, the cells, with or without pretreatment with 30 mM of NAC for 60 minutes, were treated with 0.1 mM of H2O2 for 10 minutes. To examine the effects

of HUVEC-derived TSP-1 on TGF-β/Smad signaling and proliferation in primary hepatocyte cultures, primary hepatocytes were isolated from 8- to 12-week-old adult WT mouse livers using collagenase perfusion as previously described.15 Isolated hepatocytes were plated on type I collagen

(10-μg/mL)-coated dishes Y-27632 solubility dmso in Williams’ E medium, supplemented MCE with 5 μg/mL of insulin, 5 μg/mL of transferrin, 10 ng/mL of endothelial growth factor, 10−5 M aprotinin, 10−5 M of dexamethasone, 10−3 M of nicotinamide, and 10% fetal bovine serum and incubated at 37°C for 24 hours. To examine the effect of HUVEC-derived TSP-1 on TGF-β/Smad signaling in hepatocytes, the conditioned media from HUVECs (treated with 1.0 mM of H2O2 for 2 hours) were added to primary hepatocytes with or without pretreatment of 5 μM of LSKL or SLLK peptide (GenScript, Piscataway, NJ),16, 17 cultured for an additional 4 hours, and the cells were used for the analysis. To examine the effect of HUVEC-derived TSP-1 on hepatocyte proliferation, the conditioned media from HUVECs were added to primary hepatocytes, cultured for an additional 24 hours, and the cells were used for the analysis. All experiments were performed in triplicate, and the data shown are representative of results consistently observed. Data are expressed as the mean ± standard deviation. Data analysis was performed with SPSS 12.0.1 for Windows (SPSS, Inc., Chicago, IL). Statistical analyses were performed using the Student’s t test or analysis of variance, followed by Bonferroni’s multiple comparison tests, when appropriate.

The most prevalent ‘inappropriate indication’ find protocol for PPI usage was for uninvestigated anaemia in stable patients who had no evidence of GIT bleeding. The most prevalent ‘borderline indication’ for PPI usage was for endoscopic findings of gastropathy/gastritis(excluding peptic ulcer disease). Conclusion: PPI usage is pravelent in hospitals. Less than half of the total PPI usage amongst hospitalized patients has evidence-based indications to support their use. Overuse of PPI has a negative

impact on health care cost and may lead to certain adverse effects. Steps to curb inappropriate PPI use should address a few factors including indications to initiate PPI, reassessing need for on-going use while in hospital or upon discharging patients and upon out-patient reviews. Key Word(s): 1. PPI; 2. inappropriate use; 3. guidelines;

4. hospitalized; Presenting Author: TSZ TING LAW Additional Authors: KWAN KIT CHAN, DANIEL KING HUNG TONG, SAM WAI HO WONG, FION SIU YIN CHAN, SIMON LAW Corresponding Author: TSZ TING LAW Affiliations: – Objective: Esophageal perforation is uncommon and the prognosis could be GSI-IX dismal if managed inappropriately. Methods: Records of patients with esophageal perforation treated between 1997 and 2012 were retrospectively reviewed. Demographics, etiology and outcomes were analyzed. Results: Thirty-seven patients [23 men, median age 66 years (range 19–98)] were included. Eighteen patients (48.6%) had spontaneous perforation (Boerhaave’s syndrome: n = 14; esophageal cancer: n = 4), 13 (35.1%) were iatrogenic and 6 (16.2%) occurred after foreign body ingestion. Prior to presentation, 25 (67.6%) had had MCE公司 no pre-existing esophageal pathology; 6 had cancer, and 7 other had benign pathologies. Diagnosis was made >24 hours from onset of symptoms in 5 patients (13.5%). The perforation site was located

in the intra-thoracic esophagus in 24 patients (64.9%).Nineteen patients had emergency operations at presentation: 12 underwent primary repair (which was successful in 10), 6 had surgical drainage or exclusion, and 1 had esophagectomy. Of the 18 managed non-operatively, 10 had stenting performed, of whom 2 later required esophagectomy. Overall 6 patients (16.2%) required esophagectomy as definitive treatment. The overall mortality rate was 21.6%. Hospital mortality rate was 15.8% and 27.8% in the operative and non-operative group respectively. Fever (≥38.5°C), hypotension, pre-existing esophageal pathology and malignancy were associated with in-hospital mortality (p = 0.02, 0.03, <0.01, <0.01 respectively). A modified perforation severity score that comprised of 9 clinical parameters was studied. Early diagnosis (<24 h) was significantly associated with a low perforation score (p = 0.04). A high perforation score was associated with mortality (p < 0.01). Conclusion: Spontaneous esophageal perforation was the most commson etiology. Timely diagnosis and repair has a high successful rate.

The most prevalent ‘inappropriate indication’ AZD3965 solubility dmso for PPI usage was for uninvestigated anaemia in stable patients who had no evidence of GIT bleeding. The most prevalent ‘borderline indication’ for PPI usage was for endoscopic findings of gastropathy/gastritis(excluding peptic ulcer disease). Conclusion: PPI usage is pravelent in hospitals. Less than half of the total PPI usage amongst hospitalized patients has evidence-based indications to support their use. Overuse of PPI has a negative

impact on health care cost and may lead to certain adverse effects. Steps to curb inappropriate PPI use should address a few factors including indications to initiate PPI, reassessing need for on-going use while in hospital or upon discharging patients and upon out-patient reviews. Key Word(s): 1. PPI; 2. inappropriate use; 3. guidelines;

4. hospitalized; Presenting Author: TSZ TING LAW Additional Authors: KWAN KIT CHAN, DANIEL KING HUNG TONG, SAM WAI HO WONG, FION SIU YIN CHAN, SIMON LAW Corresponding Author: TSZ TING LAW Affiliations: – Objective: Esophageal perforation is uncommon and the prognosis could be learn more dismal if managed inappropriately. Methods: Records of patients with esophageal perforation treated between 1997 and 2012 were retrospectively reviewed. Demographics, etiology and outcomes were analyzed. Results: Thirty-seven patients [23 men, median age 66 years (range 19–98)] were included. Eighteen patients (48.6%) had spontaneous perforation (Boerhaave’s syndrome: n = 14; esophageal cancer: n = 4), 13 (35.1%) were iatrogenic and 6 (16.2%) occurred after foreign body ingestion. Prior to presentation, 25 (67.6%) had had 上海皓元 no pre-existing esophageal pathology; 6 had cancer, and 7 other had benign pathologies. Diagnosis was made >24 hours from onset of symptoms in 5 patients (13.5%). The perforation site was located

in the intra-thoracic esophagus in 24 patients (64.9%).Nineteen patients had emergency operations at presentation: 12 underwent primary repair (which was successful in 10), 6 had surgical drainage or exclusion, and 1 had esophagectomy. Of the 18 managed non-operatively, 10 had stenting performed, of whom 2 later required esophagectomy. Overall 6 patients (16.2%) required esophagectomy as definitive treatment. The overall mortality rate was 21.6%. Hospital mortality rate was 15.8% and 27.8% in the operative and non-operative group respectively. Fever (≥38.5°C), hypotension, pre-existing esophageal pathology and malignancy were associated with in-hospital mortality (p = 0.02, 0.03, <0.01, <0.01 respectively). A modified perforation severity score that comprised of 9 clinical parameters was studied. Early diagnosis (<24 h) was significantly associated with a low perforation score (p = 0.04). A high perforation score was associated with mortality (p < 0.01). Conclusion: Spontaneous esophageal perforation was the most commson etiology. Timely diagnosis and repair has a high successful rate.

Longer intervals between travel to water by the sable antelope herd enabled it to occupy regions of the landscape further from water than those heavily exploited by the more common grazers Obeticholic Acid mouse during the critical dry season months. By avoiding concentrations of other grazers, the sable also probably gained a reduction in predation risk, balancing the substantial costs in terms of time and energy associated with travel to water. Thereby the distinctions in water dependency of this relatively rare grazer facilitated its coexistence alongside more abundant grazers in the KNP. “
“Damaraland mole-rats Fukomys damarensis are eusocial subterranean rodents that exhibit

an extreme reproductive skew with one female and one or two males breeding. The non-reproductive individuals in the colony are reproductively suppressed, and yet show a rapid initiation of copulatory behaviour (within 1 h) when taken out of the colony and exposed to non-kin. Little is known about how these individuals can quickly become sexually active if the causes of suppression are removed. This study investigated circulating gonadotrophin concentrations [follicle stimulating hormone MS-275 datasheet (FSH)] and testicular morphology and function in reproductive and non-reproductive

male Damaraland mole-rats taken directly from their natal colonies and non-reproductive males that had been introduced to non-kin females outside their colony for 10 or 60 min. The main findings were that 60-min exposure males had a significantly heavier body mass-corrected testicular mass than reproductive males. In addition, MCE公司 the external seminiferous tubule diameter was significantly larger in reproductive

males than in non-reproductive males, and the tubule lumen area was significantly greater in reproductive, 10 and 60-min exposure males than in non-reproductive males. Plasma concentrations of FSH were not different between the groups; however, the reproductive status significantly affected the area of testicular tissue stained immunopositive for the FSH receptor (FSH-R). Reproductive males had almost six times more FSH-R compared with non-reproductive males, and 60-min exposure males had eight times more FSH-R compared with non-reproductive males. In conclusion, the increase in the seminiferous tubular lumen area and the testicular FSH receptor content when non-reproductive male mole-rats come into contact with non-kin females indicates a rapid activation of testicular spermatogenic pathways to accompany the onset of copulatory behaviour, and is likely to be adaptive in allowing pairs formed of dispersing individuals from different colonies to rapidly bond and become fertile. “
“The red-legged partridge, Alectoris rufa (Phasianidae), is a game bird hunted throughout its range (Italy, France with Corsica Island, Iberian Peninsula).

Wiegand, Birgit Bremer, Patrick Lehmann, Katja Deterding Amino acid substitutions in the major antigenic a determinant region of hepatitis B virus (HBV) S region are often observed in patients of immunoprophylaxis failure, and are considered to be responsible for the vaccine-escape mutants. However, the rate of emergence of the amino acid substitutions in this region is still unknown among patients of acute hepatitis B. The aim of this

study is to evaluate the rate of amino acid polymorphisms of S region including the a determinant region among the patients of acute hepatitis B in Japan. From 2002 to

2012, serum samples were collected from 91 patients (male: female 81:10, median age 32.6 ± 10.6 ) diagnosed Selleck FK228 with acute hepatitis B in our institutions. None had received any vaccination against HBV. Anti-HIV was tested in 48 patients under informed consent, and 3 (6.3%) of them were positive. A fragment of HBV S region (nt. 155-835) was obtained VX-765 by nested PCR amplification and was subsequently analyzed by direct sequencing. The HBV genotypes of isolated strains were determined by phylogenetic analysis. Deduced amino acid sequences were compared with the consensus sequence of each genotype in the database. Of the 91 patients, 62 (68.1%) were infected with genotype (gt) A, 14 (15.4%) were with gt B, and 15 (16.5%) were with gt C. In these isolated strains, 19 (20.9%) had the

amino acid polymorphisms in S region (aa 1- 227), 9 (9.9%) were in the major hydrophilic region (aa 110 – 160), and 6 (6.6%) were in the a determinant region (aa 124 – 147). Identified polymorphisms in the a determinant region were T126S (gt B), T131P/A MCE (gt C), M133L (gt B), F134Y (gt A), and P135H (gtA, Anti-HIV positive). Clinical features (age, gender), laboratory data (maximum ALT, T-Bil, HBV DNA) were not different in the 19 patients with polymorphisms in S region as compared with patients without them. In conclusion, the emergence of HBV strains with amino acid polymorphisms in S region was observed in about 20% of the patients with among acute hepatitis B in Japan. The 6 of 19 identified polymorphisms were in the a determinant region. These strains may affect antigenicity and reduce binding capability to neutralizing antibodies. The efficacy of current HBV vaccine used all over the world widely and the necessity of booster vaccination should be evaluated particularly in these strains with polymorphisms.

Wiegand, Birgit Bremer, Patrick Lehmann, Katja Deterding Amino acid substitutions in the major antigenic a determinant region of hepatitis B virus (HBV) S region are often observed in patients of immunoprophylaxis failure, and are considered to be responsible for the vaccine-escape mutants. However, the rate of emergence of the amino acid substitutions in this region is still unknown among patients of acute hepatitis B. The aim of this

study is to evaluate the rate of amino acid polymorphisms of S region including the a determinant region among the patients of acute hepatitis B in Japan. From 2002 to

2012, serum samples were collected from 91 patients (male: female 81:10, median age 32.6 ± 10.6 ) diagnosed click here with acute hepatitis B in our institutions. None had received any vaccination against HBV. Anti-HIV was tested in 48 patients under informed consent, and 3 (6.3%) of them were positive. A fragment of HBV S region (nt. 155-835) was obtained Selleckchem Erlotinib by nested PCR amplification and was subsequently analyzed by direct sequencing. The HBV genotypes of isolated strains were determined by phylogenetic analysis. Deduced amino acid sequences were compared with the consensus sequence of each genotype in the database. Of the 91 patients, 62 (68.1%) were infected with genotype (gt) A, 14 (15.4%) were with gt B, and 15 (16.5%) were with gt C. In these isolated strains, 19 (20.9%) had the

amino acid polymorphisms in S region (aa 1- 227), 9 (9.9%) were in the major hydrophilic region (aa 110 – 160), and 6 (6.6%) were in the a determinant region (aa 124 – 147). Identified polymorphisms in the a determinant region were T126S (gt B), T131P/A 上海皓元 (gt C), M133L (gt B), F134Y (gt A), and P135H (gtA, Anti-HIV positive). Clinical features (age, gender), laboratory data (maximum ALT, T-Bil, HBV DNA) were not different in the 19 patients with polymorphisms in S region as compared with patients without them. In conclusion, the emergence of HBV strains with amino acid polymorphisms in S region was observed in about 20% of the patients with among acute hepatitis B in Japan. The 6 of 19 identified polymorphisms were in the a determinant region. These strains may affect antigenicity and reduce binding capability to neutralizing antibodies. The efficacy of current HBV vaccine used all over the world widely and the necessity of booster vaccination should be evaluated particularly in these strains with polymorphisms.

We found similar results in our population (details not shown). However, the analysis by Kettaneh et al. was performed in a subgroup of patients with LSE including at least 10 valid measurements; their results probably do not reflect the accuracy of LSE for which only three or five valid measurements are genuinely available because of examination difficulties. In our study, 92.8% of LSE had at least 10 valid measurements and this rate was 96.9% in the large series of Castera et al.4 Considering the current state of knowledge, and because LSE is a quick and easy

procedure, the pragmatic goal of operators should be to obtain 10 valid measurements, whatever the success rate.19 Several recent longitudinal studies have shown that LSE median was Selleck LDK378 linked to clinical events such as liver decompensation,20, 21 hepatocellular carcinoma,22, 23 or death.24 This suggests that liver

stiffness may be used as a prognostic index in chronic liver diseases. Reliability criteria of LSE are thus important to correctly compare LSE repeated over time and accurately evaluate the course of liver stiffness in patients. We have previously shown that interobserver reproducibility of LSE median depends on IQR/M and liver stiffness level.25, 26 Interobserver agreement decreased in LSE with 上海皓元医药股份有限公司 IQR/M see more >0.25,25 confirming the key role of this index for the interpretation of LSE median in the management of patients with chronic liver diseases. Our results suggest that LSE is less accurate in CHC patients than in patients with other causes of chronic liver disease (Table 2). However, the cause of liver disease was not an independent predictor of fibrosis (Table 3). Moreover, the characteristics of CHC and non-CHC patients were significantly different, especially for F stages with a significantly higher prevalence of FM≥2, FM≥3, and F4 in non-CHC patients (Table 1). It has been previously

shown that a higher prevalence of the diagnostic target is associated with an increase in fibrosis tests accuracy.27 Finally, the difference in LSE accuracy observed between CHC and non-CHC patients is probably explained by the significantly different characteristics of these two subgroups. LSE diagnostic cutoffs calculated in published studies are very heterogeneous.28 We tested several cutoffs, some calculated for CHC12-14 and others determined in a large meta-analysis including patients with various causes of chronic liver disease.15 Interestingly, we found significant but slight differences in diagnostic accuracy, either in CHC patients or in patients with other causes of chronic liver disease.