We observed significant variations of serum sphingolipids with sphingosine and sphinganine being both in univariate (P<0.05) as well as in multivariate analysis significantly associated to ABT 263 severity of liver fibrosis
in HCV infected patients (odds ratio (OR)=1.111, confidence interval (CI)=1.028-1.202, P=0.007 and OR=0.634, CI=0.435-0.925, P=0.018 respectively). Serum sphingolipids correlated significantly with serum triglyceride and cholesterol levels as well as with insulin resistance, defined by the homeostatic model assessment-index in HCV patients. Sustained viral response rates in HCV patients were independently predicted by serum C24ceramide (OR=0.998, CI=0.997-0.999, P=0.001), its unsaturated derivative C24:1ceramide (OR=1.001, CI=1.000-1.002, P=0.059) and C18:1ceramide (OR=0.973, CI=0.947-0.999, P=0.048) together with ferritin (OR=1.006, CI=1.003-1.010, P<0.001), alkaline phosphatase (AP) (OR=1.020, CI=1.001-1.039, P=0.032) and IL28B genotype (OR=9.483, CI=3.139-28.643, P<0.001). Conclusion: Our study demonstrates a tight interaction between variations in serum sphingolipid levels and progression of liver fibrosis as well as
responsiveness to antiviral therapy. Selleckchem Omipalisib Particularly sphingosine, sphinganine and C24ceramide appear as promising novel biomarkers in chronic HCV infection and should be further evaluated within the non-invasive prediction of liver fibrosis. (Hepatology 2014;) “
“Davila et al. showed that 17% of the patients older than 65 years with cirrhosis underwent regular screening for hepatocellular carcinoma (HCC), in whom only 54% had only an ultrasound procedure. Gastroenterologists were more likely (4.5-fold) than primary care physicians to perform regular surveillance.1 Hepatologist associations recommended that “patients at high risk for developing hepatocellular carcinoma should be entered into surveillance programs (Level I)”.2 However, only inconclusive or negative observational studies are available. Trevisani et al. concluded that screening improved survival (5 months) learn more despite
raw data showing that screened patients died 18 months younger than nonscreened patients (length of time and lead time biases)!3, 4 Other examples are available: Kemp et al. reported a 26-month increase in survival in screened versus incidentally discovered HCC, but screened patients were 3 years younger.5, 6 Recently, I reviewed a large series with similar biases and the authors refused to resubmit a revised version against screening. The National Cancer Institute wisely stated (last revision on April 3, 2008) that “based on fair evidence, screening would not result in a decrease in mortality from HCC … based on fair evidence, screening would result in rare but serious side effects (Study Design: Randomized controlled trials and observational studies. Internal validity: Fair. Consistency: Multiple studies, large number of participants. External validity: Good/Fair.)”.