Evaluation of Role of Transient Elastography (Fibroscan) in Differentiating Patients of Acute Severe Viral Hepatitis and Acute on Chronic Liver Failure

NCT ID: NCT01866072

Last Updated: 2013-06-04

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

100 participants

Study Classification

OBSERVATIONAL

Study Start Date

2013-05-31

Study Completion Date

2014-01-31

Brief Summary

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Transient elastography is novel non-invasive method for assessment of hepatic fibrosis in patients with chronic liver disease, by measuring liver stiffness. Transient elastography is a user friendly technique that can be easily performed at bedside or in outpatient clinic with immediate results and good reproducibility.

Liver stiffness values ranges from 2.5 to 75 kPa with lower values \<6kPa suggest no fibrosis where as higher values above 14kPa suggests cirrhosis. In the present study the investigators hypothesis that the investigators can differentiate ACLF and acute severe viral hepatitis based on fibroscan as patients with underlying fibrosis with superadded inflammation would have higher fibroscan value than when patient have only inflammation with no underlying fibrosis and hence the investigators can avoid unnecessary test in such subgroup.

Detailed Description

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Transient elastography is a novel non-invasive method that for the assessment of hepatic fibrosis in patients with chronic liver diseases, by measuring liver stiffness.

Acute on chronic liver failure: acute hepatic insult manifesting as jaundice and coagulopathy, complicated within 4 weeks by ascites and/or encephalopathy in patients with previously diagnosed or undiagnosed chronic liver disease.

Acute severe hepatitis: Acute severe hepatitis which is characterized by serum bilirubin \> or = 10.0 mg/dL and international normalized ratio (INR) \> or = 1.5.

Patients with acute severe viral hepatitis or acute on chronic liver failure will be enrolled in this prospective study after taking informed written consent. All patients will be evaluated at baseline as per standard protocol which include evaluation of etiology of disease and tests to exclude underlying liver disease which includes ultrasound/computed tomography and if necessary upper gastrointestinal endoscopy and liver biopsy if imaging shows any signs of underlying liver disease. the patients will be followed up for 1 month, all patients will undergo Fibroscan at the time of admission and thereafter at 1week and 4th week .

Conditions

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Acute Severe Viral Hepatitis Acute on Chronic Liver Failure

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

PROSPECTIVE

Study Groups

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AVH

AVH: Patients with Acute Viral Hepatitis

No interventions assigned to this group

ACLF

ACLF: Patients with Acute on Chronic Liver Failure

No interventions assigned to this group

Eligibility Criteria

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Inclusion Criteria

* Patient's age 18-70years.
* Patients with a diagnosis of acute severe viral hepatitis or acute on chronic liver failure.
* Patients willing for informed consent and follow up for 1 month.

Exclusion Criteria

* Patients with gross ascites, hepatic encephalopathy.
* Patient fail to give written consent.
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Sir Ganga Ram Hospital

OTHER

Sponsor Role lead

Responsible Party

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Dr. Praveen Shrama

Associate professor & Consultant

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Anil Arora, M.D

Role: PRINCIPAL_INVESTIGATOR

Deptartment of gastroenterology & hepatology, Sir Ganga Ram Hospital

Praveen Sharma, M.D

Role: PRINCIPAL_INVESTIGATOR

Department of Gatroenterology & Hepatology, Sir Gnaga Ram Hospital

Locations

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Department of Gastroenterology & Hepatology, Sir Ganga Ram Hospital

New Delhi, New Delhi, India

Site Status RECRUITING

Countries

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India

Central Contacts

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Praveen Sharma, M.D

Role: CONTACT

091-9540951004

Anil Arora, M.D

Role: CONTACT

091-9311638779

Facility Contacts

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Praveen Sharma, M.D

Role: primary

091-9540951004

Anil Arora, M.D

Role: backup

091-9311638779

References

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Roulot D, Czernichow S, Le Clesiau H, Costes JL, Vergnaud AC, Beaugrand M. Liver stiffness values in apparently healthy subjects: influence of gender and metabolic syndrome. J Hepatol. 2008 Apr;48(4):606-13. doi: 10.1016/j.jhep.2007.11.020. Epub 2008 Jan 3.

Reference Type BACKGROUND
PMID: 18222014 (View on PubMed)

Kumar M, Sharma P, Garg H, Kumar R, Bhatia V, Sarin SK. Transient elastographic evaluation in adult subjects without overt liver disease: influence of alanine aminotransferase levels. J Gastroenterol Hepatol. 2011 Aug;26(8):1318-25. doi: 10.1111/j.1440-1746.2011.06736.x.

Reference Type BACKGROUND
PMID: 21443658 (View on PubMed)

de Ledinghen V, Vergniol J. Transient elastography for the diagnosis of liver fibrosis. Expert Rev Med Devices. 2010 Nov;7(6):811-23. doi: 10.1586/erd.10.46.

Reference Type BACKGROUND
PMID: 21050091 (View on PubMed)

Castera L, Forns X, Alberti A. Non-invasive evaluation of liver fibrosis using transient elastography. J Hepatol. 2008 May;48(5):835-47. doi: 10.1016/j.jhep.2008.02.008. Epub 2008 Feb 26.

Reference Type BACKGROUND
PMID: 18334275 (View on PubMed)

Garg H, Kumar A, Garg V, Sharma P, Sharma BC, Sarin SK. Clinical profile and predictors of mortality in patients of acute-on-chronic liver failure. Dig Liver Dis. 2012 Feb;44(2):166-71. doi: 10.1016/j.dld.2011.08.029. Epub 2011 Oct 5.

Reference Type BACKGROUND
PMID: 21978580 (View on PubMed)

McDONOUGH PG, Tho PT, Byrd JR. Twins discordant for 46,XX gonadal dysgenesis. Fertil Steril. 1977 Mar;28(3):251-2. doi: 10.1016/s0015-0282(16)42434-9.

Reference Type BACKGROUND
PMID: 557003 (View on PubMed)

Arena U, Vizzutti F, Corti G, Ambu S, Stasi C, Bresci S, Moscarella S, Boddi V, Petrarca A, Laffi G, Marra F, Pinzani M. Acute viral hepatitis increases liver stiffness values measured by transient elastography. Hepatology. 2008 Feb;47(2):380-4. doi: 10.1002/hep.22007.

Reference Type BACKGROUND
PMID: 18095306 (View on PubMed)

Kumar M, Satapathy S, Monga R, Das K, Hissar S, Pande C, Sharma BC, Sarin SK. A randomized controlled trial of lamivudine to treat acute hepatitis B. Hepatology. 2007 Jan;45(1):97-101. doi: 10.1002/hep.21486.

Reference Type BACKGROUND
PMID: 17187417 (View on PubMed)

Other Identifiers

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EC/01/13/455

Identifier Type: -

Identifier Source: org_study_id

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