Possible
New Method for Detecting and Monitoring Liver Disease without Liver Biopsies
Scientists
working at the Hepatitis B Foundation,
in partnership with Drexel University College of Medicine, believe they have discovered
a reliable alternative to liver biopsy for the early detection of liver fibrosis
and cirrhosis, which afflict more than 5 million Americans.
People
with hepatitis B or C
infection, as well as fatty liver diseases, are at greatest risk for progressing
to cirrhosis, which may lead to
liver cancer and end-stage liver failure.
Successful
management depends on the early detection of fibrosis
and cirrhosis. Currently, detection
involves a liver biopsy, in which a small sample of liver tissue is removed using
a hollow needle. This is an unpleasant, expensive procedure and carries a small
risk of complications. Patients and doctors would prefer tests that are not invasive,
such as blood tests or external imaging to detect and monitor liver disease.
Lead
investigators Anand Mehta and Timothy Block report in the forthcoming Journal
of Virology (February 2008) their discovery that the blood of most -- if not
all -- people they tested with a diagnosis of liver cirrhosis contained high levels
of an antibody that recognizes a carbohydrate sugar commonly found on bacteria.
Detection of this antibody in the blood correlates very well with a diagnosis
of increasing fibrosis.
"This
is a fascinating discovery and is important because, if confirmed, the test could
help us replace liver biopsy as a method for staging liver disease. In addition,
it may be teaching us something about how liver disease occurs," said David
Thomas, MD, Chief, Infectious Diseases, Johns Hopkins School of Medicine.
Working
with the National Cancer Institute Early Detection Research Network, the investigators
have been able to test this approach on 300 blood samples from people with liver
disease, and can conduct the new test in thousands more. Although the test is
still experimental and more study is needed before it can be used to monitor liver
disease, the discovery is promising.
"If
this work is validated, it may offer a new, non-invasive way to test for liver
disease, allowing people to either avoid biopsy or to know when they really need
one," said Block. "It also implies that bacteria may have a much bigger
role in initiating liver disease than realized, and even lead to new therapies."
Complications
due to bacterial infection in people with cirrhosis are well understood; however,
bacteria are not usually detected early in the disease. The new discovery may
suggest that earlier treatment with antibiotics could benefit patients with chronic
liver disease.
01/15/08
Source
Hepatitis
B Foundation. HBF Scientists Discover Possible New Alternative to Liver Biopsy
for Early Detection and Monitoring. Press release. December 24, 2007. http://www.hepb.org.
