to take it into account in their review. Second, performance of noninvasive methods is certainly good for diagnosing cirrhosis but poor for significant fibrosis; the Fibrostic study did not even reach the minimum values of 85% sensitivity and specificity deemed high enough by Martínez et al. Moreover, the Fibrostic study results showed the ability of noninvasive tests to confirm or rule out significant fibrosis was satisfactory in limited ranges of high or low values only.3 Third, accuracy is
only a step toward a possible usefulness of a test.5 As rightly stressed Metformin order by Martínez et al. at the end of their article, the improvement of patient outcomes is more relevant. However, the prediction
of clinical endpoints by noninvasive methods was only recently investigated by very few studies, and to our knowledge, no study assessed their ability to predict response to therapy. We all wish that noninvasive methods could allow us to avoid liver biopsy while ensuring that patients will be managed as well or better than with old techniques. Therefore, studies are needed in order to specify their contribution to the choice of patient management for improving clinical endpoints or treatment response. Françoise Degos M.D., Ph.D.*, Louis Lebrun M.D., Paul Perez M.D., Ph.D., Isabelle Durand-Zaleski M.D., * Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Beaujon, Hepatology Department, Institut National de la Santé et de la Recherche Médicale Unité 773, Clichy, France, AP-HP, DRCD-URC Eco, Paris, Natural Product Library molecular weight France, Centre Hospitalier Universitaire de Bordeaux, Clinical Epidemiology Unit and CIC-EC7, Bordeaux, France. “
“Hepatitis C virus (HCV) is
a commonly transmitted infection that has both hepatic and extrahepatic repercussions. These range from the inflammatory to the oncologic with an undisputed link to hepatitis, liver cirrhosis, and hepatocellular carcinoma. Its role in the development of B cell non-Hodgkin lymphoma (B-NHL) is becoming better understood, DNA Synthesis inhibitor leading to opportunities for research, therapy, and even prevention. Research in the field has progressed significantly over the last decade, with the number of patients diagnosed with HCV and B-NHL rising incrementally. It is therefore becoming crucial to fully understand the pathobiologic link of HCV in B cell lymphomagenesis and its optimal management in the oncologic setting. (HEPATOLOGY 2012) Over 180 million people are infected with hepatitis C virus (HCV), accounting for 3% of the global population.1 HCV is well-recognized as a cause of hepatic disease and hepatocellular carcinoma, while its hematologic manifestations (mixed cryoglobulinemia [MC] and B cell non-Hodgkin lymphoma [B-NHL]) are less appreciated.