{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T00:39:08Z","timestamp":1785458348957,"version":"3.56.0"},"reference-count":28,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2015,3,4]],"date-time":"2015-03-04T00:00:00Z","timestamp":1425427200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2015,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background &amp; Aims<\/jats:title><jats:p>Diagnosis of preclinical compensated cirrhosis (occult cirrhosis, <jats:styled-content style=\"fixed-case\">OC<\/jats:styled-content>) is challenging due to lack of clinical findings. We evaluated prevalence and outcomes of <jats:styled-content style=\"fixed-case\">OC<\/jats:styled-content> by transient elastography (<jats:styled-content style=\"fixed-case\">TE<\/jats:styled-content>, Fibroscan<jats:sup>\u00ae<\/jats:sup>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Eight hundred and seventy\u2010one patients with compensated chronic liver disease (<jats:styled-content style=\"fixed-case\">CLD<\/jats:styled-content>) and <jats:styled-content style=\"fixed-case\">TE<\/jats:styled-content> examination were divided into: (i) <jats:styled-content style=\"fixed-case\">OC<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">TE<\/jats:styled-content>\u00a0\u2265\u00a013\u00a0kPa and no sign of cirrhosis, including absence of thrombocytopenia and signs of advanced liver disease on ultrasound or gastroscopy); (ii) clinically evident cirrhosis (<jats:styled-content style=\"fixed-case\">TE<\/jats:styled-content>\u00a0\u2265\u00a013\u00a0kPa with signs of cirrhosis); (iii) non\u2010cirrhotic <jats:styled-content style=\"fixed-case\">CLD<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">TE<\/jats:styled-content>\u00a0&lt;\u00a013\u00a0kPa). Outcomes included hepatocellular carcinoma (<jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content>), esophageal varices and ascites. Late diagnosis of outcomes was defined as <jats:styled-content style=\"fixed-case\">HCC<\/jats:styled-content> stage \u2265intermediate by <jats:styled-content style=\"fixed-case\">BCLC<\/jats:styled-content> or variceal bleeding.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Occult cirrhosis represented 12% of the cohort and 37% of cirrhotic patients. Independent predictors of <jats:styled-content style=\"fixed-case\">OC<\/jats:styled-content> were age [odds ratio (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>) 1.15; 95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>), 1.04\u20131.26], <jats:styled-content style=\"fixed-case\">HIV<\/jats:styled-content> co\u2010infection (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 3.53; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 1.85\u20136.76) and <jats:styled-content style=\"fixed-case\">APRI<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 2.63; 95 <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 1.87\u20133.71). During a median follow\u2010up of 24 (interquartile range 20\u201337) months, <jats:styled-content style=\"fixed-case\">OC<\/jats:styled-content> received less surveillance than clinically evident cirrhosis, with fewer ultrasounds (2.7\u00a0\u00b1\u00a01.5 vs 3.6\u00a0\u00b1\u00a02; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) and gastroscopies (2\u00a0\u00b1\u00a00.8 vs 2.6\u00a0\u00b1\u00a01.4; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Incidence of outcomes was 3.5\/100 per person\u2010years (<jats:styled-content style=\"fixed-case\">PY<\/jats:styled-content>) (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.1\u20136.9) in <jats:styled-content style=\"fixed-case\">OC<\/jats:styled-content>, 0 in non\u2010cirrhotic <jats:styled-content style=\"fixed-case\">CLD<\/jats:styled-content> and 9.8\/100 <jats:styled-content style=\"fixed-case\">PY<\/jats:styled-content> (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>, 0.3\u201319.3) in clinically evident cirrhosis (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). Late diagnosis occurred more in <jats:styled-content style=\"fixed-case\">OC<\/jats:styled-content> than clinically evident cirrhosis (60 vs 15%, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Occult cirrhosis is a frequent and under\u2010monitored clinical entity associated with short\u2010term risk of outcomes. <jats:styled-content style=\"fixed-case\">TE<\/jats:styled-content> may help early diagnosis, prompt initiation of surveillance and specific therapy for an otherwise unrecognized condition.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.12802","type":"journal-article","created":{"date-parts":[[2015,2,12]],"date-time":"2015-02-12T16:50:10Z","timestamp":1423759810000},"page":"2285-2293","source":"Crossref","is-referenced-by-count":12,"title":["Occult cirrhosis diagnosed by transient elastography is a frequent and under\u2010monitored clinical entity"],"prefix":"10.1111","volume":"35","author":[{"given":"Tianyan","family":"Chen","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology Royal Victoria Hospital McGill University Health Centre Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Remy","family":"Wong","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Royal Victoria Hospital McGill University Health Centre Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Wong","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Royal Victoria Hospital McGill University Health Centre Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen C.","family":"Rollet\u2010Kurhajec","sequence":"additional","affiliation":[{"name":"Chronic Viral Illness Service McGill University Health Centre Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rasha","family":"Alshaalan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Royal Victoria Hospital McGill University Health Centre Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Deschenes","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Royal Victoria Hospital McGill University Health Centre Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Ghali","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Royal Victoria Hospital McGill University Health Centre Montreal QC Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giada","family":"Sebastiani","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Royal Victoria Hospital McGill 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