Hepatiq Inc.

The HEPATIQ report provides six indices of liver disease that may be used for diagnosis, staging, interventions, and monitoring disease progression. It includes color-coded serial and differential graphs with green regions indicating normal.  An interpretation of the quantitative indices including a physiologic model of liver disease is provided based on peer-reviewed publications.

HEPATIQ Indices

The HEPATIQ report provides six indices of liver disease that may be used for diagnosis, staging, interventions, and monitoring disease progression.

    (1) PHM - Quantitative Liver Function (normal ≥100).  PHM indicates likelihood of liver decompensation.  Patients with PHM < 95 have cirrhosis and a 15-fold increase in the risk of outcomes such as ascites, variceal bleeding, hepatic encephalopathy, and death.[4,5,6,10,15,16,18,19,20,24] 

    (2) fLV - Liver Volume (7 ≤ normal < 12).  fLV indicates steatotic liver disease when high and shrinking functional volume when low.[8,11,14,21,22,23] 

    (3) fSV - Spleen Volume (normal < 2.5).  fSV provides a non-invasive measure of portal hypertension.[5,6,10,12,13,15,19,20]  May be used for assessing a transjugular intrahepatic portosystemic shunt (TIPS). 

    (4) HAI - Alcoholic Index (normal > -0.1).  HAI indicates alcoholic hepatitis when low.[10,15,18,19,20,23,24] 

    (5) eFS - Fibrosis Stage (normal = 0, range 0 to 6).  eFS estimates fibrosis stage and correlates with Ishak fibrosis.[5,6]

    (6) eEV - Esophageal Varices (normal =0, range 0 to 3).  eEV estimates presence and size of esophageal varices and the risk of bleeding.[5,6]

Differential Diagnostics

(1)  PHM and fLV can be used to differentiate steatohepatitis and non-steatotic cirrhosis.[8,10,11,14,21,22]  

(2) PHM and fLV reflect intrahepatic hemodynamics allowing differentiation of acute and chronic liver disease.[6,8,10,11,25] 

(3) PHM and fSV can be used to differentiate infiltrative spleen disease and cirrhotic portal hypertension.[6,12,15,19] 

(4) HAI and fLV allow differentiation of alcoholic steatohepatitis (ASH) and metabolic dysfunction-associated steatohepatitis (MASH).[8,10,14,18,21,22,23] 

Physiologic Stage

HEPATIQ also provides a physiologic model of liver disease [1-27]:

              H0          Normal liver function.                                                                

              H1          Severe acute liver disease.                                                       

              H2          Steatotic liver disease.                                                              

              H3          Compensated cirrhosis.                                                           

              H4          Decompensated cirrhosis.                                                        

              H5          Liver transplant candidate.                                           

Subscripts further indicate:  (p) portal hypertension, (s) spleen infiltration, and (a) alcolohic hepatitis.  

Managing Disease Progression

(1)  Interventions: For HCC patients being considered for radioembolization or chemotherapy, PHM indicates possibility of post-intervention liver failure.[6,10,13,15]

(2)  Transplantation: For patients with severe liver disease but MELD score not high enough for transplant priority, low PHM may be used to justify a MELD exception for liver transplantation.[6,10,15,18] 

(3)  Therapy: PHM provides objective monitoring of the efficacy of pharmacological, radiological or surgical therapies for the underlying causes of liver disease.[6,10,15,18,24]

(4)  Vigilance: HEPATIQ can provide early detection of progressive liver disease prompting a vigilant evaluation for complications.[24,25]