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World J Hepatol. Mar 27, 2026; 18(3): 117040
Published online Mar 27, 2026. doi: 10.4254/wjh.v18.i3.117040
Published online Mar 27, 2026. doi: 10.4254/wjh.v18.i3.117040
Multimarker model for non-invasive assessment of variceal bleeding in chronic hepatitis C cirrhotic patients
Amira Ahmed Abdelrahman Othman, Mohamed W Saleh, Department of Internal Medicine, Suez University, Suez 43511, Egypt
Lamiaa Elsharkawy, Department of Diagnostic Radiology, Faculty of Medicine, Suez University, Suez 43511, Egypt
Mohamed Medhat Mohamed, Department of Infectious Diseases, Gastroenterology and Hepatology, Faculty of Medicine, Suez University, Suez 43511, Egypt
Fatma M Attia Elsayed, Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig 44523, Sharkiah, Egypt
Author contributions: Othman AAA contributed to concept and design of the study, data acquisition, statistical analysis, interpreted the results, analyzed the data, drafted the manuscript, critically revised the manuscript, approved the final version to be published, and agreed to be accountable for all aspects of the work; Elsharkawy L, Saleh MW, Mohamed MM, Elsayed FMA contributed to concept and design of the study, methodology, interpreted the results, analyzed the data, drafted the manuscript, critically revised the manuscript, and approved the final version to be published.
Institutional review board statement: The study was conducted after obtaining approval from the Institutional Review Board of Zagazig University (No. ZU-IRB#1897).
Informed consent statement: All subjects were informed and gave their voluntary, written informed consent.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement- checklist of items.
Data sharing statement: All relevant data are included in this published article.
Corresponding author: Amira Ahmed Abdelrahman Othman, MD, PhD, Lecturer, Principal Investigator, Department of Internal Medicine, Suez University, Cairo-Suez Road, Suez 43511, Egypt. amira.othman@med.suezuni.edu.eg
Received: November 27, 2025
Revised: December 17, 2025
Accepted: January 22, 2026
Published online: March 27, 2026
Processing time: 119 Days and 22.8 Hours
Revised: December 17, 2025
Accepted: January 22, 2026
Published online: March 27, 2026
Processing time: 119 Days and 22.8 Hours
Core Tip
Core Tip: This study validates a novel, non-invasive multimarker approach for identifying chronic hepatitis C cirrhotic patients at high risk for variceal bleeding. We identified a core panel of independent predictors: Low free triiodothyronine levels, low platelet count, and high international normalized ratio. A composite Variceal Risk Score integrating these with portal vein diameter demonstrated outstanding accuracy (area under the curve = 0.94). This strategy can efficiently triage patients for endoscopic screening, potentially reducing procedural burden in resource-limited settings.