A Comparative Study of Non-Invasive Methods for Fibrosis Assessment in Chronic HCV Infection

Ali Kabir; Seyed Tabatabaei; Siamak Khaleghi; Shahram Agah; Amir Hossein Kashani; Mehrdad Moghimi; Fahimeh Kerahroodi; Seyed-e Alavian; Seyed Moayed Alavian

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A Comparative Study of Non-Invasive Methods for Fibrosis Assessment in Chronic HCV Infection

Author(s):

Ali Kabir,

Seyed Tabatabaei,

Siamak Khaleghi,

Shahram Agah,

Amir Hossein Kashani,

Mehrdad Moghimi,

Fahimeh Kerahroodi,

Seyed-e Alavian,

Seyed Moayed Alavian

^1,*

1Seyed Moayed Alavian, M.D. Founder of Global Hepatitis Network & Tehran Hepatitis Center, Professor of Internal Medicine, Gastroenterology and Hepatology, Baqiyatallah Research Center for Gastroenterology and Liver Disease, Ground floor of Baqiyatallah Hospital, Mollasadra St., Vanak Sq., P.O. Box: 14155-3651, Tehran, Iran.

Hepatitis Monthly:Vol. 10, issue 3; 88-94

Published online:Jun 30, 2010

Article type:Research Article

Received:Jan 15, 2010

Accepted:Mar 24, 2010

How to Cite:Kabir A, Tabatabaei S, Khaleghi S, Agah S, Kashani A H, et al. A Comparative Study of Non-Invasive Methods for Fibrosis Assessment in Chronic HCV Infection.Hepat Mon.2010;10(3):88-94.

Abstract

Background and Aims: To compare several non-invasive methods of fibrosis assessment in chronic hepatitis C virus (HCV) infection (platelet count, the APRI score, the Forns score, the Lok score, FIB-4, Transient Elastography [TE]), versus percutaneous liver biopsy (LB).

Methods: Our study included 150 patients with chronic HCV infection in which LB, liver stiffness measurement (LSM) by means of TE and biological tests needed for calculating the scores (according to the classic formulas) were performed in the same session.

Results: The best test for predicting significant fibrosis (F ≥ 2 Metavir) was LSM with AUROC-0.773, followed by APRI (AUROC-0.763), Forns (AUROC-0.744), platelet count (AUROC-0.732), Lok (AUROC-0.701) and FIB-4 (AUROC-0.669), but the differences were not statistically significant (P > 0.05). For excluding cirrhosis, all the tests had excellent NPV (>97%). The best test for predicting cirrhosis was LSM (AUROC-0.979), significantly better than platelet count (AUROC- 0.899, P = 0.022) and than FIB-4 (AUROC-0.839, P = 0.042), otherwise the differences were not statistically significant (P > 0.05). All of the non-invasive tests were statistically significantly correlated (P < 0.0001) to the severity of fibrosis: APRI r=0.570; Forns r=0.540; Lok r=0.4843; FIB-4 r=0.4171; platelet count r=-0.4842.

Conclusions: LSM by means of TE seems to be more sensitive than APRI, Forns, Lok and FIB-4 scores and than platelet count for the prediction of significant fibrosis, but the differences are not statistically significant. The APRI score and Forns scores correctly identified most (71%) of the patients having, or not having, significant fibrosis. LSM was the best method for predicting cirrhosis, but all the evaluated tests had excellent predictive value (AUROCs 0.839-0.979).

Keywords

Chronic Hepatitis C

Fibrosis

Liver Function Tests

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Author(s):

Ali Kabir:[PubMed][Scholar]
Seyed Tabatabaei:[PubMed][Scholar]
Siamak Khaleghi:[PubMed][Scholar]
Shahram Agah:[PubMed][Scholar]
Amir Hossein Kashani:[PubMed][Scholar]
Mehrdad Moghimi:[PubMed][Scholar]
Fahimeh Kerahroodi:[PubMed][Scholar]
Seyed-e Alavian:[PubMed][Scholar]
Seyed Moayed Alavian:[PubMed][Scholar]

Official Journal of Research Center for Gastroenterology and Liver Diseases

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A Comparative Study of Non-Invasive Methods for Fibrosis Assessment in Chronic HCV Infection

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