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

Somaye Khosravi; Seyed Alavian; Ali Zare; Seyed-Mohammad Fereshtehnejad; Narges Daryani; Mohammad Keramati; Sina Abdollahzade; Sahar Vakili; Nasser Ebrahimi Daryani

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

Author(s):

Somaye Khosravi,

Seyed Alavian,

Ali Zare,

Seyed-Mohammad Fereshtehnejad,

Narges Daryani,

Mohammad Keramati,

Sina Abdollahzade,

Sahar Vakili,

Nasser Ebrahimi Daryani^1,*

1Department of Gastroenterology, Tehran University of Medical Sciences, Tehran, IR Iran

Hepatitis Monthly:Vol. 11, issue 6; 88-94

Published online:Jun 30, 2010

Article type:Research Article

Received:Jan 15, 2010

Accepted:Mar 24, 2010

How to Cite:Khosravi S, Alavian S, Zare A, Fereshtehnejad S, Daryani N, et al. A Comparative Study of Non-Invasive Methods for Fibrosis Assessment in Chronic HCV Infection.Hepat Mon.2010;11(6):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):

Somaye Khosravi:[PubMed][Scholar]
Seyed Alavian:[PubMed][Scholar]
Ali Zare:[PubMed][Scholar]
Seyed-Mohammad Fereshtehnejad:[PubMed][Scholar]
Narges Daryani:[PubMed][Scholar]
Mohammad Keramati:[PubMed][Scholar]
Sina Abdollahzade:[PubMed][Scholar]
Sahar Vakili:[PubMed][Scholar]
Nasser Ebrahimi Daryani:[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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