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News

Non-invasive markers of liver fibrosis in chronic hepatitis C infection

August's issue of Liver International reports on liver fibrosis staging through a stepwise analysis of non-invasive markers in patients with chronic hepatitis C infection.

News image

Non-invasive fibrosis markers can distinguish between liver fibrosis stages in lieu of liver biopsy or imaging elastography.

Dr Samer El-Kamary and colleagues from Maryland, USA developed a sensitive, non-invasive, freely-available algorithm that differentiates between individual liver fibrosis stages in chronic hepatitis C virus patients.

Chronic HCV patients at Cairo University Hospital, Egypt, with liver biopsy to determine fibrosis stage, were tested for preselected fibrosis markers.

The researh team undertook a novel multistage stepwise fibrosis classification algorithm using random forest analysis for biomarker selection, and logistic regression for modelling.

FibroSteps predicted fibrosis stage using 4 steps.

The final classification had accuracies of 95% for the training sets
Liver International

Step 1 distinguished no/mild fibrosis vs. moderate/severe fibrosis/cirrhosis; whereas Step 2a distinguished F0 vs. F1.

Step 2b distinguished F2 vs. F3/F4, and Step 3 distinguished F3 vs. F4.

FibroSteps was developed using a randomly-selected training set and evaluated using the remaining patients as a validation set.

Hyaluronic Acid, TGF-β1, α2-macroglobulin, MMP-2, Apolipoprotein-A1, Urea, MMP-1, alpha-fetoprotein, haptoglobin, RBCs, haemoglobin and TIMP-1 were selected into the models.

The final classification had accuracies of 95%, and 89% for the training and validation sets respectively.

The research team concluded, "FibroSteps, a freely available, non-invasive liver fibrosis classification, is accurate and can assist clinicians in making prognostic and therapeutic decisions."

"The statistical code for FibroSteps using R software is provided in the supplementary materials."

Liver International 2013: 33(7): 982–990
23 July 2013

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