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Von Willebrand Factor is a new marker for non-invasive assessment of liver fibrosis in HCV

A study in February's publication of the Alimentary Pharmacology & Therapeutics investigates Von Willebrand Factor as a new marker for non-invasive assessment of liver fibrosis and cirrhosis in patients with chronic hepatitis C.

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Staging of liver fibrosis in patients with chronic hepatitis C (CHC) is recommended prior to anti-viral therapy.

As vWF-Ag was shown as a predictor of portal hypertension, decompensation and mortality in patients with liver cirrhosis, Dr Ferlitsch and colleagues from Austria performed this study to investigate if vWF-Ag is able to predict different fibrosis stages and if it is comparable to other fibrosis scores.

The team investigated if vWF-Ag is able to predict different fibrosis stages and if it is comparable to other fibrosis scores.

The research team analyzed 294 patients with chronic hepatitis C who underwent biopsy.

vWF-Ag levels were increasing with stage of fibrosis
Alimentary Pharmacology & Therapeutics

The team assessed stage of liver fibrosis according to Metavir, measured vWF-Ag and calculated different fibrosis scores (APRI, FCI, FORNS, FI, Fib-4), and compared them by AUCs.

The research team also calculated a new score: vWF-Ag/thrombocytes (VITRO score) for prediction of fibrosis.

vWF-Ag levels were increasing with stage of fibrosis.

The team observed that at F0,vWF-Ag was median 137%, FI at 141%, FII at 158%, FIII at 171%, and FIV at 252%.

vWF-Ag and VITRO score produced AUCs of 0.7 and 0.72 for ≥F2, comparable to the AUCs of APRI, Fib-4, FORNS with 0.75, 0.65 and 0.64.

For ≥F3 AUCs were 0.79 and 0.86 for vWF-Ag and VITRO score, comparable with AUCs of 0.79, 0.86 and 0.87 for APRI, Fib-4 and FORNS.

The team found that cirrhosis shows AUCs of 0.84 and 0.89 for vWF-Ag and VITRO score, APRI, Fib-4 and FORNS showed similar results with AUCs of 0.82, 0.88 and 0.87.

Dr Ferlitsch's team concludes, "vWF-Ag and VITRO score offer an easy possibility to evaluate the stage of fibrosis to diagnose subclinical cirrhosis in patients with chronic hepatitis C."

"Both vWF-Ag and VITRO score show equal performance in comparison to other fibrosis scores assessed in our study."

Aliment Pharmacol Ther 2014: 39(3): 331–338
31 January 2014

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