Recent longitudinal studies have emphasised the prognostic value of noninvasive tests of liver fibrosis and cross-sectional studies have shown their combination significantly improves diagnostic accuracy.
Dr Boursier and colleagues compared the prognostic accuracy of 6 blood fibrosis tests and liver biopsy, and evaluated if test combination improves the liver-prognosis assessment in chronic hepatitis C.
A total of 373 patients with compensated chronic hepatitis C, liver biopsy (Metavir F) and blood tests targeting fibrosis or cirrhosis were included.
Significant liver-related events and liver-related deaths were recorded during follow-up.
|CirrhoMeter was the only independent predictor of liver-related death|
|Alimentary Pharmacology & Therapeutics|
During the median follow-up of 9.5 years, the team found that 47 patients had a liver-related events, and 23 patients died from liver-related causes.
For the prediction of first liver-related events, most blood tests allowed higher prognostication than liver biopsy with a significant increase for FIB.
The team found that FibroMeter, CirrhoMeter and sustained viral response were independent predictors of first liver-related events.
CirrhoMeter was the only independent predictor of liver-related death.
The team observed that the combination of FibroMeter and CirrhoMeter classifications into a new FM/CM classification improved the liver-prognosis assessment compared to liver biopsy staging or single tests by identifying five subgroups of patients with significantly different prognoses.
Dr Boursier's team concluded, "Some blood fibrosis tests are more accurate than liver biopsy for determining liver prognosis in chronic hepatitis C."
"A new combination of 2 complementary blood tests, one targeted for fibrosis and the other for cirrhosis, optimises assessment of liver-prognosis."