Biopsy is the gold standard for assessing cirrhosis in patients with chronic Hepatitis C virus infection, but it is expensive and at risk of complications.
Alternative non-invasive methods have been developed but their usefulness remains uncertain.
Dr Borroni and colleagues from Italy compared the accuracy of five non-invasive scores in detecting cirrhosis.
The team reviewed the charts and liver biopsies of 228 consecutive, treatment-naïve, Hepatitis C virus-positive patients.
Of these, 13% had histological diagnosis of cirrhosis.
The team assessed 5 alternative scores.
These included age-platelet index, cirrhosis discriminant score, and aspartate transaminases to platelet ratio index.
|The specificities of the scores were between 87% and 100%|
|Alimentary Pharmacology & Therapeutics|
Pohl's index, and aspartate transaminases/alanine transaminases ratio was also assessed.
The researchers found that the specificities of the scores were good, between 87% and 100%.
However, the tests' sensitivities were only between 17% and 67%.
Accordingly, the team noted that positive likelihood ratios were generally good but negative likelihood ratios were suboptimal.
The researchers observed that combinations of the scores independently related to cirrhosis only slightly change this diagnostic accuracy.
Using double cut-offs to exclude or diagnose cirrhosis, cirrhosis discriminant score classified 21% of patients without misdiagnoses.
The team found that aspartate transaminases to platelet ratio index classified 85% of cases with 9% misdiagnoses.
Dr Borroni's team concluded, “The 5 scores showed variable sensitivities and specificities in detecting liver cirrhosis, both individually and in combination.”
“The use of double cut-off points may make the cirrhosis discriminant score and aspartate transaminases to platelet ratio index useful to reduce the number of patients submitted to liver biopsy.”