Noninvasive indexes have been developed to predict fibrosis staging.
Dr Philippe Halfron and colleagues from France assessed the diagnostic accuracy of these indexes in comparison with liver histology in Hepatitis C virus-infected patients.
A total of 235 consecutive patients with Hepatitis C infection from the Fibropaca multicenter independent study were included.
The research team assessed FibroTest, aspartate aminotransferase to platelet ratio index and Forns score in the cohort and compared with liver histology performed on the same day.
|Combining all tests without liver biopsy allowed 81% patients to be correctly classified|
|Journal of Viral Hepatitis|
The main end point was the area under characteristic curves for the diagnosis of significant fibrosis and cirrhosis.
The team noted that the patient's mean age was 46 years, 55% were males, 42% had significant fibrosis and 7% had cirrhosis.
For the diagnosis of fibrosis, respective area under characteristic curves of FibroTest, aspartate aminotransferase to platelet ratio index and Forns score were 0.8, 0.7 and 0.8
For cirrhosis prognosis, the team found that area under characteristic curves of FibroTest and aspartate aminotransferase to platelet ratio index were both 0.8.
Using each index independently, all patients were classified by FbroTest.
The researchers observed that 91% patients were classified by aspartate aminotransferase to platelet ratio index and 55% by Forns score.
There were significantly more cases of discordances between aspartate aminotransferase to platelet ratio index and liver biopsy than between FibroTest or Forns score and liver biopsy.
Performing all scores without liver biopsy allowed fibrosis to be well evaluated in 81% of patients, including patients with FibroTest failure.
The team found that liver biopsy remained mandatory to evaluate fibrosis in 19% of patients.
Dr Halfron's team concludes, “Our study shows that performing all the tests and liver biopsy improves the diagnostic accuracy for liver fibrosis in chronic Hepatitis C patients without patent comorbidities.”
“The combination of all tests with liver biopsy allowed 96% patients to be correctly classified.”
“The combination of all tests without liver biopsy allowed 81% patients to be correctly classified, and liver biopsy remained mandatory in some patients.”