Correlations between Noninvasive Explorations and Liver Biopsy in the Determination of Liver Fibrosis in Chronic Viral Hepatitis C

Introduction. An adequate diagnosis of fi brosis in viral hepatitis C is essential for treatment decisions and disease prognostic. Because of the limitations of liver biopsy, noninvasive explorations of fi brosis are frequently employed nowadays. Th is study’s aim was that of evaluating the correlation between the currently available noninvasive standardized tests (FibroTest and FibroScan) and liver biopsy. Material and methods Th e study cluster consisted of n=26 naïve patients with chronic viral hepatitis C, which underwent antiviral treatment in the National Institute for Infectious Diseases “Prof. Dr. Matei Balş”, Bucharest, Romania, during December 2007 – December 2008. Fibrosis was assessed before commencement of the combined treatment (Pegylated Interferon and Ribavirin) by means of liver biopsy, FibroScan and FibroTest and at 48 weeks through FibroScan and FibroTest, verifying the statistic correlation of the results acquired through the three methods. Results. Th e values obtained through FibroScan ranged between min 4.9 kPa and max 49.1kPa, respecting the validation criteria IQR<30%, SR>60%. Th e cut-off values were: 7.1kPa for F2, 9.5 kPa for F3 and 12.5 kPa for F4. FibroScan and FibroTest results have correlated in a 92% percentage. When the results of FibroScan and FibroTest coincided, biopsies were statistically correlated at AUROC 0.79 for F>= 2, 0.91 for F>=3 and 0.97 for F>=4. Th e frequency of grounds for discrepancy of the three evaluation methods was: LB 5%, Fibroscan 2%, Fibrotest 1%. Conclusions. FibroScan is a new, simple, noninvasive method which is available at the patient’s bedside for quick evaluation of liver fi brosis degree with accuracy similar to that of the FibroTest, especially for the assessment of signifi cant hepatic fi brosis (F2-F4). Th e combined use of FibroScan and FibroTest results for the evaluation of hepatic fi brosis degree can permit avoiding liver biopsy in a considerable number of patients with chronic viral hepatitis C.