Non-Invasive Prediction of Hepatic Fibrosis in Patients With Chronic HCV Based on the Routine Pre-Treatment Workup
نویسندگان
چکیده
BACKGROUND Hepatic fibrosis is an inclusion indicator for treatment and a major independent predictor of treatment response in patients with chronic hepatitis C. Liver biopsy, considered as the "gold standard" for evaluating liver fibrosis, has carried some drawbacks. Currently used noninvasive predictors of fibrosis are considered less accurate than liver biopsy. OBJECTIVES Our aim was to assess noninvasive predictors of fibrosis in patients with chronic hepatitis C using the routine laboratory pre-treatment workup. PATIENTS AND METHODS Cross sectional study including 4289 Egyptian patients with chronic hepatitis C were assessed for the need to interferon and ribavirin therapy. Routine pre-treatment workup and reference needle liver biopsy were performed. FIB-4 index, APRI and modified APRI scores were validated. Patients were divided into two groups, first with no or minimal fibrosis, and second with moderate and marked fibrosis using the Metavir score. RESULTS Multivariate logistic regression analysis showed that age, body mass index, aspartate aminotransferase, alpha fetoprotein, platelets count, FIB-4 index, APRI and modified APRI score were significant independent predictors of fibrosis. Age > 43 years, aspartate aminotransferase > 47U/L, platelets < 205×103/mm(3), and alpha fetoprotein > 2.6 ng/ml had the highest cutoff points in receiver operator characteristic curves. Taking into account the four variables together; the presence of ≥ 2 variables is associated with moderate and advanced fibrosis with a sensitivity of 0.81, specificity of 0.5, positive predictive value of 0.53 and negative predictive value of 0.79. FIB-4 index represented the best performing receiver operator characteristic curve for diagnosing moderate and marked fibrosis among other independent factors with a sensitivity of 0.74, specificity of 0.6, positive predictive value of 0.56 and negative predictive value of 0.76. CONCLUSIONS Chronic HCV pre-treatment routine work up and composite fibrosis scores are good noninvasive predictor of liver fibrosis and can be used as an alternative method to invasive liver biopsy without adding more financial expenses to the treatment.
منابع مشابه
Prevalence of hepatic steatosis and associated factors in Iranian patients with chronic hepatitis C
Background: Hepatic steatosis is commonly observed in patients with chronic hepatitis C (CHC). Many studies indicate a relationship between steatosis and fibrosis progression. The aim of this study was to analyze the prevalence of hepatic steatosis and related factors in Iranian CHC patients. Methods: One hundred and fifteen consecutive patients with CHC were enrolled which were treat...
متن کاملBackground: Hepatic steatosis is commonly observed in patients with chronic hepatitis C (CHC). Many studies indicate a relationship between steatosis and fibrosis progression. The aim of this study was to analyze the prevalence of hepatic steatosis and related factors in Iranian CHC patients. Methods: One hundred and fifteen consecutive patients with CHC were enrolled which were treat...
متن کاملThe protective role of deferoxamine in the prevention of doxorubicin-induced hepatic fibrosis in children: A randomized controlled clinical trial
Background: This study aimed to investigate the protective effects of Deferoxamine (DFO) against hepatic fibrosis in treatment of pediatric cancer patients. Methods: In this prospective randomized controlled trial, 61 treatment-naïve children (2-18 years) with different types of cancer who referred to a tertiary teaching hospital in South of Iran were enrolled. They were randomly assigned to 3...
متن کاملSerum and Urine Level of IP-10 in Patients with HCV infection Based on Clinical and Virological Markers
Abstract Background and Aims: IP-10 molecule is a new biomarker to predict response to treatment in chronic HCV infection. Also urine IP-10 has been suggested as a biomarker in other infections. But already, it has low data in urine as well as serum level of IP-10 for HCV infection. The aim of this study was to assess urine and serum level of IP-10 in patients with type 1 and 3a HCV infect...
متن کاملDetermination of HCV Genotypes among Chronic Hepatic Patients in Ahvaz
Background and Aims: Chronic hepatitis C is one of the most important etiologies of cirrhosis and hepatocellular carcinoma worldwide. Clinical condition of hepatic patients and the outcome of chemotherapy are under impact of Hepatitis C virus (HCV) genotypes. Therefore, HCV genotyping is important for prediction of success of chemotherapy and progression of liver diseases. Methods: In thi...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
دوره 12 شماره
صفحات -
تاریخ انتشار 2012