Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Lackner, C; Struber, G; Liegl, B; Leibl, S; Ofner, P; Bankuti, C; Bauer, B; Stauber, RE.
Comparison and validation of simple noninvasive tests for prediction of fibrosis in chronic hepatitis C.
Hepatology. 2005; 41(6):1376-1382
Doi: 10.1002/hep.20717
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- Führende Autor*innen der Med Uni Graz
- Lackner Karoline
- Stauber Rudolf
- Co-Autor*innen der Med Uni Graz
- Leibl Sebastian
- Liegl-Atzwanger Bernadette
- Ofner-Kopeinig Petra
- Putz-Bankuti Csilla
- Struber Gerd
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- Abstract:
- Liver biopsy is recommended before antiviral treatment, particularly for patients with hepatitis C virus (HCV) genotype 1 infection, but it may cause complications and is limited by sampling error. Several non-invasive tests comprising routine laboratory parameters (simple fibrosis tests) have been proposed to predict fibrosis in chronic HCV. The aim of the current study was to validate and compare the diagnostic accuracies of the simple fibrosis tests, aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio (AAR), cirrhosis discriminant score (CDS), age-platelet (AP) index, Pohl score, AST-to-platelet ratio index (APRI), and platelet count per se. Staging was performed in liver biopsy specimens of 194 treatment-naive patients with chronic HCV according to Ishak et al. by two independent pathologists. Receiver operating characteristic curve analysis showed comparable diagnostic accuracies of CDS, AP index, APRI, and platelet count for prediction of significant fibrosis (F3-F6) (area under the ROC curve [AUROC], 0.71, 0.74, 0.80, and 0.71, respectively; pathologist A) and for prediction of cirrhosis (F5-F6) (AUROC, 0.91, 0.91, 0.90, and 0.89, respectively; pathologist A). Diagnostic accuracy of APRI for prediction of significant fibrosis was superior to that of AAR (P < .05). Significant fibrosis was reliably predicted by APRI > or = 1.5 and platelet count <150 x10(9)/L in 24% and 22% of the patients, respectively, whereas cirrhosis was reliably excluded by APRI <2.0 and platelet count > or = 150 x10(9)/L in 85% and 78% of the patients, respectively. In conclusion, simple fibrosis tests may render liver biopsy unnecessary only in a minority of patients with chronic HCV. Improved serum fibrosis markers with greater sensitivity for severe fibrosis or cirrhosis are needed.
- Find related publications in this database (using NLM MeSH Indexing)
- Adult -
- Alanine Transaminase - blood
- Aspartate Aminotransferases - blood
- Cohort Studies -
- Female -
- Hepatitis C, Chronic - complications Hepatitis C, Chronic - diagnosis
- Humans -
- Liver Cirrhosis - pathology Liver Cirrhosis - virology
- Liver Function Tests - standards
- Male -
- Middle Aged -
- Platelet Count -
- Predictive Value of Tests -
- ROC Curve -
- Sensitivity and Specificity -