Fibrosis Markers and their Relation to Liver Cirrhosis and Fibrosis in Patients with Chronic Hepatitis C
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- Category: Vol. 78, September 2010
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Fibrosis Markers and their Relation to Liver Cirrhosis and Fibrosis in Patients with Chronic Hepatitis C,MAGDA Sh. HASSAN, NADIA ABDEL SALAM, AHMED F.A. HASSANEN, AHLAM M. FARGHALY, HOWIDA I. HASSAN and HEBA G. RASHED
Abstract
Background: Hepatitis C virus infection is the leading cause of chronic liver disease worldwide; in Egypt, hepatitis C virus infection is considered the leading cause of liver cirrhosis, hepatocellular failure and hepatocellular carcinoma. Liver biopsy is currently the gold standard in assessing liver histology; yet, it is an invasing technique carrying many drawbacks and limitations as sampling errors and intra ob-servers discrepancies in assessing hepatic fibrosis. Therefore, simple non-invasive, low cost and safe variable are needed to diagnosis and follow-up cases with liver cirrhosis and fibrosis such as AST level, ALT level ratio (AAR), Aspartate amino transferase/platelet ratio index (APRI), Goteborg university cirrhosis index (GUCI), multivariate discriminant analysis (MDA) and FIB-4.
Aim: To evaluate the validity of simple non invasive markers for predicting hepatic fibrosis and its relation to L.C. in patients with chronic HCV infection.
Methods: This study included 92 patients with chronic HCV infection (selected among those attending specialized hepatitis viruses outpatient Clinic, Department of Tropical Medicine and Gastroenterology, Assiut University Hospital and outpatient clinic of Health Insurance. All patients were subjected to full medical history, complete clinical examination and abdominal ultrasonography in addition to fibrotic markers which include AST/ALT ratio (AAR), Aspartate aminatrans-frase/Platelet ration (APRI), GUCI, MDA and FIB-4.
Result: Regarding fibrosis: FIB-4 had the highest accuracy (69.7%), APRI had an excellent PPV (100%). Regarding L.C. diagnosis, FIB-4 had the highest accuracy (88%), the highest PPV (50%) and MDA had the highest NPV (95%). GUCI had the highest correlation to fibrosis stage.
Conclusion: Estimations of amino transfers levels, platelets counts, GUCI, MDI and FIB-4 are valuable markers of liver fibrosis and cirrhosis in patients with chronic HCV infection.