Document Type : Original article
Authors
1
Internal Medicine dept., Mansoura Univ.; Egyptian Liver Research Institute and Hospital (ELRIH), Sherbin, El-Mansoura, Egypt
2
Internal Medicine dept., Mansoura Univ., Egypt
3
Public health and community medicine dept., Faculty of Medicine, Beni- Suef Univ., Egypt.
4
Tropical Medicine dept., Faculty of Medicine, Beni-Suef Univ., Egypt,
Abstract
Background and aims. Liver biopsy is the gold standard for
diagnosis and staging of liver fibrosis, but it is invasive and has
many complications that diminished its practice. Now, robust of
non-invasive index for predicting fibrosis is very valuable. The aim
of this study is to validate and determine the efficacy of noninvasive
markers aspartate aminotransferase to platelet ratio
(APRI), FIB4 and AFP versus Fibroscan for predicting the fibrosis
stages of patients with chronic HCV infection. Methods: This crosssectional
study included 621 patients with chronic hepatitis C
infection attended out-patient clinic (Medical center Beni-Suef
branch, the association of liver patient care, ELP, El-Mansoura)
for HCV viral hepatitis treatment. The patients were diagnosed
by RT-PCR. Sensitivity and specificity of APRI, FIb-4 and AFP
were estimated by receiver operator characteristic curve (ROC)
for predicting stage of fibrosis versus Fibroscan. Results: Compared
to Fibroscan as standard at value 12 kPa, the sensitivity and
specificity of APRI was (67% and 61% and AUC= 0.747), of
FIb-4 was (77% and 72% and AUC = 0.769) and of AFP was (77%
and 60% and AUC = 0.734) for predicting early stages of fibrosis
(F0-F1-F2). However, with advanced liver fibrosis (F3-F4) compared
to Fibroscan at value 15 kPa, the sensitivity and specificity of
APRI was (100% and 95.3% and AUC= 0.960) and of FIb-4
was (100% and 87.4% and AUC= 0.879) and of AFP were
(100% and 51% and AUC= 0.684) for predicting F4 fibrosis.
Conclusion: Given the higher cost and reduced availability of
Fibroscan, this study showed that, the non-invasive tests APRI,
FIB-4 index and AFP are practically useful markers for diagnosis
and monitoring of liver fibrosis among patients with chronic
HCV patients especially with advanced liver fibrosis.
Keywords
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