Simple blood tests can predict compensated liver cirrhosis in patients with chronic hepatitis C.
OBJECTIVE
Twenty to fifty percent of patients with chronic hepatitis C virus infection will insidiously progress to cirrhosis after 10-20 years' follow-up. The aim of this study is to retrospectively evaluate the role of simple non-invasive blood tests in detecting the presence of compensated liver cirrhosis in Chinese patients with chronic hepatitis C.


METHODS
One hundred and eleven biopsy-proven chronic hepatitis C patients were enrolled, 23 (20.7%) patients showed cirrhosis with class A in Child-Pugh's classification and were all asymptomatic. Liver biochemistry, complete blood count, and serum N-terminal propeptide of type III procollagen were determined and then compared between chronic hepatitis C patients with compensated cirrhosis and without cirrhosis. Multivariate logistic regression analysis was used to predict factors associated with compensated cirrhosis.


RESULTS
Multivariate logistic regression analysis showed platelet count < or = 140,000/mm3 (odds ratio: 23.44, P < 0.001), globulin/albumin ratio > or = 1 (odds ratio: 31.47, P = 0.008), and AST/ALT ratio > or = (odds ratio: 6.58, P = 0.035) were significant predictors associated with hepatitis C virus-related compensated cirrhosis. Platelet count < or = 140,000/mm3 had 83% sensitivity and 85% specificity in detecting liver cirrhosis. Globulin/albumin ratio > or = 1 had 43% sensitivity, 98% specificity and AST/ALT ratio > or = 1 had 39% sensitivity, 92% specificity in detecting liver cirrhosis. Combined tests with AST/ALT > or = 1 and globulin/albumin > or = 1, platelet count < or = 140,000/mm3 and globulin/albumin > or = 1 had 100% specificity, 100% positive predictive value but lower sensitivity (22% and 39% respectively), lower negative predictive value (83% and 86%, respectively) in detecting hepatitis C virus-related compensated liver cirrhosis.


CONCLUSIONS
Simple blood tests with platelet count < or = 140,000/mm3, globulin/albumin ratio > or = 1, and AST/ALT ratio > or = 1 can indicate liver cirrhosis in follow-up patients with chronic hepatitis C.
Luo
Jiing-Chyuan
JC
Division of Gastroenterology, Department of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.
Hwang
Shinn-Jang
SJ
Chang
Full-Young
FY
Chu
Chen-Wei
CW
Lai
Chiung-Ru
CR
Wang
Yuan-Jen
YJ
Lee
Pui-Ching
PC
Tsay
Shyh-Haw
SH
Lee
Shou-Dong
SD
D000328:Adult; D000368:Aged; D018450:Disease Progression; D005260:Female; D019698:Hepatitis C, Chronic / Q000097:blood* / Q000150:complications; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000209:etiology / Q000821:virology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010446:Peptide Fragments / Q000097:blood; D011237:Predictive Value of Tests; D011347:Procollagen / Q000097:blood; D012189:Retrospective Studies
D010446:Peptide Fragments; D011347:Procollagen; C041876:procollagen Type III-N-terminal peptide