title: Biochemical markers of fibrosis in patients with chronic hepatitis C: a comparison with prothrombin time, platelet count, and age-platelet index.
abstract: As an alternative to liver biopsy, an index of five biochemical markers (alpha2-macroglobulin, apolipoprotein A1, haptoglobin, total bilirubin, gamma-glutamyl-transpeptidase) has been shown to predict the severity of hepatitis C-related fibrosis. The objective of this study was to compare this index with other markers frequently used for this purpose (prothrombin time, platelets, age-platelet index). In 323 hepatitis C-infected patients, the discriminative values of these markers for F2-F4 fibrosis (by the METAVIR classification) were compared. By multiple logistic regression analysis, only the five-marker index (P < 0.0001) and prothrombin time (P = 0.02) were independently predictive of F2-F4 fibrosis. For this outcome, the area under the receiver operating characteristic curve was significantly higher for the five-marker index (0.836 +/- 0.024) than the age-platelet index (P = 0.002), and the platelet count and prothrombin time (P < 0.001), indicating greater diagnostic value. The addition of the latter markers to the five-marker index proved unhelpful for increasing its accuracy. In conclusion, an index of five biochemical markers accurately predicts significant hepatitis C-related fibrosis and is superior to traditional markers.
authors.affiliation: Department of Gastroenterology and Hepatology, Groupe Hospitalier Pitié-Salpêtriére, Paris, France.
authors.forename: Robert P
authors.initials: RP
authors.lastname: Myers
authors.forename: Mercedes
authors.initials: M
authors.lastname: De Torres
authors.forename: Françoise
authors.initials: F
authors.lastname: Imbert-Bismut
authors.forename: Vlad
authors.initials: V
authors.lastname: Ratziu
authors.forename: Frédéric
authors.initials: F
authors.lastname: Charlotte
authors.forename: Thierry
authors.initials: T
authors.lastname: Poynard
mesh_terms: D000328:Adult; D015415:Biomarkers; D005260:Female; D019698:Hepatitis C, Chronic / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000473:pathology; D016015:Logistic Models; D008297:Male; D010976:Platelet Count; D011517:Prothrombin Time; D012372:ROC Curve
chemical_list: D015415:Biomarkers