[Assessment of the usefulness of combination of selected clinical and demographic parameters in prediction of the severity of liver fibrosis in patients with chronic hepatitis C].
OBJECTIVE
To create a simple diagnostic index I for noninvasive distinguish between mild and significant liver fibrosis (stages 0-2 versus 3-6 according to Ishak's criteria) among patients with chronic hepatitis C (CHC).


METHODS
Consecutive interferon-naive 572 CHC patients (F/M: 246/326; median age: 43 years). The I index was created on the data from training group (341 patients diagnosed in 1995-2000 years) and its discriminative value was then assessed separately in training group, validation group (231 patients diagnosed in 2001-2003 years) and entire group using among other things the AUROC measure.


RESULTS
The I index is based on information about patient's age, alcohol abuse, AST activity and platelet counts. The AUROC measures were 0.875 [95% CI (0.833-0.916)], 0.926 [95% CI (0.889-0.962)] and 0.890 [95% CI(0.860-0.921)] for training, validation and entire group, respectively. The I values corresponding to at least 95% of sensitivity (observed in about 40% of all patients) could excluded the stage 0-2 with accuracy close to 100%. Based on I values corresponding to at least 95% of specificity (observed in about 17% of all patients) the presence of stage 3-6 could be confirmed with accuracy of about 70%. The I index possesses the statistically significant ability to distinguish between mild and significant fibrosis and seems to be useful in monitoring of non-treated patient with mild fibrosis.
Kryczka
Wiesław
W
Oddzial Obserwacyjno-Zakaźny, Wojewódzki Szpital Zespolony w Kielcach.
Chrapek
Magdalena
M
Zarebska-Michaluk
Dorota
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D016001:Confidence Intervals; D005260:Female; D015438:Health Behavior; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000503:physiopathology*; D006801:Humans; D008103:Liver Cirrhosis / Q000473:pathology* / Q000821:virology*; D008111:Liver Function Tests / Q000592:standards; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010976:Platelet Count; D011044:Poland; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D012923:Social Class
D015415:Biomarkers