Biological markers of liver fibrosis and activity as non-invasive alternatives to liver biopsy in patients with chronic hepatitis C and associated mixed cryoglobulinemia vasculitis.
OBJECTIVE
We assessed the reliability of non-invasive biological scoring indexes (Fibrotest-Actitest [FT-AT], Forns, APRI, age-platelet, platelet, hyaluronic acid) as non-invasive alternatives to liver biopsy (LB) in 138 HCV-infected patients.


RESULTS
Thirty-six of 138 (26%) patients had systemic vasculitis, 27% significant serum inflammation, 47% fibrosis (F2F3F4) on LB. The diagnostic value of FT (F2F3F4 vs. F0F1) was assessed by an AUC of 0.83, without difference regarding to systemic vasculitis or serum inflammation. A discordance between FT-AT and the Metavir scoring indexes, present in 29% of patients, was associated with serum hemolysis and male but not with systemic vasculitis or serum inflammation. The other non-invasive biological tests were not influenced by serum inflammation or systemic vasculitis but were less reliable than FT (P <or= 0.05).


CONCLUSIONS
The FT-AT is a reliable non-invasive biochemical alternative to LB in HCV-infected patients with systemic vasculitis and is more reliable than other non-invasive biological indexes.
Sène
Damien
D
Department of Internal Medicine, La Pitié-Salpêtrière Hospital, France.
Limal
Nicholas
N
Messous
Djamila
D
Ghillani-Dalbin
Pascale
P
Charlotte
Frédéric
F
Thiollière
Jean-Marie
JM
Piette
Jean-Charles
JC
Imbert-Bismut
Françoise
F
Halfon
Philippe
P
Poynard
Thierry
T
Cacoub
Patrice
P
D000328:Adult; D015415:Biomarkers / Q000097:blood*; D001706:Biopsy; D003449:Cryoglobulinemia / Q000209:etiology*; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D008111:Liver Function Tests / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D014657:Vasculitis / Q000209:etiology*
D015415:Biomarkers