title: 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.
abstract: 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.
authors.affiliation: Department of Internal Medicine, La Pitié-Salpêtrière Hospital, France.
authors.forename: Damien
authors.initials: D
authors.lastname: Sène
authors.forename: Nicholas
authors.initials: N
authors.lastname: Limal
authors.forename: Djamila
authors.initials: D
authors.lastname: Messous
authors.forename: Pascale
authors.initials: P
authors.lastname: Ghillani-Dalbin
authors.forename: Frédéric
authors.initials: F
authors.lastname: Charlotte
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Thiollière
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Piette
authors.forename: Françoise
authors.initials: F
authors.lastname: Imbert-Bismut
authors.forename: Philippe
authors.initials: P
authors.lastname: Halfon
authors.forename: Thierry
authors.initials: T
authors.lastname: Poynard
authors.forename: Patrice
authors.initials: P
authors.lastname: Cacoub
mesh_terms: 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*
chemical_list: D015415:Biomarkers