Fibrotest-Actitest: the biochemical marker of liver fibrosis--the Israeli experience.
BACKGROUND
The Fibrotest-Actitest is a six-parameter scoring system that allows quantification of liver fibrosis and inflammation. This test has been validated by several studies in hepatitis B and C viruses and alcoholic liver disease, with a high correlation between the liver biopsy and the results of the FT-AT (AUROC between 0.78 and 0.95). The FT-AT was introduced in Israel (Rambam Laboratory) in March 2005.


OBJECTIVE
To assess the results of HCV patients who underwent the test during the period March 2005 to February 2006.


METHODS
Serum was taken and brought to the central laboratory performing the tests within 4 hours. Six parameters were evaluated using commercial kits approved by the designer of the test (Biopredictive): total bilirubin, gamma-glutamyltransferase, alpha-2 macroglobulin, haptoglobin, alanine aminotransferase, and apolipoprotein-A1. The results were sent to the website of Biopredictive (France), which provided the FT-AT score online using a patented formula.


RESULTS
Of the 325 patients tested, only 4 were not interpretable because of hemolysis. Patients' age ranged from 7 to 72 years (median 42); 54% were female. Liver biopsy was performed in 81 patients and was compared with the results of the Fibrotest. Findings were as follows: 27% of the patients were F0, 19% F1, 20% F2, 17% F3 and 17% F4; 18% were A0, 32% A1, 28% A2 and 22% A3. The AUROC curve comparing the Fibrotest with liver biopsy with a cutoff point at F2 and A2 for significant fibrosis and inflammation was 0.85 and 0.79 respectively.


CONCLUSIONS
Fibrotest is a simple and effective method to assess liver fibrosis and inflammation and can be considered an alternative to liver biopsy in most patients with HCV.
Morali
Gilles
G
Department of Gastroenterology, Shaare Zedek Medical Center, Jerusalem, Israel. gmorali@netvision.net.il
Maor
Yaacov
Y
Klar
Rachel
R
Braun
Marius
M
Ben Ari
Ziv
Z
Bujanover
Yoram
Y
Zuckerman
Eli
E
Boger
Sarah
S
Halfon
Philippe
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D001054:Apolipoproteins A / Q000097:blood; D001663:Bilirubin / Q000097:blood; D002648:Child; D005260:Female; D006242:Haptoglobins / Q000032:analysis; D019698:Hepatitis C, Chronic / Q000150:complications; D006801:Humans; D007557:Israel; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity; D000511:alpha-Macroglobulins / Q000032:analysis; D005723:gamma-Glutamyltransferase / Q000097:blood
D001054:Apolipoproteins A; D006242:Haptoglobins; D000511:alpha-Macroglobulins; D005723:gamma-Glutamyltransferase; D000410:Alanine Transaminase; D001663:Bilirubin