title: Fibrotest-Actitest: the biochemical marker of liver fibrosis--the Israeli experience.
abstract: 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.
authors: Department of Gastroenterology, Shaare Zedek Medical Center, Jerusalem, Israel. gmorali@netvision.net.il
authors: Gilles
authors: G
authors: Morali
authors: Yaacov
authors: Y
authors: Maor
authors: Rachel
authors: R
authors: Klar
authors: Marius
authors: M
authors: Braun
authors: Ziv
authors: Z
authors: Ben Ari
authors: Yoram
authors: Y
authors: Bujanover
authors: Eli
authors: E
authors: Zuckerman
authors: Sarah
authors: S
authors: Boger
authors: Philippe
authors: P
authors: Halfon
mesh_terms: 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
chemical_list: D001054:Apolipoproteins A; D006242:Haptoglobins; D000511:alpha-Macroglobulins; D005723:gamma-Glutamyltransferase; D000410:Alanine Transaminase; D001663:Bilirubin