title: Performance of 11 biomarkers for liver fibrosis assessment in HIV/HBV co-infected patients.
abstract: OBJECTIVE
  The aim of this study was to compare the performance of 11 biochemical scores to estimate liver fibrosis in HIV/HBV co-infection.
  
  
  METHODS
  Performance was evaluated using the Receiver Operating Characteristics (ROC) curve method. The Kappa index was used to study overall agreement with liver biopsy results. Interpretative algorithms were established by optimizing sensitivity and specificity and the percentage of correctly classified patients.
  
  
  RESULTS
  One hundred and eight patients (F0-F1, n = 47; F2, n = 28; F3, n = 17; F4, n = 16) were considered for the evaluation of serum biomarker performance. The AUROCs of the Fibrotest, Hepascore, Fibrometer, and Zeng's scores ranged from 0.74 to 0.77 for significant fibrosis (> or = F2), from 0.79 to 0.84 for advanced fibrosis (> or = F3) and from 0.87 to 0.92 for cirrhosis (F4). Thresholds defined for each stage of fibrosis were close to those previously published for the Fibrotest and Hepascore. Strict concordance with biopsies correctly classified 50% of the patients.
  
  
  CONCLUSIONS
  Fibrotest, Fibrometer, Hepascore, and Zeng's score were the most accurate non-invasive biochemical scores for liver fibrosis assessment in HIV/HBV co-infection. Global performance of biomarkers was not significantly improved by a decision tree combining the results of two biochemical scores.
authors.affiliation: INSERM UMR-S707, Paris, France.
authors.forename: Julie
authors.initials: J
authors.lastname: Bottero
authors.forename: Karine
authors.initials: K
authors.lastname: Lacombe
authors.forename: Jérôme
authors.initials: J
authors.lastname: Guéchot
authors.forename: Lawrence
authors.initials: L
authors.lastname: Serfaty
authors.forename: Patrick
authors.initials: P
authors.lastname: Miailhes
authors.forename: Philippe
authors.initials: P
authors.lastname: Bonnard
authors.forename: Dominique
authors.initials: D
authors.lastname: Wendum
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Molina
authors.forename: Caroline
authors.initials: C
authors.lastname: Lascoux-Combe
authors.forename: Pierre-Marie
authors.initials: PM
authors.lastname: Girard
mesh_terms: D000328:Adult; D000465:Algorithms; D015415:Biomarkers / Q000097:blood*; D001706:Biopsy; D001774:Blood Chemical Analysis / Q000379:methods / Q000706:statistics & numerical data; D015331:Cohort Studies; D005260:Female; D015658:HIV Infections / Q000097:blood* / Q000150:complications*; D006509:Hepatitis B / Q000097:blood* / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers