title: Noninvasive assessment of hepatic fibrosis and necroinflammatory activity in Egyptian children with chronic hepatitis C virus infection using FibroTest and ActiTest.
abstract: BACKGROUND
  Hepatitis C virus (HCV) is a major cause of chronic hepatitis and hepatic fibrosis. Liver biopsy, because of its limitations and risks, might be considered an imperfect gold standard for assessing the severity of chronic liver diseases. In this study, we aimed to prospectively validate FibroTest (FT) and ActiTest (AT) as noninvasive serum biochemical markers for assessment of the degree of hepatic fibrosis and necroinflammatory activity respectively, in pediatric patients with chronic HCV infection and compare them to liver biopsy.
  
  
  METHODS
  Fifty patients, aged 2 to 18 years, with chronic HCV infection were prospectively enrolled. Two assessments were carried out, within 24-h duration, one of a liver biopsy specimen and the other FT and AT measured in serum sample.
  
  
  RESULTS
  A highly significant linear trend and correlation were found between FT-related fibrosis and fibrosis stage by METAVIR scoring on histopathological examination. A highly significant correlation was also found between AT and necroinflammatory histological activity using METAVIR as well. The FT area under the receiver operating characteristic curve (AUROC) is 0.97, SE=0.02 which can diagnose patients with mild stage of fibrosis, thus discriminating them from those with no (or minimal) fibrosis. The AT can successfully discriminate between patients with moderate activity and those with mild activity with AUROC=0.93, SE=0.06.
  
  
  CONCLUSIONS
  FT and AT are potential noninvasive methods for assessment of hepatic fibrosis and necroinflammatory activity in pediatric patients with chronic HCV infection in comparison with liver biopsy.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Cairo University, Egypt. melshabrawi@medicine.cu.edu.eg
authors.forename: Mortada Hassan
authors.initials: MH
authors.lastname: El-Shabrawi
authors.forename: Nabil A
authors.initials: NA
authors.lastname: Mohsen
authors.forename: Mai M
authors.initials: MM
authors.lastname: Sherif
authors.forename: Hanaa M
authors.initials: HM
authors.lastname: El-Karaksy
authors.forename: Hazem
authors.initials: H
authors.lastname: Abou-Yosef
authors.forename: Hussein M
authors.initials: HM
authors.lastname: El-Sayed
authors.forename: Hany
authors.initials: H
authors.lastname: Riad
authors.forename: Nevine
authors.initials: N
authors.lastname: Bahaa
authors.forename: Mona
authors.initials: M
authors.lastname: Isa
authors.forename: Ahmed
authors.initials: A
authors.lastname: El-Hennawy
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood; D001774:Blood Chemical Analysis / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D004534:Egypt; D005260:Female; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000473:pathology* / Q000821:virology; D008297:Male; D011446:Prospective Studies
chemical_list: D015415:Biomarkers