[Non-invasive fibrosis assessment in chronic hepatitis C: aspartate-aminotransferase to platelet ratio index (APRI) and transient elastography (FibroScan)].
Although liver biopsy is the gold standard for the diagnosis of liver disease, non-invasive tests may also play a role in the evaluation of liver fibrosis. Authors studied two fibrosis markers, aspartate-aminotransferase / platelet ratio index (APRI) and liver stiffness (LS) measurement to assess fibrosis in different forms of chronic hepatitis C virus (HCV) infection.


METHODS
out of 119 HCV-infected patients 75 had biopsy-proven chronic hepatitis C, 24 had HCV-cirrhosis, 20 individuals were symptom-free HCV-carriers with persistently normal alanine-aminotransferase and 30 healthy blood donors served as controls. Wai's APRI score was calculated from aspartate-aminotransferase and platelet number. For LS measurement transient elastography (FibroScan) was applied. METAVIR fibrosis score was determined by liver biopsy.


RESULTS
In patients with chronic hepatitis C infection both fibrosis markers were significantly elevated comparing to normal controls and the markers were the highest in HCV-associated cirrhosis. Values of symptom-free HCV-carriers corresponded to those obtained from healthy controls. Both APRI and LS results correlated with the METAVIR score. LS identified fibrosis better than APRI. Using a novel sequential algorithm that comprises APRI and LS for assessment of fibrosis, 47.8% of HCV patients did not need biopsy for diagnosing significant (F≥2) fibrosis.


CONCLUSIONS
both fibrosis markers, particularly in combination, may represent a useful option in the noninvasive assessment of fibrosis in HCV infection.
Pécsi Tudományegyetem, Általános Orvostudományi Kar I. Belgyógyászati Klinika Pécs Ifjúság u. 13. 7624. alajos.par@aok.pote.hu
Alajos
A
Pár
Gabriella
G
Pár
D000328:Adult; D000368:Aged; D001219:Aspartate Aminotransferases / Q000097:blood*; D005260:Female; D019698:Hepatitis C, Chronic / Q000097:blood* / Q000201:enzymology* / Q000473:pathology; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis* / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D010976:Platelet Count
D001219:Aspartate Aminotransferases