title: A comparison of four fibrosis indexes in chronic HCV: development of new fibrosis-cirrhosis index (FCI).
abstract: BACKGROUND
  Hepatitis C can lead to liver fibrosis and cirrhosis. We compared readily available non-invasive fibrosis indexes for the fibrosis progression discrimination to find a better combination of existing non-invasive markers.
  
  
  METHODS
  We studied 157 HCV infected patients who underwent liver biopsy. In order to differentiate HCV fibrosis progression, readily available AAR, APRI, FI and FIB-4 serum indexes were tested in the patients. We derived a new fibrosis-cirrhosis index (FCI) comprised of ALP, bilirubin, serum albumin and platelet count. FCI = [(ALP × Bilirubin) / (Albumin × Platelet count)].
  
  
  RESULTS
  Already established serum indexes AAR, APRI, FI and FIB-4 were able to stage liver fibrosis with correlation coefficient indexes 0.130, 0.444, 0.578 and 0.494, respectively. Our new fibrosis cirrhosis index FCI significantly correlated with the histological fibrosis stages F0-F1, F2-F3 and F4 (r = 0.818, p < 0.05) with AUROCs 0.932 and 0.996, respectively. The sensitivity and PPV of FCI at a cutoff value < 0.130 for predicting fibrosis stage F0-F1 was 81% and 82%, respectively with AUROC 0.932. Corresponding value of FCI at a cutoff value ≥1.25 for the prediction of cirrhosis was 86% and 100%.
  
  
  CONCLUSIONS
  The fibrosis-cirrhosis index (FCI) accurately predicted fibrosis stages in HCV infected patients and seems more efficient than frequently used serum indexes.
authors.affiliation: Applied and Functional Genomics Lab, Centre of Excellence in Molecular Biology, University of the Punjab, Lahore-53700, Pakistan.
authors.forename: Waqar
authors.initials: W
authors.lastname: Ahmad
authors.forename: Bushra
authors.initials: B
authors.lastname: Ijaz
authors.forename: Fouzia T
authors.initials: FT
authors.lastname: Javed
authors.forename: Sana
authors.initials: S
authors.lastname: Gull
authors.forename: Humaira
authors.initials: H
authors.lastname: Kausar
authors.forename: Muhammad T
authors.initials: MT
authors.lastname: Sarwar
authors.forename: Sultan
authors.initials: S
authors.lastname: Asad
authors.forename: Imran
authors.initials: I
authors.lastname: Shahid
authors.forename: Aleena
authors.initials: A
authors.lastname: Sumrin
authors.forename: Saba
authors.initials: S
authors.lastname: Khaliq
authors.forename: Shah
authors.initials: S
authors.lastname: Jahan
authors.forename: Asim
authors.initials: A
authors.lastname: Pervaiz
authors.forename: Sajida
authors.initials: S
authors.lastname: Hassan
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D019540:Area Under Curve; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D001706:Biopsy; D016009:Chi-Square Distribution; D005260:Female; D019698:Hepatitis C, Chronic / Q000097:blood* / Q000473:pathology*; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011237:Predictive Value of Tests; D012372:ROC Curve; D012709:Serum Albumin / Q000378:metabolism; D012720:Severity of Illness Index; D019562:Viral Load; D055815:Young Adult
chemical_list: D012709:Serum Albumin; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase; D001663:Bilirubin