title: 13C-aminopyrine breath test accurately predicts long-term outcome of chronic hepatitis C.
abstract: OBJECTIVE
  Although numerous non-invasive tests are currently available to explore liver function and disease activity in patients with HCV-related chronic diseases, none of these indicate the likelihood of disease progression in the individual patient. We aimed at assessing the prognostic ability of (13)C(2)-aminopyrine breath test ((13)C-ABT) in the prediction of liver fibrosis progression in patients with HCV chronic hepatitis who prospectively entered a long-term follow-up.
  
  
  METHODS
  Fifty patients with HCV-related chronic disease who underwent paired liver biopsy (at baseline and after a mean period of 86 months) were included in the study. (13)C-ABT was carried out at baseline and every 3 years. Histological progression was defined as increase of at least 2 fibrosis units according to Ishak score.
  
  
  RESULTS
  Fourteen patients progressed of at least 2 fibrosis units during the follow-up. These patients were more frequently infected with a HCV-1b genotype and had, at baseline, a significantly older age, higher BMI, AST levels, and AST to platelet ratio index (APRI). (13)C-ABT was altered in 57% of cases at baseline and in 100% of the cases at 3-year follow-up. In the univariate analysis, age (p=0.005), BMI (p=0.006), platelet count (p=0.03), AST (p=0.012) and ALT (p=0.04) levels, APRI (p=0.03), and baseline (13)C-ABT results (p<0.0001) were all independently associated with progression of liver fibrosis. By Cox's multiple regression analysis, the (13)C-ABT was the only covariate that significantly predicted liver fibrosis progression (HR 6.7; 95% CI 2.3-20.1; p<0.001).
  
  
  CONCLUSIONS
  (13)C-ABT accurately predicts the risk of disease progression in patients with HCV-related chronic hepatitis.
authors.affiliation: Department of Clinical and Experimental Medicine, Gastroenterology Unit, University of Naples Federico II, Naples, Italy.
authors.forename: Alba
authors.initials: A
authors.lastname: Rocco
authors.forename: Germana
authors.initials: G
authors.lastname: de Nucci
authors.forename: Giovanna
authors.initials: G
authors.lastname: Valente
authors.forename: Debora
authors.initials: D
authors.lastname: Compare
authors.forename: Agesilao
authors.initials: A
authors.lastname: D'Arienzo
authors.forename: Lucia
authors.initials: L
authors.lastname: Cimino
authors.forename: Francesco
authors.initials: F
authors.lastname: Perri
authors.forename: Gerardo
authors.initials: G
authors.lastname: Nardone
mesh_terms: D000328:Adult; D000632:Aminopyrine / Q000378:metabolism*; D000998:Antiviral Agents / Q000627:therapeutic use*; D001944:Breath Tests / Q000379:methods*; D002247:Carbon Isotopes / Q000378:metabolism; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000188:drug therapy* / Q000378:metabolism*; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000453:epidemiology / Q000378:metabolism; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D002247:Carbon Isotopes; D000632:Aminopyrine