title: Fibrosis progression under maintenance interferon in hepatitis C is better detected by blood test than liver morphometry.
abstract: We evaluated whether quantitative measurements of liver fibrosis with recently developed diagnostics outperform histological staging in detecting natural or interferon-induced changes. We compared Metavir staging, morphometry (area and fractal dimension) and six blood tests in 157 patients with chronic hepatitis C from two trials testing maintenance interferon for 96 weeks. Paired liver biopsies and blood tests were available for 101 patients, and there was a significant improvement in Metavir activity and a significant increase in blood tests reflecting fibrosis quantity in patients treated with interferon when compared with controls - all per cent changes in histological fibrosis measures were significantly increased in F1 vs F2-4 stages only in the interferon group. For the whole population studied between weeks 0 and 96, there was significant progression only in the area of fibrosis (AOF) (P = 0.026), FibroMeter (P = 0.020) and CirrhoMeter (P = 0.003). With regards to dynamic reproducibility, agreement was good (r(ic) ≥ 0.72) only for Metavir fibrosis score, FibroMeter and CirrhoMeter. The per cent change in AOF was significantly higher than that of fractal dimension (P = 0.003) or Metavir fibrosis score (P = 0.015). CirrhoMeter was the only blood test with a change significantly higher than that of AOF (P = 0.039). AOF and two blood tests, reflecting fibrosis quantity, have high sensitivity and/or reproducibility permitting the detection of a small progression in liver fibrosis over two years. A blood test reflecting fibrosis quantity is more sensitive and reproducible than morphometry. The study also shows that maintenance interferon does not improve fibrosis, whatever its stage.
authors.affiliation: Liver-Gastroenterology Department, University Hospital, Angers, France. paul.cales@univ-angers.fr
authors.forename: P
authors.initials: P
authors.lastname: Calès
authors.forename: J P
authors.initials: JP
authors.lastname: Zarski
authors.forename: J Marc
authors.initials: JM
authors.lastname: Chapplain
authors.forename: S
authors.initials: S
authors.lastname: Bertrais
authors.forename: N
authors.initials: N
authors.lastname: Sturm
authors.forename: C
authors.initials: C
authors.lastname: Michelet
authors.forename: G
authors.initials: G
authors.lastname: Babany
authors.forename: J
authors.initials: J
authors.lastname: Chaigneau
authors.forename: M
authors.initials: M
authors.lastname: Eddine Charaf
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000008:administration & dosage; D001706:Biopsy; D002986:Clinical Trials as Topic; D005260:Female; D005355:Fibrosis / Q000175:diagnosis* / Q000473:pathology; D006403:Hematologic Tests / Q000379:methods*; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000188:drug therapy*; D006801:Humans; D007372:Interferons / Q000008:administration & dosage*; D008099:Liver / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D010338:Pathology, Clinical / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D000998:Antiviral Agents; D007372:Interferons