title: Routinely evaluated clinical assays and laboratory tests [real test] and fibrosis stages of chronic hepatitis B and C.
abstract: OBJECTIVE
  To provide a new mathematical formula to predict liver fibrosis in patients with chronic viral hepatitis.
  
  
  METHODS
  Patients with chronic hepatitis B and C who underwent liver biopsy at different centers were included in this study. Chronic hepatitis B was defined as immunopositivity for the hepatitis B surface antigen for at least 6 months, and chronic hepatitis C was defined as positivity for HCV RNA for at least 3 months. The histological features were evaluated by the histological activity index and fibrosis.
  
  
  RESULTS
  In total, 1299 patients were included in the study. The distribution and the mean of the parameters of the patients were as follows: 1009 patients with chronic hepatitis B with a mean age of 45±13/years [emale/male (F/M)=47.5/52.5%] and 290 patients with hepatitis C with a mean age of 52±10.3/years [F/M=61/39%]. When the cut-off value of the REAL TEST formula"[(age x pT x AST)/(PLT/1000)]/100" in patients with hepatitis B was determined to be ≥1.37, it was found that it could predict fibrosis with 79% specificity, 78% sensitivity, 85% negative predictive value (NPV), and 70% positive predictive value (PPV) (area under the curve (AUC)=0.852, 95% CI:0.82-0.87). When the cut-off value of the REAL TEST formula in patients with hepatitis C was determined to be ≥1.99, it was found that it could predict significant fibrosis with 87% specificity, 90% sensitivity, 94.4% NPV, and 79.4% PPV (AUC:0.95, 95% CI:0.93-0.98).
  
  
  CONCLUSIONS
  The REAL TEST formula results correlated with the pathological findings and may be a useful method for the evaluation of patients with chronic hepatitis B and C.
authors.affiliation: Department of Gastroenterohepatology, Bezmialem Vakif University Faculty of Medicine, İstanbul, Turkey. msbugdaci@gmail.com.
authors.forename: Mehmet Sait
authors.initials: MS
authors.lastname: Buğdacı
authors.forename: Hüseyin
authors.initials: H
authors.lastname: Korkmaz
authors.forename: Ali
authors.initials: A
authors.lastname: Demir
authors.forename: Murat
authors.initials: M
authors.lastname: Bıyık
authors.forename: Tuncer
authors.initials: T
authors.lastname: Temel
authors.forename: Hüseyin Savaş
authors.initials: HS
authors.lastname: Göktürk
authors.forename: Ayşegül
authors.initials: A
authors.lastname: Ozakyol
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Hatemi
authors.forename: Birol
authors.initials: B
authors.lastname: Baysal
authors.forename: Cetin
authors.initials: C
authors.lastname: Karaca
authors.forename: Hakan
authors.initials: H
authors.lastname: Sentürk
mesh_terms: D000328:Adult; D000367:Age Factors; D000410:Alanine Transaminase / Q000097:blood; D019540:Area Under Curve; D001219:Aspartate Aminotransferases / Q000097:blood; D003955:Diagnostic Tests, Routine; D018450:Disease Progression; D005260:Female; D006454:Hemoglobins / Q000378:metabolism; D019694:Hepatitis B, Chronic / Q000097:blood* / Q000150:complications / Q000473:pathology; D019698:Hepatitis C, Chronic / Q000097:blood* / Q000150:complications / Q000473:pathology; D006801:Humans; D019934:International Normalized Ratio; D008103:Liver Cirrhosis / Q000473:pathology* / Q000821:virology; D008297:Male; D055641:Mathematical Concepts; D008875:Middle Aged; D010976:Platelet Count; D011237:Predictive Value of Tests; D011517:Prothrombin Time; D012372:ROC Curve
chemical_list: D006454:Hemoglobins; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase