title: Non-invasive assessment of liver fibrosis in chronic viral hepatitis.
abstract: BACKGROUND
  Hyaluronic acid (HA), ASAT to Platelet Ratio Index (APRI), ASAT/ALAT ratio, Fibrosis 4 score (FIB4) and FibroScan were studied as non-invasive markers of liver fibrosis (F) in chronic viral hepatitis B (CHB) and C (CHC), in an attempt to avoid the complications of liver puncture biopsy, considered the gold standard in the evaluation of F. The aim of our research was to study whether HA, APRI, ASAT/ALAT ratio, FIB4 and FibroScan are useful non-invasive markers in predicting severe F in Romanian patients.
  
  
  METHODS
  This was a prospective multicenter transversal and observational study, which included 76 patients with CHB/CHC. The independent effect of studied markers was tested using multiple binary logistic regression.
  
  
  RESULTS
  In patients with CHB and CHC, the APRI cut-off value for F4 was 0·70 ng/mL (Se = 77%, Sp = 78%), the FIB4 cut-off value was 2·01 (Se = 77%, Sp = 69%), and the FibroScan cut-off value was 13·15 (Se = 92%, Sp = 88%). For patients with CHB/CHC, there was a significant linear positive correlation between F and HA (r = 0·42, P = 0·001), FibroScan (r = 0·67, P < 0·001), APRI (r = 0·46, P < 0·001) and FIB4 (r = 0·51, P < 0·001). Considering age, sex and body mass index as possible confounding factors or covariates in multivariable logistic modelling, FibroScan was the unique test that able to significantly highlight the presence of F4 score in CHB/CHC patients (P = 0·009) while FIB4 test seems to have a tendency to statistical significance.
  
  
  CONCLUSIONS
  FibroScan, APRI and FIB4 are useful non-invasive tests for the evaluation of F4 in patients with CHB and CHC.
authors.affiliation: 4th Medical Department, University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Olga H
authors.initials: OH
authors.lastname: Orasan
authors.affiliation: Medical Informatics and Biostatistics, University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Mihaela
authors.initials: M
authors.lastname: Iancu
authors.affiliation: 4th Medical Department, University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Madalina
authors.initials: M
authors.lastname: Sava
authors.affiliation: Heart Institute, University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Aniela
authors.initials: A
authors.lastname: Saplontai-Pop
authors.affiliation: 4th Medical Department, University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Angela
authors.initials: A
authors.lastname: Cozma
authors.affiliation: 4th Medical Department, University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Simina Tarmure
authors.initials: ST
authors.lastname: Sarlea
authors.affiliation: 4th Surgical Department, University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Corneliu
authors.initials: C
authors.lastname: Lungoci
authors.affiliation: Department of Public Health and Management, University of Medicine and Pharmacy, Cluj-Napoca, Romania.|Center for Health Policy and Public Health, College of Political, Administrative and Communication Sciences, Babeș-Bolyai University, Cluj-Napoca, Romania.
authors.forename: Marius-Ionut
authors.initials: MI
authors.lastname: Ungureanu
authors.affiliation: 4th Medical Department, University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Vasile
authors.initials: V
authors.lastname: Negrean
authors.affiliation: 4th Medical Department, University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Dorel
authors.initials: D
authors.lastname: Sampelean
authors.affiliation: 2nd Medical Department, University of Medicine and Pharmacy, Cluj-Napoca, Romania.
authors.forename: Dan Lucian
authors.initials: DL
authors.lastname: Dumitrascu
mesh_terms: D000410:Alanine Transaminase / Q000378:metabolism; D001219:Aspartate Aminotransferases / Q000378:metabolism; D015415:Biomarkers / Q000378:metabolism; D004548:Elasticity; D005260:Female; D019694:Hepatitis B, Chronic; D019698:Hepatitis C, Chronic; D006801:Humans; D006820:Hyaluronic Acid / Q000378:metabolism; D008103:Liver Cirrhosis / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011446:Prospective Studies; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D006820:Hyaluronic Acid; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase
keywords: APRI; FibroScan; chronic viral hepatitis B; chronic viral hepatitis C; hyaluronic acid; liver fibrosis