title: Validation of APRI and FIB-4 score in an Antwerp cohort of chronic hepatitis C patients.
abstract: OBJECTIVE
  Evaluation of liver fibrosis in chronic hepatitis C patients guides clinical decision-making. The aim of this study is to validate APRI and FIB-4, two easily calculated noninvasive tests to predict fibrosis, in chronic HCV patients using biopsy as a gold standard and to compare accuracy between HCV monoinfected and HIV/HCV coinfected patients.
  
  
  METHODS
  We retrospectively studied HCV patients of two centres who underwent liver biopsy. Liver fibrosis was staged according to METAVIR.
  
  
  RESULTS
  136 patients were included. The AUROC of FIB-4 (0.896) to discriminate F0-F2 vs. F3-F4 was significantly higher (p=0.0186) than the AUROC of APRI (0.842). The difference in AUROC between HIV-negative and positive patients was not significant for APRI (p=0.471), nor for FIB-4 (p=0.495). Performance status was lower in HIV-positive patients with 46.7% and 69.0% of patients correctly classified using APRI and FIB-4, compared to 56.6% and 73.6% in HIV-negative patients, respectively. Conversion of transaminase values from one hospital to the other did not significantly change the AUROC of FIB-4 (p=0.928).
  
  
  CONCLUSIONS
  APRI and FIB-4 have a better performance status in HCV monoinfected patients compared to HIV/HCV coinfected patients. FIB-4 has a better AUROC compared to APRI and is the preferred noninvasive fibrosis score to discriminate between F0-F2 and F3-F4. Different hospitals should use their local absolute serum transaminase values without conversion.
authors.forename: Wim
authors.initials: W
authors.lastname: Verlinden
authors.forename: Stefan
authors.initials: S
authors.lastname: Bourgeois
authors.forename: Marc
authors.initials: M
authors.lastname: De Maeyer
authors.forename: Luisa
authors.initials: L
authors.lastname: Vonghia
authors.forename: Thomas
authors.initials: T
authors.lastname: Vanwolleghem
authors.forename: Peter
authors.initials: P
authors.lastname: Michielsen
authors.forename: Sven
authors.initials: S
authors.lastname: Francque
mesh_terms: D000328:Adult; D000367:Age Factors; D000410:Alanine Transaminase / Q000378:metabolism; D001219:Aspartate Aminotransferases / Q000378:metabolism; D015331:Cohort Studies; D005260:Female; D019698:Hepatitis C, Chronic / Q000378:metabolism* / Q000473:pathology*; D006801:Humans; D008103:Liver Cirrhosis / Q000175:diagnosis* / Q000821:virology; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011237:Predictive Value of Tests; D012189:Retrospective Studies
chemical_list: D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase