title: Diagnostic performance of T lymphocyte subpopulations in assessment of liver fibrosis stages in hepatitis C virus patients: simple noninvasive score.
abstract: OBJECTIVE
  Evaluation of liver fibrosis in patients infected with hepatitis C virus is highly useful for the diagnosis of the disease as well as therapeutic decision. Our aim was to develop and validate a simple noninvasive score for liver fibrosis staging in chronic hepatitis C (CHC) patients and compare its performance against three published simple noninvasive indexes.
  
  
  METHODS
  CHC patients were divided into two groups: an estimated group (n=70) and a validated group (n=52). Liver fibrosis was tested in biopsies using the Metavair score system. CD4 and CD8 count/percentage were assayed by fluorescence-activated cell sorting analysis.
  
  
  RESULTS
  The multivariate discriminant analysis selects a function on the basis of absolute values of five biochemical markers: immune fibrosis index (IFI); score=3.07+3.06×CD4/CD8+0.02×α-fetoprotein (U/l)-0.07×alanine aminotransferase ratio-0.005×platelet count (10/l)-1.4×albumin (g/dl). The IFI score produced areas under curve of 0.949, 0.947, and 0.806 for differentiation of all patient categories [significant fibrosis (F2-F4), advanced fibrosis (F3-F4), and cirrhosis (F4)].
  
  
  CONCLUSIONS
  The IFI score, a novel noninvasive test, can be used easily for the prediction of liver fibrosis stage in CHC patients. Our score was more efficient than aspartate aminotransferase to platelet ratio index, fibrosis index, and fibroQ and more suitable for use in Egyptian hepatitis C virus patients.
authors.affiliation: aDepartment of Chemistry, Damietta University bDepartment of Clinical Pathology, Damietta Cancer Institute, Damietta cEgyptian Liver Research Institute and Hospital (ELRIAH) dDepartment of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura eDepartment of Chemistry, Helwan University, Cairo, Egypt.
authors.forename: El-Shatat A
authors.initials: el-SA
authors.lastname: Toson
authors.forename: Gamal E
authors.initials: GE
authors.lastname: Shiha
authors.forename: Hatem A
authors.initials: HA
authors.lastname: El-Mezayen
authors.forename: Aml M
authors.initials: AM
authors.lastname: El-Sharkawy
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D019540:Area Under Curve; D015415:Biomarkers / Q000097:blood; D016516:CD4-CD8 Ratio; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology* / Q000821:virology; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology* / Q000821:virology; D002469:Cell Separation / Q000379:methods; D004534:Egypt; D005260:Female; D005434:Flow Cytometry; D006526:Hepatitis C / Q000097:blood / Q000175:diagnosis* / Q000276:immunology / Q000821:virology; D006801:Humans; D008099:Liver / Q000276:immunology* / Q000378:metabolism / Q000473:pathology / Q000821:virology; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis* / Q000276:immunology / Q000821:virology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010976:Platelet Count; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D015203:Reproducibility of Results; D012709:Serum Albumin / Q000032:analysis; D000075462:Serum Albumin, Human; D012720:Severity of Illness Index; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: C097353:AFP protein, human; C422455:ALB protein, human; D015415:Biomarkers; D012709:Serum Albumin; D000509:alpha-Fetoproteins; D000410:Alanine Transaminase; D000075462:Serum Albumin, Human