title: New index for the diagnosis of liver fibrosis in Schistosomiasis mansoni.
abstract: BACKGROUND
  - Periportal fibrosis is the major pathological consequence of the Schistosoma mansoni infection.
  
  
  OBJECTIVE
  - To evaluate the accuracy of serum markers and to construct an index to assess fibrosis.
  
  
  METHODS
  - Patients (n=116) with schistosomiasis were evaluated by ultrasound scan and measurements of serum levels of aminotransferases, γ-glutamyl transferase, alkaline phosphatase, hyaluronic acid, cytokines and platelets. Ultrasound images were used to evaluate the fibrosis using Niamey's classification and identified 19 patients without periportal fibrosis (patterns A and B), 48 with mild to moderate fibrosis (C and D) and 49 with advanced fibrosis (E and F).
  
  
  RESULTS
  - Using multivariate analysis, a model was created, which involved alkaline phosphatase and platelets and could separate patients with different patterns of fibrosis. This index showed a better performance in separating patients without fibrosis from with advanced periportal fibrosis. The biological index showed an area under the ROC curve of 1.000. Using values below the lowest or above the highest cut-off point, the presence or absence of advanced fibrosis could be predicted in all patients.
  
  
  CONCLUSIONS
  - The index constructed can be used to separate patients with different patterns of periportal fibrosis, specially to predict advanced fibrosis in schistosomiasis patients.
authors.affiliation: Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brasil.
authors.forename: Ana Virgínia Matos Sá
authors.initials: AV
authors.lastname: Barreto
authors.affiliation: Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brasil.
authors.forename: Vinícius Martins
authors.initials: VM
authors.lastname: Alecrim
authors.affiliation: Departamento de Medicina Clínica, Universidade Federal de Pernambuco, Recife, PE, Brasil.
authors.forename: Tibério Batista de
authors.initials: TB
authors.lastname: Medeiros
authors.affiliation: Departamento de Medicina Clínica, Universidade Federal de Pernambuco, Recife, PE, Brasil.
authors.forename: Ana Lúcia Coutinho
authors.initials: AL
authors.lastname: Domingues
authors.affiliation: Departamento de Medicina Clínica, Universidade Federal de Pernambuco, Recife, PE, Brasil.
authors.forename: Edmundo Pessoa
authors.initials: EP
authors.lastname: Lopes
authors.affiliation: Departamento de Bioquímica, Disciplina de Biologia Molecular, Escola Paulista de Medicina, Universidade Federal de São Paulo, SP, Brasil.
authors.forename: João Roberto Maciel
authors.initials: JR
authors.lastname: Martins
authors.affiliation: Departamento de Bioquímica, Disciplina de Biologia Molecular, Escola Paulista de Medicina, Universidade Federal de São Paulo, SP, Brasil.
authors.forename: Helena Bonciani
authors.initials: HB
authors.lastname: Nader
authors.affiliation: Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brasil.
authors.forename: George Tadeu Nunes
authors.initials: GT
authors.lastname: Diniz
authors.affiliation: Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brasil.
authors.forename: Silvia Maria Lucena
authors.initials: SM
authors.lastname: Montenegro
authors.affiliation: Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, PE, Brasil.
authors.forename: Clarice Neuenschwander Lins de
authors.initials: CN
authors.lastname: Morais
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D001792:Blood Platelets; D016207:Cytokines / Q000097:blood; D005260:Female; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood; D008103:Liver Cirrhosis / Q000097:blood* / Q000000981:diagnostic imaging* / Q000469:parasitology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012555:Schistosomiasis mansoni / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D000637:Transaminases / Q000097:blood; D055815:Young Adult; D005723:gamma-Glutamyltransferase / Q000097:blood
chemical_list: D015415:Biomarkers; D016207:Cytokines; D006820:Hyaluronic Acid; D005723:gamma-Glutamyltransferase; D000637:Transaminases; D000469:Alkaline Phosphatase