13C-aminopyrine breath test accurately predicts long-term outcome of chronic hepatitis C

J Hepatol. 2012 Apr;56(4):782-7. doi: 10.1016/j.jhep.2011.10.015. Epub 2011 Dec 13.

Abstract

Background & aims: Although numerous non-invasive tests are currently available to explore liver function and disease activity in patients with HCV-related chronic diseases, none of these indicate the likelihood of disease progression in the individual patient. We aimed at assessing the prognostic ability of (13)C(2)-aminopyrine breath test ((13)C-ABT) in the prediction of liver fibrosis progression in patients with HCV chronic hepatitis who prospectively entered a long-term follow-up.

Methods: Fifty patients with HCV-related chronic disease who underwent paired liver biopsy (at baseline and after a mean period of 86 months) were included in the study. (13)C-ABT was carried out at baseline and every 3 years. Histological progression was defined as increase of at least 2 fibrosis units according to Ishak score.

Results: Fourteen patients progressed of at least 2 fibrosis units during the follow-up. These patients were more frequently infected with a HCV-1b genotype and had, at baseline, a significantly older age, higher BMI, AST levels, and AST to platelet ratio index (APRI). (13)C-ABT was altered in 57% of cases at baseline and in 100% of the cases at 3-year follow-up. In the univariate analysis, age (p=0.005), BMI (p=0.006), platelet count (p=0.03), AST (p=0.012) and ALT (p=0.04) levels, APRI (p=0.03), and baseline (13)C-ABT results (p<0.0001) were all independently associated with progression of liver fibrosis. By Cox's multiple regression analysis, the (13)C-ABT was the only covariate that significantly predicted liver fibrosis progression (HR 6.7; 95% CI 2.3-20.1; p<0.001).

Conclusions: (13)C-ABT accurately predicts the risk of disease progression in patients with HCV-related chronic hepatitis.

Publication types

  • Evaluation Study

MeSH terms

  • Adult
  • Aminopyrine / metabolism*
  • Antiviral Agents / therapeutic use*
  • Breath Tests / methods*
  • Carbon Isotopes / metabolism
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Hepatitis C, Chronic / diagnosis
  • Hepatitis C, Chronic / drug therapy*
  • Hepatitis C, Chronic / metabolism*
  • Humans
  • Liver Cirrhosis / diagnosis
  • Liver Cirrhosis / epidemiology
  • Liver Cirrhosis / metabolism
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Prognosis
  • Reproducibility of Results
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome

Substances

  • Antiviral Agents
  • Carbon Isotopes
  • Aminopyrine