Simple non-invasive markers as a predictor of fibrosis and viral response in chronic hepatitis C patients

Turk J Gastroenterol. 2012;23(5):538-45. doi: 10.4318/tjg.2012.0358.

Abstract

Background/aims: Chronic hepatitis C has a high prevalence and leads to development of cirrhosis and hepatocellular carcinoma. Liver fibrosis staging is one of the main factors that influence the decision to indicate therapy for chronic hepatitis C carriers. Several simple laboratory tests, scores and indices have been proposed for the non-invasive prediction of hepatic fibrosis in patients with chronic hepatitis C. The purpose of this study was to evaluate non-invasive liver fibrosis tests as a predictive factor of fibrosis and non-sustained viral response (relapse/non-responder) in chronic hepatitis C naive patients.

Materials and methods: We performed a retrospective case-control study with utilization of non-invasive liver fibrosis test, platelet count, aspartate aminotransferase/alanine aminotransferase ratio, age-platelet index and aspartate aminotransferase to platelet ratio index, as a predictor of non-sustained viral response in chronic hepatitis C naive patients between July 2008 and August 2010 in İzmir Atatürk Training and Research Hospital.

Results: We observed non-invasive liver fibrosis test to be highly effective in predicting non-sustained viral response patients, especially with age-platelet index (Accuracy=73%, OR=6.93, 95% CI, 2.41-19.8). A strong relationship was shown with multivariate analysis between non-sustained viral response and some non-invasive liver fibrosis tests such as viral load (OR=4.51, 95% CI, 1.16 -17.6, p=0.03) and age-platelet index (OR=11.8, 95% CI, 2.25-62.15, p=0.004).

Conclusions: If non-invasive tests could be standardized according to age, gender, race, and body mass index and individualized according to the fibrosis, then a nearly full correlation of non-invasive liver fibrosis test with histologic results could be obtained, stage of fibrosis could be predicted initially, sustained viral response/non-sustained viral response could be estimated, and the need for a repeat biopsy could be eliminated.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Alanine Transaminase / blood*
  • Aspartate Aminotransferases / blood*
  • Biomarkers / blood*
  • Biopsy, Needle
  • Disease Progression
  • Female
  • Follow-Up Studies
  • Hepacivirus / immunology*
  • Hepatitis C Antibodies / blood*
  • Hepatitis C, Chronic / blood*
  • Hepatitis C, Chronic / complications
  • Hepatitis C, Chronic / virology
  • Humans
  • Liver Cirrhosis / blood*
  • Liver Cirrhosis / diagnosis
  • Liver Cirrhosis / etiology
  • Liver Function Tests
  • Male
  • Middle Aged
  • Platelet Count
  • Prognosis
  • ROC Curve
  • Retrospective Studies
  • Severity of Illness Index
  • Viral Load
  • Young Adult

Substances

  • Biomarkers
  • Hepatitis C Antibodies
  • Aspartate Aminotransferases
  • Alanine Transaminase