Noninvasive methods for fibrosis assessment in chronic hepatitis C virus infection

Abstract

Objective The objective of this study is to compare several noninvasive methods of fibrosis assessment (platelet count, the aspartate aminotransferase/platelet ratio index, the Lok score, and the fibrosis-4 score) versus percutaneous liver biopsy (LB) in chronic hepatitis C virus infection. Background Noninvasive methods for assessment of hepatic fibrosis are increasingly needed. LB is an invasive procedure and includes a risk of complications, such as pain, pneumothorax, puncture of other viscera, and hemorrhage. In addition to the added cost, LB cannot be performed universally in all patients with impaired hemostasis of any origin. Patients and methods Our study included 500 patients with chronic hepatitis C virus infection in which LB and biological tests needed for calculating the scores (according to the classic formulas) were performed. Results There was a highly significant correlation between different stages of fibrosis and all studied markers of fibrosis (P < 0.001). Lok score at a cutoff value of 0.25 had 68.73% sensitivity and 55% specificity for diagnosis of liver fibrosis, fibrosis-4 score at a cutoff value of 1.26 had 55.9% sensitivity and 68.54% specificity, aspartate aminotransferase/platelet ratio index at a cutoff value of 0.66 had 50.0% sensitivity and 74.16% specificity, and platelet count at a cutoff value of 208 (103/mm3) had 67.7% sensitivity and 59.55% specificity for diagnosis of liver fibrosis. Conclusion All studied noninvasive markers of fibrosis are very good markers for detection of fibrosis.