Routine blood tests to predict liver fibrosis in chronic hepatitis C

Abstract

Aim: To verify the usefulness of FibroQ for predicting fibrosis in patients with chronic hepatitis C, compared with other noninvasive tests.

Methods: This retrospective cohort study included 237 consecutive patients with chronic hepatitis C who had undergone percutaneous liver biopsy before treatment. FibroQ, aspartate aminotransferase (AST)/alanine aminotransferase ratio (AAR), AST to platelet ratio index, cirrhosis discriminant score, age-platelet index (API), Pohl score, FIB-4 index, and Lok's model were calculated and compared.

Results: FibroQ, FIB-4, AAR, API and Lok's model results increased significantly as fibrosis advanced (analysis of variance test: P < 0.001). FibroQ trended to be superior in predicting significant fibrosis score in chronic hepatitis C compared with other noninvasive tests.

Conclusion: FibroQ is a simple and useful test for predicting significant fibrosis in patients with chronic hepatitis C.

Keywords: Alanine aminotransferase; Aspartate aminotransferase; Aspartate aminotransferase to platelet ratio index; Cirrhosis discriminant score; FIB-4 index; FibroQ; Liver fibrosis; Lok’s model; Noninvasive test; Pohl score.

Figure 1

Score values according to Metavir fibrosis stages. Each outlier value is represented by a small circle symbol (o) in the Box Plot graph. If an outlier is more than 3 times the inter-quartile range away from Q1 or Q3, it is classified as an extreme outlier, asterisk sign (*). The top and bottom of each box are the 25th and the 75th percentiles. The line through the box is the median, and the errors bars are the 5th and 95th percentiles. AAR: AST/ALT ratio; APRI: AST-to-platelet ratio index; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; API: Age-platelet index; CDS: Cirrhosis discriminant score.

Figure 2

Receiver operating characteristic curves of simple noninvasive tests evaluated for prediction of significant fibrosis (F2, F3 and F4). AAR: AST/ALT ratio; APRI: AST-to-platelet ratio index; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; API: Age-platelet index; CDS: Cirrhosis discriminant score; ROC: Receiver operating characteristic.

Figure 3

Receiver operating characteristic curves of simple noninvasive tests evaluated for prediction of extensive fibrosis (F3 and F4). AAR: AST/ALT ratio; APRI: AST-to-platelet ratio index; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; API: Age-platelet index; CDS: Cirrhosis discriminant score; ROC: Receiver operating characteristic.