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. 2016 Jun 15;11(6):e0155967.
doi: 10.1371/journal.pone.0155967. eCollection 2016.

Serological Tests Do Not Predict Residual Fibrosis in Hepatitis C Cirrhotics with a Sustained Virological Response to Interferon

Roberta D'Ambrosio  1 , Elisabetta Degasperi  1 , Alessio Aghemo  1 , Mirella Fraquelli  2 , Pietro Lampertico  1 , Maria Grazia Rumi  3 , Floriana Facchetti  1 , Eleonora Grassi  1 , Giovanni Casazza  4 , William Rosenberg  5 , Pierre Bedossa  6 , Massimo Colombo  1
Affiliations

Serological Tests Do Not Predict Residual Fibrosis in Hepatitis C Cirrhotics with a Sustained Virological Response to Interferon

Roberta D'Ambrosio et al. PLoS One. .

Abstract

Background and aim: Liver biopsy (LB) has lost popularity to stage liver fibrosis in the era of highly effective anti-hepatitis C virus (HCV) therapy, yet diagnosis of persistent cirrhosis may have important implications following HCV eradication. As performance of serological non-invasive tests (NITs) to predict residual fibrosis in non-viremic HCV patients is unknown, we investigated accuracy of NITs to predict residual fibrosis in cirrhotics after a sustained virological response (SVR) to interferon (IFN).

Methods: Thirty-eight patients with a pre-treatment histological diagnosis of cirrhosis and a 48-104 months post-SVR LB were tested with APRI, CDS, FIB-4, FibroQ, Forns Score, GUCI Index, King Score, Lok Index, PLF, ELF. In 23 (61%) patients, cirrhosis had histologically regressed.

Results: All NITs values declined after SVR without any significant difference between regressors and non-regressors (AUROC 0.52-0.75). Using viremic cut-offs, PPV ranged from 34% to 100%, with lower NPV (63% - 68%). NITs performance did not improve using derived cut-offs (PPV: 40% - 80%; NPV: 66% - 100%). PLF, which combines several NITs with transient elastography, had the best diagnostic performance (AUROC 0.75, Sn 61%, Sp 90%, PPV 80%, NPV 78%). After treatment, none of the NITs resulted significantly associated with any of the histological features (activity grade, fibrosis stage, area of fibrosis).

Conclusions: The diagnostic estimates obtained using both viremic and derived cut-off values of NITs were suboptimal, indicating that none of these tests helps predicting residual fibrosis and that LB remains the gold standard for this purpose.

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Conflict of interest statement

Competing Interests: Prof. William Rosenberg has been paid by Siemens for providing lectures on ELF marker. He is named inventor on a patent wholly owned by Siemens. He has no financial or non-financial competing relevant interests to declare. This does not alter the authors' adherence to PLOS ONE policies on sharing data and materials.

Figures

Fig 1
Fig 1. Non-invasive Tests (NITs) values stratification according to post-SVR fibrosis stage.
Fig 2
Fig 2. Non-invasive Tests (NITs) values stratification according to post-SVR fibrosis stage.
Fig 3
Fig 3. Non-invasive tests (NITs) values distribution at baseline and after an SVR.
Fig 4
Fig 4. Non-invasive tests (NITs) values distribution at baseline and after an SVR.
See this image and copyright information in PMC

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References

    1. Chang TT, Liaw YF, Wu SS, Schiff E, Han KH, Lai CL, et al. Long-term entecavir therapy results in the reversal of fibrosis/cirrhosis and continued histological improvement in patients with chronic hepatitis B. Hepatology 2010;52:886–93 10.1002/hep.23785 - DOI - PubMed
    1. Schiff ER, Lee SS, Chao YC, Kew Yoon S, Bessone F, Wu ss, et al. Long-term treatment with entecavir induces reversal of advanced fibrosis or cirrhosis in patients with chronic hepatitis B. Clin Gastroenterol Hepatol 2011;9:274–6 10.1016/j.cgh.2010.11.040 - DOI - PubMed
    1. Marcellin P, Gane E, Buti M, Afdhal N, Sievert W, Jacobson IM, et al. Regression of cirrhosis during treatment with tenofovir disoproxil fumarate for chronic hepatitis B: a 5-year open-label follow-up study. Lancet 2013;381:468–75 10.1016/S0140-6736(12)61425-1 - DOI - PubMed
    1. Reichard O, Glaumann H, Frydén A, Norkrans G, Wejstål R, Weiland O. Long-term follow-up of chronic hepatitis C patients with sustained virological response to alpha-interferon. J Hepatol 1999;30:783–7 - PubMed
    1. Shiratori Y, Imazeki F, Moriyama M, Yano M, Arakawa Y, Yokosuka O, et al. Histologic improvement of fibrosis in patients with hepatitis C who have sustained response to interferon therapy. Ann Intern Med 2000;132:517–24 - PubMed

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