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. 2025 Apr 8;12(4):ofae628.
doi: 10.1093/ofid/ofae628. eCollection 2025 Apr.

FibroScan-AST Score vs Liver Stiffness for the Prediction of Liver Events After HCV Cure

Anaïs Corma-Gómez  1   2   3 , Diana Corona-Mata  3   4   5   6 , Jésica Martín-Carmona  1   2   3   7 , María José Galindo  8 , Angela Camacho  3   4   5   6 , Carmen Martín-Sierra  1   2 , Marina Gallo-Marín  3   4   5   6 , Pilar Rincón  1 , Ignacio Perez-Valero  3   4   5   6 , Margarita Pérez-García  1 , Angela Carrasco-Dorado  4   5   6 , Juan A Pineda  1   3   7 , Antonio Rivero-Juárez  3   4   5   6 , Antonio Rivero  3   4   5   6 , Luis M Real  1   2   3   7 , Juan Macías  1   2   3   7
Affiliations

FibroScan-AST Score vs Liver Stiffness for the Prediction of Liver Events After HCV Cure

Anaïs Corma-Gómez et al. Open Forum Infect Dis. .

Abstract

Background: Liver stiffness (LS) predicts liver complication occurrence in patients with hepatitis C virus (HCV) infection after sustained virological response (SVR). The FibroScan-AST (FAST) score, which includes aspartate aminotransferase (AST) and controlled attenuation parameter (CAP; measured by FibroScan), may improve the prediction ability of isolated LS. Our aim was to compare the predictive capacity of LS vs FAST in this setting.

Methods: Multicenter cohort study including individuals with HIV/HCV coinfection or HCV monoinfection from Spain if they had (1) LS ≥9.5 kPa pretreatment, (2) SVR with a direct-acting antiviral (DAA)-based regimen, and (3) LS and CAP measurement at SVR. Fatty liver disease (FLD) was defined as CAP ≥248 dB/m. The primary outcome was the occurrence of a liver complication (decompensation or hepatocellular carcinoma [HCC]) after SVR.

Results: Three hundred patients were included; 213 (71%) had HIV. At SVR, 131 (44%) had FLD. The FAST score was <0.35 in 182 (61%), 0.35-0.67 in 79 (27%), and >0.67 in 34 (12%) patients. After a median (Q1-Q3) follow-up of 73 (53-83) months, 36 (12%) liver complications (15 [5%] HCC) occurred. LS was independently associated with an increased risk of developing liver complications (sub-hazard ratio [sHR], 1.06; 95% CI, 1.04-1.08; P < .001). In a separate model, FAST ≥0.35 was also independently associated with greater risk of liver complications (sHR, 8.12; 95% CI, 3.11-21.17; P < .001). The area under the receiver operating characteristics curve of the model based on LS was 0.83 (95% CI, 0.76-0.91), and that of the model based on FAST was 0.80 (95% CI, 0.72-0.88; P = .158).

Conclusions: The FAST score predicts the development of liver events after SVR but does not improve the predictive capacity of LS alone at this time point.

Keywords: FAST score; HCV infection; liver complications; liver stiffness; sustained virological response.

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Conflict of interest statement

Potential conflicts of interest. All authors: no reported conflicts.

Figures

Figure 1.
Figure 1.
Probability of remaining free from liver-related outcomes after SVR, according to FAST score. Abbreviations: FAST, FibroScan-AST; SVR, sustained virological response.
Figure 2.
Figure 2.
ROC curves of FAST score and LS for the prediction of liver-related events. Abbreviations: FAST, FibroScan-AST; LS, liver stiffness; ROC, receiver operating characteristics.
See this image and copyright information in PMC

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