Prediction of liver stiffness by serum indexes in HCV-infected patients with or without HIV coinfection.
Aspartate Aminotransferases
/ blood
Biomarkers
/ blood
Coinfection
Elasticity Imaging Techniques
/ methods
Female
Fibrosis
HIV Infections
/ complications
Hepacivirus
Hepatitis C
/ complications
Humans
Liver
/ diagnostic imaging
Liver Cirrhosis
/ blood
Male
Middle Aged
Predictive Value of Tests
Retrospective Studies
Journal
Medicine
ISSN: 1536-5964
Titre abrégé: Medicine (Baltimore)
Pays: United States
ID NLM: 2985248R
Informations de publication
Date de publication:
19 Nov 2021
19 Nov 2021
Historique:
received:
16
04
2021
accepted:
30
10
2021
entrez:
19
11
2021
pubmed:
20
11
2021
medline:
1
2
2022
Statut:
ppublish
Résumé
Identification of advanced fibrosis/cirrhosis in hepatitis C virus (HCV)-infected patients should be a mainstay before starting treatment; however, the limited access of many centres to transient elastography (TE) is often a barrier for early assessments. We aimed to investigate the diagnostic accuracy of serum indexes for predicting liver stiffness.Retrospective analysis of HCV patients (with or without HIV coinfection) routinely assessed in 7 centres in Spain. The diagnostic accuracy of aspartate aminotransferase-to-platelet ratio index (APRI), fibrosis-4 (FIB-4), and their combinations was evaluated using a recent TE examination as a reference test (liver stiffness ≥ 9.5 kPa and ≥12.5 kPa for advanced fibrosis and cirrhosis, respectively). In addition to area under the receiving operating characteristic curves, sensitivity, specificity, and negative predictive value (NPV) and positive predictive value were estimated.The analysis included 1391 patients: 346 (25%) HIV-positive, 732 (53%) people who inject drugs, and 178 (13%) incarcerated. Advanced fibrosis and cirrhosis were found in 557 (40%) and 351 (25%) patients, respectively. APRI < 0.5 (n = 595; 43%) had an NPV of 95% for excluding cirrhosis. Combined FIB-4 < 1.45 with APRI < 0.5 (n = 467; 34%) had an NPV of 87% for excluding advanced fibrosis. Combined APRI > 2 and FIB-4 > 3.25 (n = 134; 10%) had a positive predictive value of 89% for advanced fibrosis. Globally, this approach would avoid the need for TE in 53% of patients. HIV coinfection did not influence diagnostic accuracy.Inexpensive and simple serum indexes confidently allowed identifying the absence of cirrhosis and the presence of advanced fibrosis in 53% of a heterogeneous series of real-world HCV patients with or without HIV infection.
Identifiants
pubmed: 34797315
doi: 10.1097/MD.0000000000027838
pii: 00005792-202111190-00045
pmc: PMC8601296
doi:
Substances chimiques
Biomarkers
0
Aspartate Aminotransferases
EC 2.6.1.1
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e27838Informations de copyright
Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
The authors have no funding and conflicts of interest to disclose.
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