Role of simple biomarkers in predicting fibrosis progression in HCV infection

作     者：Rajasekhara R Mummadi John R Petersen Ned Snyder 

作者机构：Division of Gastroenterology and HepatologyDepartment of Internal MedicineUniversity of Texas Medical BranchHoustonTX 77025United States Department of PathologyUniversity of Texas Medical BranchHoustonTX 77025United States Department of Gastroenterology and HepatologyKelsey Seybold Clinic2727 W. HolcombeHoustonTX 77025United States 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2010年第16卷第45期

页      面：5710-5715页

核心收录：

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 100401[医学-流行病与卫生统计学] 10[医学] 

基　　金：Supported by Portions of this study were performed on the General Clinical Research Center at the University of Texas Medical Branch at Galveston funded by M01RR00073 from the National Center for Research Resources,NIH,USPHS 

主　　题：Hepatitis C Liver fibrosis Liver biopsy Biomarkers 

摘      要：AIM: To examine the accuracy of the aspartate aminotransferase (AST)/Platelet Ratio Index (APRI) and FIB-4, in predicting longitudinal changes in liver histology in hepatitis C virus (HCV) ***: Patients that underwent repeat liver biopsies at least 1 year apart from 1999 to 2007 were identified. Liver fibrosis was staged on needle core biopsies evaluated by a single expert liver pathologist. Only laboratory values within 3 mo of the liver biopsies were ***: Thirty-six patients met the inclusion criteria with 50% stage 1 on initial biopsy, 25% stage 2, and 22% stage 3. Nineteen of 36 (53%) had progression of fibrosis on repeat biopsies, while 16 (44%) showed no change in stage, and one (3%) showed improvement. Patients that showed progression of fibrosis had significantly higher alanine aminotransferase and aspartate aminotransferase levels than the group that did not show progression. A significant correlation was seen between change in stage of fibrosis and change in APRI (r2 = 0.39, P = 0.00001) and a change in FIB-4 (r2 = 0.31, P = 0.00004). A change in APRI (ΔAPRI) of 0.18 had 80% positive predictive value (PPV) and 67% nega- tive predictive value (NPV) for progression of fibrosis. A change in FIB-4 (ΔFIB-4) of 0.39 had 75% PPV and 75% NPV for predicting progression of fibrosis. CONCLUSION: ΔAPRI and ΔFIB-4 parallel changes in fibrosis progression, and could be useful tools for clinicians in following patients with active chronic HCV infection.