Utility and limitations of APRI and FIB4 to predict staging in a cohort of nonselected outpatients with hepatitis C.
Journal Title: Annals of Hepatology - Year 2016, Vol 15, Issue 3
Abstract
Background. Chronic hepatitis C(CHC) staging is important for therapeutic decision-making. Identification of noninvasive markers can provide alternatives to liver biopsy. Aim. To assess the value of APRI and FIB4 for CHC fibrosis staging in a cohort of nonselected outpatients from a referral center in Sao Paulo, Brazil. Material and methods. Medical records of 798 adult outpatients were analyzed retrospectively. For calculations of APRI and FIB4, the original descriptions were considered, and markers were compared with degree of liver injury. Results. Overall, 49.3% of participants were female, and mean age was 56.9 ± 12.5 years. Genotype 1 was predominant (71.7vs. 23.7% genotype 3); 64% had significant fibrosis, 44% had advanced fibrosis, and 28% had cirrhosis. The areas under the receiver operating curve for significant fibrosis, advanced fibrosis, and cirrhosis, respectively, were 0.809, 0.819, and 0.815 for the APRI marker and 0.803, 0.836 and 0.852 for FIB4. Using the recommended cut off values, approximately 30-40% of the patients could not be classified. In the remainder, either APRI or FIB4 alone correctly diagnosed 80-85% of cases. Concomitant or consecutive use of both APRI and FIB4 increased the number of the cases correctly diagnosed only slightly, but also increased the number of patients not classified within the cutoff values. Conclusions. In conclusion, use of the APRI or FIB4 markers for detection of hepatic fibrosis may be a viable alternative at referral centers for treatment of CHC in low- and middleincomecountries. Despite relatively good accuracy, a significant number of patients could not be assessed by these methods.
Authors and Affiliations
Ana de Oliveira, Ibrahin El-Bacha, Mônica Vianna, Edison Parise
Keywords
Related Articles
- EP ID EP78573
- DOI 10.5604/16652681.1198801
- Views 128
- Downloads 0
Recreational Drug and Psychosocial Profile in Chronic Hepatitis C Patients Seeking Antiviral Therapy
Background and aims. Practitioners treating hepatitis C (HCV) provide healthcare to a special population with high rates of substance abuse and psychiatric disorders. We investigated the psychosocial profile in HCV patie...
Embolization of porto-systemic shunt as treatment for recurrent hepatic encephalopathy
Course of a HBsAg positive liver transplantation in a hepatitis B and D virus coinfected recipient
The increasing demand for transplantation has led to consideration of liver grafts from donors exposed to hepatitis B virus (HBV). Six transplantations of liver grafts from hepatitis B surface antigen (HBsAg) positive do...
Intrahepatic, perihilar and distal cholangiocarcinoma: Management and outcomes
Introduction and aims. Cholangiocarcinomas are a heterogeneous group of tumors that can be classified into three clinically distinct types of cancers, intrahepatic, perihilar and distal cholangiocarcinoma. The inconsist...
Trans-arterial 90yttrium radioembolization for patients with unresectable tumors originating from the biliary tree
Patients with malignant tumors originating from the biliary tree have a poor prognosis, since only a minority of tumors can be resected and most palliative regimens have shown only limited success. We present two patient...