Comparison of non-invasive fibrosis markers and classical liver biopsy in chronic hepatitis C

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G Usluer1, N Erben, N Aykin

  • 1Department of Infectious Diseases and Clinical Microbiology, Eskisehir Osmangazi University, Eskisehir, Turkey.

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
|January 11, 2012
PubMed

Insights

Non-invasive serum biomarkers like FibroTest and FIB4 show promise in diagnosing significant liver fibrosis in chronic hepatitis C patients. While not replacing liver biopsy, they can help exclude advanced fibrosis with high negative predictive values.

Area of Science:

  • Hepatology
  • Biomarker Discovery
  • Diagnostic Accuracy

Background:

  • Chronic hepatitis C (HCV) infection can lead to liver fibrosis and cirrhosis.
  • Liver biopsy, the gold standard for staging fibrosis, is invasive.
  • Non-invasive biomarkers are sought to improve fibrosis assessment.

Purpose of the Study:

  • To compare the diagnostic performance of nine non-invasive serum biomarkers against liver biopsy for staging liver fibrosis in treatment-naive HCV patients.
  • To evaluate the utility of these biomarkers in identifying significant fibrosis (F3-F4).

Main Methods:

  • Seventy-seven treatment-naive, HCV genotype 1 patients were enrolled across 14 centers.
  • Nine serum biomarkers were calculated: platelet count, AST/ALT ratio (AAR), cirrhosis discriminate score (CDS), FIB4, AST/platelet ratio index (APRI), age-platelet (AP) index, Göteborg University cirrhosis index (GUCI), FibroTest, and ActiTest.
  • Biomarker results were correlated with histological findings (ISHAK fibrosis score).

Main Results:

  • Most serum biomarkers, excluding AAR, showed weak to moderate correlation with liver biopsy results.
  • FibroTest, FIB4, APRI, and AP index demonstrated significant differences between early (F0-F2) and advanced (F3-F4) fibrosis stages.
  • Negative predictive values (NPVs) for advanced fibrosis (F3-F4) were high: 95% for FibroTest, 85% for FIB4, 85% for APRI, and 83% for AP index.

Conclusions:

  • Non-invasive serum biomarkers can aid in diagnosing significant liver fibrosis but are insufficient for detecting early-stage fibrosis.
  • FibroTest, FIB4, APRI, and AP index are valuable tools for excluding significant fibrosis in chronic HCV patients, offering >80% NPV.

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