Validation of Hepascore, compared to simple indices of fibrosis, in US patients with chronic hepatitis C virus infection. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association [Clin Gastroenterol Hepatol] Journal article | | Title | Validation of Hepascore, compared to simple indices of fibrosis, in US patients with chronic hepatitis C virus infection. | | Author(s) | Becker L, Salameh W, Sferruzza A, Zhang K, Chen R, Malik R, Reitz R, Nasser I, Afdhal NH | | Institution | Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA. | | Source | Clin Gastroenterol Hepatol 2009 Jan 24. | | Abstract | BACKGROUND & AIMS:: Biomarkers are being developed as alternatives to liver biopsy for predicting liver fibrosis in patients with chronic hepatitis C (CHC). Hepascore utilizes non-invasive serum markers and has been validated in Australian and European populations for predicting different degrees of fibrosis. This study validated this test in a US population.
METHODS:: Patients with chronic hepatitis C virus infection were assigned to training (n=203) or validation (n=188) sets. Liver fibrosis was staged according to the METAVIR scoring system. The Hepascore algorithm utilizes data on age, sex, as well as total bilirubin, gamma-glutamyl transferase, alpha2-macroglobulin and hyaluronic acid levels.
RESULTS:: The ability of Hepascore to predict significant fibrosis (F2-4) as determined by the area under the ROC was similar in training (0.83) and validation sets (0.81) and was comparable to results seen in previous studies. A cutoff score of =0.55 was best for predicting significant fibrosis with a sensitivity and specificity of 82% and 65%, and positive and negative predictive values of 70% and 78%. When compared with two simple indices FIB-4 (age, platelets, AST and ALT) and APRI (AST and platelets), Hepascore performed better at excluding advanced fibrosis using a low cutoff score but worse at predicting fibrosis using a high cutoff score. An algorithm using Hepascore followed by FIB-4 or APRI, spared 103 of 391 individuals a liver biopsy missing advanced fibrosis in only 1 patient.
CONCLUSION:: Hepascore accurately predicted likelihood of developing fibrosis and could alleviate the need for liver biopsy in a subset of patients. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19558996 |
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