Optimized stepwise combination algorithms of non-invasive liver fibrosis scores including Hepascore in hepatitis C virus patients
Version of Record online: 21 MAY 2008
© 2008 The Authors. Journal compilation © 2008 Blackwell Publishing Ltd
Alimentary Pharmacology & Therapeutics
Volume 28, Issue 4, pages 458–467, August 2008
How to Cite
BOURLIERE, M., PENARANDA, G., OUZAN, D., RENOU, C., BOTTA-FRIDLUND, D., TRAN, A., ROSENTHAL, E., WARTELLE-BLADOU, C., DELASALLE, P., OULES, V., PORTAL, I., CASTELLANI, P., LECOMTE, L., ROSENTHAL-ALLIERI, M. A. and HALFON, P. (2008), Optimized stepwise combination algorithms of non-invasive liver fibrosis scores including Hepascore in hepatitis C virus patients. Alimentary Pharmacology & Therapeutics, 28: 458–467. doi: 10.1111/j.1365-2036.2008.03742.x
- Issue online: 23 JUL 2008
- Version of Record online: 21 MAY 2008
- Publication data Submitted 7 April 2008 First decision 21 April 2008 Resubmitted 14 May 2008 Accepted 16 May 2008 Epub Accepted Article 21 May 2008
Background Non-invasive liver fibrosis scores such as Hepascore (HS) have been proposed as an alternative to liver biopsy in hepatitis C virus (HCV)-infected patients.
Aim To validate HS as an alternative to liver biopsy and Fibrotest (FT) and propose five optimized combination algorithms to improve diagnostic accuracy.
Methods The cohort included 467 patients with HCV. There were 274/467 (59%) men, and mean age was 47 ± 12 years.
Results Hepascore area under ROC curves (AUC) for ≥F2, F3F4 and F4 diagnosis were 0.82, 0.84 and 0.90 respectively, in the same range as FT. HS and FT were concordant in 387/467 (82%) for fibrosis staging. Among these patients, 342/387 (88%) were concordant with liver biopsy. AUCs of aspartate aminotransferase (AST) to Platelets Ratio Index (APRI) and Forns for ≥F2 were 0.76 and 0.73 (0.65–0.79) respectively. The algorithm combining APRI and HS had the highest rate of avoided liver biopsies (45%) with a high diagnostic accuracy (91%).
Conclusions Hepascore is an accurate non-invasive marker for ≥F2 and F4 diagnosis in HCV patients. In a pragmatic approach, a stepwise optimized algorithm combining APRI and FT or HS considerably increases diagnostic accuracy and avoided liver biopsies.