Noninvasive tests may determine chronic hepatitis C survival
By Lauretta Ihonor
06 April 2011Gastroenterology 2011;
Advance online publicationMedWire News: Noninvasive determination of liver fibrosis severity offers greater 5-year prognostic value in chronic hepatitis C patients than the gold standard liver biopsy, study findings indicate.
These noninvasive tests - FibroTest (a liver biomarker test) and liver stiffness (measured by ultrasound scan) - may help clinicians evaluate liver disease severity earlier in the disease process, and to decide if liver transplant, portosystemic shunts, or surgery will be required by the patient at a later date, say the authors.
The analysis, published in the journal Gastroenterology showed that FibroTest and liver stiffness measurements had high predictive accuracies for 5-year chronic hepatitis C survival, with respective area under the receiver operating characteristic curve (AUC) values of 0.80 and 0.82.
In contrast, liver biopsy had a lower, albeit clinically acceptable, AUC value of 0.76.
The findings arise from a study involving 1457 patients with chronic hepatitis C who were followed-up for 5 years.
During this time, 16 (1.1%) patients underwent liver transplant and 77 (5.3%) died from any cause (39 liver disease-related).
Victor de Lédinghen (Hôpital Haut-Lévêque, Bordeaux, France) and team report that the majority of patients with a major adverse outcome (death or transplant) during follow-up had liver fibrosis defined as severe by biopsy, FibroTest, or liver stiffness measurement.
For example, of the 93 patients who died or had a transplant, 68.8% had a liver stiffness measurement of at least 14.5 kPa - a level indicating liver cirrhosis.
In addition as liver stiffness and FibroTest values increased, reflecting worsening fibrosis severity, patient survival rates decreased.
De Lédinghen and colleagues say: "Liver stiffness and FibroTest are already a strong daily parameter to give information to patients and their family on the severity of the liver disease."
However, these tests could replace liver biopsy in the evaluation of hepatitis C prognosis, they conclude.
MedWire (www.medwire-news.md) is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011
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