Blood Tests to Diagnose Fibrosis or Cirrhosis in Patients With Chronic Hepatitis C Virus Infection

Chou, Roger; Wasson, Ngoc

doi:10.7326/0003-4819-158-11-201306040-00005

Cited by 316 publications

(233 citation statements)

References 194 publications

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“…When evaluating those studies that performed direct comparisons, the Forns index and APRI showed a very similar performance for both significant fibrosis and cirrhosis [49] . The Fibroindex was originally proposed for diagnosis of HCV-related fibrosis and includes the following variables: platelet count, AST, and gamma globulin [50] .…”

Section: Serum Biomarkersmentioning

confidence: 82%

“…Fibro index was also correlated significantly with variation in fibrosis stage when a subset of 30 patients who had undergone a liver biopsy twice was evaluated [50] . Nevertheless, in the mentioned systematic review, the median AUROC for significant fibrosis detection was 0.76 and for cirrhosis was 0.86 [49] . Direct comparisons showed no superiority of Fibroindex over APRI for both significant fibrosis and cirrhosis detection [49] .…”

Section: Serum Biomarkersmentioning

confidence: 94%

“…Nevertheless, in the mentioned systematic review, the median AUROC for significant fibrosis detection was 0.76 and for cirrhosis was 0.86 [49] . Direct comparisons showed no superiority of Fibroindex over APRI for both significant fibrosis and cirrhosis detection [49] .…”

Section: Serum Biomarkersmentioning

confidence: 94%

“…A meta-analysis published in 2007 showed a pooled adjusted AUROC of 0.83 for the FibroTest ® in HCV patients [54] . However, the systematic review published by Chou and Wasson [49] revealed that when only studies that performed direct comparisons were considered, the APRI was associated with only a slightly lower AUROC than the FibroTest ® for significant fibrosis (median difference between AUROCs, -0.03; range, -0.10 to 0.07), but there was no difference for cirrhosis (median difference between AUROCs, 0.0; range, -0.04 to 0.06). In addition, the FibroTest ® was not superior to FIB-4 and other models such as the Fibrometer ® and Hepascore ® for the diagnosis HCV-related fibrosis, as shown in the same review [49] .…”

Section: Direct (Or Class ⅰ) Markers Of Liver Fibrosismentioning

confidence: 97%

“…was 0.76 for significant fibrosis and 0.87 for cirrhosis [49] . When evaluating those studies that performed direct comparisons, the Forns index and APRI showed a very similar performance for both significant fibrosis and cirrhosis [49] .…”

Section: Serum Biomarkersmentioning

confidence: 99%

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Non-invasive diagnosis of liver fibrosis in chronic hepatitis C

Schiavon

Narciso-Schiavon

Carvalho-Filho

2014

WJG

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Assessment of liver fibrosis in chronic hepatitis C virus (HCV) infection is considered a relevant part of patient care and key for decision making. Although liver biopsy has been considered the gold standard for staging liver fibrosis, it is an invasive technique and subject to sampling errors and significant intra- and inter-observer variability. Over the last decade, several noninvasive markers were proposed for liver fibrosis diagnosis in chronic HCV infection, with variable performance. Besides the clear advantage of being noninvasive, a more objective interpretation of test results may overcome the mentioned intra- and inter-observer variability of liver biopsy. In addition, these tests can theoretically offer a more accurate view of fibrogenic events occurring in the entire liver with the advantage of providing frequent fibrosis evaluation without additional risk. However, in general, these tests show low accuracy in discriminating between intermediate stages of fibrosis and may be influenced by several hepatic and extra-hepatic conditions. These methods are either serum markers (usually combined in a mathematical model) or imaging modalities that can be used separately or combined in algorithms to improve accuracy. In this review we will discuss the different noninvasive methods that are currently available for the evaluation of liver fibrosis in chronic hepatitis C, their advantages, limitations and application in clinical practice.

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Section: Serum Biomarkersmentioning

confidence: 82%

Section: Serum Biomarkersmentioning

confidence: 94%

Section: Serum Biomarkersmentioning

confidence: 94%

Section: Direct (Or Class ⅰ) Markers Of Liver Fibrosismentioning

confidence: 97%

Section: Serum Biomarkersmentioning

confidence: 99%

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Non-invasive diagnosis of liver fibrosis in chronic hepatitis C

Schiavon

Narciso-Schiavon

Carvalho-Filho

2014

WJG

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Screening for Hepatitis C Virus Infection in Adolescents and Adults

Force¹,

Owens

Davidson

et al. 2020

JAMA

204

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Hepatitis C virus (HCV) is the most common chronic bloodborne pathogen in the US and a leading cause of complications from chronic liver disease. 1 Hepatitis C virus infection is associated with more deaths than the top 60 other reportable infectious diseases combined, including HIV. 2 The most important risk factor for HCV infection is past or current injection drug use. 1 In the US, an estimated 4.1 million persons have past or current HCV infection (ie, they test positive for the anti-HCV antibody). Of these persons who test positive for the anti-HCV antibody, approximately 2.4 million have current infections based on testing with molecular assays for HCV RNA. 1,3-5 The estimated prevalence of chronic HCV infection is approximately 1.0% (2013 to 2016). 6 An estimated 44 700 new HCV infections occurred in the US in 2017. 7 Cases of acute HCV infection have increased approximately 3.8-fold (2010 to 2017) over the last decade because of increasing injection drug use and improved surveillance. 7 The most rapid increase in acute HCV incidence has been in young adults aged 20 to 39 years who inject drugs, with increases in both sexes but more pronounced in men. 7 Rates increased especially in American Indian/Alaskan Native and non-Hispanic white populations. 7 Assessment of Magnitude of Net Benefit The US Preventive Services Task Force (USPSTF) concludes with moderate certainty that screening for HCV infection in adults aged 18 to 79 years has substantial net benefit. See the Figure and Table for more information on the USPSTF recommendation rationale and assessment. For more details on the methods the USPSTF uses to determine net benefit, see the USPSTF Procedure Manual. 8 Practice Considerations Patient Population Under Consideration This recommendation applies to all asymptomatic adults aged 18 to 79 years without known liver disease. IMPORTANCE Hepatitis C virus (HCV) is the most common chronic blood-borne pathogen in the US and a leading cause of complications from chronic liver disease. HCV is associated with more deaths than the top 60 other reportable infectious diseases combined, including HIV. Cases of acute HCV infection have increased approximately 3.8-fold over the last decade because of increasing injection drug use and improved surveillance. OBJECTIVE To update its 2013 recommendation, the USPSTF commissioned a review of the evidence on screening for HCV infection in adolescents and adults. POPULATION This recommendation applies to all asymptomatic adults aged 18 to 79 years without known liver disease. EVIDENCE ASSESSMENT The USPSTF concludes with moderate certainty that screening for HCV infection in adults aged 18 to 79 years has substantial net benefit. RECOMMENDATION The USPSTF recommends screening for HCV infection in adults aged 18 to 79 years. (B recommendation)

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