Concordance of non-invasive serology-based scoring indices and transient elastography for liver fibrosis and cirrhosis in chronic hepatitis C

Abstract

<p><strong>Aim <br /></strong>To assess concordance of eight frequently used serology-based scoring indices for liver fibrosis and cirrhosis with transient elastography (TE) in chronic hepatitis C (CHC) patients in order to determine serum indices with the highest concordance and clinical usability in clinical practice.<br /><strong>Methods <br /></strong>In this prospective study, 63 CHC patients were included and TE results were compared with eight non-invasive indices.<br />The diagnostic performance of these tests was assessed using receiver operating characteristic curves with kappa index calculated for the concordance analysis.<br /><strong>Results</strong> <br />Median age of 63 patients was 54 years (interquartile range: 42 to 63); 27 (42.9%) were females. According to areas under the Receiver Operating Characteristics (AUROC), the best performing serum markers for significant liver fibrosis (METAVIR ≥F2), advanced liver fibrosis (≥F3) and cirrhosis (F4) determined by TE measurements (≥7.1kPa, ≥9.5kPa and ≥12kPa, respectively) were Fibrotest (AUROC=0.727 for ≥F2) and FIB-4 score (AUROC=0.779 for ≥F3 and AUROC=0.889 for F4). Fibrotest cut-off at >0.50 was concordant with TE for presence of significant fibrosis in 30 (out of 45; 66.7%), FIB-4 cut-off at <1.45 was concordant for absence of significant fibrosis in 13 (out of 18; 72.2%) and<br />Goeteborg University Cirrhosis Index (GUCI) cut-off at >1 was concordant for presence of cirrhosis in 16 (out of 22; 72.7%) patients, but not for exclusion of cirrhosis.<br /><strong>Conclusion</strong> <br />Serology-based scoring indices had moderate overall concordance with TE. We propose that FIB-4 score, Fibrotest and<br />GUCI be used in routine practice to exclude and diagnose significant fibrosis and diagnose cirrhosis, respectively.</p>