Evaluation of a panel of non-invasive serum markers to differentiate mild from moderate-to-advanced liver fibrosis in chronic hepatitis C patients

Patel, Keyur; Gordon, Stuart C.; Jacobson, Ira M.; Hézode, Christophe; Oh, Esther S.; Smith, Katie; Pawlotsky, Jean‐Michel; McHutchison, John G.

doi:10.1016/j.jhep.2004.08.008

Cited by 296 publications

(184 citation statements)

References 37 publications

(33 reference statements)

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“…In clinical practice, the assay gives a high likelihood of prediction as to the presence of mild and advanced fibrosis but performs less well for intermediate stages. 120 The assay has been validated prospectively and appears to be particularly useful in excluding advanced fibrosis. 121,122 The European Liver Fibrosis group reported an assay in a multicenter cohort of 1021 patients with chronic HCV, NAFLD, and alcoholic liver disease.…”

Section: Fibrospectmentioning

confidence: 99%

Diagnosis and Quantitation of Fibrosis

2008

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Section: Fibrospectmentioning

confidence: 99%

Diagnosis and Quantitation of Fibrosis

2008

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“…FIBROSpect uses three serum markers, a-2-M, HA, and TIMP, to calculate a score. When applied to 696 patients with HCV infection, a score lower than 0.36 excluded significant fibrosis with a negative predictive value of 76% and a score higher than 0.36 detected significant fibrosis with a positive predictive value of 74% [20].…”

Section: Fibrospectmentioning

confidence: 99%

Liver fibrosis: consensus recommendations of the Asian Pacific Association for the Study of the Liver (APASL)

et al. 2008

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“…Serum biochemical tests, including direct and indi-rect markers of liver fibrosis, have been the most widely investigated. 8,9 Direct markers such as glycoproteins (for example, hyaluronic acid, laminin, YKL-40), collagens, the matrix metalloproteinases and their inhibitors, and cytokines (for example, transforming growth factor beta) have demonstrated associations with fibrosis, and some have been incorporated into panels available on a proprietary basis (for example, FibroSpect, 10 FibroMeter, 11 Hepascore, 12 the European Liver Fibrosis test 13 ). Although these markers are less expensive than liver biopsy, they are still costly and are not available in most clinical settings.…”

mentioning

confidence: 99%

Diagnostic accuracy of the aspartate aminotransferase-to-platelet ratio index for the prediction of hepatitis C–related fibrosis: A systematic review

2007

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The development of noninvasive markers of liver fibrosis is a clinical and research priority. The aspartate aminotransferase-to-platelet ratio index (APRI) is a promising tool with limited expense and widespread availability. Our objective was to systematically review the performance of the APRI in hepatitis C virus (HCV)-infected patients. Random effects meta-analyses and areas under summary receiver operating characteristic curves (AUC) were examined to characterize APRI accuracy for significant fibrosis (stages 2-4) and cirrhosis. In 22 studies (n ‫؍‬ 4,266), the summary AUCs of the APRI for significant fibrosis and cirrhosis were 0.76 [95% confidence interval (CI), 0.74-0.79] and 0.82 (95%CI, 0.79-0.86), respectively. For significant fibrosis, an APRI threshold of 0.5 was 81% sensitive and 50% specific. At a 40% prevalence of significant fibrosis, this threshold had a negative predictive value (NPV) of 80%, but could reduce the necessity of liver biopsy by only 35%. For cirrhosis, a threshold of 1.0 was 76% sensitive and 71% specific. At a 15% cirrhosis prevalence, the NPV of this threshold was 91%. Higher APRI thresholds had suboptimal positive predictive values except in settings with a high prevalence of cirrhosis. APRI accuracy was not affected by the prevalence of advanced fibrosis, or study and biopsy quality. However, the accuracy for cirrhosis was greater in studies including human immunodeficiency virus (HIV)/HCV-co-infected patients. Conclusion: The major strength of the APRI is the exclusion of significant HCV-related fibrosis. Future studies of novel markers should demonstrate improved accuracy and cost-effectiveness compared with this economical and widely available index. (HEPATOLOGY 2007;46:912-921.)

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Evaluation of a panel of non-invasive serum markers to differentiate mild from moderate-to-advanced liver fibrosis in chronic hepatitis C patients

Cited by 296 publications

References 37 publications

Diagnosis and Quantitation of Fibrosis

Diagnosis and Quantitation of Fibrosis

Liver fibrosis: consensus recommendations of the Asian Pacific Association for the Study of the Liver (APASL)

Diagnostic accuracy of the aspartate aminotransferase-to-platelet ratio index for the prediction of hepatitis C–related fibrosis: A systematic review

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