Noninvasive diagnosis of cirrhosis in chronic hepatitis C based on standard laboratory tests

Early detection in routine clinical practice of cirrhosis and oesophageal varices in chronic hepatitis C: Comparison of transient elastography (FibroScan) with standard laboratory tests and non-invasive scores

“…Receiver operating characteristics (ROC) curves were constructed. Sensitivity (Se), specificity (Sp), positive and negative predictive values (PPV and NPV), positive likelihood ratio (+LR) and negative likelihood ratio (ÀLR) were calculated using cut-offs previously described for cirrhosis for each serum index (FibroTest value P0.75 [22]; platelet count <150 Â 10 9 L À1 [18]; PI 685% [17]; AST/ ALT ratio >1 [20]; APRI <1 or P2 [21]; Lok index <0.2 or P0.5 [23]) and the two reported TE cut-offs (12.5 and 14.6 kPa) [26,27].…”

“…Several laboratory tests and scores have been proposed for the non-invasive prediction of cirrhosis in patients with CHC. Among these, prothrombin index (PI) [17], platelet count [18], AST/ALT ratio (AAR) [19,20], and AST-to-platelet ratio index (APRI) [21] are based on routine laboratory parameters and therefore readily available in clinical practice. Among scores calculated from statistical models, the FibroTest (FT; Biopredictive, Paris, France) is based on a mathematical formula combining five variables (total bilirubin, cGT, haptoglobin, a2-macroglobulin and apoliprotein A1) [22] and the Lok index (combining platelet count, AST/ALT ratio, and international normalized ratio, INR) has been specifically designed for the diagnosis of HCV-cirrhosis [23].…”

Chronic hepatitis C and liver fibrosis

“…Platelet count showed a discrete performance in ruling-out cirrhosis with a cut-off value of 150 × 10 9 /L, with 84% to 95% NPV [119,136,137] . The prothrombin index, based on prothrombin time, showed a NPV ranging from 82% to 91% to rule-out cirrhosis [119,137] .…”

The impact of liver disease aetiology and the stages of hepatic fibrosis on the performance of non-invasive fibrosis biomarkers: an international study of 2411 cases

“…Recently, increasing interest has been directed towards the use of non‐invasive tools to assess liver fibrosis. These include simple markers based on routinary tests, like platelets, AST‐to‐platelet ratio index (APRI), Forns’ index, Fib‐4, Lok index and AST‐to‐ALT ratio (AAR), and other more sophisticated and patented tests, such as Fibrotest‐Fibrosure 15–21 . In the midst of a large series of publications on these markers, investigated mainly in CHC, their implementation in clinical practice is still debated and large‐scale studies in aetiological forms other than HCV are still limited 12, 13, 22 .…”