Utility and limitations of APRI and FIB4 to predict staging in a cohort of nonselected outpatients with hepatitis C

Oliveira, Ana Cláudia de; El-Bacha, Ibrahin; Vianna, Mônica V; Parise, Edison Roberto

doi:10.5604/16652681.1198801

Cited by 23 publications

(19 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…FIB-4 has a better AUROC compared to APRI and is the preferred noninvasive fibrosis score to discriminate between F0-F2 and F3-F4. This is similar to results of other studies [21,22]. The majority of studies which involved 13Clabelled hepatic breath test substrates comprised heterogeneous patient groups with a variety of hepatic diseases.…”

Section: Discussionsupporting

confidence: 89%

The 13C-Aminopyrine Breath Test Predicts Advanced Fibrosis in Patients with Chronic Hepatitis C: A Pilot Study

Soliman¹,

Shiha

El-Basiouny

et al. 2016

Medical Journal of Viral Hepatitis

View full text Add to dashboard Cite

13C Aminopyrine breath test (13C-ABT) is a dynamic function test based on the use of a labelled substrate that selectively metabolized by the liver which is useful in the evaluation of hepatocyte function providing a quantitative information on liver function activity. A significant inverse correlation between C13-ABT results and liver fibrosis was found. In this study we investigate the accuracy of 13C-ABT as non-invasive method for identification of liver fibrosis compared to other non-invasive methods. Thirty-six chronic hepatitis C patients were recruited from the outpatient clinic of the Egyptian Liver Research Institute and Hospital (ELRIAH). Percutaneous liver biopsy and routine blood sampling were performed at the same day. FibroScan and 13C-ABT were done. Liver fibrosis showed strong correlation with FibroScan (r=0.717, p<0.001) and significant inverse correlation with 13C-ABT results, especially at 30 min. (r=-0.371, p=0.026). Significant correlation was found with FIB-4 (r=0.350, p=0.039) and not significant correlation was found with APRI (r=0.261, p=0.240). The cutoff value of 3.15% (dose/hr at 30 min) was associated with high prediction (positive predictive value, 60%; negative predictive value, 92.3%) yielding an overall sensitivity of 75% and specificity of 85.7%. As regards the 13C-ABT % cum. dose at 120 min, a cutoff value of 4.35 was also associated with high accuracy (PPV=47.1%, NPV=100%, Sensitivity=100% and Specificity=67.9%. These results of high accuracy is comparable to FibroScan and FIB-4, and is better than the results of APRI. 13C-aminopyrine breath test is a potential biomarker for advanced fibrosis that warrants further validation.

show abstract

Section: Discussionsupporting

confidence: 89%

The 13C-Aminopyrine Breath Test Predicts Advanced Fibrosis in Patients with Chronic Hepatitis C: A Pilot Study

Soliman¹,

Shiha

El-Basiouny

et al. 2016

Medical Journal of Viral Hepatitis

View full text Add to dashboard Cite

show abstract

“…Although APRI and FIB‐4 have previously been shown to be useful to stage liver fibrosis, our results suggested that LSM was, at present, the most accurate noninvasive method for early detection of fibrosis in AIH. The lower performance of APRI and FIB‐4 for predicting severe fibrosis in AIH patients was due to, at least partly, higher aminotransferase levels in our patients than those from previous studies in which the patients of ALT more than two times ULN were excluded …”

Section: Discussionmentioning

confidence: 55%

Evaluation of transient elastography in assessing liver fibrosis in patients with autoimmune hepatitis

Sheng

Bao

et al. 2017

J of Gastro and Hepatol

View full text Add to dashboard Cite

show abstract

“…It was published previously, that intermediate FIB-4 values of 1.45–3.25 have negative predictive value of 89% for excluding advanced fibrosis and patients in this range would require a liver biopsy to assess the fibrosis stage. Thirty to forty percent of patients have an indeterminate score, and in these cases, additional testing is needed[ 35 , 46 ].…”

Section: Discussionmentioning

confidence: 99%

Longitudinal decrease in platelet counts as a surrogate marker of liver fibrosis

Gotlieb¹,

Schwartz²,

Zelber‐Sagi³

et al. 2020

WJG

View full text Add to dashboard Cite

BACKGROUND Liver cirrhosis is a significant source of morbidity and mortality worldwide. The disease is usually indolent and asymptomatic early in its course while many cirrhotic patients are diagnosed late when severe complications occur. A major challenge is to diagnose advanced fibrosis as early as possible, using simple and non-invasive diagnostics tools. Thrombocytopenia represents advanced fibrosis and portal hypertension (HTN) and most non-invasive scores that predict liver fibrosis incorporate platelets as a strong risk factor. However, little is known about the association between longitudinal changes in platelet counts (PTC), when still within the normal range, and the risk of cirrhosis. AIM To explore whether platelet counts trajectories over time, can predict advanced liver fibrosis across the different etiologies of liver diseases. METHODS A nested case-control study utilizing a large computerized database. Cirrhosis cases ( n = 5258) were compared to controls ( n = 15744) matched for age and sex at a ratio of 1:3. All participants had multiple laboratory measurements prior to enrollment. We calculated the trends of PTC, liver enzymes, bilirubin, international normalized ratio, albumin and fibrosis scores (fibrosis-4 and aspartate transaminase-to-platelet ratio index) throughout the preceding 20 years prior to cirrhosis diagnosis compared to healthy controls. The association between PTC, cirrhosis complications and fibrosis scores prior to cirrhosis diagnosis was investigated. RESULTS The mean age in both groups was 56 (SD 15.8). Cirrhotic patients were more likely to be smokers, diabetic with chronic kidney disease and had a higher prevalence of HTN. The leading cirrhosis etiologies were viral, alcoholic and fatty liver disease. The mean PTC decreased from 240000/μL to 190000/μL up to 15 years prior to cirrhosis diagnosis compared to controls who’s PTC remained stable around the values of 240000/μL. This trend was consistent regardless of sex, cirrhosis etiology and was more pronounced in patients who developed varices and ascites. Compared to controls whose values remained in the normal range, in the cirrhosis group aspartate aminotransferase and alanine aminotransferase, increased from 40 U/L to 75 U/L and FIB-4 increased gradually from 1.3 to 3 prior to cirrhosis diagnosis. In multivariable regression analysis, a decrease of 50 units in PTC was associated with 1.3 times odds of cirrhosis (95%CI 1.25-1.35). CONCLUSION In the preceding years before the diagnosis of cirrhosis, there is a progressive decline in PTC, within the normal range, matched to a gradual increase in fibrosis scores.

show abstract

Utility and limitations of APRI and FIB4 to predict staging in a cohort of nonselected outpatients with hepatitis C

Cited by 23 publications

References 24 publications

The 13C-Aminopyrine Breath Test Predicts Advanced Fibrosis in Patients with Chronic Hepatitis C: A Pilot Study

The 13C-Aminopyrine Breath Test Predicts Advanced Fibrosis in Patients with Chronic Hepatitis C: A Pilot Study

Evaluation of transient elastography in assessing liver fibrosis in patients with autoimmune hepatitis

Longitudinal decrease in platelet counts as a surrogate marker of liver fibrosis

Contact Info

Product

Resources

About