Utility and limitations of APRI and FIB4 to predict staging in a cohort of nonselected outpatients with hepatitis C
Título del documento: Utility and limitations of APRI and FIB4 to predict staging in a cohort of nonselected outpatients with hepatitis C
Revue: Annals of hepatology
Base de datos: PERIÓDICA
Número de sistema: 000411154
ISSN: 1665-2681
Autores: 1
2
2
2
Instituciones: 1Universidade Federal de Sao Carlos, Departamento de Medicina, Sao Carlos, Sao Paulo. Brasil
2Universidade Federal de Sao Paulo, Divisao de Gastroenterologia, Sao Paulo. Brasil
Año:
Periodo: May-Jun
Volumen: 15
Número: 3
Paginación: 326-332
País: México
Idioma: Inglés
Tipo de documento: Estadística o encuesta
Enfoque: Analítico
Resumen en inglés Chronic hepatitis C (CHC) staging is important for therapeutic decision-making. Identification of noninvasive markers can provide alternatives to liver biopsy. Aim. To assess Aim. the value of APRI and FIB4 for CHC fibrosis staging in a cohort of nonselected outpatients from a referral center in Sao Paulo, Brazil. Material and methods. Material and methods. Medical records of 798 adult outpatients were analyzed retrospectively. For calculations of APRI and FIB4, the original descriptions were considered, and markers were compared with degree of liver injury. Results. Results. Results. Overall, 49.3% of participants were female, and mean age was 56.9 ± 12.5 years. Genotype 1 was predominant (71.7vs. 23.7% genotype 3); 64% had significant fibrosis, 44% had advanced fibrosis, and 28% had cirrhosis. The areas under the receiver operating curve for significant fibrosis, advanced fibrosis, and cirrhosis, respectively, were 0.809, 0.819, and 0.815 for the APRI marker and 0.803, 0.836 and 0.852 for FIB4. Using the recommended cut off values, approximately 30-40% of the patients could not be classified. In the remainder, either APRI or FIB4 alone correctly diagnosed 80-85% of cases. Concomitant or consecutive use of both APRI and FIB4 increased the number of the cases correctly diagnosed only slightly, but also increased the number of patients not classified within the cutoff values. Conclusions. Use of the APRI or FIB4 markers for detection of hepatic fibrosis may be a viable alternative at referral centers for treatment of CHC in low- and middleincome countries. Despite relatively good accuracy, a significant number of patients could not be assessed by these methods
Disciplinas: Medicina
Palabras clave: Diagnóstico,
Gastroenterología,
Hepatitis C,
Fibrosis hepática,
Estadios,
Marcadores serológicos
Keyword: Medicine,
Diagnosis,
Gastroenterology,
Hepatitis C,
Serum markers,
Liver fibrosis,
Stages
Texte intégral: Texto completo (Ver PDF)