OBJECTIVES: Fibrotest (FT) and Actitest (AT) are biochemical markers of fibrosis and activity for use as a non-invasive alternative to liver biopsy in patients with chronic hepatitis C virus (HCV). The aim of this study was to perform an external validation of FT and AT and to study the discordances between FT/AT and liver biopsy in patients with chronic hepatitis C. METHODS: A total of 519 consecutive patients with chronic HCV were prospectively included in five centers, with liver biopsy and biochemical markers taken at the same day. Fifteen patients were excluded because their biopsies could not be interpreted. Diagnostic accuracies were assessed by receiver operating characteristic (ROC) curve analysis. RESULTS: Median biopsy size was 15 mm (range: 2-58), with 9 portal tracts (1-37) and 1 fragment (1-12). 46% (230/504) were classified F2-F4 in fibrosis and 39% A2-A3 in activity. FT area under ROC curve for diagnosis of activity (A2-A3), significant fibrosis (F2-F4), and severe fibrosis (F3-F4) were 0.73 [0.69-0.77], 0.79 [0.75-0.82], and 0.80 [0.76-0.83], respectively. Among the 92 patients (18%) with 2 fibrosis stages of discordance between FT and biopsy, the discordance was attributable to FT in 5% of cases, to biopsy in 4%, and undetermined in 9%. CONCLUSIONS: This prospective independent and multicenter study confirms the diagnostic value of FT and AT found in the princeps study and suggests that FT and AT can be an alternative to biopsy in most patients with chronic HCV.
OBJECTIVES: Fibrotest (FT) and Actitest (AT) are biochemical markers of fibrosis and activity for use as a non-invasive alternative to liver biopsy in patients with chronic hepatitis C virus (HCV). The aim of this study was to perform an external validation of FT and AT and to study the discordances between FT/AT and liver biopsy in patients with chronic hepatitis C. METHODS: A total of 519 consecutive patients with chronic HCV were prospectively included in five centers, with liver biopsy and biochemical markers taken at the same day. Fifteen patients were excluded because their biopsies could not be interpreted. Diagnostic accuracies were assessed by receiver operating characteristic (ROC) curve analysis. RESULTS: Median biopsy size was 15 mm (range: 2-58), with 9 portal tracts (1-37) and 1 fragment (1-12). 46% (230/504) were classified F2-F4 in fibrosis and 39% A2-A3 in activity. FT area under ROC curve for diagnosis of activity (A2-A3), significant fibrosis (F2-F4), and severe fibrosis (F3-F4) were 0.73 [0.69-0.77], 0.79 [0.75-0.82], and 0.80 [0.76-0.83], respectively. Among the 92 patients (18%) with 2 fibrosis stages of discordance between FT and biopsy, the discordance was attributable to FT in 5% of cases, to biopsy in 4%, and undetermined in 9%. CONCLUSIONS: This prospective independent and multicenter study confirms the diagnostic value of FT and AT found in the princeps study and suggests that FT and AT can be an alternative to biopsy in most patients with chronic HCV.
Authors: Dana Lau-Corona; Luís Alberto Pineda; Héctor Hugo Avilés; Gabriela Gutiérrez-Reyes; Blanca Eugenia Farfan-Labonne; Rafael Núñez-Nateras; Alan Bonder; Rosalinda Martínez-García; Clara Corona-Lau; Marco Antonio Olivera-Martínez; Maria-Concepción Gutiérrez-Ruiz; Guillermo Robles-Díaz; David Kershenobich Journal: World J Gastroenterol Date: 2009-06-07 Impact factor: 5.742
Authors: Saurabh Sethi; Douglas A Simonetto; Soha S Abdelmoneim; Michael B Campion; Irakli Kaloiani; Amy C Clayton; Walter K Kremers; Kevin C Halling; Patrick S Kamath; Jayant Talwalkar; Vijay H Shah Journal: J Clin Exp Hepatol Date: 2012-04-12
Authors: Gia L Tyson; Peter A Richardson; Donna L White; Jill Kuzniarek; David J Ramsey; Shahriar Tavakoli-Tabasi; Hashem B El-Serag Journal: J Clin Gastroenterol Date: 2013-07 Impact factor: 3.062
Authors: D L White; S Tavakoli-Tabasi; F Kanwal; D J Ramsey; A Hashmi; J Kuzniarek; P Patel; J Francis; H B El-Serag Journal: Aliment Pharmacol Ther Date: 2013-05-26 Impact factor: 8.171