BACKGROUND: The accurate diagnosis of hepatitis C virus (HCV)-related fibrosis is crucial for prognostication and treatment decisions. Due to the limitations of biopsy, noninvasive alternatives including FibroTest and FibroScan have been developed. Our objective was to systematically review studies describing the accuracy of these tests for predicting HCV-related fibrosis. METHODS: Studies comparing FibroTest or FibroScan versus biopsy in HCV patients were identified via an electronic search. Random effects meta-analyses and areas under summary receiver operating characteristics curves (AUC) were examined to characterize test accuracy for significant fibrosis (F2-4) and cirrhosis. Heterogeneity was explored using meta-regression. RESULTS: Twelve studies were identified, 9 for FibroTest (N = 1,679) and 4 for FibroScan (N = 546). In heterogeneous analyses for significant fibrosis, the AUCs for FibroTest and FibroScan were 0.81 (95% CI 0.78-84) and 0.83 (0.03-1.00), respectively. At a threshold of approximately 0.60, the sensitivity and specificity of the FibroTest were 47% (35-59%) and 90% (87-92%). For FibroScan (threshold approximately 8 kPa), corresponding values were 64% (50-76%) and 87% (80-91%), respectively. Methodological quality, the length of liver biopsy specimens, and inclusion of special populations did not explain the observed heterogeneity. However, the diagnostic accuracy of both measures was associated with the prevalence of significant fibrosis and cirrhosis in the study populations. For cirrhosis, the summary AUCs for FibroTest and FibroScan were 0.90 (95% CI not calculable) and 0.95 (0.87-0.99), respectively. CONCLUSIONS: FibroTest and FibroScan have excellent utility for the identification of HCV-related cirrhosis, but lesser accuracy for earlier stages. Refinements are necessary before these tests can replace liver biopsy.
BACKGROUND: The accurate diagnosis of hepatitis C virus (HCV)-related fibrosis is crucial for prognostication and treatment decisions. Due to the limitations of biopsy, noninvasive alternatives including FibroTest and FibroScan have been developed. Our objective was to systematically review studies describing the accuracy of these tests for predicting HCV-related fibrosis. METHODS: Studies comparing FibroTest or FibroScan versus biopsy in HCVpatients were identified via an electronic search. Random effects meta-analyses and areas under summary receiver operating characteristics curves (AUC) were examined to characterize test accuracy for significant fibrosis (F2-4) and cirrhosis. Heterogeneity was explored using meta-regression. RESULTS: Twelve studies were identified, 9 for FibroTest (N = 1,679) and 4 for FibroScan (N = 546). In heterogeneous analyses for significant fibrosis, the AUCs for FibroTest and FibroScan were 0.81 (95% CI 0.78-84) and 0.83 (0.03-1.00), respectively. At a threshold of approximately 0.60, the sensitivity and specificity of the FibroTest were 47% (35-59%) and 90% (87-92%). For FibroScan (threshold approximately 8 kPa), corresponding values were 64% (50-76%) and 87% (80-91%), respectively. Methodological quality, the length of liver biopsy specimens, and inclusion of special populations did not explain the observed heterogeneity. However, the diagnostic accuracy of both measures was associated with the prevalence of significant fibrosis and cirrhosis in the study populations. For cirrhosis, the summary AUCs for FibroTest and FibroScan were 0.90 (95% CI not calculable) and 0.95 (0.87-0.99), respectively. CONCLUSIONS: FibroTest and FibroScan have excellent utility for the identification of HCV-related cirrhosis, but lesser accuracy for earlier stages. Refinements are necessary before these tests can replace liver biopsy.
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: Mohammed Aljawad; Eric M Yoshida; Julia Uhanova; Paul Marotta; Natasha Chandok Journal: Can J Gastroenterol Date: 2013-11 Impact factor: 3.522
Authors: Giovanna Ferraioli; Carmine Tinelli; Barbara Dal Bello; Mabel Zicchetti; Raffaella Lissandrin; Gaetano Filice; Carlo Filice; Elisabetta Above; Giorgio Barbarini; Enrico Brunetti; Willy Calderon; Marta Di Gregorio; Roberto Gulminetti; Paolo Lanzarini; Serena Ludovisi; Laura Maiocchi; Antonello Malfitano; Giuseppe Michelone; Lorenzo Minoli; Mario Mondelli; Stefano Novati; Savino F A Patruno; Alessandro Perretti; Gianluigi Poma; Paolo Sacchi; Domenico Zanaboni; Marco Zaramella Journal: World J Gastroenterol Date: 2013-01-07 Impact factor: 5.742
Authors: Alexander R Guimaraes; Luiz Siqueira; Ritika Uppal; Jamu Alford; Bryan C Fuchs; Suguru Yamada; Kenneth Tanabe; Raymond T Chung; Gregory Lauwers; Michael L Chew; Giles W Boland; Duhyant V Sahani; Mark Vangel; Peter F Hahn; Peter Caravan Journal: Quant Imaging Med Surg Date: 2016-04
Authors: Jason Grebely; Geert Robaeys; Philip Bruggmann; Alessio Aghemo; Markus Backmund; Julie Bruneau; Jude Byrne; Olav Dalgard; Jordan J Feld; Margaret Hellard; Matthew Hickman; Achim Kautz; Alain Litwin; Andrew R Lloyd; Stefan Mauss; Maria Prins; Tracy Swan; Martin Schaefer; Lynn E Taylor; Gregory J Dore Journal: Int J Drug Policy Date: 2015-07-17