Noninvasive serum markers in the diagnosis of structural liver damage in chronic

October 11, 2006

Liver International

Volume 26 Page 1095 - November 2006

doi:10.1111/j.1478-3231.2006.01356.x

Volume 26 Issue 9

Clinical Studies

Noninvasive serum markers in the diagnosis of structural liver damage in

chronic hepatitis C virus infection

Edison R. Parise1, Ana C. Oliveira1, Cláudio Figueiredo-Mendes1, Valéria

Lanzoni2, João s3, Helena Nader3 and L. Ferraz1

Parise ER, Oliveira AC, Figueiredo-Mendes C, Lanzoni V, s J, Nader H,

Ferraz ML. Noninvasive serum markers in the diagnosis of structural liver

damage in chronic hepatitis C virus infection.

Liver International 2006: 26: 1095–1099.

Abstract: Aim: Several noninvasive markers are being used to assess the

structural liver damage in patients with chronic hepatitis C (CHC). We

evaluated the capacity of serum hyaluronic acid (HA), aspartate

aminotransferase (AST)/ALT ratio, the AST to platelet ratio index (APRI) and

& #947;-glutamyltransferase (GGT) levels to predict the intensity of hepatic

fibrosis in patients with CHC.

Patients and methods: In a total of 206 hepatitis C virus RNA-positive

biopsied patients, AST, ALT, GGT levels, platelet count and serum HA

concentration were determined. The APRI was calculated as the ratio of AST

to platelets.

Results: HA levels were best correlated with disease stage (r= & #8722;0.694;

P<0.001). In the diagnosis of significant fibrosis (F2–F4), HA levels

[AUC=0.879, 95% CI (0.832–0.927)] and APRI [AUC=0.824 (0.772–0.903)] were

the markers with the best diagnostic accuracy. These parameters also best

identified the presence of cirrhosis (F4), with an AUC of 0.908

(0.868–0.949) for HA and of 0.837 (0.772–0.903) for APRI.

Conclusion: Serum HA was the parameter that alone presented the best

diagnostic accuracy in the assessment of hepatic fibrosis in CHC. The APRI

showed a better diagnostic sensitivity than GGT levels or the AST/ALT ratio.

Its simple determination and low cost make this index a valid alternative

for the noninvasive staging of CHC.

_________________________________________________________________

Recommended Posts