Diagnostic accuracy of the fibrotest in hemodialysis and renal transplant patien

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Diagnostic accuracy of the fibrotest in hemodialysis and renal transplant

patients with chronic hepatitis C virus.

Varaut A, Fontaine H, Serpaggi J, Verkarre V, Vallet-Pichard A, Nalpas B,

Imbertbismuth F, Lebray P, Pol S.

1 Liver Diseases Unit, INSERM U-370, Pathological Anatomy Department,

Hopital Necker, Paris, France. 2 Biochemistry Department, Hopital de la

Pitie-Salpetriere, Paris, France.

BACKGROUND.: An accurate diagnosis of hepatitis C virus (HCV)-related liver

lesions is mandatory in dialysis patients and kidney recipients to better

define the treatment of and contraindications to kidney transplantation. The

aim of this study was to assess the diagnostic accuracy of the fibrotest (a

noninvasive method to assess liver fibrosis in HCV on a scale from 0 to 1)

in hemodialysis and renal transplant patients infected by chronic HCV.

METHODS.: In all, 110 patients with biopsy-proven HCV (60 renal transplant

recipients and 50 hemodialysis patients), determined using the METAVIR

scoring system, were studied. RESULTS.: Forty-six percent of patients had

fibrosis >/=F2. A positive predictive value of a score >0.6 for the presence

of significant fibrosis by comparison with liver biopsy was 71%, and an

negative predictive value of <0.2 for excluding significant fibrosis was

77%, respectively. The areas under the ROC curves for the diagnosis of

significant fibrosis were 0.66, 0.47, and 0.71 in the global population,

hemodialysis patients, and renal transplant patients, respectively. In all,

75% of patients were correctly classified using the fibrotest. If biopsy was

restricted to scores in the intermediate range (<0.6 and >0.2), the index

could reduce the indication for biopsy by 47%. The results did not differ

significantly in hemodialysis and renal transplant patients. CONCLUSION.:

The fibrotest has a diagnostic value in hemodialysis and renal transplant

patients which is similar to that reported in the general population (75%)

and its use could avoid 32% of liver biopsies if it were interpreted in

detail in nephrology patients.

PMID: 16371924 [PubMed - in process]

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=PubMed & list_uids=1\

6371924 & dopt=Abstract

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