Role of simple biomarkers in predicting fibrosis progression in HCV infection

Rajasekhara R. Mummadi, John R. Petersen, Shu Yuan Xiao, Ned Snyder

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

AIM: To examine the accuracy of the aspartate aminotransferase (AST)/Platelet Ratio Index (APRI) and FIB-4, in predicting longitudinal changes in liver histology in hepatitis C virus (HCV) patients. METHODS: Patients that underwent repeat liver biopsies at least 1 year apart from 1999 to 2007 were identified. Liver fibrosis was staged on needle core biopsies evaluated by a single expert liver pathologist. Only laboratory values within 3 mo of the liver biopsies were used. RESULTS: Thirty-six patients met the inclusion criteria with 50% stage 1 on initial biopsy, 25% stage 2, and 22% stage 3. Nineteen of 36 (53%) had progression of fibrosis on repeat biopsies, while 16 (44%) showed no change in stage, and one (3%) showed improvement. Patients that showed progression of fibrosis had significantly higher alanine aminotransferase and aspartate aminotransferase levels than the group that did not show progression. A significant correlation was seen between change in stage of fibrosis and change in APRI (r2 = 0.39, P = 0.00001) and a change in FIB-4 (r2 = 0.31, P = 0.00004). A change in APRI (ΔAPRI) of 0.18 had 80% positive predictive value (PPV) and 67% negative predictive value (NPV) for progression of fibrosis. A change in FIB-4 (ΔFIB-4) of 0.39 had 75% PPV and 75% NPV for predicting progression of fibrosis. CONCLUSION: ΔAPRI and ΔFIB-4 parallel changes in fibrosis progression, and could be useful tools for clinicians in following patients with active chronic HCV infection.

Original languageEnglish
Pages (from-to)5710-5715
Number of pages6
JournalWorld Journal of Gastroenterology
Volume16
Issue number45
DOIs
StatePublished - Dec 2010
Externally publishedYes

Fingerprint

Virus Diseases
Hepacivirus
Fibrosis
Biomarkers
Blood Platelets
Biopsy
Liver
Aspartate Aminotransferases
Large-Core Needle Biopsy
Chronic Hepatitis C
Alanine Transaminase
Liver Cirrhosis
Histology

Keywords

  • Biomarkers
  • Hepatitis C
  • Liver biopsy
  • Liver fibrosis

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Role of simple biomarkers in predicting fibrosis progression in HCV infection. / Mummadi, Rajasekhara R.; Petersen, John R.; Xiao, Shu Yuan; Snyder, Ned.

In: World Journal of Gastroenterology, Vol. 16, No. 45, 12.2010, p. 5710-5715.

Research output: Contribution to journalArticle

Mummadi, Rajasekhara R. ; Petersen, John R. ; Xiao, Shu Yuan ; Snyder, Ned. / Role of simple biomarkers in predicting fibrosis progression in HCV infection. In: World Journal of Gastroenterology. 2010 ; Vol. 16, No. 45. pp. 5710-5715.
@article{afd1f1b3855e463e9d895db3eb99fe19,
title = "Role of simple biomarkers in predicting fibrosis progression in HCV infection",
abstract = "AIM: To examine the accuracy of the aspartate aminotransferase (AST)/Platelet Ratio Index (APRI) and FIB-4, in predicting longitudinal changes in liver histology in hepatitis C virus (HCV) patients. METHODS: Patients that underwent repeat liver biopsies at least 1 year apart from 1999 to 2007 were identified. Liver fibrosis was staged on needle core biopsies evaluated by a single expert liver pathologist. Only laboratory values within 3 mo of the liver biopsies were used. RESULTS: Thirty-six patients met the inclusion criteria with 50{\%} stage 1 on initial biopsy, 25{\%} stage 2, and 22{\%} stage 3. Nineteen of 36 (53{\%}) had progression of fibrosis on repeat biopsies, while 16 (44{\%}) showed no change in stage, and one (3{\%}) showed improvement. Patients that showed progression of fibrosis had significantly higher alanine aminotransferase and aspartate aminotransferase levels than the group that did not show progression. A significant correlation was seen between change in stage of fibrosis and change in APRI (r2 = 0.39, P = 0.00001) and a change in FIB-4 (r2 = 0.31, P = 0.00004). A change in APRI (ΔAPRI) of 0.18 had 80{\%} positive predictive value (PPV) and 67{\%} negative predictive value (NPV) for progression of fibrosis. A change in FIB-4 (ΔFIB-4) of 0.39 had 75{\%} PPV and 75{\%} NPV for predicting progression of fibrosis. CONCLUSION: ΔAPRI and ΔFIB-4 parallel changes in fibrosis progression, and could be useful tools for clinicians in following patients with active chronic HCV infection.",
keywords = "Biomarkers, Hepatitis C, Liver biopsy, Liver fibrosis",
author = "Mummadi, {Rajasekhara R.} and Petersen, {John R.} and Xiao, {Shu Yuan} and Ned Snyder",
year = "2010",
month = "12",
doi = "10.3748/wjg.v16.i45.5710",
language = "English",
volume = "16",
pages = "5710--5715",
journal = "World Journal of Gastroenterology",
issn = "1007-9327",
publisher = "WJG Press",
number = "45",

}

TY - JOUR

T1 - Role of simple biomarkers in predicting fibrosis progression in HCV infection

AU - Mummadi, Rajasekhara R.

AU - Petersen, John R.

AU - Xiao, Shu Yuan

AU - Snyder, Ned

PY - 2010/12

Y1 - 2010/12

N2 - AIM: To examine the accuracy of the aspartate aminotransferase (AST)/Platelet Ratio Index (APRI) and FIB-4, in predicting longitudinal changes in liver histology in hepatitis C virus (HCV) patients. METHODS: Patients that underwent repeat liver biopsies at least 1 year apart from 1999 to 2007 were identified. Liver fibrosis was staged on needle core biopsies evaluated by a single expert liver pathologist. Only laboratory values within 3 mo of the liver biopsies were used. RESULTS: Thirty-six patients met the inclusion criteria with 50% stage 1 on initial biopsy, 25% stage 2, and 22% stage 3. Nineteen of 36 (53%) had progression of fibrosis on repeat biopsies, while 16 (44%) showed no change in stage, and one (3%) showed improvement. Patients that showed progression of fibrosis had significantly higher alanine aminotransferase and aspartate aminotransferase levels than the group that did not show progression. A significant correlation was seen between change in stage of fibrosis and change in APRI (r2 = 0.39, P = 0.00001) and a change in FIB-4 (r2 = 0.31, P = 0.00004). A change in APRI (ΔAPRI) of 0.18 had 80% positive predictive value (PPV) and 67% negative predictive value (NPV) for progression of fibrosis. A change in FIB-4 (ΔFIB-4) of 0.39 had 75% PPV and 75% NPV for predicting progression of fibrosis. CONCLUSION: ΔAPRI and ΔFIB-4 parallel changes in fibrosis progression, and could be useful tools for clinicians in following patients with active chronic HCV infection.

AB - AIM: To examine the accuracy of the aspartate aminotransferase (AST)/Platelet Ratio Index (APRI) and FIB-4, in predicting longitudinal changes in liver histology in hepatitis C virus (HCV) patients. METHODS: Patients that underwent repeat liver biopsies at least 1 year apart from 1999 to 2007 were identified. Liver fibrosis was staged on needle core biopsies evaluated by a single expert liver pathologist. Only laboratory values within 3 mo of the liver biopsies were used. RESULTS: Thirty-six patients met the inclusion criteria with 50% stage 1 on initial biopsy, 25% stage 2, and 22% stage 3. Nineteen of 36 (53%) had progression of fibrosis on repeat biopsies, while 16 (44%) showed no change in stage, and one (3%) showed improvement. Patients that showed progression of fibrosis had significantly higher alanine aminotransferase and aspartate aminotransferase levels than the group that did not show progression. A significant correlation was seen between change in stage of fibrosis and change in APRI (r2 = 0.39, P = 0.00001) and a change in FIB-4 (r2 = 0.31, P = 0.00004). A change in APRI (ΔAPRI) of 0.18 had 80% positive predictive value (PPV) and 67% negative predictive value (NPV) for progression of fibrosis. A change in FIB-4 (ΔFIB-4) of 0.39 had 75% PPV and 75% NPV for predicting progression of fibrosis. CONCLUSION: ΔAPRI and ΔFIB-4 parallel changes in fibrosis progression, and could be useful tools for clinicians in following patients with active chronic HCV infection.

KW - Biomarkers

KW - Hepatitis C

KW - Liver biopsy

KW - Liver fibrosis

UR - http://www.scopus.com/inward/record.url?scp=78649857794&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=78649857794&partnerID=8YFLogxK

U2 - 10.3748/wjg.v16.i45.5710

DO - 10.3748/wjg.v16.i45.5710

M3 - Article

C2 - 21128320

AN - SCOPUS:78649857794

VL - 16

SP - 5710

EP - 5715

JO - World Journal of Gastroenterology

JF - World Journal of Gastroenterology

SN - 1007-9327

IS - 45

ER -