Noninvasive serum markers in the diagnosis of structural liver damage in chronic hepatitis C virus infection

Author(s)

Parise‚ E.R. ; Oliveira‚ A.C. ; Figueiredo-Mendes‚ C. ; Lanzoni‚ V. ; Martins‚ J. ; Nader‚ H. ; Ferraz‚ M.L.

• Document type: Journal article
• Source: LIVER INTERNATIONAL; v. 26, n. 9, p. 1095-1099, 2006.

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 gamma-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=-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. Conclusions: 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. (AU)

• FAPESP's process: 02/05260-6 - Experimental and clinical aspects of liver fibrosis and portal hypertension
• Grantee: Durval Rosa Borges
• Support Opportunities: Research Projects - Thematic Grants