Novel non-invasive biological predictive index for liver fibrosis in hepatitis C virus genotype 4 patients

AIM To investigate the diagnostic ability of a non-invasive biological marker to predict liver fibrosis in hepatitis C genotype 4 patients with high accuracy.METHODS A cohort of 332 patients infected with hepatitis C genotype 4 was included in this cross-sectional study. Fasting plasma glucose, insu...

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Bibliographic Details
Published in:World journal of hepatology 2016-11, Vol.8 (32), p.1392-1401
Main Authors: Khattab, Mahmoud, Sakr, Mohamed Amin, Fattah, Mohamed Abdel, Mousa, Youssef, Soliman, Elwy, Breedy, Ashraf, Fathi, Mona, Gaber, Salwa, Altaweil, Ahmed, Osman, Ashraf, Hassouna, Ahmed, Motawea, Ibrahim
Format: Article
Language:English
Subjects:
Observational Study
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Summary:AIM To investigate the diagnostic ability of a non-invasive biological marker to predict liver fibrosis in hepatitis C genotype 4 patients with high accuracy.METHODS A cohort of 332 patients infected with hepatitis C genotype 4 was included in this cross-sectional study. Fasting plasma glucose, insulin, C-peptide, and angiotensinconverting enzyme serum levels were measured. Insulin resistance was mathematically calculated using the homeostasis model of insulin resistance(HOMA-IR).RESULTS Fibrosis stages were distributed based on Metavir score as follows: F0 = 43, F1 = 136, F2 = 64, F3 = 45 and F4 = 44. Statistical analysis relied upon reclassification of fibrosis stages into mild fibrosis(F0-F) = 179, moderate fibrosis(F2) = 64, and advanced fibrosis(F3-F4) = 89. Univariate analysis indicated that age, log aspartate amino transaminase, log HOMA-IR and log platelet count were independent predictors of liver fibrosis stage(P < 0.0001). A stepwise multivariate discriminant functional analysis was used to drive a discriminative model for liver fibrosis. Our index used cut-off values of ≥ 0.86 and ≤-0.31 to diagnose advanced and mild fibrosis, respectively, with receiving operating characteristics of 0.91 and 0.88, respectively. The sensitivity, specificity, positive predictive value, negative predictive value and positive likelihood ratio were: 73%, 91%, 75%, 90% and 8.0 respectively for advanced fibrosis, and 67%, 88%, 84%, 70% and 4.9, respectively, for mild fibrosis.CONCLUSION Our predictive model is easily available and reproducible, and predicted liver fibrosis with acceptable accuracy.
ISSN:1948-5182
1948-5182
DOI:10.4254/wjh.v8.i32.1392