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Fibroscan
Is Superior to the FibroTest in the Noninvasive Identification
of Fibrosis
The
course of hepatitis C virus (HCV) infection carriers with
normal/near-normal
aminotransferases (NALT) is usually mild. In
a few, however,
fibrosis progression
occurs. In this study, researchers aimed to verify whether
monitoring by liver
biopsy might be replaced by noninvasive methods
and to identify factors associated with fibrosis progression
in patients with persistently normal alanine aminotransferases.
The
researchers studied 40 untreated HCV-RNA-positive subjects
(22 male; median age, 44 years), who underwent two liver biopsies,
with a median interval of 78.5 months, during which alanine
aminotransferase concentrations (median number of determinations:
12) never exceeded 1.2 times the upper normal limit.
Results
·
Within
9 months from the second biopsy, they were tested by the shear
elasticity probe (Fibroscan) and the artificial
intelligence algorithm FibroTest.
·
METAVIR
fibrosis scores were analyzed in relationship to demographic,
clinical, and viral parameters.
·
Weighted
kappa analysis was used to verify whether the results of noninvasive
methods agreed with histology.
·
Significant
fibrosis ( F2), present at the first
biopsy in only one patient (2.5%), was observed at the second
biopsy in 14 patients (35%).
·
At
multivariate analysis, excess alcohol
consumption in the past (>20 g/d; P
= .017) and viral load (>8.0 × 106 copies/mL;
P = .021) were independent predictors of progression.
·
In
identifying patients with significant fibrosis, inter-rater
agreement was excellent for Fibroscan (weighted kappa = 1.0),
and poor for FibroTest (weighted kappa = -0.041).
The
authors conclude, “Among HCV carriers with NALT, Fibroscan
is superior to the FibroTest in the noninvasive identification
of fibrosis, for which excess alcohol consumption in the past
and high viral load represent risk factors.”
09/30/05
Reference
C
Colletta and others. Value of two noninvasive methods to detect
progression of fibrosis among HCV carriers with normal aminotransferases.
Hepatology 42(4): 838-845.
October 2005.
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