A simple approach to noninvasively identifying significant fibrosis in chronic hepatitis C patients in clinical practice.

A simple approach to noninvasively identifying significant fibrosis in chronic hepatitis C patients in clinical practice. Research Abstract Details 

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A simple approach to noninvasively identifying significant fibrosis in chronic hepatitis C patients in clinical practice. Abstract Text:

Cosimo Colletta,Carlo Smirne,Claudia Marini,Mario Pirisi,Cosimo Colletta,Carlo Smirne,Claudia Marini,Mario Pirisi,

BACKGROUND: Identification of the presence of significant fibrosis is an important part of the diagnostic work-up of patients with chronic hepatitis C (CHC). AIM: To evaluate the performance of the aspartate to alanine aminotransferase ratio (AST/ALT ratio) and platelet count in reducing the number of liver biopsies and diagnosing the presence/absence of significant fibrosis in a large cohort of patients with CHC seen at 2 tertiary referral centers. METHODS: Liver biopsies of 409 patients with CHC were evaluated. Staging was carried out by means of the Ishak and METAVIR scores in the Italian and US series, respectively. Prevalence of significant fibrosis was 43%. Receiver operating characteristic curves were used to identify AST/ALT ratio and platelet count cutoffs with the highest accuracy for the diagnosis of significant fibrosis. These cutoffs were used to devise a diagnostic algorithm for reducing the number of liver biopsies and diagnosing/ruling out significant fibrosis. RESULTS: AST/ALT ratios increased and platelet counts decreased as liver fibrosis worsened. Both AST/ALT ratio (c-index=0.747) and platelet count (c-index=0.733) had high accuracy for the diagnosis of significant fibrosis. The use of AST/ALT ratio and platelet count cutoffs in a diagnostic algorithm would have avoided liver biopsy in 68.9% of the patients and would have correctly identified the absence/presence of significant fibrosis in 80.5% of these cases. CONCLUSIONS: In clinical practice, the use of simple, reproducible, and inexpensive parameters such as the AST/ALT ratio and platelet count can reduce the need for liver biopsy in a substantial proportion of patients with CHC.

A simple approach to noninvasively identifying significant fibrosis in chronic hepatitis C patients in clinical practice. Publishing Authors By Initials

C Colletta,C Smirne,C Marini,M Pirisi,C Colletta,C Smirne,C Marini,M Pirisi,

For similar investigative techniques: epidemiologic methods: epidemiologic study characteristics as topic: epidemiologic studies: case-control studies: retrospective studies research abstracts see: investigative techniques: epidemiologic methods: epidemiologic study characteristics as topic: epidemiologic studies: case-control studies: retrospective studies research

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A simple approach to noninvasively identifying significant fibrosis in chronic hepatitis C patients in clinical practice. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Journal of clinical gastroenterology

VOLUME: 40

Page Numbers: 521-7

Journal Abbreviation: J. Clin. Gastroenterol.

ISSN: 0192-0790

DAY: 1

MONTH: Jul

YEAR: 2006

A simple approach to noninvasively identifying significant fibrosis in chronic hepatitis C patients in clinical practice. Information

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LANGUAGE: eng

NlmUniqueID: 7910017

A simple approach to noninvasively identifying significant fibrosis in chronic hepatitis C patients in clinical practice. Keywords Mesh Terms:

KEYWORDS: Retrospective Studies

MESH TERMS: methods

Chemical & Substance for Abstract: A simple approach to noninvasively identifying significant fibrosis in chronic hepatitis C patients in clinical practice. Information

Substance Name: Alanine Transaminase

Registry Number: EC 2.6.1.2

Grant and Affiliation Information for A simple approach to noninvasively identifying significant fibrosis in chronic hepatitis C patients in clinical practice.

AFFILIATION: Gastroenterology Unit, Department of Internal Medicine, University of Genoa, Genoa, Italy. egiannini@unige.it

Country: United States

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MEDLINETA: J Clin Gastroenterol

REFSOURCE: J Clin Gastroenterol. 2008 Feb;42(2):219

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