Serological tests do not predict residual fibrosis in hepatitis C cirrhotics with a sustained virological response to interferon
Articolo
Data di Pubblicazione:
2016
Citazione:
Serological tests do not predict residual fibrosis in hepatitis C cirrhotics with a sustained virological response to interferon / R. D'Ambrosio, E. Degasperi, A. Aghemo, M. Fraquelli, P. Lampertico, M.G. Rumi, F. Facchetti, E. Grassi, G. Casazza, W. Rosenberg, P. Bedossa, M. Colombo. - In: PLOS ONE. - ISSN 1932-6203. - 11:6(2016 Jun), pp. e0155967.1-e0155967.14. [10.1371/journal.pone.0155967]
Abstract:
Background and Aim: Liver biopsy (LB) has lost popularity to stage liver fibrosis in the era of highly effective antihepatitis C virus (HCV) therapy, yet diagnosis of persistent cirrhosis may have important implications following HCV eradication. As performance of serological non-invasive tests (NITs) to predict residual fibrosis in non-viremic HCV patients is unknown, we investigated accuracy of NITs to predict residual fibrosis in cirrhotics after a sustained virological response (SVR) to interferon (IFN). Methods: Thirty-eight patients with a pre-treatment histological diagnosis of cirrhosis and a 48-104 months post-SVR LB were tested with APRI, CDS, FIB-4, FibroQ, Forns Score, GUCI Index, King Score, Lok Index, PLF, ELF. In 23 (61%) patients, cirrhosis had histologically regressed. Results: All NITs values declined after SVR without any significant difference between regressors and non-regressors (AUROC 0.52-0.75). Using viremic cut-offs, PPV ranged from 34% to 100%, with lower NPV (63% - 68%). NITs performance did not improve using derived cutoffs (PPV: 40% - 80%; NPV: 66% - 100%). PLF, which combines several NITs with transient elastography, had the best diagnostic performance (AUROC 0.75, Sn 61%, Sp 90%, PPV 80%, NPV 78%). After treatment, none of the NITs resulted significantly associated with any of the histological features (activity grade, fibrosis stage, area of fibrosis). Conclusions: The diagnostic estimates obtained using both viremic and derived cut-off values of NITs were suboptimal, indicating that none of these tests helps predicting residual fibrosis and that LB remains the gold standard for this purpose.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
Agricultural and Biological Sciences (all); Biochemistry, Genetics and Molecular Biology (all); Medicine (all)
Elenco autori:
R. D'Ambrosio, E. Degasperi, A. Aghemo, M. Fraquelli, P. Lampertico, M.G. Rumi, F. Facchetti, E. Grassi, G. Casazza, W. Rosenberg, P. Bedossa, M. Colombo
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