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Transient elastography in hepatitis C virus‐infected patients with beta‐thalassemia for assessment of fibrosis
Author(s) -
Poustchi Hossein,
Eslami Masoomeh,
Ostovaneh Mohammad Reza,
Modabbernia Amirhossein,
Saeedian Fatemeh Sima,
Taslimi Shervin,
George Jacob,
Malekzadeh Reza,
Zamani Farhad
Publication year - 2013
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.12088
Subject(s) - cirrhosis , medicine , transient elastography , gastroenterology , liver biopsy , receiver operating characteristic , stage (stratigraphy) , fibrosis , beta thalassemia , magnetic resonance imaging , thalassemia , biopsy , nuclear medicine , liver fibrosis , radiology , biology , paleontology
Aim We sought to evaluate the performance of transient elastography ( TE ) for the assessment of liver fibrosis in chronic hepatitis C ( CHC ) patients with beta‐thalassemia. Methods Seventy‐six CHC patients with beta‐thalassemia underwent TE , liver biopsy, T 2 ‐weighted magnetic resonance imaging ( MRI ) for the assessment of liver iron content ( LIC ) and laboratory evaluation. The accuracy of TE and its correlation with the other variables was assessed. Results TE values increased proportional to fibrosis stage ( r = 0.404, P < 0.001), but was independent of T 2 ‐weighted MRI‐LIC ( r = 0.064, P = 0.581). In multivariate analysis, fibrosis stage was still associated with the log‐transformed TE score(standardized β = 0.42 for F4 stage of METAVIR , P = 0.001). No correlation was noted between LIC and TE score (standardized β = 0.064, P = 0.512). The area under the receiver operating characteristic curve for prediction of cirrhosis was 80% (95% confidence interval, 59–100%). A cut‐off TE score of 11 had a sensitivity of 78% and specificity of 88.1% for diagnosing cirrhosis. The best cut‐off values for “ TE‐FIB ‐4 cirrhosis score” comprising TE and FIB ‐4 and “ TE‐APRI cirrhosis score” combining TE with aspartate aminotransferase‐to‐platelet ratio index ( APRI ) both had 87.5% sensitivity and 91.04% specificity for the diagnosis of cirrhosis. Conclusion Regardless of LIC , TE alone or when combined with FIB ‐4 or APRI , is a diagnostic tool with moderate to high accuracy to evaluate liver fibrosis in CHC patients with beta‐thalassemia. However, because splenectomy in a proportion of our subjects might have affected the platelet count, the scores utilizing APRI and FIB ‐4 should be interpreted cautiously.