Premium
Comparison of liver biopsy and noninvasive techniques for liver fibrosis assessment in patients infected with HCV ‐genotype 4 in E gypt
Author(s) -
Bonnard P.,
Elsharkawy A.,
Zalata K.,
DelarocqueAstagneau E.,
Biard L.,
Le Fouler L.,
Hassan A. B.,
AbdelHamid M.,
ElDaly M.,
Gamal M. E.,
El Kassas M.,
Bedossa P.,
Carrat F.,
Fontanet A.,
Esmat G.
Publication year - 2015
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/jvh.12285
Subject(s) - liver biopsy , medicine , liver fibrosis , hepatitis c virus , biopsy , fibrosis , gastroenterology , genotype , receiver operating characteristic , gold standard (test) , hepatitis c , pathology , virus , immunology , gene , biology , biochemistry
Summary In E gypt, as elsewhere, liver biopsy ( LB ) remains the gold standard to assess liver fibrosis in chronic hepatitis C ( CHC ) and is required to decide whether a treatment should be proposed. Many of its disadvantages have led to develop noninvasive methods to replace LB . These new methods should be evaluated in E gypt, where circulating virus genotype 4 ( G 4), increased body mass index and co‐infection with schistosomiasis may interfere with liver fibrosis assessment. E gyptian CHC ‐infected patients with G 4 underwent a LB , an elastometry measurement ( F ibroscan © ), and serum markers ( APRI , F ib4 and F ibrotest © ). Patients had to have a LB ≥15 mm length or ≥10 portal tracts with two pathologists blinded readings to be included in the analysis. Patients with hepatitis B virus co‐infection were excluded. Three hundred and twelve patients are reported. The performance of each technique for distinguishing F 0 F 1 vs F 2 F 3 F 4 was compared. The area under receiver operating characteristic curves was 0.70, 0.76, 0.71 and 0.75 for APRI , F ib‐4, F ibrotest© and F ibroscan©, respectively (no influence of schistosomiasis was noticed). An algorithm using the F ib4 for identifying patients with F 2 stage or more reduced by nearly 90% the number of liver biopsies. Our results demonstrated that noninvasive techniques were feasible in E gypt, for CHC G4‐infected patients. Because of its validity and its easiness to perform, we believe that F ib4 may be used to assess the F 2 threshold, which decides whether treatment should be proposed or delayed.