The diagnostic accuracy of the Forns index, platelet count and AST to Platelet Ratio Index derived fibrosis index for the prediction of Hepatitis C virus-related significant liver fibrosis and cirrhosis. (April 2014)

• Record Type: Journal Article
• Authors: Kayadibi, Huseyin; Yasar, Bulent; Ozkara, Selvinaz; Serdar, Muhittin A.; Kurdas, Oya O.; Gonen, Can
• Is Part Of: Scandinavian journal of clinical & laboratory investigation. Volume 74:Number 3(2014)
• Page Start: 240
• Page End: 247
• Publication Date: 2014-04
• Subjects: Clinical biochemistry -- Periodicals; Physiology, Pathological -- Periodicals; Physiology, Experimental -- Periodicals; Medicine -- Research -- Periodicals; Clinical medicine -- Periodicals; 616.0072
• DOI: 10.3109/00365513.2013.879392
• Languages: English
• ISSNs: 0036-5513

Abstract

<abstract> <title>Abstract</title> <p> <bold> <italic>Aim</italic>.</bold> To provide a simple fibrosis index combining the routine laboratory markers for predicting significant fibrosis (SF) and cirrhosis in patients with chronic HCV. <bold><italic>Methods</italic>.</bold> Platelet count, ALT, AST, AST to ALT Ratio, AST to Platelet Ratio Index (APRI), Forns index, FIB-4 and Age Platelet Index of 202 liver biopsy performed HCV-infected patients were reviewed. METAVIR classification was used to determine the stage of liver fibrosis. The predictive fibrosis index was constructed by multiple linear regression analysis (− 2.948 + 0.562 × Forns index + 0.288 × APRI + 0.006 × platelet count [10<sup>9</sup>/L]). <bold><italic>Results</italic>.</bold> Median (25th–75th interquartile range) age was 52 (42–59) years, and 61% were male. 65.8% (<italic>n</italic> = 133) had SF (F2–F4) and 23.3% (<italic>n</italic> = 47) had cirrhosis (F4). For discrimination of SF, AUROCs were: Fibrosis index = 0.869, Forns index = 0.837, APRI = 0.814, platelet count = 0.764. For cirrhosis, AUROCs were: Fibrosis index = 0.911, Forns index = 0.883, APRI = 0.847, platelet count = 0.827. A cut-off point of ≤ 1.2 for fibrosis index excluded SF in 89% of patients with sensitivity of 96%, while > 2.0 predicted SF in 88% of patients with specificity of 86%. Threshold of ≤ 1.9 excluded cirrhosis in 95% of patients with sensitivity of 94%, while > 2.7 showed cirrhosis in 88% of patients with specificity of 95%. In multivariate logistic regression analysis, OR (95% CI) of fibrosis index was 7.825 (3.682–16.629) for SF (<italic>p</italic> < 0.001) and was 8.672 (4.179–17.996) for cirrhosis (<italic>p</italic> < 0.001). <bold><italic>Conclusion</italic>.</bold> SF and cirrhosis were predicted with accuracy of 82% and 89% and were excluded with accuracy of 74% and 82% using this fibrosis index which may potentially decrease the need for liver biopsy in 76% and 83% of patients, respectively.</p> </abstract>