Comparing the efficiency of Fib‐4, Egy‐score, APRI, and GUCI in liver fibrosis staging in Egyptians with chronic hepatitis C. Issue 6 (12th March 2018)

• Record Type: Journal Article
• Authors: Cordie, Ahmed; Salama, Ahmed; El‐Sharkawy, Marwa; El‐Nahaas, Saeed M.; Khairy, Marwa; Elsharkawy, Aisha; Hassany, Mohamed; Esmat, Gamal
• Is Part Of: Journal of medical virology. Volume 90:Issue 6(2018)
• Page Start: 1106
• Page End: 1111
• Publication Date: 2018-03-12
• Subjects: endemic infection -- hepatitis C virus -- hepatitis virus; Virology -- Periodicals; 616
• DOI: 10.1002/jmv.25064
• Languages: English
• ISSNs: 0146-6615

Abstract

Abstract : Assessment of hepatic fibrosis in chronic hepatitis C virus patients by liver biopsy is not widely accepted despite its accuracy, being invasive, carrying complications, and adding cost. This paved the way to development and use of non‐invasive markers of fibrosis in diagnosis of hepatic fibrosis. We aimed at evaluating the efficiency of Fib‐4, Egy‐score, Aspartate‐to‐platelet ratio index (APRI), and Göteborg University Cirrhosis Index (GUCI) in comparison to liver biopsy, in the assessment of hepatic fibrosis in chronic hepatitis C patients. This was a cross sectional study including 200 chronic HCV patients were divided into two groups according to stage of fibrosis (Metavir score) into non‐significant fibrosis (<F2) and significant fibrosis (≥F2). Reference needle liver biopsy was compared to Fib‐4, Egyscore, APRI, and GUCI. Older age ( P < 0.001) and higher BMI ( P = 0.005) were significantly related to significant fibrosis and positively correlated with fibrosis progression ( r = 0.361, P = 0.000, and r = 0.165, P = 0.019 respectively). Fib‐4 >1.27, APRI >0.48, Egy‐score >0.73, and GUCI >0.57 significantly predict significant fibrosis ( P < 0.01). Fib‐4 carries the best performance and significant reliability with AUROC 0.783, sensitivity 74%, specificity 69%, PPV 0.55, and NPV 0.86. The addition of BMI to Fib‐4 improved the significant fibrosis AUROC curve performance but did not reach statistical significant improvement. We concluded that age and BMI are good predictors of hepatic fibrosis. Fib‐4 (>1.27) is the best method of prediction of significant fibrosis compared to Egy‐score, APRI, and GUCI. Addition of BMI to Fib‐4 did not improve diagnostic value of Fib‐4.