Comparison between FIB-4 Index and Fibroscan as Marker of Fibrosis in Chronic HCV Infection in Egyptian Patients
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Author(s)
The FIB-4 index is a simple and noninvasive
algorithm consisting to evaluate liver fibrosis in chronic HCV
infection. Aim: To evaluate the utility of FIB-4 index as a noninvasive
marker to assess liver fibrosis in chronic HCV infection in comparison
to transient elastography. Patients and Methods: We studied 30 patients
having chronic HCV infection based on clinical features, laboratory
tests, diagnostics images, Fibroscan and FIB-4 score. According to the
results of Fibroscan, the 30 patients were classified into two groups in
order to obtain a cutoff value to exclude patient with significant
fibrosis: group Ia: 7 patients with no or mild liver fibrosis (F0-F1)
and group Ib: 23 pa-tients with significant fibrosis or cirrhosis
(F2-F3-F4). Group IIa: 17 patients with no or significant fibrosis
(F0-F1-F2-F3) and group IIb (F4): 13 patients with cirrhosis (F4).
Results: The mean of FIB-4 index increased with the increase of the
fibrosis score. FIB-4 index proved to be sensitive and specific in
differentiation between patients with no or mild fibrosis (F0-F1) and
patients with significant fibrosis or cirrhosis (F2-F3-F4) with the best
cutoff value at 1.61. It also proved to be sensitive and specific in
differentiation between patients with no or significant fibrosis
(F0-F1-F2-F3) and patients with cirrhosis (F4) with cutoff value at
1.88. Conclusion: The FIB-4 index enabled the correct identification of
extreme types of fibrosis. Using these cutoffs (1.61 - 1.88), 87% of
patients fell outside these ranges and could thus avoid liverbiopsy with
an overall accuracy of 70%.
Cite this paper
Nakeeb, N. , Helmy, A. , Saleh, S. , Abdellah, H. ,
Aleem, M. and Elshennawy, D. (2014) Comparison between FIB-4 Index
and Fibroscan as Marker of Fibrosis in Chronic HCV Infection in Egyptian
Patients. Open Journal of Gastroenterology, 4, 383-391. doi: 10.4236/ojgas.2014.412052.
| [1] |
Pybus, O.G., Drummond, A.J.,
Nakano, T., et al. (2003) The Epidemiology and Iatrogenic Transmission
of Hepatitis C Virus in Egypt: A Bayesian Coalescent Approach. Molecular
Biology and Evolution, 20, 381-387. http://dx.doi.org/10.1093/molbev/msg043 |
| [2] | Saadeh, S., Cammell, G., Carey, W.D., et al. (2001) The Role of Liver Biopsy in Chronic Hepatitis C. Hepatology, 33, 196-200. |
| [3] |
Ishak, K., Baptista, A.,
Bianchi, L., et al. (1995) Histological Grading and Staging of Chronic
Hepatitis. Journal of Hepatology, 22, 696-699. http://dx.doi.org/10.1016/0168-8278(95)80226-6 |
| [4] | Bedossa, P. and Poynard, T. (1996) An Algorithm for the Grading of Activity in Chronic Hepatitis C. The METAVIR Cooperative Study Group. Hepatology, 24, 289-293. |
| [5] |
Regev, A., Berho, M., Jeffers,
L.J., et al. (2002) Sampling Error and Intraobserver Variation in Liver
Biopsy in Patients with Chronic HCV Infection. The American Journal of
Gastroenterology, 97, 2614-2618. http://dx.doi.org/10.1111/j.1572-0241.2002.06038.x |
| [6] |
Ziol, M., Handra-Luca, A.,
Kettaneh, A., et al. (2005) Noninvasive Assessment of Liver Fibrosis by
Measurement of Stiffness in Patients with Chronic Hepatitis C.
Hepatology, 41, 48-54. http://dx.doi.org/10.1002/hep.20506 |
| [7] |
Sandrin, L., Oudry, J., Bastard,
C., et al. (2011) Non-Invasive Assessment of Liver Fibrosis by
Vibration-Controlled Transient Elastography (Fibroscan®). In: Takahashi,
H., Ed., Liver Biopsy, InTech, Chapter 19. http://dx.doi.org/10.5772/20729 |
| [8] |
Arena, U., Vizzutti, F., Corti,
G., et al. (2008) Acute Viral Hepatitis Increases Liver Stiffness Values
Measured by Transient Elastography. Hepatology, 47, 380-384. http://dx.doi.org/10.1002/hep.22007 |
| [9] |
Torriani, F.J.,
Rodriguez-Torres, M., Rockstroh, J.K., Lissen, et al. (2004)
Peginterferon Alfa-2a plus Ribavirin for Chronic Hepatitis C Virus
Infection in HIV-Infected Patients. The New England Journal of Medicine,
351, 438-450. http://dx.doi.org/10.1056/NEJMoa040842 |
| [10] |
Sterling, R.K., Lissen, E.,
Clumeck, N., et al. (2006) Development of a Simple Noninvasive Index to
Predict Significant Fibrosis in Patients with HIV/HCV Coinfection.
Hepatology, 43, 1317-1325. http://dx.doi.org/10.1002/hep.21178 |
| [11] |
Vallet-Pichard, A., Mallet, V.,
Nalpas, B., Verkarre, V., Nalpas, A., Dhalluin-Venier, V., et al. (2007)
FIB-4: An Inexpensive and Accurate Marker of Fibrosis in HCV Infection.
Comparison with Liver Biopsy and Fibrotest. Hepatology, 46, 32-36. http://dx.doi.org/10.1002/hep.21669 |
| [12] |
Pohl, A., Behling, C., Oliver,
D., Kilani, M., Monson, P. and Hassanein, T. (2001) Serum
Aminotransferase Levels and Platelet Counts as Predictors of Degree of
Fibrosis in Chronic Hepatitis C Virus Infection. The American Journal of
Gastroenterology, 96, 3142-3146. http://dx.doi.org/10.1111/j.1572-0241.2001.05268.x |
| [13] |
Kelleher, T.B., Mehta, S.H.,
Bhaskar, R., Sulkowski, M., Astemborski, J., Thomas, D.L., et al. (2005)
Prediction of Hepatic Fibrosis in HIV/HCV Co-Infected Patients Using
Serum Fibrosis Markers: The SHASTA Index. Journal of Hepatology, 43,
78-84. http://dx.doi.org/10.1016/j.jhep.2005.02.025 |
| [14] | Hatzakis, A., Wait, S., Bruix, J., Buti, M., Carballo, M., Cavaleri, M., et al. (2011) The State of Hepatitis B and C in Europe: Report from the Hepatitis B and C Summit Conference. Journal of Viral Hepatitis, 18, 1-16. |
| [15] |
Lavanchy, D. (2009) The Global Burden of Hepatitis C. Liver International, 29, 74-81. http://dx.doi.org/10.1111/j.1478-3231.2008.01934.x |
| [16] |
Shepard, C.W., Finelli, L. and
Alter, M.J. (2005) Global Epidemiology of Hepatitis C Virus Infection.
The Lancet Infectious Diseases, 5, 558-567. http://dx.doi.org/10.1016/S1473-3099(05)70216-4 |
| [17] | Kamal, S.M. and Nasser, I.A. (2008) Hepatitis C Genotype 4. What We Know and What We Don’t Yet Know. Hepatology, 47, 1371-1383. |
| [18] |
Massard, J., Ratziu, V., Thabut,
D., Moussalli, J., Lebray, P., Benhamou, Y. and Poynard, T. (2006)
Natural History and Predictors of Disease Severity in Chronic Hepatits
C. Journal of Hepatology, 44, S19-S24. http://dx.doi.org/10.1016/j.jhep.2005.11.009 |
| [19] |
Wait, C.T., Greeson, J.K.,
Fontana, R.J., Kalbfleisch, J.D., Marrero, J.A., Conjeevaram, H.S. and
Lok, A.S. (2003) A Simple Non Invasive Index Can Predict both
Significant Fibrosis and Cirrhosis with Chronic Hepatitis C. Hepatology,
38, 518-526. http://dx.doi.org/10.1053/jhep.2003.50346 |
| [20] |
Sterling, R.K., Stravitz, R.T.,
Luketic, V.A., Sanyal, A.J., Contos, M.J., Mills, A.S. and Shiffman,
M.L. (2004) A Comparison of the Spectrum of Chronic Hepatitis C Virus
between Caucasians and African Americans. Clinical Gastroenterology and
Hepatology, 2, 469-473. http://dx.doi.org/10.1016/S1542-3565(04)00164-8 |
| [21] | Sumida, Y., Yoneda, M., Hyogo, H., Itoh, Y., Ono, M., Fujii, H., et al. (2012) Validation of the FIB4 Index in a Japanese Nonalcoholic Fatty Liver Disease Population. BMC Gastroenterology, 12, 2. eww141231lx |
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