Development of a novel glycated protein‐based fibrosis prediction score for determination of significant liver fibrosis in HCV‐infected patients, a preliminary study

• Published in: Journal of medical virology 2020-12, Vol.92 (12), p.3525-3533
• Main Authors: Abo El‐khair, Salwa M., El‐Alfy, Hatem A., Elsamanoudy, Ayman Z., Elhammady, Dina, Abd‐elfattah, Nahed, Eldeek, Bassem, Farid, Khaled
• Format: Article
• Language: English
• Subjects: Adult; Aged; Albumin; Albumins; alpha-Fetoproteins - analysis; Bile; Bilirubin; Biomarkers; Biomarkers - blood; Biopsy; chronic hepatitis C; Cirrhosis; Diagnostic systems; Female; Fibrosis; fibrosis prediction score; glycated albumin; Glycated Hemoglobin - analysis; Glycated Serum Albumin; Glycation End Products, Advanced - blood; Health problems; Hemoglobin; Hepatitis; Hepatitis C; Hepatitis C, Chronic - blood; Hepatitis C, Chronic - complications; Hepatitis C, Chronic - pathology; Humans; Liver; Liver - pathology; Liver cirrhosis; Liver Cirrhosis - blood; Liver Cirrhosis - diagnosis; Liver Cirrhosis - pathology; liver fibrosis; Liver Function Tests - methods; Male; Middle Aged; Platelet Count; Platelets; Predictions; Sensitivity; Sensitivity and Specificity; Serum Albumin - analysis; Severity of Illness Index; Ultrasound; Virology; Viruses
• ISSN: 0146-6615; 1096-9071
• DOI: 10.1002/jmv.26204

The current study aimed to investigate the diagnostic value of glycated albumin (GA), glycated hemoglobin (HbA1c), and a number of routine biomarkers as noninvasive indicators of liver fibrosis in patients with chronic hepatitis C (CHC). One hundred patients with CHC were subjected to full medical history and examination, in addition to ultrasound‐guided liver biopsy and histopathological examination for assessment of liver fibrosis stage. GA and HbA1c values, GA/HbA1c ratio, liver function tests, complete blood count, and alpha fetoprotein (AFP) were determined. A novel noninvasive index, dubbed Fibrosis Prediction Score (FPS), was selected for predicting significant liver fibrosis based on total bilirubin, glycated albumin, platelet count, age, and AFP. A validation study for FPS was applied on archival data which include 66 diabetics' patients. The FPS had area under the curve (AUC) of 0.92 for classification of patients with significant fibrosis with 81% sensitivity and 95% specificity. The AUCs of FPS in predicting advanced fibrosis and cirrhosis were 0.86 and 0.82, respectively. Comparison of AST‐to‐platelet ratio index (APRI) and FIB‐4 with FPS indicated increased sensitivity and specificity of FPS over APRI and FIB4 in both significant and advanced fibrosis. FPS has a good sensitivity and specificity for prediction of significant and advanced liver fibrosis in patients with CHC. Highlights Progression of hepatitis C virus infection to chronicity is one of the most pressing health problems. Accurate assessment of liver fibrosis is important to make therapeutic decisions, determine prognosis and to follow‐up disease progression. Accurate, reproducible and easily applied methods are required for evaluation of hepatic fibrosis. Fibrosis Prediction Score (FPS), based on five simple variables including AFP, age, glycated albumin, total bilirubin and platelet count, demonstrated better diagnostic power for detection significant and advanced liver fibrosis.