Comparison of test performance profile for blood tests of liver fibrosis in chronic hepatitis C

• Published in: Journal of hepatology 2007-03, Vol.46 (3), p.395-402
• Main Authors: Halfon, Philippe, Bacq, Yannick, De Muret, Anne, Penaranda, Guillaume, Bourliere, Marc, Ouzan, Denis, Tran, Albert, Botta, Danielle, Renou, Christophe, Bréchot, Marie-Claude, Degott, Claude, Paradis, Valérie
• Format: Article
• Language: English
• Subjects: Adult; Algorithms; Aspartate Aminotransferases - blood; Biological and medical sciences; Biopsy; Blood marker; Blood Platelets - enzymology; Blood test; C chronic hepatitis; Disease Progression; Female; Gastroenterology and Hepatology; Gastroenterology. Liver. Pancreas. Abdomen; Hematologic Tests - methods; Hepatitis C, Chronic - blood; Hepatitis C, Chronic - complications; Human viral diseases; Humans; Infectious diseases; Liver - pathology; Liver biopsy; Liver Cirrhosis - blood; Liver Cirrhosis - diagnosis; Liver Cirrhosis - etiology; Liver fibrosis; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Metavir staging; Middle Aged; Other diseases. Semiology; Predictive Value of Tests; Retrospective Studies; Viral diseases; Viral hepatitis
• ISSN: 0168-8278; 1600-0641
• DOI: 10.1016/j.jhep.2006.09.020

Background/Aims We evaluated the test performance profile (TPP) of blood tests of liver fibrosis. Methods Three hundred and fifty-six patients with C chronic hepatitis were included in two centers. Metavir staging of liver specimens by two independent pathologists and the following tests were evaluated: Fibrotest (FT), APRI, FibroMeter (FM), and Hepascore (HS). Results Metavir stages were: F0: 4%, F1: 55%, F2: 26%, F3: 11%, and F4: 4%. The AUROCs were not significantly different, respectively, FT, FM, APRI, HS: ⩾ F2: 0.79, 0.78, 0.76, 0.76; ⩾F3: 0.81, 0.85, 0.81, 0.81; and F4: 0.86, 0.94, 0.92, 0.89. The TPP relies on the paired comparison of blood-test misclassification based on liver specimen, e.g. FT vs FM, respectively: F0+1: 18 vs 28% ( p = 0.0003), ⩾F2: 43 vs 31% ( p = 0.004). There was no center effect. Conclusions In those populations, the four blood tests had a similar performance for significant fibrosis ( F ⩾ 2), lying in the lower range of published results which is attributable to a low ⩾F2 prevalence, and for ⩾F3 and F4. However, FM and FT had performance profiles significantly different as a function of fibrosis stages or diagnostic target (fibrosis cut-off). This has to be considered during the interpretation process. Moreover, the performance should be reported with different diagnostic targets.