The value of indirect serum markers in predicting severity of fibrosis in treatment naive patients with non-cirrhotic hepatitis C virus infection

Abstract

We conducted this study for determining the value of indirect serum markers such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), INR (International Normalized Ratio) and platelet counts and the roles of the scores such as AST-to-ALT ratio (AAR), AST-to-platelet ratio index (APRI), FIB-4 index, King’s score, Goteborg University Cirrhosis Index (GUCI) and FibroQ in predicting severity of fibrosis in treatment naive patients with non-cirrhotic hepatitis C virus (HCV) infection. Treatment naive non-cirrhotic chronic HCV patients who underwent percutaneous liver biopsy between 01 January 2012 and 01 June 2015 were included in the study. For evaluating the difference in variables, patients were divided into 2 groups such as no or minimal fibrosis group (fibrosis score<2) and significiant fibrosis group (fibrosis score≥2). Statistical analyses were performed by SSPS 15.0. Overall, 78 (98.7%) male and only 1 (1.3%) female patients with a mean age of 24.27±6.08 years were included in the study. Mean age was 24.27±6.08 years. There was no difference in age variable (p=0.054), platelet counts (p=0.798), INR values (p=0.672), AAR (p=0.522) and FibroQ (p=0.535) between significiant fibrosis group and no or minimal fibrosis group. We found that as a predictor of significiant fibrosis, area under ROC curve (AUROC) for APRI was 0.727 (p=0.001), for FIB-4 index was 0.722 (p=0.001), for King’s score was 0.753 (p<0.001) and for GUCI was 0.720 (p=0.001). Consequently, although they do not substitute liver biopsy, APRI, FIB-4 index, GUCI or King’s score can be used as screening tests to predict significiant fibrosis in treatment naive patients with HCV infection