Non-Invasive Evaluation of Liver Fibrosis in Chronic Hepatitis C Patients

Non-Invasive Evaluation of Liver Fibrosis in Chronic Hepatitis C Patients

Eglė Audronytė, Diana Aksionova, Ilona Savlan, Arida Buivydienė, Dalius Vitkus, Valentina Liakina

Objective. The aim the study was to evaluate correlation of basic blood count and routine clinical chemistry tests with liver fibrosis score in chronic hepatitis C patients and validate non-invasive prog­nostic indices for the assessment of sig­nificant fibrosis.

Patients and methods. 329 chronic hepatitis C or viral C cirrhosis patients (143 women, 186 men) were enrolled into the retrospective study. Basic blood count, clin-cal chem-stry tests and liver biopsy was performed for all patients. Fi­brosis was graded using METAVIR scale. According to fibrosis score patients were divided into 2 groups: I - with mild fibro­sis (METAVIR 0-I) and II - with signifi­cant fibrosis (METAVIR II-IV).

The APRI, FIB-4, Forns, GUCI and VirahepC indices were evaluated for the prognosis of significant fibrosis.

Results. Statistically significant dif­ference in platelet count, erythrocyte sed­imentation rate, liver enzymes activity, glucose and urea concentrations was found between 2 groups of patients. The fibrosis score correlated with patient’s age, mean corpuscular volume (MCV), platelet count, erythrocyte sedimenta­tion rate, total and direct bil-rubin con­centration, liver enzymes activity, albu­min concentration, prothrombin complex activity and international normalized ra­tio, and with all investigated prognostic indices. The area under ROC curves showed that all indices are suitable for detection of significant fibrosis: APRI -

0.811; FIB-4 - 0.740; Forn’s - 0.762; GUCI - 0.836; VirahepC - 0.784. The best results were obtained for APRI and GUCI. Both indices were characterized by high sensitivity and specificity: APRI (81.96% and 75%), GUCI (76.85% and 81.82%).

Conclusions. Statistically signifi­cant differences in basic blood count pa­rameters and clinical chemistry tests as well as in prognostic indices were ob­served in patients with mild and signifi­cant fibrosis. APRI and GUCI indices were the most re-iable predictors of sig­nificant fibrosis.

Keywords: hepatitis C, fibrosis, non-in­vasive markers of fibrosis, indices.