Prediction of significant fibrosis in chronic hepatitis C patients with normal ALT

Jae Jun Park, Jun Yong Park, Do Young Kim, Young Nyun Park, Sang Hoon Ahn, Chae Yoon Chon, Kwang Hyub Han

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background/Aims: Prediction of significant fibrosis (F≥2) using non-invasive methods for chronic hepatitis C (CHC) patients with persistently normal alanine aminotransferase (PNALT) levels remains a challenging problem. We aimed to develop a novel non-invasive model for predicting the presence of significant fibrosis in CHC patients with PNALT. Methodology: We prospectively enrolled 40 treatment-naive CHC patients with PNALT who underwent liver biopsy and liver stiffness measurements (LSM). Age-platelet index (API), aspartate aminotransferase to platelet ratio index (APRI), LSM and LSM to platelet ratio index (LPRI) were compared with liver histology results. Results: Significant fibrosis was diagnosed in 17 patients (42.5%). The diagnostic accuracy of LPRI was the highest for the prediction of significant fibrosis (AUROC=0.859) when compared to that of APRI (0.770), LSM (0.769) and API (0.703). Using a cutoff value of LPRI ≥37, the significant fibrosis could be correctly identified with high accuracy (100% PPV) in 6 (15.0%) patients. While, using an LPRI cutoff value <20, it could be excluded with 94.1% NPV in 17 (42.5%) patients. Consequently, 57.5% of the CHC patients with PNALT levels could avoid liver biopsy. Conclusions: The LPRI was useful in predicting significant fibrosis. Screening CHC patients PNALT using LPRI has the potential to reduce the number of liver biopsies and might help designing appropriate management plans.

Original languageEnglish
Pages (from-to)1321-1327
Number of pages7
JournalHepato-gastroenterology
Volume58
Issue number109
DOIs
Publication statusPublished - 2011 Jul 1

Fingerprint

Chronic Hepatitis C
Fibrosis
Blood Platelets
Alanine Transaminase
Liver
Biopsy
Aspartate Aminotransferases
Transaminases
Histology

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

@article{34aa45e4351044d2bb94262a61095f5f,
title = "Prediction of significant fibrosis in chronic hepatitis C patients with normal ALT",
abstract = "Background/Aims: Prediction of significant fibrosis (F≥2) using non-invasive methods for chronic hepatitis C (CHC) patients with persistently normal alanine aminotransferase (PNALT) levels remains a challenging problem. We aimed to develop a novel non-invasive model for predicting the presence of significant fibrosis in CHC patients with PNALT. Methodology: We prospectively enrolled 40 treatment-naive CHC patients with PNALT who underwent liver biopsy and liver stiffness measurements (LSM). Age-platelet index (API), aspartate aminotransferase to platelet ratio index (APRI), LSM and LSM to platelet ratio index (LPRI) were compared with liver histology results. Results: Significant fibrosis was diagnosed in 17 patients (42.5{\%}). The diagnostic accuracy of LPRI was the highest for the prediction of significant fibrosis (AUROC=0.859) when compared to that of APRI (0.770), LSM (0.769) and API (0.703). Using a cutoff value of LPRI ≥37, the significant fibrosis could be correctly identified with high accuracy (100{\%} PPV) in 6 (15.0{\%}) patients. While, using an LPRI cutoff value <20, it could be excluded with 94.1{\%} NPV in 17 (42.5{\%}) patients. Consequently, 57.5{\%} of the CHC patients with PNALT levels could avoid liver biopsy. Conclusions: The LPRI was useful in predicting significant fibrosis. Screening CHC patients PNALT using LPRI has the potential to reduce the number of liver biopsies and might help designing appropriate management plans.",
author = "Park, {Jae Jun} and Park, {Jun Yong} and Kim, {Do Young} and Park, {Young Nyun} and Ahn, {Sang Hoon} and Chon, {Chae Yoon} and Han, {Kwang Hyub}",
year = "2011",
month = "7",
day = "1",
doi = "10.5754/hge11041",
language = "English",
volume = "58",
pages = "1321--1327",
journal = "Acta hepato-splenologica",
issn = "0172-6390",
publisher = "H.G.E. Update Medical Publishing Ltd.",
number = "109",

}

Prediction of significant fibrosis in chronic hepatitis C patients with normal ALT. / Park, Jae Jun; Park, Jun Yong; Kim, Do Young; Park, Young Nyun; Ahn, Sang Hoon; Chon, Chae Yoon; Han, Kwang Hyub.

In: Hepato-gastroenterology, Vol. 58, No. 109, 01.07.2011, p. 1321-1327.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prediction of significant fibrosis in chronic hepatitis C patients with normal ALT

AU - Park, Jae Jun

AU - Park, Jun Yong

AU - Kim, Do Young

AU - Park, Young Nyun

AU - Ahn, Sang Hoon

AU - Chon, Chae Yoon

AU - Han, Kwang Hyub

PY - 2011/7/1

Y1 - 2011/7/1

N2 - Background/Aims: Prediction of significant fibrosis (F≥2) using non-invasive methods for chronic hepatitis C (CHC) patients with persistently normal alanine aminotransferase (PNALT) levels remains a challenging problem. We aimed to develop a novel non-invasive model for predicting the presence of significant fibrosis in CHC patients with PNALT. Methodology: We prospectively enrolled 40 treatment-naive CHC patients with PNALT who underwent liver biopsy and liver stiffness measurements (LSM). Age-platelet index (API), aspartate aminotransferase to platelet ratio index (APRI), LSM and LSM to platelet ratio index (LPRI) were compared with liver histology results. Results: Significant fibrosis was diagnosed in 17 patients (42.5%). The diagnostic accuracy of LPRI was the highest for the prediction of significant fibrosis (AUROC=0.859) when compared to that of APRI (0.770), LSM (0.769) and API (0.703). Using a cutoff value of LPRI ≥37, the significant fibrosis could be correctly identified with high accuracy (100% PPV) in 6 (15.0%) patients. While, using an LPRI cutoff value <20, it could be excluded with 94.1% NPV in 17 (42.5%) patients. Consequently, 57.5% of the CHC patients with PNALT levels could avoid liver biopsy. Conclusions: The LPRI was useful in predicting significant fibrosis. Screening CHC patients PNALT using LPRI has the potential to reduce the number of liver biopsies and might help designing appropriate management plans.

AB - Background/Aims: Prediction of significant fibrosis (F≥2) using non-invasive methods for chronic hepatitis C (CHC) patients with persistently normal alanine aminotransferase (PNALT) levels remains a challenging problem. We aimed to develop a novel non-invasive model for predicting the presence of significant fibrosis in CHC patients with PNALT. Methodology: We prospectively enrolled 40 treatment-naive CHC patients with PNALT who underwent liver biopsy and liver stiffness measurements (LSM). Age-platelet index (API), aspartate aminotransferase to platelet ratio index (APRI), LSM and LSM to platelet ratio index (LPRI) were compared with liver histology results. Results: Significant fibrosis was diagnosed in 17 patients (42.5%). The diagnostic accuracy of LPRI was the highest for the prediction of significant fibrosis (AUROC=0.859) when compared to that of APRI (0.770), LSM (0.769) and API (0.703). Using a cutoff value of LPRI ≥37, the significant fibrosis could be correctly identified with high accuracy (100% PPV) in 6 (15.0%) patients. While, using an LPRI cutoff value <20, it could be excluded with 94.1% NPV in 17 (42.5%) patients. Consequently, 57.5% of the CHC patients with PNALT levels could avoid liver biopsy. Conclusions: The LPRI was useful in predicting significant fibrosis. Screening CHC patients PNALT using LPRI has the potential to reduce the number of liver biopsies and might help designing appropriate management plans.

UR - http://www.scopus.com/inward/record.url?scp=83355172725&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=83355172725&partnerID=8YFLogxK

U2 - 10.5754/hge11041

DO - 10.5754/hge11041

M3 - Article

C2 - 21937403

AN - SCOPUS:83355172725

VL - 58

SP - 1321

EP - 1327

JO - Acta hepato-splenologica

JF - Acta hepato-splenologica

SN - 0172-6390

IS - 109

ER -