Artigo
Noninvasive serum markers in the diagnosis of structural liver damage in chronic hepatitis C virus infection
Fecha
2006-11-01Registro en:
Liver International. Oxford: Blackwell Publishing, v. 26, n. 9, p. 1095-1099, 2006.
1478-3223
10.1111/j.1478-3231.2006.01356.x
WOS:000241157700010
Autor
Parise, Edison R.
Oliveira, Ana C.
Figueiredo-Mendes, Claudio
Lanzoni, Valeria
Martins, Joao
Nader, Helena
Ferraz, Maria L.
Institución
Resumen
Aim: Several noninvasive markers are being used to assess the structural liver damage in patients with chronic hepatitis C (CHC). We evaluated the capacity of serum hyaluronic acid (HA), aspartate aminotransferase (AST)/ALT ratio, the AST to platelet ratio index (APRI) and gamma-glutamyltransferase (GGT) levels to predict the intensity of hepatic fibrosis in patients with CHC.Patients and methods: in a total of 206 hepatitis C virus RNA-positive biopsied patients, AST, ALT, GGT levels, platelet count and serum HA concentration were determined. the APRI was calculated as the ratio of AST to platelets.Results: HA levels were best correlated with disease stage (r=-0.694; P < 0.001). in the diagnosis of significant fibrosis (F2-F4), HA levels [AUC=0.879, 95% CI (0.832-0.927)] and APRI [AUC=0.824 (0.772-0.903)] were the markers with the best diagnostic accuracy. These parameters also best identified the presence of cirrhosis (F4), with an AUC of 0.908 (0.868-0.949) for HA and of 0.837 (0.772-0.903) for APRI.Conclusions: Serum HA was the parameter that alone presented the best diagnostic accuracy in the assessment of hepatic fibrosis in CHC. the APRI showed a better diagnostic sensitivity than GGT levels or the AST/ALT ratio. Its simple determination and low cost make this index a valid alternative for the noninvasive staging of CHC.