Resumen

Objective: To evaluate the performance of noninvasive models that predict liver fibrosis in Mexican patients with autoimmune liver diseases. Methods: This retrospective single-center study included patients diagnosed with autoimmune hepatitis, primary biliary cirrhosis, or overlap syndrome, who were assessed according to the AST to Platelet Ratio Index (APRI), nonalcoholic fatty liver disease (NAFLD) fibrosis score, body mass index, aspartate transaminase/alanine transaminase ratio and Diabetes (BARD), Forns’ score, AST/ALT ratio (the ratio of serum aspartate aminotransferase to serum alanine aminotransferase), and FIB-4. The sensitivity, specificity, and positive and negative predictive values were calculated. Results: Fifty-four (49.7%) of the patients were overweight or obese. Advanced fibrosis was significantly more common in patients with autoimmune hepatitis (72%) and overlap syndrome (86%) (p < 0.05). In the total group, AST levels were higher in patients with advanced fibrosis (p < 0.05), whereas platelet counts and cholesterol levels were significantly lower (p < 0.05). The APRI score showed high sensitivity in the total group (79%) and in patients with autoimmune hepatitis (73%). The nonalcoholic fatty liver disease fibrosis score showed greatest sensitivity in primary biliary cirrhosis (86%). However, in patients with overlap syndrome, all the models/scores evaluated performed rather poorly; APRI showed sensitivity of 83%, however with low specificity of 50%, positive predictive value of 91%, and low negative predictive value of 33%. Signs of nonalcoholic steatohepatitis were evident in the baseline liver biopsies of 13/92 (14%) patients; a second liver biopsy was performed in 24 patients during follow-up, two of them showing evidence of nonalcoholic steatohepatitis. Conclusion: Noninvasive models that predict liver fibrosis can be used as an alternative method of monitoring patients during follow-up especially in autoimmune hepatitis and primary biliary cirrhosis.

Palabras clave: Fibrosis noninvasive models autoimmune liver disease.

2016-09-06   |   490 visitas   |   Evalua este artículo 0 valoraciones

Vol. 9 Núm.2. Abril-Junio 2016 Pags. 77-83 Evid Med Invest Salud 2016; 9(2)