Resumen

Background: In the management of chronic hepatitis C (CHC) patients, liver biopsy is the gold standard for liver fibrosis assessment despite some technical limits and risks. Non-invasive approaches have been proposed as alternative methods to evaluate structural liver damage. Aim: To investigate the diagnostic accuracy of transient elastography, ¹³C-aminopyrine breath test (¹³C-ABT), serum hyaluronic acid (HA) and cytokeratin 18 Asp396 fragment (CK-18) as non-invasive methods of liver fibrosis assessment ad their correlation to METAVIR score. Material and methods: In a cohort of 57 CHC patients, liver stiffness, cumulative percentage of administered dose of ¹³C-aminopyrine at 120 min, serum HA and serum CK-18 concentration were determined. Diagnostic accuracy in detecting significant fibrosis (F ≥2), severe fibrosis (F ≥3) and cirrhosis (F = 4) was assessed by the area under the receiver operating characteristic curve. Results: Liver fibrosis score showed a strong correlation with liver stiffness (r = 0.667; p < 0.0001) and a significant inverse correlation with ¹³C-ABT results (r = -0.418; p = 0.0012). A weaker correlation was found with CK18 (r = 0.329; p = 0.0126) and no correlation with HA. Areas under the curve of elastography, ¹³C-ABT, HA and CK18 were: 0.98, 0.75, 0.69, 0.64, respectively, for F ≥ ; 0.97, 0.69, 0.80, 0.66, respectively, for F ≥ ; 0.95, 0.64, 0.70, 0.56, respectively, for F = 4. Conclusion: Elastography has the best diagnostic accuracy for the assessment of the degree of liver fibrosis in CHC patients. Its application can provide an alternative useful tool for monitoring the disease evolution.

Palabras clave: Chronic hepatitis C. Liver fibrosis. Liver biopsy. Fibroscan. Non-invasive fibrosis markers.

2014-03-01   |   350 visitas   |   1 valoraciones

Vol. 13 Núm.1. Enero-Febrero 2014 Pags. 91-97 Ann Hepatol 2014; 13(1)