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Value of two noninvasive methods to detect progression of fibrosis among HCV carriers with normal aminotransferases

COLLETTA, Cosimo ; SMIRNE, Carlo ; FABRIS, Carlo ; TONIUTTO, Pierluigi ; RAPETTI, Rachele ; MINISINI, Rosalba ; PIRISI, Mario

Hepatology (Baltimore, Md.), 2005-10, Vol.42 (4), p.838-845 [Periódico revisado por pares]

Hoboken, NJ: Wiley

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Título:
Value of two noninvasive methods to detect progression of fibrosis among HCV carriers with normal aminotransferases
Autor: COLLETTA, Cosimo ; SMIRNE, Carlo ; FABRIS, Carlo ; TONIUTTO, Pierluigi ; RAPETTI, Rachele ; MINISINI, Rosalba ; PIRISI, Mario
Assuntos: Adult ; Aged ; Alanine Transaminase - blood ; Algorithms ; Biological and medical sciences ; Biomarkers - blood ; Biopsy ; Carrier State ; Disease Progression ; Female ; Gastroenterology. Liver. Pancreas. Abdomen ; Hepatitis C, Chronic - blood ; Hepatitis C, Chronic - diagnostic imaging ; Hepatitis C, Chronic - pathology ; Human viral diseases ; Humans ; Infectious diseases ; Liver Cirrhosis - blood ; Liver Cirrhosis - diagnostic imaging ; Liver Cirrhosis - pathology ; Male ; Medical sciences ; Middle Aged ; Sensitivity and Specificity ; Severity of Illness Index ; Ultrasonography ; Viral diseases ; Viral hepatitis
É parte de: Hepatology (Baltimore, Md.), 2005-10, Vol.42 (4), p.838-845
Notas: ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
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Descrição: The course of hepatitis C virus (HCV) infection carriers with normal/near-normal aminotransferases (NALT) is usually mild; however, in a few, fibrosis progression occurs. We aimed to verify whether monitoring by liver biopsy might be replaced by noninvasive methods and to identify factors associated with fibrosis progression in patients with persistently normal alanine aminotransferases. We studied 40 untreated HCV-RNA-positive subjects (22 male; median age, 44 years), who underwent two liver biopsies, with a median interval of 78.5 months, during which alanine aminotransferase concentrations (median number of determinations: 12) never exceeded 1.2 times the upper normal limit. Within 9 months from the second biopsy, they were tested by the shear elasticity probe (Fibroscan) and the artificial intelligence algorithm FibroTest. METAVIR fibrosis scores were analyzed in relationship to demographic, clinical, and viral parameters. Weighted kappa analysis was used to verify whether the results of noninvasive methods agreed with histology. Significant fibrosis (> or = F2), present at the first biopsy in only one patient (2.5%), was observed at the second biopsy in 14 patients (35%). At multivariate analysis, excess alcohol consumption in the past (>20 g/d; P = .017) and viral load (>8.0 x 10(6) copies/mL; P = .021) were independent predictors of progression. In identifying patients with significant fibrosis, inter-rater agreement was excellent for Fibroscan (weighted kappa = 1.0), and poor for FibroTest (weighted kappa = -0.041). In conclusion, among HCV carriers with NALT, Fibroscan is superior to the FibroTest in the noninvasive identification of fibrosis, for which excess alcohol consumption in the past and high viral load represent risk factors.
Editor: Hoboken, NJ: Wiley
Idioma: Inglês

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Value of two noninvasive methods to detect progression of fibrosis among HCV carriers with normal aminotransferases

COLLETTA, Cosimo ; SMIRNE, Carlo ; FABRIS, Carlo ; TONIUTTO, Pierluigi ; RAPETTI, Rachele ; MINISINI, Rosalba ; PIRISI, Mario

Hoboken, NJ: Wiley

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