Diagnostic accuracy of predictive indexes of liver fibrosis in patients with chronic hepatitis C

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Abstract

Aim. Assessment of the diagnostic accuracy of predictive indexes of liver fibrosis for the identification of severe fibrosis and cirrhosis (F3–F4) in patients with chronic hepatitis C (CHC).

Materials and methods. The retrospective design study included 127 patients with chronic hepatitis C (mean age 44.5±11.1 years). To assess the degree of liver fibrosis, all patients underwent transient elastography using a Fibroscan (EchoSens, France) and predictive indexes of liver fibrosis were calculated (APRI, FIB-4, discriminant Bonacini score). Transient elastography was considered as a reference method for assessing the degree of liver fibrosis for subsequent comparison of results with predictive fibrosis indixes.

Results. The sensitivity of the APRI index for the identification of severe fibrosis and cirrhosis of the liver (F3–F4) was 79%, and specificity was 69%. The FIB-4 index showed greater specificity (86%), but less sensitivity (68%). The sensitivity of the discriminant Bonacini scale was 81%, and the specificity was 77%. The positive predictive value of the APRI index, FIB-4 and the Bonacini scale for the identification of severe fibrosis and cirrhosis of the liver (F3–F4) in patients with chronic hepatitis C was 66; 78 and 72% respectively, and negative predictive value – 82; 78 and 84% respectively.

Conclusion. The results of this study indicate the relatively high diagnostic accuracy of a number of predictive indexes for evaluating liver fibrosis (APRI, FIB-4, discriminant Bonachini scale) in identifying severe fibrosis and cirrhosis of the liver (F3–F4) in patients with chronic hepatitis C.

About the authors

I. V. Maev

Yevdokimov Moscow State University of Medicine and Dentistry

Email: dna-mit8@mail.ru

д.м.н., проф., академик РАН, зав. каф. пропедевтики внутренних болезней и гастроэнтерологии

Russian Federation, Moscow

E. I. Kuznetsova

Yevdokimov Moscow State University of Medicine and Dentistry

Email: dna-mit8@mail.ru

клинический ординатор каф. пропедевтики внутренних болезней и гастроэнтерологии

Russian Federation, Moscow

D. N. Andreev

Yevdokimov Moscow State University of Medicine and Dentistry

Author for correspondence.
Email: dna-mit8@mail.ru

к.м.н., ассистент каф. пропедевтики внутренних болезней и гастроэнтерологии, н.с. лаб. функциональных методов исследования в гастроэнтерологии

Russian Federation, Moscow

D. T. Dicheva

Yevdokimov Moscow State University of Medicine and Dentistry

Email: dna-mit8@mail.ru

к.м.н., доц. каф. пропедевтики внутренних болезней и гастроэнтерологии

Russian Federation, Moscow

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