A new scoring system for prediction of fibrosis in chronic hepatitis C

AUTHORS

Simona Bota 1 , * , Roxana Sirli 2 , Ioan Sporea 2 , Mircea Focsa 2 , Alina Popescu 2 , Mirela Danila 2 , Mihnea Strain 2 , Madalina Sendroiu 2 , Alexandra Deleanu 2 , Isabel Dan 2

1 Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy, bota_simona1982@yahoo.com, Romania

2 Department of Gastroenterology and Hepatology, University of Medicine and Pharmacy, Romania

How to Cite: Bota S, Sirli R, Sporea I, Focsa M, Popescu A, et al. A new scoring system for prediction of fibrosis in chronic hepatitis C, Hepat Mon. Online ahead of Print ; 11(7):548-555.

ARTICLE INFORMATION

Hepatitis Monthly: 11 (7); 548-555
Article Type: Research Article
Received: February 20, 2011
Accepted: June 24, 2011

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Abstract

Background: Liver biopsy (LB) is still considered to be the gold standard for assessment of liver fibrosis.
Objectives: To evaluate the effectiveness of various non-invasive methods for predicting liver fibrosis, including transient elastography (TE), APRI score, Lok score, Forns score, FIB-4 score, Fibrosis Index, King score, and Bonacini score, in comparison with the effectiveness of LB and to create a new scoring system for fibrosis prediction.
Patients and Methods: This study included 212 patients with chronic HCV hepatitis. LB, TE, and various biological tests were performed during a single hospital visit. Using established formulae, data from these tests were used to create scores for assessment of liver fibrosis.
Results: The results of all the tests showed significant correlation with histological fibrosis. TE results (r = 0.62), King score (r = 0.57), and APRI score (r = 0.56) showed the closest correlation with severity of fibrosis. The following formula was derived from our data by multiple regression: Predicted liver fibrosis score (PLF score) = 0.956 + 0.084 × TE - 0.004 × King score + 0.124 × Forns score + 0.202 × APRI score. A direct correlation (r = 0.68) was found between the PLF score and liver fibrosis. The cut-off values of the PLF score for various stages of fibrosis were: F ≥ 1, 1.77 (Area under ROC curve (AUROC) = 0.76); F ≥ 2, 2.18 (AUROC = 0.78); F ≥ 3, 2.47 (AUROC = 0.86); and F = 4, 2.98 (AUROC = 0.97).
Conclusions: We found that our newly developed PLF score, which is derived from the scores of multiple tests, is more strongly correlated with fibrosis than each component score used individually. The PLF score is more effective than TE for predicting severe fibrosis, but they have similar effectiveness in predicting liver cirrhosis. 


  • Implication for health policy/practice/research/medical education:
    Evaluation of fibrosis is important for the assessment of chronic HCV hepatitis. In the last years the noninvasive methods are increasingly used and this is an improvement in the field of hepatology. The original article tries to open a new window for gastroenterologists, hepatologists, and other clinicians in the field.
  • Please cite this paper as:
    Bota S, Sirli R, Sporea I, Focsa M, Popescu A, Danila M, et al. A new scoring system for prediction of fibrosis in chronic hepatitis C. Hepat Mon. 2011;11(7):548-5.

© 2011 Kowsar M.P.Co. All rights reserved.


Keywords

Liver fibrosis Chronic HCV hepatitis Elastography Serological test

© 0, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

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