FIB-4 and APRI scores for predicting severe fibrosis in chronic hepatitis C - a developing country's perspective in DAA era

  • Uros Karic Clinical Centre of Serbia, Belgrade, Serbia
  • Ivana Pesic-Pavlovic Clinical Centre of Serbia, Belgrade, Serbia
  • Goran Stevanovic Clinical Centre of Serbia, Belgrade, Serbia
  • Milos Korac Clinical Centre of Serbia, Belgrade, Serbia
  • Natasa Nikolic Clinical Centre of Serbia, Belgrade, Serbia
  • Aleksandra Radovanovic-Spurnic Clinical Centre of Serbia, Belgrade, Serbia
  • Aleksandra Barac Clinical Centre of Serbia, Belgrade, Serbia
  • Nikola Mitrovic Clinical Centre of Serbia, Belgrade, Serbia
  • Aleksandar Markovic Clinical Centre of Serbia, Belgrade, Serbia
  • Marko Markovic Clinical Centre of Serbia, Belgrade, Serbia
  • Anita Petkovic Clinical Centre of Serbia, Belgrade, Serbia
  • Ivana Ostojic Clinical Centre of Serbia, Belgrade, Serbia
  • Sanja Perunicic Clinical Centre of Serbia, Belgrade, Serbia
  • Natalija Kekic Clinical Centre of Serbia, Belgrade, Serbia
  • Martina Glidzic Clinical Centre of Serbia, Belgrade, Serbia
  • Miljana Djonin-Nenezic Clinical Centre of Serbia, Belgrade, Serbia
  • Branko Brmbolic Clinical Centre of Serbia, Belgrade, Serbia
  • Ivana Milosevic Clinical Centre of Serbia, Belgrade, Serbia
Keywords: FIB-4, APRI score, chronic hepatitis C, liver fibrosis

Abstract

Introduction: Chronic Hepatitis C Virus (HCV) infection leads to progressive fibrosis making fibrosis staging necessary in the evaluation of such patients. Different fibrosis scores are emerging as possible non-invasive alternatives for liver biopsy. The Fibrosis-4 Index (FIB-4) and AST to Platelet Ratio Index (APRI) scores are the most widely used and the most extensively tested. This study aims to determine if it was possible to accurately use these to identify patients that are unlikely to have severe fibrosis.

Methodology: One hundred and forty-two patients with chronic hepatitis C infection who underwent liver biopsy since January 1st 2014 until May 31st 2017 at the Hospital for Infectious and Tropical Diseases in Belgrade were analyzed. The FIB-4 and APRI scores were calculated for each patient and compared to histologically determined fibrosis stage.

Results: A comprehensive statistical analysis was conducted in order to compare patients with and without severe fibrosis and to evaluate the accuracy of the fibrosis scores. Patients with non-severe fibrosis were younger, had higher platelet counts and lower transaminase levels. FIB-4 had an AUC of 0.875 and the APRI score had an AUC of 0.861. No patients with severe fibrosis or cirrhosis had a FIB-4 lower than 1.08. FIB-4 was superior to APRI in identifying patients with severe fibrosis in the study cohort.

Conclusion: FIB-4 was superior to APRI in the recognition of severe fibrosis. FIB-4 may prove very useful in identifying patients without advanced liver disease, especially if other non-invasive methods are inaccessible.

Author Biography

Ivana Milosevic, Clinical Centre of Serbia, Belgrade, Serbia

Infectious diseases, Hepatology, Gastroenterology

Published
2018-03-31
How to Cite
1.
Karic U, Pesic-Pavlovic I, Stevanovic G, Korac M, Nikolic N, Radovanovic-Spurnic A, Barac A, Mitrovic N, Markovic A, Markovic M, Petkovic A, Ostojic I, Perunicic S, Kekic N, Glidzic M, Djonin-Nenezic M, Brmbolic B, Milosevic I (2018) FIB-4 and APRI scores for predicting severe fibrosis in chronic hepatitis C - a developing country’s perspective in DAA era. J Infect Dev Ctries 12:178-182. doi: https://doi.org/10.3855/jidc.10190
Section
Original Articles