Study of some Fib
Study of some Fibrosis Indices in Genotype 4 HCV Infected Egyptian Patients
Niveen Saudy1*, Doaa M. Elghannam1, Raghada Farag2, Mohamed Abd El-Maksoud2 , Mona A. El-Hussiny1, Mohamed El-Malky3, Nader El-Malky 4
Departments of 1Clinical Pathology, 2Tropical Medicine, 3Medical Parasitology and 4Internal Medicine, Faculty of Medicine, Mansoura University, Egypt.
Abstract: Background and Aims: In HCV infected patients, liver biopsy is considered essential to stage liver fibrosis. Procedure of liver biopsy is invasive, expensive and not suitable for all patients. The present study aimed to evaluate the diagnostic accuracy of the readily available non-invasive fibrosis indexes for the fibrosis progression discrimination in chronic HCV mono infected and co-infected Schistisoma mansoni patients and to find a better combination of existing non invasive markers. Methods: The study included 100 genotype 4 HCV mono-infected and S. mansoni co-infected patients who underwent liver biopsy. The degree of fibrosis was scored according to the METAVIR staging system. The readily available AAR, APRI, FI, FCI, FT and FIB-4 serum indices. were tested in the patients. Results: There was a significant relationship between fibrosis stages and serum indexes except AAR and FCI (P > 0.05). AUROC of FT was higher than other indexes (P < 0.05) for differentiating minimal fibrosis (F1) from significant fibrosis (F2-F4). Also, FT showed high AUROC to predict cirrhosis. In HCV mono infected patients, minimal fibrosis can be identified using FCI and FT with sensitivity 57% for both , and specificity 58% and 57% respectively while cirrhosis can be identified using FI, FIB-4, APRI, FT, and AAR with sensitivity 100%, 75%, 100%, 50% and 100% and specificity 53%, 77%, 60%, 100%, and 59% respectively. In HCV/S. mansoni coinfection patients, minimal fibrosis can be identified using FT, FIB-4, APRI, FI, FCI and AAR with sensitivity 70%, 70%, 71%, 70% 60% and 60% and specificity 61%, 75%, 55%, 62%, 55% and 50% respectively while cirrhosis can be identified using FT, FI, FIB-4, and FCI with sensitivity 88%, 88%, 50% and 50% and specificity 52%, 70%, 60%, and 58% respectively. Moreover, S. mansoni anti-SEA was poorly significant with fibrosis stages. Conclusion: All methods used for predicting liver fibrosis were directly, and significantly, correlated with histological findings, but FT , FI, and APRI score had the strongest correlation with fibrosis severity while, AAR, and FCI showed significantly low ‘r’ index. These results suggest that the using FT as a first-line test in the social health centers seems feasible and effective.
[Niveen Saudy, Doaa M. Elghannam, Raghada Farag, Mohamed Abd El-Maksoud, Mona A. El-Hussiny, Mohamed El-Malky, Nader El-Malky. Study of some Fibrosis Indices in Genotype 4 HCV Infected Egyptian Patients. Life Sci J2012;9(1):972-984] (ISSN:1097-8135). http://www.lifesciencesite.com. 141
Key words: HCV, Schistisoma mansoni, fibrosis, Egypt Full Text 141