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
