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- Title
Comparison of simple tests for the non-invasive diagnosis of clinically silent cirrhosis in chronic hepatitis C.
- Authors
BORRONI, G.; CERIANI, R.; CAZZANIGA, M.; TOMMASINI, M.; RONCALLI, M.; MALTEMPO, C.; FELLINE, C.; SALERNO, F.
- Abstract
Background Biopsy is the gold standard for assessing cirrhosis in patients with chronic hepatitis C virus infection, but it is expensive and at risk of complications. Alternative non-invasive methods have been developed but their usefulness remains uncertain. Aim To compare the accuracy of five non-invasive scores in detecting cirrhosis. Methods We reviewed the charts and liver biopsies of 228 consecutive, treatment-naïve, hepatitis C virus-positive patients, 13.2% of whom with histological diagnosis of cirrhosis. The five alternative scores were age-platelet index, cirrhosis discriminant score, aspartate transaminases to platelet ratio index, Pohl's index, and aspartate transaminases/alanine transaminases ratio. Results The specificities of the scores were good (87-100%), but not so their sensitivities (17-67%). Accordingly positive likelihood ratios were generally good but negative likelihood ratios were suboptimal. Combinations of the scores independently related to cirrhosis only slightly change this diagnostic accuracy. Using double cut-offs to exclude/diagnoses cirrhosis, cirrhosis discriminant score classified 21% of patients without misdiagnoses and aspartate transaminases to platelet ratio index classified 85% of case with 9% of misdiagnoses. Conclusions The five scores showed variable sensitivities and specificities in detecting liver cirrhosis, both individually and in combination. The use of double cut-off points may make the cirrhosis discriminant score and aspartate transaminases to platelet ratio index useful to reduce the number of patients submitted to liver biopsy.
- Subjects
CHRONIC active hepatitis; HEPATITIS C; CIRRHOSIS of the liver; LIVER diseases; DIAGNOSIS; VIRAL hepatitis; AUTOIMMUNE diseases
- Publication
Alimentary Pharmacology & Therapeutics, 2006, Vol 24, Issue 5, p797
- ISSN
0269-2813
- Publication type
Article
- DOI
10.1111/j.1365-2036.2006.03034.x