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- Title
The applicability of non-invasive methods for assessing liver fibrosis in hemodialysis patients with chronic hepatitis C.
- Authors
Lee, Jia-Jung; Wei, Yu-Ju; Lin, Ming-Yen; Niu, Sheng-Wen; Hsu, Po-Yao; Huang, Jiun-Chi; Jang, Tyng-Yuan; Yeh, Ming-Lun; Huang, Ching-I; Liang, Po-Cheng; Lin, Yi-Hung; Hsieh, Ming-Yen; Hsieh, Meng-Hsuan; Chen, Szu-Chia; Dai, Chia-Yen; Lin, Zu-Yau; Chen, Shinn-Cherng; Huang, Jee-Fu; Chang, Jer-Ming; Hwang, Shang-Jyh
- Abstract
Background: The accurate assessment of liver fibrosis among hemodialysis patients with chronic hepatitis C (CHC) is important for both treatment and for follow up strategies. Applying the non-invasive methods in general population with viral hepatitis have been successful but the applicability of the aminotransferase/platelet ratio index (APRI) or the fibrosis-4 index (FIB-4) in hemodialysis patients need further evaluation. Materials and methods: We conducted a prospective, multi-center, uremic cohort to verify the applicability of APRI and FIB-4 in identifying liver fibrosis by reference with the standard transient elastography (TE) measures. Results: There were 116 CHC cases with valid TE were enrolled in our analysis. 46 cases (39.6%) were classified as F1, 35 cases (30.2%) as F2, 11 cases (9.5%) as F3, and 24 cases (20.7%) as F4, respectively. The traditional APRI and FIB-4 criteria did not correctly identify liver fibrosis. The optimal cut-off value of APRI was 0.28 and of FIB-4 was 1.91 to best excluding liver cirrhosis with AUC of 76% and 77%, respectively. The subgroup analysis showed that female CHC hemodialysis patients had better diagnostic accuracy with 74.1% by APRI. And CHC hemodialysis patients without hypertension had better diagnostic accuracy with 78.6% by FIB-4. Conclusions: This study confirmed the traditional category level of APRI and FIB-4 were unable to identify liver fibrosis of CHC hemodialysis patients. With the adjusted cut-off value, APRI and FIB-4 still showed suboptimal diagnostic accuracy. Our results suggest the necessary of TE measures for liver fibrosis in the CHC uremic population.
- Subjects
CHRONIC hepatitis C; HEMODIALYSIS patients; CHRONIC hepatitis B; VIRAL hepatitis; FIBROSIS; SURGICAL arteriovenous shunts; LIVER; CIRRHOSIS of the liver
- Publication
PLoS ONE, 2020, Vol 15, Issue 11, p1
- ISSN
1932-6203
- Publication type
Article
- DOI
10.1371/journal.pone.0242601