Basic Science Sector

Background: An intensive research effort in the field of non-invasive evaluation of liver fibrosis has recently permitted the description of several blood markers of fibrosis, mainly in chronic hepatitis C (CHC) patients. Our aim was to evaluate the diagnostic performance of a panel of simple blood markers of liver fibrosis in CHC patients. Materials and Methods: One hundred and thirty two patients with CHC evaluated for deciding on antiviral therapy were included. We used receiver operating characteristic (ROC) curves and a stepwise combination algorithm was developed to assess and compare the diagnostic accuracy of blood markers. Results: The areas under the ROC curves of AST/ALT ratio, albumin, platelet count, APRI and fibronectin for discriminating advanced liver fibrosis (F3-F4) were 0.58, 0.73, 0.76 , 0.73 and 0.74; respectively. The AUC of combined markers score based on AST-ALT ratio, albumin, fibronectin and platelets count was 0.86 for advanced liver fibrosis patients. The combined markers correctly classified 35 positive patients from 43 patients with 81% sensitivity and classified 64 patients as negative from a total of 89 patients with 72% specificity. Discussions.we have developed multivariate discriminate analysis (MDA), a function may contribute to differentiating advanced fibrosis in patients with CHC. The MDA function is based on easily and routinely analyzed four blood markers as noninvasive, reproducible, quantitative, precise, accurate and low cost method that can be applied to patients who either have contraindications or refuse liver biopsy for the management of their HCV infection.