Noninvasive serum markers in the diagnosis of structural liver damage in chronic hepatitis C virus infection

Liver Int. 2006 Nov;26(9):1095-9. doi: 10.1111/j.1478-3231.2006.01356.x.

Abstract

Aim: Several noninvasive markers are being used to assess the structural liver damage in patients with chronic hepatitis C (CHC). We evaluated the capacity of serum hyaluronic acid (HA), aspartate aminotransferase (AST)/ALT ratio, the AST to platelet ratio index (APRI) and gamma-glutamyltransferase (GGT) levels to predict the intensity of hepatic fibrosis in patients with CHC.

Patients and methods: In a total of 206 hepatitis C virus RNA-positive biopsied patients, AST, ALT, GGT levels, platelet count and serum HA concentration were determined. The APRI was calculated as the ratio of AST to platelets.

Results: HA levels were best correlated with disease stage (r=-0.694; P<0.001). In the diagnosis of significant fibrosis (F2-F4), HA levels [AUC=0.879, 95% CI (0.832-0.927)] and APRI [AUC=0.824 (0.772-0.903)] were the markers with the best diagnostic accuracy. These parameters also best identified the presence of cirrhosis (F4), with an AUC of 0.908 (0.868-0.949) for HA and of 0.837 (0.772-0.903) for APRI.

Conclusion: Serum HA was the parameter that alone presented the best diagnostic accuracy in the assessment of hepatic fibrosis in CHC. The APRI showed a better diagnostic sensitivity than GGT levels or the AST/ALT ratio. Its simple determination and low cost make this index a valid alternative for the noninvasive staging of CHC.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Alanine Transaminase / blood
  • Area Under Curve
  • Aspartate Aminotransferases / blood
  • Biomarkers / blood*
  • Female
  • Hepatitis C, Chronic / blood*
  • Hepatitis C, Chronic / complications*
  • Humans
  • Hyaluronic Acid / blood
  • Liver Cirrhosis / diagnosis*
  • Liver Cirrhosis / virology*
  • Male
  • Middle Aged
  • Platelet Count
  • Predictive Value of Tests
  • Prospective Studies
  • gamma-Glutamyltransferase / blood

Substances

  • Biomarkers
  • Hyaluronic Acid
  • gamma-Glutamyltransferase
  • Aspartate Aminotransferases
  • Alanine Transaminase