Journal Article

Noninvasive laboratory tests proposed for predicting cirrhosis in patients with chronic hepatitis C are also useful in patients with non-alcoholic steatohepatitis

Kobayashi, Sawako, Iwai, Shuji, Morikawa, Hiroyasu, Mori, Mami, Ueda, Makiko, Sakaguchi, Hiroki, Enomoto, Masaru, Kawada, Norifumi, Fukushima, Wakaba, Ohfuji, Satoko, Fujii, Hideki, Ikura, Yoshihiro, Tamori, Akihiro

2009

Overview

Background Several noninvasive tests have been proposed to predict cirrhosis in patients with chronic hepatitis C, but not in patients with non-alcoholic steatohepatitis (NASH). We assessed whether noninvasive laboratory tests designed to predict the risk of cirrhosis in patients with chronic hepatitis C virus (HCV) infection could be used in patients with NASH. Methods The subjects were 50 patients with biopsy-proved NASH and 100 age- and sex-matched patients with HCV. Aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio (AAR), age-platelet (AP) index, AST-to-platelet ratio index (APRI), cirrhosis discriminant score (CDS), and the hepatitis C antiviral long-term treatment against cirrhosis (HALT-C) model were calculated. Results The areas under the receiver-operating characteristic curves of the AAR, AP index, APRI, CDS, and HALT-C model for predicting cirrhosis were respectively 0.813, 0.877, 0.786, 0.949, and 0.908 in patients with NASH and 0.555, 0.652, 0.761, 0.782, and 0.782 in patients with HCV. A CDS cutoff value of less than 5 misclassified none of the 9 patients with NASH who had cirrhosis, while a value of more than 8 misclassified none of the 41 patients with NASH without cirrhosis. With the HALT-C model, a cutoff value of less than 0.6 classified non-cirrhotic NASH, while a cutoff value of 0.97 or higher classified cirrhotic NASH. The use of CDS and HALT-C model could avoid liver biopsy for predicting cirrhosis in 60 and 48% of the patients with NASH, respectively. Conclusions Noninvasive laboratory tests designed to predict cirrhosis in patients with HCV are also useful in patients with NASH.

• Publisher: Japan : Springer Japan,Springer Japan,Springer Nature B.V
• Subject: Abdominal Surgery / Adult / Aged / Alanine Transaminase - blood / Aspartate Aminotransferases - blood / Biliary Tract / Cirrhosis discriminant score / Colorectal Surgery / Fatty Liver - complications / Female / Fibrosis / Gastroenterology / HALT-C / Hepatitis C virus / Hepatitis C, Chronic - complications / Hepatology / Humans / Liver Cirrhosis - etiology / Liver Cirrhosis - virology / Liver Function Tests - methods / Liver Function Tests - standards / Male / Medicine / Medicine & Public Health / Middle Aged / NASH / Noninvasive test / Original Article—Liver / Pancreas / Platelet Count / Predictive Value of Tests / ROC Curve / Surgical Oncology