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1 Clinical Biochemistry,
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Anatomical Pathology, and
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Virology, PathCentre, QE II Medical Centre, Nedlands, Western Australia 6009, Australia.
2 Department of Gastroenterology and Hepatology, Sir Charles Gairdner Hospital, QE II Medical Centre, Nedlands, Western Australia 6009, Australia.
Departments of
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Public Health and
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Medicine, University of Western Australia, QE II Medical Centre, Nedlands, Western Australia 6009, Australia.
aAddress correspondence to this author at: Clinical Biochemistry, PathCentre, Locked Bag 2009, Nedlands, Western Australia 6009, Australia. Fax 61-8-9346-3882; e-mail ric.rossi{at}health.wa.gov.au.
Background: Determining the stage of fibrosis by liver biopsy is important in managing patients with hepatitis C virus infection. We investigated the predictive value of the proprietary FibroTest score to accurately identify significant fibrosis in Australian hepatitis C patients.
Methods: Serum obtained from 125 confirmed hepatitis C patients before antiviral therapy was analyzed for haptoglobin, 
2-macroglobulin, apolipoprotein A1, bilirubin, and 
-glutamyltransferase activity, and the FibroTest score was computed. Liver fibrosis pathology was staged according to a defined system on a scale of F0 to F4. We used predictive values and a ROC curve to assess the accuracy of FibroTest scores.
Results: The prevalence of significant fibrosis defined by liver biopsy was 0.38. The most useful single test for predicting significant fibrosis was serum 2-macroglobulin (cutoff value, 2.52 g/L; sensitivity, 75%; specificity, 67%). The negative predictive value of a FibroTest score <0.1 was 85%, and the positive predictive value of a score >0.6 was 78%. Although 33 of the 125 patients had FibroTest scores <0.1 and were therefore deemed unlikely to have fibrosis, 6 (18%) had significant fibrosis. Conversely, of the 24 patients with scores >0.6 who were likely to have significant fibrosis, 5 (21%) had mild fibrosis. Of the 125 patients in the cohort, 57 (46%) could have avoided liver biopsy, but discrepant results were recorded in 11 of those 57 (19%).
Conclusion: The FibroTest score could not accurately predict the presence or absence of significant liver fibrosis.
The following articles in journals at HighWire Press have cited this article:
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  B. Gangadharan, R. Antrobus, R. A. Dwek, and N. Zitzmann Novel Serum Biomarker Candidates for Liver Fibrosis in Hepatitis C Patients Clin. Chem., October 1, 2007; 53(10): 1792 - 1799. [Abstract] [Full Text] [PDF]
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T. Poynard, P. Halfon, L. Castera, M. Munteanu, F. Imbert-Bismut, V. Ratziu, Y. Benhamou, M. Bourliere, V. de Ledinghen, and FibroPaca Group Standardization of ROC Curve Areas for Diagnostic Evaluation of Liver Fibrosis Markers Based on Prevalences of Fibrosis Stages Clin. Chem., September 1, 2007; 53(9): 1615 - 1622. [Abstract] [Full Text] [PDF]
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 G. S. Belinsky, A. L. Parke, Q. Huang, K. Blanchard, S. Jayadev, R. Stoll, M. Rothe, L. E. K. Achenie, R. R. Gupta, G. Y. Wu, et al. The Contribution of Methotrexate Exposure and Host Factors on Transcriptional Variance in Human Liver Toxicol. Sci., June 1, 2007; 97(2): 582 - 594. [Abstract] [Full Text] [PDF]
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Y. Ngo, M. Munteanu, D. Messous, F. Charlotte, F. Imbert-Bismut, D. Thabut, P. Lebray, V. Thibault, Y. Benhamou, J. Moussalli, et al. A Prospective Analysis of the Prognostic Value of Biomarkers (FibroTest) in Patients with Chronic Hepatitis C Clin. Chem., October 1, 2006; 52(10): 1887 - 1896. [Abstract] [Full Text] [PDF]
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 J Macias, J A Giron-Gonzalez, M Gonzalez-Serrano, D Merino, P Cano, J A Mira, A Arizcorreta-Yarza, J Ruiz-Morales, J M Lomas-Cabeza, J A Garcia-Garcia, et al. Prediction of liver fibrosis in human immunodeficiency virus/hepatitis C virus coinfected patients by simple non-invasive indexes Gut, March 1, 2006; 55(3): 409 - 414. [Abstract] [Full Text] [PDF]
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D. R. Dufour Assessment of Liver Fibrosis: Can Serum Become the Sample of Choice? Clin. Chem., October 1, 2005; 51(10): 1763 - 1764. [Full Text] [PDF]
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L. A. Adams, M. Bulsara, E. Rossi, B. DeBoer, D. Speers, J. George, J. Kench, G. Farrell, G. W. McCaughan, and G. P. Jeffrey Hepascore: An Accurate Validated Predictor of Liver Fibrosis in Chronic Hepatitis C Infection Clin. Chem., October 1, 2005; 51(10): 1867 - 1873. [Abstract] [Full Text] [PDF]
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T. C.W. Poon, A. Y. Hui, H. L.Y. Chan, I. L. Ang, S. M. Chow, N. Wong, and J. J.Y. Sung Prediction of Liver Fibrosis and Cirrhosis in Chronic Hepatitis B Infection by Serum Proteomic Fingerprinting: A Pilot Study Clin. Chem., February 1, 2005; 51(2): 328 - 335. [Abstract] [Full Text] [PDF]
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A K P Lim, S D Taylor-Robinson, N Patel, R J Eckersley, R D Goldin, G Hamilton, G R Foster, H C Thomas, D O Cosgrove, and M J K Blomley Hepatic vein transit times using a microbubble agent can predict disease severity non-invasively in patients with hepatitis C Gut, January 1, 2005; 54(1): 128 - 133. [Abstract] [Full Text] [PDF]
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T. Poynard, M. Munteanu, F. Imbert-Bismut, F. Charlotte, D. Thabut, S. Le Calvez, D. Messous, V. Thibault, Y. Benhamou, J. Moussalli, et al. Prospective Analysis of Discordant Results between Biochemical Markers and Biopsy in Patients with Chronic Hepatitis C Clin. Chem., August 1, 2004; 50(8): 1344 - 1355. [Abstract] [Full Text] [PDF]
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