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Received on March 30, 2006
Accepted on August 2, 2006
Proteomics and Protein Markers |
1 Service d'Hépato-Gastroentérologie, Groupe Hospitalier Pitié-Salpêtrière, Université Paris VI, CNRS, Paris, France
2 Biopredictive, Paris, France
3 Laboratoire de Biochimie, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
4 Service d'Anatomie Pathologique Groupe Hospitalier Pitié-Salpêtrière, Paris, France
5 Laboratoire de Virologie, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
* To whom correspondence should be addressed. E-mail: tpoynard{at}teaser.fr.
Background:FibroTest, a noninvasive method of measuring biomarkers of liver fibrosis, is an alternative to liver biopsy for determining the severity of chronic hepatitis C virus (HCV) infection. We compared the 5-year prognostic value of the FibroTest with biopsy staging for predicting cirrhosis decompensation and survival for patients with chronic HCV infection.
Methods: Fibrosis stage was assessed on the same day by FibroTest and biopsy in a prospective cohort of 537 patients. Disease classification at baseline was 157 patients with severe fibrosis (FibroTest >0.58), 137 with moderate fibrosis (FibroTest 0.32-0.58), and 243 with no or minimal fibrosis (FibroTest <0.32).
Results: In 64 untreated patients with severe fibrosis, survival without HCV complications was 73% [95% confidence interval (CI), 59%-086%; 13 complications], and survival without HCV-related death was 85% (95% CI, 73%-96%; 7 HCV deaths). Survival rates were higher in patients with moderate fibrosis, [99% (95% CI, 97%-100%; 1 complication; P <0.001) and 100% (no HCV death; P <0.001) for with and without HCV-related complications, respectively], and in patients with minimal fibrosis [100% (no complication; P <0.001 vs severe) and 100% (no HCV death; P <0.001 vs severe), respectively]. FibroTest was a better predictor than biopsy staging for HCV complications, with area under the ROC curves (AUROC) = 0.96 (95% CI, 0.93%-0.97%) vs 0.91 (95% CI, 0.85%-0.94%; P = 0.01), respectively; it was also a better predictor for HCV deaths: AUROC = 0.96 (95% CI, 0.93%-0.98%) vs 0.87 (95% CI, 0.70%-0.94%; P = 0.046), respectively. The prognostic value of FibroTest was still significant (P <0.001) in multivariate analyses after taking into account histology, treatment, alcohol consumption, and HIV coinfection.
Conclusion: The FibroTest measurement of HCV biomarkers has a 5-year prognostic value similar to that of liver biopsy.
The following articles in journals at HighWire Press have cited this article:
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  M. Puoti, P. Nasta, F. Gatti, A. Matti, K. Prestini, L. Biasi, and G. Carosi HIV-Related Liver Disease: ARV Drugs, Coinfection, and Other Risk Factors J Int Assoc Physicians AIDS Care (Chic Ill), January 1, 2009; 8(1): 30 - 42. [Abstract] [PDF]
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 A. Orlacchio, F. Bolacchi, M. Cadioli, A. Bergamini, V. Cozzolino, M. Angelico, and G. Simonetti Evaluation of the Severity of Chronic Hepatitis C with 3-T1H-MR Spectroscopy Am. J. Roentgenol., May 1, 2008; 190(5): 1331 - 1339. [Abstract] [Full Text] [PDF]
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 M. Friedrich-Rust, C. Koch, A. Rentzsch, C. Sarrazin, P. Schwarz, E. Herrmann, A. Lindinger, U. Sarrazin, T. Poynard, H.-J. Schafers, et al. Noninvasive assessment of liver fibrosis in patients with Fontan circulation using transient elastography and biochemical fibrosis markers J. Thorac. Cardiovasc. Surg., March 1, 2008; 135(3): 560 - 567. [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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