Blood Tests to Diagnose Fibrosis or Cirrhosis in Patients With Chronic Hepatitis C Virus Infection

LettersSeptember 3, 2013Blood Tests to Diagnose Fibrosis or Cirrhosis in Patients With Chronic Hepatitis C Virus InfectionRoger Chou, MD and Ngoc Wasson, MPHRoger Chou, MDFrom Oregon Health & Science University, Portland, Oregon. and Ngoc Wasson, MPHFrom Oregon Health & Science University, Portland, Oregon.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-159-5-201309030-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Although liver biopsy has limitations, such as sampling error and variability in interpretation, it remains the reference standard for evaluating hepatic fibrosis in almost all diagnostic studies. As we reported, results were largely unchanged when analyses were restricted to studies using adequate biopsy specimens (defined as >15 mm in length and >5 portal tracts in the absence of cirrhosis).We focused on diagnostic rather than prognostic accuracy because determination of fibrosis stage at the time of biopsy affects clinical decisions regarding treatment, and few studies on prognostic performance are available (6 in a recent meta-analysis [1]) compared with ...References1. Poynard T, Ngo Y, Perazzo H, Munteanu M, Lebray P, Moussalli J, et al. Prognostic value of liver fibrosis biomarkers: a meta-analysis. Gastroenterol Hepatol (N Y). 2011;7:445-54. [PMID: 22298979] MedlineGoogle Scholar2. Takwoingi Y, Leeflang MM, and Deeks JJ. Empirical evidence of the importance of comparative studies of diagnostic test accuracy. Ann Intern Med. 2013;158:544-54 LinkGoogle Scholar3. Ngo Y, Munteanu M, Messous D, Charlotte F, Imbert-Bismut F, Thabut D, et al. A prospective analysis of the prognostic value of biomarkers (FibroTest) in patients with chronic hepatitis C. Clin Chem. 2006;52:1887-96. [PMID: 16931569] CrossrefMedlineGoogle Scholar4. Vergniol J, Foucher J, Terrebonne E, Bernard PH, le Bail B, Merrouche W, et al. Noninvasive tests for fibrosis and liver stiffness predict 5-year outcomes of patients with chronic hepatitis C. Gastroenterology. 2011;140:1970-9, 1979.e1-3. [PMID: 21376047] CrossrefMedlineGoogle Scholar5. Calès P, Boursier J, Bertrais S, Oberti F, Gallois Y, Fouchard-Hubert I, et al. multicentric groups (SNIFF 14 & 17, ANRS HC EP 23 Fibrostar). Optimization and robustness of blood tests for liver fibrosis and cirrhosis. Clin Biochem. 2010;43:1315-22. [PMID: 20713037] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Oregon Health & Science University, Portland, Oregon.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M12-3007. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoBlood Tests to Diagnose Fibrosis or Cirrhosis in Patients With Chronic Hepatitis C Virus Infection Roger Chou and Ngoc Wasson Blood Tests to Diagnose Fibrosis or Cirrhosis in Patients With Chronic Hepatitis C Virus Infection Thierry Poynard , Vlad Ratziu , and Mona Munteanu Blood Tests to Diagnose Fibrosis or Cirrhosis in Patients With Chronic Hepatitis C Virus Infection Paul Calès , Victor de Ledinghen , and Jérôme Guéchot Metrics September 3, 2013Volume 159, Issue 5Page: 372KeywordsAcidsAminotransferasesBiopsyCirrhosisFibrosisHematologic testsLiverLiver fibrosisSystematic reviews ePublished: 3 September 2013 Issue Published: September 3, 2013 CopyrightCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...