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Fibrosis progression under maintenance interferon in hepatitis C is better detected by blood test than liver morphometry.

Abstract
We evaluated whether quantitative measurements of liver fibrosis with recently developed diagnostics outperform histological staging in detecting natural or interferon-induced changes. We compared Metavir staging, morphometry (area and fractal dimension) and six blood tests in 157 patients with chronic hepatitis C from two trials testing maintenance interferon for 96 weeks. Paired liver biopsies and blood tests were available for 101 patients, and there was a significant improvement in Metavir activity and a significant increase in blood tests reflecting fibrosis quantity in patients treated with interferon when compared with controls - all per cent changes in histological fibrosis measures were significantly increased in F1 vs F2-4 stages only in the interferon group. For the whole population studied between weeks 0 and 96, there was significant progression only in the area of fibrosis (AOF) (P = 0.026), FibroMeter (P = 0.020) and CirrhoMeter (P = 0.003). With regards to dynamic reproducibility, agreement was good (r(ic) ≥ 0.72) only for Metavir fibrosis score, FibroMeter and CirrhoMeter. The per cent change in AOF was significantly higher than that of fractal dimension (P = 0.003) or Metavir fibrosis score (P = 0.015). CirrhoMeter was the only blood test with a change significantly higher than that of AOF (P = 0.039). AOF and two blood tests, reflecting fibrosis quantity, have high sensitivity and/or reproducibility permitting the detection of a small progression in liver fibrosis over two years. A blood test reflecting fibrosis quantity is more sensitive and reproducible than morphometry. The study also shows that maintenance interferon does not improve fibrosis, whatever its stage.
AuthorsP Calès, J P Zarski, J Marc Chapplain, S Bertrais, N Sturm, C Michelet, G Babany, J Chaigneau, M Eddine Charaf, multicentric groups (Fibrosys, ANRS HC 12, Fibrostop)
JournalJournal of viral hepatitis (J Viral Hepat) Vol. 19 Issue 2 Pg. e143-53 (Feb 2012) ISSN: 1365-2893 [Electronic] England
PMID22239512 (Publication Type: Comparative Study, Evaluation Study, Journal Article, Research Support, Non-U.S. Gov't)
Copyright© 2011 Blackwell Publishing Ltd.
Chemical References
  • Antiviral Agents
  • Interferons
Topics
  • Adult
  • Aged
  • Antiviral Agents (administration & dosage)
  • Biopsy
  • Clinical Trials as Topic
  • Female
  • Fibrosis (diagnosis, pathology)
  • Hematologic Tests (methods)
  • Hepatitis C, Chronic (complications, drug therapy)
  • Humans
  • Interferons (administration & dosage)
  • Liver (pathology)
  • Male
  • Middle Aged
  • Pathology, Clinical (methods)
  • Reproducibility of Results
  • Sensitivity and Specificity

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