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.