Von Willebrand Factor as a new marker for non-invasive assessment of liver fibrosis and cirrhosis in patients with chronic hepatitis C.

Abstract

BACKGROUND:

Staging of liver fibrosis in patients with chronic hepatitis C (CHC) is recommended prior to anti-viral therapy. As vWF-Ag was shown as a predictor of portal hypertension, decompensation and mortality in patients with liver cirrhosis, we performed this study to investigate if vWF-Ag is able to predict different fibrosis stages and if it is comparable to other fibrosis scores.

AIM:

To investigate if vWF-Ag is able to predict different fibrosis stages and if it is comparable to other fibrosis scores.

METHODS:

We analysed 294 patients with chronic hepatitis C who underwent biopsy. We assessed stage of liver fibrosis according to Metavir, measured vWF-Ag and calculated different fibrosis scores (APRI, FCI, FORNS, FI, Fib-4) and compared them by AUCs. We also calculated a new score: vWF-Ag/thrombocytes (VITRO score) for prediction of fibrosis.

RESULTS:

vWF-Ag levels were increasing with stage of fibrosis: F0: vWF-Ag was median 136.5%, FI 140.6%, FII 157.5%, FIII 171.0%, FIV 252.0%; P < 0.001. vWF-Ag and VITRO score produced AUCs of 0.7 and 0.72 for ≥F2, comparable to the AUCs of APRI, Fib-4, FORNS with 0.75, 0.65 and 0.64 (P > 0.05). For ≥F3 AUCs were 0.79 and 0.86 for vWF-Ag and VITRO score, comparable with AUCs of 0.79, 0.86 and 0.87 for APRI, Fib-4 and FORNS. Cirrhosis shows AUCs of 0.84 and 0.89 for vWF-Ag and VITRO score, APRI, Fib-4 and FORNS showed similar results with AUCs of 0.82, 0.88 and 0.87.

CONCLUSIONS:

vWF-Ag and VITRO score offer an easy possibility to evaluate the stage of fibrosis to diagnose subclinical cirrhosis in patients with chronic hepatitis C. Both vWF-Ag and VITRO score show equal performance in comparison to other fibrosis scores assessed in our study.

• Authors: A Maieron, P Salzl, M Peck-Radosavljevic, M Trauner, S Hametner, R Schöfl, P Ferenci, M Ferlitsch
• Journal: Alimentary pharmacology & therapeutics (Aliment Pharmacol Ther) Vol. 39 Issue 3 Pg. 331-8 (Feb 2014) ISSN: 1365-2036 [Electronic] England
• PMID: 24308724 (Publication Type: Journal Article)
• Copyright: © 2013 John Wiley & Sons Ltd.

Chemical References

• Biomarkers
• von Willebrand Factor

Topics

• Adult
• Biomarkers (metabolism)
• Biopsy
• Female
• Hepatitis C, Chronic (diagnosis, pathology)
• Humans
• Liver Cirrhosis (diagnosis, pathology)
• Male
• Middle Aged
• Predictive Value of Tests
• Retrospective Studies
• von Willebrand Factor (metabolism)