The aim of this study was to compare the results of nine non-invasive serum
biomarkers with liver biopsies to predict
liver fibrosis stage. HCV-
RNA-positive, HCV genotype 1, treatment-naive patients with chronic HCV
infections were included from 14 centers (n=77). The platelet count, AST/ALT ratio (AAR),
cirrhosis discriminate score (CDS), FIB4, AST/platelet ratio index (APRI), age-platelet (AP) index, Göteborg University
cirrhosis index (GUCI), FibroTest, and ActiTest were calculated and compared to histologic findings. All serum
biomarkers, except AAR, were weakly or moderately correlated with liver biopsy results (ISHAK
fibrosis score). The mean scores of FibroTest, FIB4, APRI, and AP index were significantly different between F0-F2 and F3-F4 groups and the negative predictive values (NPVs) of the F3-F4 group were 95%, 85%, 85%, and 83%, respectively, for these serum
biomarkers. Our study suggests that serum
biomarkers may help to diagnose significant
fibrosis but inadequate to detect
fibrosis in early stages. Although liver biopsy is still the gold standard to diagnose
liver fibrosis, FibroTest, FIB4, APRI, or AP index may be used to exclude significant
fibrosis with >80% NPV.