New Index For Measuring Liver Fibrosis

[Guest guest]

Source: Wiley & Sons, Inc.

Date: February 21, 2007

New Index For Measuring Liver Fibrosis

Science Daily — A new study to find a non-invasive alternative to

liver biopsy when diagnosing fibrosis found that a series of simple

blood tests can accurately diagnose the condition. Fibrosis, the

formation of scar-like tissue in the liver, usually indicates damage

and can lead to cirrhosis. The new series of markers, called

FibroIndex, was found to more accurately diagnose fibrosis than two

other indices that are commonly used.

The results of this study appear in the February 2007 issue of

Hepatology, the official journal of the American Association for the

Study of Liver Diseases (AASLD), published by Wiley & Sons, Inc.

In patients with hepatitis C, determining the stage of liver fibrosis

is important for prognosis and treatment. Liver biopsy is the gold

standard, but it is invasive and costly. The current study tested an

index of routinely available blood tests to predict significant

fibrosis in hepatitis C patients and compared it to two other

indices, the Forns' index and APRI (aspartate aminotransferase to

platelet ration index).

Led by Masahiko Koda of Tottori University in Tottori, Japan, the

study included 402 patients with chronic hepatitis C who were

scheduled to undergo a liver biopsy between April 1994 and March

2004. Blood samples were collected within three days of the biopsy

and patients who had previously been diagnosed with cirrhosis were

not included. The researchers identified platelets, AST (a liver

enzyme), and gamma-globulin (a protein in the blood that helps fight

infection) as independent predictors of fibrosis and used these to

construct the FibroIndex equation.

The results showed that FibroIndex was more accurate in predicting

significant or severe fibrosis than Forns' index or APRI. By

determining cutoff values to identify the absence or presence of

significant fibrosis, the study found that 101 patients could have

avoided a liver biopsy. In addition, the FibroIndex was applied to a

subgroup of 30 patients treated with interferon who underwent a

second biopsy more than one year after treatment. Changes in

FibroIndex were found to correlate with changes in fibrosis, while

APRI and Forns' index did not show this correlation. FibroIndex was

also accurate in patients with normal levels of the liver enzyme ALT,

one third of whom had significant fibrosis.

The authors point out that blood tests for the predictors used by

FibroIndex are routinely available in most hospitals and

laboratories, making it a widely accessible tool for determining

fibrosis. Although other markers can be useful in diagnosing

fibrosis, their measurements are less standardized and expensive. The

authors note that the sensitivity of FibroIndex was limited, which

may be due to variation found in laboratory tests. Nevertheless, they

conclude: " The utilization of FibroIndex should decrease the number

of liver biopsies necessary during follow-up of patients with

hepatitis C and could safely provide longitudinal data on the

progression of liver fibrosis. " It could also provide important

information on the clinical course of hepatitis C and help evaluate

the effect of treatment.

Article: " FibroIndex, a Practical Index for Predicting Significant

Fibrosis in Patients with Chronic Hepatitis C, " Masahiko Koda,

Yoshiko Matunaga, Manri Kawakami, Yukihiro Kishimoto, Takeaki Suou,

Yoshikazu Murawaki, Hepatology; February 2007 (DOI:

10.1002/hep.21520).

Note: This story has been adapted from a news release issued by

Wiley & Sons, Inc..