Automation of the Hepascore and validation as a biochemical index of liver fibrosis in patients with chronic hepatitis C from the ANRS HC EP 23 Fibrostar cohort

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• 作者：Jé ; rô ; me Gué ; chot ; Elisabeth Lasnier ; Nathalie Sturm ; Adeline Paris ; Jean-Pierre Zarski ; the ANRS HC EP 23 Fibrostar study group
• 关键词：Liver fibrosis ; Hepatitis C ; Blood marker ; Hepascore ; Diagnostic accuracy
• 刊名：Clinica Chimica Acta
• 出版年：2010
• 出版时间：4 January 2010
• 年：2010
• 卷：411
• 期：1-2
• 页码：86-91
• 全文大小：367 K

文摘

Background

Hepascore combining serum bilirubin, gamma glutamyl transpeptidase, hyaluronic acid (HA) and α2-macroglobulin with age and sex, was reported as relevant in predicting liver fibrosis in patients with chronic HCV infection and was proposed as an alternative to liver biopsy.

Methods

Since an automated HA assay (Latex method, Wako, Japan) became available, we investigated to automate Hepascore by simultaneous measurements of components using an OLYMPUS AU640 analyzer (Tokyo, Japan). For its clinical evaluation, we considered a cohort of chronic HCV patients included in a multicenter prospective study (ANRS HC EP 23 Fibrostar).

Results

Automated Hepascore was not significantly different than assayed as previously described. An improvement in HA variability was evidenced. In 512 chronic HCV patients, automated Hepascore, using ROC curves analysis, showed good predictive performances for significant fibrosis (AUROC = 0.81), severe fibrosis (AUROC = 0.82), and cirrhosis (AUROC = 0.88). For significant fibrosis, Hepascore (cut-off = 0.5) had a sensitivity of 0.77, a specificity of 0.70, a positive predictive value of 0.71 and a negative predictive value (NPV) of 0.77. Hepascore < 0.25 could exclude significant fibrosis with a sensitivity of 0.95 and a NPV of 0.90 and Hepascore < 0.75 could exclude cirrhosis with a sensitivity of 0.86 and a NPV of 0.97.

Conclusions

This study shows that Hepascore, a non-invasive index of liver fibrosis, necessitating only one serum sample, can be totally automated using a single analyzer and confirms that Hepascore accurately predicts liver fibrosis in chronic HCV. Hepascore might be largely used in assessing liver fibrosis as surrogate to the liver biopsy.