Blood Tests as Good as Biopsy for HCV-Related Disease
(HealthDay News) – Compared to a liver biopsy, available blood tests are accurate for diagnosing fibrosis and cirrhosis in patients with hepatitis C virus (HCV), according to a review published in the June 4 issue of the Annals of Internal Medicine.
Roger Chou, MD, and Ngoc Wasson, MPH, from the Oregon Health & Science University in Portland, conducted a literature review to identify 172 studies that compared the diagnostic accuracy of blood tests with that of liver biopsy.
The researchers found that the platelet count, age-platelet index, aspartate aminotransferase-platelet ratio index (APRI), FibroIndex, FibroTest, and Forns index had median positive likelihood ratios of 5–10 at commonly used cut-offs and areas under the receiver-operating characteristic curve (AUROCs) of ≥0.7 for identifying clinically significant fibrosis. For determining cirrhosis, the platelet count, age-platelet index, APRI, and Hepascore had median positive likelihood ratios of 5–10 and AUROCs of ≥0.8, while the Goteborg University Cirrhosis Index and the Lok index had slightly lower positive likelihood ratios (4.8 and 4.4, respectively). There was a slightly lower AUROC with APRI than with the FibroTest for identifying fibrosis, but a substantially higher AUROC with APRI than the aspartate aminotransferase-alanine aminotransferase ratio for identifying fibrosis or cirrhosis.
"Many blood tests are moderately useful for identifying clinically significant fibrosis or cirrhosis in HCV-infected patients," the authors write.