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Can serum hyaluronic acid replace simple non-invasive indexes to predict liver fibrosis in HIV/Hepatitis C coinfected patients?
- Source :
-
BMC infectious diseases [BMC Infect Dis] 2010 Aug 19; Vol. 10, pp. 244. Date of Electronic Publication: 2010 Aug 19. - Publication Year :
- 2010
-
Abstract
- Background: Hyaluronic acid (HA) serum levels correlate with the histological stages of liver fibrosis in hepatitis C virus (HCV) monoinfected patients, and HA alone has shown very good diagnostic accuracy as a non-invasive assessment of fibrosis and cirrhosis. The aim of this study was to evaluate serum HA levels as a simple non-invasive diagnostic test to predict hepatic fibrosis in HIV/HCV-coinfected patients and to compare its diagnostic performance with other previously published simple non-invasive indexes consisting of routine parameters (HGM-1, HGM-2, Forns, APRI, and FIB-4).<br />Methods: We carried out a cross-sectional study on 201 patients who all underwent liver biopsies and had not previously received interferon therapy. Liver fibrosis was determined via METAVIR score. The diagnostic accuracy of HA was assessed by area under the receiver operating characteristic curves (AUROCs).<br />Results: The distribution of liver fibrosis in our cohort was 58.2% with significant fibrosis (F≥2), 31.8% with advanced fibrosis (F≥3), and 11.4% with cirrhosis (F4). Values for the AUROC of HA levels corresponding to significant fibrosis (F≥2), advanced fibrosis (F≥3) and cirrhosis (F4) were 0.676, 0.772, and 0.863, respectively. The AUROC values for HA were similar to those for HGM-1, HGM-2, FIB-4, APRI, and Forns indexes. The best diagnostic accuracy of HA was found for the diagnosis of cirrhosis (F4): the value of HA at the low cut-off (1182 ng/mL) excluded cirrhosis (F4) with a negative predictive value of 99% and at the high cut-off (2400 ng/mL) confirmed cirrhosis (F4) with a positive predictive value of 55%. By utilizing these low and high cut-off points for cirrhosis, biopsies could have theoretically been avoided in 52.2% (111/201) of the patients.<br />Conclusions: The diagnostic accuracy of serum HA levels increases gradually with the hepatic fibrosis stage. However, HA is better than other simple non-invasive indexes using parameters easily available in routine clinical practice only for the diagnosing of cirrhosis.
- Subjects :
- Adult
Biomarkers blood
Biopsy
Cross-Sectional Studies
Female
HIV Infections diagnosis
HIV Infections pathology
Hepatitis C, Chronic diagnosis
Hepatitis C, Chronic pathology
Humans
Liver pathology
Male
Predictive Value of Tests
Serum chemistry
Severity of Illness Index
HIV Infections complications
Hepatitis C, Chronic complications
Hyaluronic Acid blood
Liver Cirrhosis diagnosis
Liver Cirrhosis pathology
Subjects
Details
- Language :
- English
- ISSN :
- 1471-2334
- Volume :
- 10
- Database :
- MEDLINE
- Journal :
- BMC infectious diseases
- Publication Type :
- Academic Journal
- Accession number :
- 20723207
- Full Text :
- https://doi.org/10.1186/1471-2334-10-244