NON-INVASIVE TOOLS TO ASSESS THE RISK OF VARICES-NEEDING-TREATMENT IN CIRRHOSIS SECONDARY TO HCV

Objective: To assess the non-invasive biomarkers of fibrosis for predicting varices-needing-treatment in patients with cirrhosis secondary to chronic-hepatitis-C. Study Design: Cross sectional comparative study. Place and Duration of Study: Department of Gastroenterology, Pak Emirates Military Hospital Rawalpindi, from Jan 2017 to Dec 2017. Methodology: A total of 153 patients aged 18-79 with cirrhosis, whether compensated or decompensated, secondary to chronic-hepatitis-C were enrolled. Relevant serum tests were used to calculate non-invasive fibrosis indices and their diagnostic performance to predict the presence of varices and varices-needing-treatment was calculated. Results: King’s score showed the best performance in detecting varices due to high positive predictive value of 96.4% and positive likelihood ratio of 2.4. Overall, all the non-invasive fibrosis indices exhibited good performance with positive predictive value >85% but none could rule out the presence of varices with adequate reliability due to low negative-predictive-value (