Comparison of liver fibrosis blood tests developed for HCV with new specific tests in HIV/HCV co-infection. - Université de Rennes Accéder directement au contenu
Article Dans Une Revue Journal of Hepatology Année : 2010

Comparison of liver fibrosis blood tests developed for HCV with new specific tests in HIV/HCV co-infection.

Philippe Halfon
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Guillaume Pénaranda
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Dominique Guyader
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Résumé

BACKGROUND & AIMS: We compared 5 non-specific and 2 specific blood tests for liver fibrosis in HCV/HIV co-infection. METHODS: Four hundred and sixty-seven patients were included into derivation (n=183) or validation (n=284) populations. Within these populations, the diagnostic target, significant fibrosis (Metavir F > or = 2), was found in 66% and 72% of the patients, respectively. Two new fibrosis tests, FibroMeter HICV and HICV test, were constructed in the derivation population. RESULTS: Unadjusted AUROCs in the derivation population were: APRI: 0.716, Fib-4: 0.722, Fibrotest: 0.778, Hepascore: 0.779, FibroMeter: 0.783, HICV test: 0.822, FibroMeter HICV: 0.828. AUROCs adjusted on classification and distribution of fibrosis stages in a reference population showed similar values in both populations. FibroMeter, FibroMeter HICV and HICV test had the highest correct classification rates in F0/1 and F3/4 (which account for high predictive values): 77-79% vs. 70-72% in the other tests (p=0.002). Reliable individual diagnosis based on predictive values > or = 90% distinguished three test categories: poorly reliable: Fib-4 (2.4% of patients), APRI (8.9%); moderately reliable: Fibrotest (25.4%), FibroMeter (26.6%), Hepascore (30.2%); acceptably reliable: HICV test (40.2%), FibroMeter HICV (45.6%) (p<10(-3) between tests). FibroMeter HICV classified all patients into four reliable diagnosis intervals (< or =F1, F1+/-1, > or =F1, > or =F2) with an overall accuracy of 93% vs. 79% (p<10(-3)) for a binary diagnosis of significant fibrosis. CONCLUSIONS: Tests designed for HCV infections are less effective in HIV/HCV infections. A specific test, like FibroMeter HICV, was the most interesting test for diagnostic accuracy, correct classification profile, and a reliable diagnosis. With reliable diagnosis intervals, liver biopsy can therefore be avoided in all patients.

Dates et versions

hal-00665946 , version 1 (03-02-2012)

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Paul Calès, Philippe Halfon, Dominique Batisse, Fabrice Carrat, Philippe Perré, et al.. Comparison of liver fibrosis blood tests developed for HCV with new specific tests in HIV/HCV co-infection.. Journal of Hepatology, 2010, 53 (2), pp.238-44. ⟨10.1016/j.jhep.2010.03.007⟩. ⟨hal-00665946⟩
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