Aminotransferase-to-platelet ratio index and Fibrosis-4 index score predict hepatic fibrosis evaluated by transient hepatic elastography in hepatitis C virus-infected hemodialysis patients.

Autor:	Pestana NF; Nephrology Department, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro., Equi CMA; Hepatology Department, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro., Gomes CP; Nephrology Department, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro., Cardoso AC; Hepatology Department, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro., Zumack JP; Nephrology Department, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro., Villela-Nogueira CA; Internal Medicine Department, Federal University of Rio de Janeiro., Perez RM; Internal Medicine Department, Federal University of Rio de Janeiro.; D'Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil.
Jazyk:	angličtina
Zdroj:	European journal of gastroenterology & hepatology [Eur J Gastroenterol Hepatol] 2021 Dec 01; Vol. 33 (1S Suppl 1), pp. e260-e265.
DOI:	10.1097/MEG.0000000000002031
Abstrakt:	Objective: This study aimed to evaluate the performance of aminotransferase-to-platelet ratio index (APRI) and Fibrosis-4 index (FIB-4) in chronic kidney disease stage 5D HCV-infected patients compared to transient hepatic elastography (TE) as the gold standard. Methods: Hemodialysis HCV-infected patients submitted to TE (FibroScan, Echosens, Paris, France) had APRI and FIB-4 calculated. Based on the best area under receiver operating characteristic curve (AUROC) for significant fibrosis and cirrhosis, APRI and FIB-4 cutoffs were determined and their performances were compared. Results: Seventy patients were included. Both APRI and FIB-4 showed good performance for identifying significant fibrosis [AUROC = 0.73, 95% confidence interval (CI) 0.61-0.83 and 0.79, 95% CI 0.68-0.88; P < 0.05] and cirrhosis [AUROC = 0.82, 95% CI 0.71-0.90 and 0.85, 95% CI 0.75-0.93; P < 0.05]. APRI ≤ 0.25 excluded significant fibrosis with negative predictive value (NPV) of 81.8% and APRI > 0.61 confirmed it with a positive predictive value (PPV) of 81.8%. Similarly, NPV for FIB-4 ≤ 0.60 regarding significant fibrosis was 90.9%. NPV for cirrhosis for APRI ≤ 0.42 or FIB-4 ≤ 1.40 was 97%. However, APRI > 0.73 or FIB-4 > 2.22 showed a modest PPV of 60 and 70% to confirm cirrhosis, respectively. Conclusion: APRI and FIB-4 are simple, non-expensive scoring systems with good accuracy to assess fibrosis in HCV-infected hemodialysis patients, mainly excluding both significant fibrosis or cirrhosis and may be an alternative to TE in the evaluation of this population. (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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