Biochemical Markers of Fibrosis in Patients with Chronic Hepatitis C: A Comparison with Prothrombin Time, Platelet Count, and Age–Platelet Index

摘要

As an alternative to liver biopsy, an index of five biochemical markers (α2-macroglobulin, apolipoprotein A1, haptoglobin, total bilirubin, γ-glutamyl-transpeptidase) has been shown to predict the severity of hepatitis C-related fibrosis. The objective of this study was to compare this index with other markers frequently used for this purpose (prothrombin time, platelets, age–platelet index). In 323 hepatitis C-infected patients, the discriminative values of these markers for F2–F4 fibrosis (by the METAVIR classification) were compared. By multiple logistic regression analysis, only the five-marker index (P < 0.0001) and prothrombin time (P = 0.02) were independently predictive of F2–F4 fibrosis. For this outcome, the area under the receiver operating characteristic curve was significantly higher for the five-marker index (0.836 ± 0.024) than the age-platelet index (P = 0.002), and the platelet count and prothrombin time (P < 0.001), indicating greater diagnostic value. The addition of the latter markers to the five-marker index proved unhelpful for increasing its accuracy. In conclusion, an index of five biochemical markers accurately predicts significant hepatitis C-related fibrosis and is superior to traditional markers.