Ultraschall Med 2016; 37 - P4_24
DOI: 10.1055/s-0036-1587944

Non-invasive assessment of liver fibrosis by means of Transient Elastography and Fibrotest in patients with HCV compensated liver cirrhosis

I Sporea 1, R Mare 1, A Popescu 1, R Sirli 1, M Danila 1, I Dan 1, A Deleanu 1
  • 1Victor Babes University of Medicine, Gastroenterology and Hepatology, Timisoara, Romania

Purpose: The severity of liver disease should be assessed prior to therapy.

The purpose of the study was to evaluate the accuracy of FibroTest and Transient Elastography (TE) for predicting HCV liver cirrhosis (LC), in naïve or treatment-experienced patients, with compensated liver disease.

Material and methods: The study included 104 consecutive patients previously diagnosed with compensated HCV LC based on clinical, biologic, ultrasonographic, morphologic, laparoscopic or endoscopic (esophageal varices) criterias, who were considered for interferon free treatment (Viekirax/Exviera). Liver fibrosis was assessed during a two week period by means of TE (using M or XL probe) and by FibroTest. For TE reliable measurements were defined as median value of 10 liver stiffness measurements, with a SR≥60% and an IQR< 30%. For diagnosing cirrhosis by means of TE we used a cut-off value 12.5 kPa [1] and for FibroTest a value of 0.75.

Results: Out of 104 patients, reliable measurements by TE were obtained in 93.3%, so that the final analysis included 98 patients (having valid TE and FibroTest). According to FibroTest cut-off, 74.5% (73/98) patients were correctly classified, while according to TE cut-off – 91.8% (90/98) patients (p = 0.002). Out of the 98 cirrhotics, 4.1% were misclassified by TE as having significant fibrosis (F2) and 4.1% with severe fibrosis (F3). When we evaluated the performance of FibroTest, 9.2% of patients with LC were misclassified as having F2, 13.3% as having F3 and 3% as having F3/F4.16% (4/25) patients misclassified by FibroTest had grade I esophageal varices.

Conclusions: The accuracy of FibroTest for predicting HCV liver cirrhosis in naïve or treatment-experienced patients, with compensated liver disease was significantly lower than of TE (74.5 vs. 91.8%; p = 0.002).

Reference: [1] Castera L,et al. Prospective comparisonof transient elastography, FibroMax, APRI, and liverbiopsy for the assessment of fibrosis in chronic hepatitis C. Gastroenterology 2005; 128: 343 – 350.