000110791 001__ 110791
000110791 005__ 20230519145522.0
000110791 0247_ $$2doi$$a10.1097/MD.0000000000027838
000110791 0248_ $$2sideral$$a127446
000110791 037__ $$aART-2021-127446
000110791 041__ $$aeng
000110791 100__ $$aMerchante, Nicolás
000110791 245__ $$aPrediction of liver stiffness by serum indexes in HCV-infected patients with or without HIV coinfection
000110791 260__ $$c2021
000110791 5060_ $$aAccess copy available to the general public$$fUnrestricted
000110791 5203_ $$aIdentification of advanced fibrosis/cirrhosis in hepatitis C virus (HCV)-infected patients should be a mainstay before starting treatment; however, the limited access of many centres to transient elastography (TE) is often a barrier for early assessments. We aimed to investigate the diagnostic accuracy of serum indexes for predicting liver stiffness.Retrospective analysis of HCV patients (with or without HIV coinfection) routinely assessed in 7 centres in Spain. The diagnostic accuracy of aspartate aminotransferase-to-platelet ratio index (APRI), fibrosis-4 (FIB-4), and their combinations was evaluated using a recent TE examination as a reference test (liver stiffness¿=¿9.5¿kPa and¿=12.5¿kPa for advanced fibrosis and cirrhosis, respectively). In addition to area under the receiving operating characteristic curves, sensitivity, specificity, and negative predictive value (NPV) and positive predictive value were estimated.The analysis included 1391 patients: 346 (25%) HIV-positive, 732 (53%) people who inject drugs, and 178 (13%) incarcerated. Advanced fibrosis and cirrhosis were found in 557 (40%) and 351 (25%) patients, respectively. APRI¿<¿0.5 (n¿=¿595; 43%) had an NPV of 95% for excluding cirrhosis. Combined FIB-4¿<¿1.45 with APRI¿<¿0.5 (n¿=¿467; 34%) had an NPV of 87% for excluding advanced fibrosis. Combined APRI > 2 and FIB-4 > 3.25 (n¿=¿134; 10%) had a positive predictive value of 89% for advanced fibrosis. Globally, this approach would avoid the need for TE in 53% of patients. HIV coinfection did not influence diagnostic accuracy.Inexpensive and simple serum indexes confidently allowed identifying the absence of cirrhosis and the presence of advanced fibrosis in 53% of a heterogeneous series of real-world HCV patients with or without HIV infection.
000110791 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000110791 590__ $$a1.817$$b2021
000110791 592__ $$a0.47$$b2021
000110791 594__ $$a2.7$$b2021
000110791 591__ $$aMEDICINE, GENERAL & INTERNAL$$b123 / 172 = 0.715$$c2021$$dQ3$$eT3
000110791 593__ $$aMedicine (miscellaneous)$$c2021$$dQ3
000110791 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000110791 700__ $$aMena, Álvaro
000110791 700__ $$aPascasio, Juan Manuel
000110791 700__ $$aMarco, Andrés
000110791 700__ $$aRodríguez, Manuel
000110791 700__ $$aHernández Guerra, Manuel
000110791 700__ $$0(orcid)0000-0003-2041-3147$$aSimón Marco, Miguel Angel$$uUniversidad de Zaragoza
000110791 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000110791 773__ $$g100, 46 (2021), 27838 [6 pp.]$$pMedicine (Baltim.)$$tMedicine$$x0025-7974
000110791 8564_ $$s348758$$uhttps://zaguan.unizar.es/record/110791/files/texto_completo.pdf$$yVersión publicada
000110791 8564_ $$s3360167$$uhttps://zaguan.unizar.es/record/110791/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000110791 909CO $$ooai:zaguan.unizar.es:110791$$particulos$$pdriver
000110791 951__ $$a2023-05-18-15:23:16
000110791 980__ $$aARTICLE