Authors: Hideki Fujii Masaru Enomoto Wakaba Fukushima Satoko Ohfuji Mami Mori Sawako Kobayashi Shuji Iwai Hiroyasu Morikawa Akihiro Tamori Hiroki Sakaguchi Yoshihiro Ikura Makiko Ueda Norifumi Kawada
Publish Date: 2009/04/10
Volume: 44, Issue: 6, Pages: 608-614
Abstract
Several noninvasive tests have been proposed to predict cirrhosis in patients with chronic hepatitis C but not in patients with nonalcoholic steatohepatitis NASH We assessed whether noninvasive laboratory tests designed to predict the risk of cirrhosis in patients with chronic hepatitis C virus HCV infection could be used in patients with NASHThe subjects were 50 patients with biopsyproved NASH and 100 age and sexmatched patients with HCV Aspartate aminotransferase AST/alanine aminotransferase ALT ratio AAR ageplatelet AP index ASTtoplatelet ratio index APRI cirrhosis discriminant score CDS and the hepatitis C antiviral longterm treatment against cirrhosis HALTC model were calculatedThe areas under the receiveroperating characteristic curves of the AAR AP index APRI CDS and HALTC model for predicting cirrhosis were respectively 0813 0877 0786 0949 and 0908 in patients with NASH and 0555 0652 0761 0782 and 0782 in patients with HCV A CDS cutoff value of less than 5 misclassified none of the 9 patients with NASH who had cirrhosis while a value of more than 8 misclassified none of the 41 patients with NASH without cirrhosis With the HALTC model a cutoff value of less than 06 classified noncirrhotic NASH while a cutoff value of 097 or higher classified cirrhotic NASH The use of CDS and HALTC model could avoid liver biopsy for predicting cirrhosis in 60 and 48 of the patients with NASH respectively
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