Novel non-invasive biological predictive index for liver fibrosis in hepatitis C virus genotype 4 patients

Core Tip

Core tip: This observational study included a cohort of 332 recruited patients with hepatitis C virus (HCV) genotype 4 infections. The study assessed the status of demographic and biological variables at different stages of liver fibrosis. Liver biopsy with Metavir scoring was the reference standard used to classify patients into five stages of liver fibrosis (F0-F4). Patient regrouping to include three levels of fibrosis, mild (F0-F1), moderate (F2), and advanced (F3-F4), was performed to conform with practical guidelines for the management and follow-up of HCV patients. Age, aspartate transaminase enzyme (AST), insulin resistance (HOMA-IR), and platelet count were significant predictors of liver fibrosis as shown on univariate analysis. Log AST, log HOMA-IR, log platelet count and age were introduced into stepwise multivariate discriminative analysis, and a model for the prediction of liver fibrosis level was derived. Our predictive index exhibited an area under the curve (AUC) of 0.91 for the diagnosis of advanced stages of fibrosis and an AUC of 0.88 for the diagnosis of mild stages of fibrosis. The index exhibited a lower AUC of 0.64 in the diagnosis of moderate stages of fibrosis.