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Title: Predictive value of FIB-4 and APRI versus METAVIR on sustained virologic response in genotype 1 hepatitis C patients
Authors: Ferenci, Peter
Aires, Rodrigo
Beavers, Kimberly L.
Curescu, Manuela
Abrao Ferreira, Paulo R. [UNIFESP]
Gschwantler, Michael
Ion, Stefan
Larrey, Dominique
Maticic, Mojca
Puoti, Massimo
Schuller, Janos
Tornai, Istvan
Tusnadi, Anna
Messinger, Diethelm
Tatsch, Fernando
Horban, Andrzej
Med Univ Vienna
Goias Fed Univ Clin Hosp
Asheville Gastroenterol Associates
Univ Med & Farm Timisoara
Universidade Federal de São Paulo (UNIFESP)
Wilhelminenspital Stadt Wien
Cent Mil Hosp
St Eloi Hosp
Univ Med Ctr
SC Malattie Infett AO Osped Niguarda Ca Granda
Szent Laszlo Hosp
Univ Debrecen
Hetenyi Geza Hosp
F Hoffmann La Roche Ltd
Med Univ Warsaw
Hosp Infect Dis
Keywords: Peginterferon alfa-2a
Noninvasive fibrosis measure
Issue Date: 1-Jan-2014
Publisher: Springer
Citation: Hepatology International. New York: Springer, v. 8, n. 1, p. 83-93, 2014.
Abstract: Advanced liver fibrosis is a negative predictor of virologic response in genotype 1 chronic hepatitis C (CHC) patients. Biopsy, however, is invasive, costly, and carries some risk of complications.Using data from the prospective, international cohort study PROPHESYS, we assessed two alternative noninvasive measures of fibrosis, the FIB-4 and AST-to-platelet ratio index (APRI), to predict virologic response in CHC patients.CHC genotype 1, monoinfected, treatment-naive patients prescribed peginterferon alfa-2a (40 KD)/ribavirin in accordance with country-specific legal and regulatory requirements and who had baseline METAVIR, FIB-4, and APRI scores (N = 1,592) were included in this analysis. Patients were stratified according to the baseline METAVIR, FIB-4, or APRI score to assess virologic response [hepatitis C virus (HCV) RNA < 50 IU/mL] by week 4 of treatment (rapid virologic response) and 24 weeks after untreated follow-up ]sustained virologic response (SVR)]. Baseline predictors of SVR were explored by multiple logistic regression, and the strength of the association between each fibrosis measure and SVR was evaluated. Both FIB-4 and APRI scores increased with increasing levels of biopsy-assessed fibrosis. the association between FIB-4 and SVR (p < 0.1 x 10(-30)) was stronger than that between METAVIR (p = 3.86 x 10(-13)) or APRI (p = 5.48 x 10(-6)) and SVR. Baseline factors significantly associated with SVR included male gender, lower HCV RNA, lower FIB-4 score, no steatosis, and higher alanine aminotransferase ratio.The FIB-4 index provides a valuable, noninvasive measure of fibrosis and can be used to predict virologic response in patients treated with peginterferon alfa-2a (40 KD)/ribavirin.
ISSN: 1936-0533
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