Blood tests as good as biopsy for HCV-related disease

(HealthDay)—Compared to a liver biopsy, available blood tests are accurate for diagnosing fibrosis and cirrhosis in patients with hepatitis C virus (HCV), according to a review published in the June 4 issue of the Annals of Internal Medicine.

Roger Chou, M.D., and Ngoc Wasson, M.P.H., from the Oregon Health & Science University in Portland, conducted a literature review to identify 172 studies that compared the diagnostic accuracy of blood tests with that of liver biopsy.

The researchers found that the platelet count, age-platelet index, aspartate aminotransferase-platelet ratio index (APRI), FibroIndex, FibroTest, and Forns index had median positive likelihood ratios of 5 to 10 at commonly used cut-offs and areas under the receiver-operating characteristic curve (AUROCs) of 0.70 or greater for identifying clinically significant fibrosis. For determining cirrhosis, the platelet count, age-platelet index, APRI, and Hepascore had median positive likelihood ratios of 5 to 10 and AUROCs of 0.80 or greater, while the Goteborg University Cirrhosis Index and the Lok index had slightly lower positive likelihood ratios (4.8 and 4.4, respectively). There was a slightly lower AUROC with APRI than with the FibroTest for identifying fibrosis, but a substantially higher AUROC with APRI than the aspartate aminotransferase-alanine aminotransferase ratio for identifying fibrosis or cirrhosis.

"Many blood tests are moderately useful for identifying clinically significant fibrosis or cirrhosis in HCV-infected patients," the authors write.