ArticleAnnals of gastroenterology
Liver fibrosis staging with combination of APRI and FIB-4 scoring systems in chronic hepatitis C as an alternative to transient elastography.
Article in Annals of gastroenterology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers.
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Who cites it
29 citing papers in PubMed, 51 citations in OpenAlex.
- Impact of sleeve gastrectomy on the course of metabolic associated fatty liver disease.Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology · 2026Observational
- Are there any non-invasive methods to predict liver fibrosis in children infected by hepatitis C virus rather than liver biopsy?Clinical and experimental hepatology · 2026Article
- Association of antinuclear antibody positivity with liver disease severity in pediatric metabolic dysfunction-associated steatotic liver disease.Frontiers in pediatrics · 2025Article
- Dietary Nutritional Supplements Are Associated with the Deterioration of Hepatic Fibrosis in Women and Individuals without Underlying Disease.International journal of environmental research and public health · 2024Article
- Article
- Progression of the FIB-4 index among patients with chronic HCV infection and early liver disease.BMJ open gastroenterology · 2023Article
- Noninvasive Fibrosis Assessment in Chronic Hepatitis C Infection: An Update.Journal of clinical and translational hepatology · 2023Review
- APRI and FIB-4 indices as diagnostic noninvasive scores for prediction of severe fibrosis in patients with biliary atresia.Clinical and experimental hepatology · 2023Article
- Liver cirrhosis: relationship between fibrosis-associated hepatic morphological changes and portal hemodynamics using four-dimensional flow magnetic resonance imaging.Japanese journal of radiology · 2023Article
- Transient Elastography as the First-Line Assessment of Liver Fibrosis and Its Correlation with Serum Markers.Medicina (Kaunas, Lithuania) · 2023Article
- Relationship between non-invasively detected liver fibrosis and in-hospital outcomes in patients with acute coronary syndrome undergoing PCI.Clinical research in cardiology : official journal of the German Cardiac Society · 2023Article
- The effect of different direct antivirals on hepatic steatosis in nondiabetic and naïve hepatitis C-infected Egyptian patients.The Egyptian journal of internal medicine · 2023Article
- Diagnostic performance of two non-invasive biomarkers used individually and in sequential combination for cirrhosis associated with hepatitis C virus infection.Scientific reports · 2022Article
- Association of Non-Alcoholic Fatty Liver Disease and Hepatic Fibrosis with Epicardial Adipose Tissue Volume and Atrial Deformation Mechanics in a Large Asian Population Free from Clinical Heart Failure.Diagnostics (Basel, Switzerland) · 2022Article
- Non-invasive precise staging of liver fibrosis using deep residual network model based on plain CT images.International journal of computer assisted radiology and surgery · 2022Article
- Efficacy and safety of elbasvir/grazoprevir treatment for Chinese patients with hepatitis C virus genotype 1b: a retrospective study.American journal of translational research · 2022Article
- Derivation of "Egyptian varices prediction (EVP) index": A novel noninvasive index for diagnosing esophageal varices in HCV Patients.Journal of advanced research · 2022Article
- APRI and FIB-4 performance to assess liver fibrosis against predefined Fibroscan values in chronic hepatitis C virus infection.Journal of family medicine and primary care · 2021Article
- Comparison between shear wave elastography and serological findings for the evaluation of fibrosis in chronic liver disease.Journal of ultrasonography · 2021Article
- The Roles of Fibrosis Index Based on Four Factors and Aspartate Transaminase-to-Platelet Ratio Index Scoring Systems as an Alternative to Transient Elastography Liver Stiffness in Liver Fibrosis Staging in Human Immunodeficiency Virus and Hepatitis C Virus Co-Infected Patients.Gastroenterology research · 2021Article
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11 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLiver disease severity must be determined before treatment of chronic hepatitis C (CHC). We evaluated the diagnostic performance of the APRI and FIB-4 scores compared to transient elastography liver stiffness (TE-LS) in detecting significant fibrosis (F3) or cirrhosis (F4).
methodsWe retrospectively enrolled 575 patients with CHC who underwent TE-LS between May 2014 and September 2018: 365 (63.5%) male, mean age 51.54±12.4 years. APRI and FIB-4 scores were compared to TE-LS.
resultsOne hundred patients (17.5%) had TE-LS values between 9 and 11.9 kPa, and were classified as F3, while 265 (46%) were classified as F4 (TE-LS ≥12 kPa). APRI and FIB-4 scores predicted F4 patients adequately using cutoff values of 0.65 (sensitivity 85.5%, specificity 77%) and 1.63 (sensitivity 91%, specificity 77%), respectively. Cutoff values of 0.64 for APRI and 1.46 for FIB-4 predicted F3/F4 patients (sensitivity 72% and 81.5%; specificity 83% and 79%, respectively). The use of these cutoff values with APRI and FIB-4 in combination adequately predicted patients with significant fibrosis or cirrhosis (positive predictive value 91.5%), while cutoff values of 0.3 and 0.98, respectively, predicted F1/F2 patients with specificity 94.5% and sensitivity 26.5%, suggesting that in 58.5% of patients TE-LS could possibly be avoided.
conclusionsThe APRI/FIB-4 combination performed well in predicting significant fibrosis, while FIB-4 performed well in predicting cirrhosis. These noninvasive biochemical markers could be used as screening tools instead of LS measurement, which is not widely available. Further prospective validation studies are required to confirm this finding.
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