ArticleClinical and experimental hepatology2026
Are there any non-invasive methods to predict liver fibrosis in children infected by hepatitis C virus rather than liver biopsy?
Article in Clinical and experimental hepatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Aim of the study: Since biopsy is an invasive procedure that is not suitable for routine monitoring, and hepatitis C virus (HCV) infection in children can lead to progressive liver damage, liver fibrosis, and its sequela, cirrhosis, aspartate aminotransferase (AST)-to-platelet ratio (APRI) and the fibrosis score (FIB-4) are increasingly substituting biopsy in the evaluation of liver fibrosis. APRI and FIB-4 are promising non-invasive markers for the safe and effective assessment of liver fibrosis. Thus, this study aimed to ascertain whether APRI and FIB-4 scores may be used to identify the stage of liver fibrosis among children diagnosed with HCV. Material and methods: From July 2024 to August 2025, a total of 120 children diagnosed with HCV were enrolled in a retrospective study conducted at the Department of Pediatric Hepatology, Gastroenterology, and Nutrition, National Liver Institute, Menoufia University. The study population was divided into two groups: 22 patients were classified as the > F2 group, while 98 patients were assigned to the ≤ F2 group. Results: There were no significant differences in hemoglobin (HB), white blood cells (WBCs), total bilirubin (TBIL), direct bilirubin (DBIL), alanine aminotransferase (ALT), AST, International Normalized Ratio (INR), and alanine aminotransferase/aspartate aminotransferase ratio (AAR) between the two groups under investigation. The ≤ F2 group showed significantly higher platelet (PLT), alkaline phosphatase (ALKP) and γ-glutamyl transferase (GGT) in comparison to the > F2 group. More importantly, the > F2 group had considerably higher APRI, levels of serum albumin and FIB-4 than the ≤ F2 group. Conclusions: In patients with persistent HCV infection, both the FIB-4 and APRI scores demonstrated high diagnostic accuracy in predicting the phases of liver fibrosis. The FIB-4 proved to be a useful non-invasive method for fibrosis assessment because of its exceptional performance, demonstrating high specificity, sensitivity, and overall accuracy.
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