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Towards a scoring system depending on laboratory and ultrasound findingsfor the detection of hepatic fibrosis in chronic HCV infected patients

Thesis

Last updated: 06 Feb 2023

Subjects

-

Tags

Tropical Medicine

Advisors

Labib, Sameh, Abdel-Razeq, Maysa, Shaker, Ulfat, Tawfiq, Muhammad

Authors

Atteya, Dina Esmaeil

Accessioned

2017-04-26 11:23:33

Available

2017-04-26 11:23:33

type

M.D. Thesis

Abstract

Non-invasive markers of liver fibrosis have recently beendeveloped as an alternative to liver biopsy.The aim of this study to Built a novel scoring system that evaluatesall the stages of fibrosis and the grading of inflammation, using serummarkers and Doppler ultrasonography, in a trial to give data comparableto liver biopsy in HCV patients.Methods: We studied 60 chronic hepatitis C patients using ELISAtest to detect hyaluronic acid & RID tests to detect haptoglobin,apolipoprotein A1& α2 macroglobulin & conventional & duplex-Dopplerabdominal ultrasonography. Liver fibrosis was staged according to theMETAVIR scoring system. Results: The study revealed significantpositive correlation as regards the age , HAI, HV, liver texture, LT lobeDIA, SV DIA, HAPS, AST, HA, α2 macroglobulin, APRI & modifiedAPRI in relation to fibrosis stages. The diagnostic performance of scoresdetermined by AUROCs, discriminating F0F1 versus F2F3, was 0.762for APRI & 0.740 for Modified APRI, at cut off 0.5 & 4.73 with PPV0.75 & 0.77, NPV 0.75 & 0.70, sensitivity 91% & 82% & specificity 54%& 64% respectively. The AUROCs were 0.660 for hyaluronic acid &0.692 for α2macroglobulin at cut off 40 &165.65 with PPV 0.75 & 0.81,NPV 0.54 & 0.64, sensitivity 62% & 74% & specificity 68% & 73%respectively. Using logistic regression, statistical independence wasdemonstrated for combined SV Vmax & HA/ SV Vmean & HA.Conclusions: Current non-invasive tests HA, α2macroglobulin &APRI, modified APRI scores give reliable information on liver fibrosis inchronic hepatitis C patients, especially when used in combination but theuse of ultrasonograghy & Doppler indexes is unclear yet & thus needfurther evaluation.

Issued

1 Jan 2009

DOI

http://dx.doi.org/10.21473/iknito-space/31779

Details

Type

Thesis

Created At

28 Jan 2023