Title: Noninvasive assessment of liver fibrosis in chronic hepatitis C patients using Transient elastography, APRI, FORNS an FI!

"#$ a prospective stu y Authors & affiliations: Francisc Iohann Bach 1, Dan Olteanu 1, Oana Schiopu 1, George Gherlan 2 1 First %e ical Clinic, &niversity 'ospital !ucharest( )Carol *avila+ &niversity of %e icine an Pharmacy, !ucharest, Romania, 2 )*r, -ictor !abes+ *iagnosis an Treatment %e ical Center, !ucharest, Romania, Abstract: Intro uction: The aim of this stu y .as to evaluate the iagnostic accuracy of transient elastography /T01, APRI, FORNS an FI!"#, alone or in combination, for the assessment of hepatic fibrosis in patients .ith chronic hepatitis C /C'C1, by comparison .ith 2!, !etho s: Our stu y inclu e 34 treatment"naive patients iagnose .ith C'C bet.een 5676 an 5675, !iological tests nee e for calculating the scores an 2! .ere performe in the same session, T0 .as performe in ma8imum three months from the moment of 2!, The egree of fibrosis .as score accor ing to the %0TA-IR staging system, "esults: The A&ROC of the T0, APRI, FORNS, an FI!"# to pre ict significant fibrosis /F951 .ere 6,34, 6,3#, 6,:: an 6,3;, respectively( for pre icting severe fibrosis /F9<1 the A&ROC .ere 6,3=, 6,=, 6,34 an 6,3: respectively( an to pre ict cirrhosis /F#1, the A&ROC .ere 6,=3 for T0, 6,=; for APRI an 6,=4 for FI!"#, The association of the noninvasive tests improve the iagnostic accuracy for pre icting fibrosis, The association bet.een a test .ith t.o cut"offs /APRI, FORNS or FI!"#1 an T0 prove to be most accurate, The best combination .as APRI>T0 /correctly classifying <:,;? of pacients as having or not having significant fibrosis, ;6? as having or not having severe fibrosis an 3=,#? as having or not having cirrhosis1, The combination of more than t.o tests ecrease significantly the number of iagnose patients an are not useful for clinical practice, Discussion # $onclusion: Noninvasive tests have goo results for the pre iction of fibrosis in C'C, especially .hen use in combination of t.o tests, but they cannot entirely replace 2!, The iagnosis of cirrhosis may rely on noninvasive tests, but 2! is nee e to iagnose interme iate stages of fibrosis, 2! remains an option in selecte patients,