Model May Predict Cirrhosis in Hepatitis C Patients

Three-variable model considers both serum markers and platelet count, does better than other models

MONDAY, March 10 (HealthDay News) -- A model that takes into account two serum markers and platelet count is able to identify chronic hepatitis C patients with cirrhosis better than other models, according to a report in the March issue of Hepatology.

Robert J. Fontana, M.D., from the University of Michigan Medical School in Ann Arbor, and colleagues examined the usefulness of serum fibrosis markers and routine laboratory tests to estimate the likelihood of histological cirrhosis in 513 liver biopsy samples from prior non-responders with chronic hepatitis C.

The researchers found that 38 percent of patients had cirrhosis (Ishak stage 5-6). A model that took into account hyaluronic acid (HA), tissue inhibitor of matrix metalloproteinase-1 (TIMP-1) and platelet count had an area under the receiver operating curve of 0.81 for estimating the presence of cirrhosis, which was superior to three other models. There was a better correlation between Ishak fibrosis scores and serum fibrosis markers than log hepatic collagen content, the report indicates.

"A three-variable model consisting of serum HA, TIMP-1 and platelet count was better than other published models in identifying cirrhosis in HALT-C Trial subjects. The stronger correlation of the serum markers with Ishak scores suggests that serum fibrosis markers reflect the pattern of fibrosis more closely than the quantity of hepatic collagen," Fontana and colleagues conclude.

Two co-authors disclosed financial relationships with Hoffmann-La Roche Inc.

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