RESUMEN
Objective: The aim of this study was to compare the efficacy of transient elastography, the direct fibrogenic markers YKL-40, and transforming growth factor beta [TGF-beta1] alone or in combination versus liver biopsy for detecting the stage as well as the progression rates of hepatic fibrosis in patients with chronic hepatitis C with or without schistosomiasis
Patients and methods: A cohort study was performed on 117 patients with hepatitis C virus alone or coinfected with schistosomiasis. Patients were enrolled and prospectively evaluated with two liver biopsies [at entry and at the end of follow-up], and true rates in the progression of fibrosis were calculated per year. Fibroscan examination and YKL-40 and TGF-beta1 evaluation were carried out at baseline and follow-up and the results were compared and correlated with histopathologic findings
Results: A significant increase in fibrosis progression rates occurred in the coinfected group [0.45 +/- 0.29] compared with the monoinfected group [0.13 +/- 0.26] [P<0.001]. The progression of fibrosis rate/year had a direct linear correlation with fibroscan [r=0.599, P<0.001], YKL-40 [r=0.630, P<0.001], and TGF-beta1 [r=0.626, P<0.001]. Sensitivity, specificity, positive predictive value, and negative predictive value were as follows: 93.5, 96.1, 96.63, and 92.59% for fibroscan; 88.23, 90.90, 88.23, and 89.63% for TGF-beta1; and 87.70, 89.28, 90.7, and 89.91% for YKL-40, respectively [95% confidence interval]
Conclusion: Fibroscan, TGF-beta1, and YKL-40 can be used, alone or in combination, as noninvasive markers for detecting the stage of hepatic fibrosis in the treatment candidates, for evaluating the efficacy of treatment and monitoring of disease progression in treated patients, and for diagnosis of liver cirrhosis in nontreated ones