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丙型肝炎病毒慢性感染患儿的FibroTest-ActiTest评估

Evaluation of FibroTest-ActiTest in children with chronic hepatitis C virus infection.

作者信息

Hermeziu B, Messous D, Fabre M, Munteanu M, Baussan C, Bernard O, Poynard T, Jacquemin E

机构信息

Pediatric Hepatology and National Reference Centre, Biliary Atresia, Bicêtre Hospital, University Paris Sud 11, Assistance publique-Hôpitaux de Paris, France.

出版信息

Gastroenterol Clin Biol. 2010 Jan;34(1):16-22. doi: 10.1016/j.gcb.2009.06.007. Epub 2009 Sep 1.

Abstract

FibroTest-ActiTest (FT-AT) has been validated in adults with chronic hepatitis C virus (HCV) infection as a noninvasive alternative to liver biopsy (LB), but there are few data of its use in children. The objective of the present study was to evaluate FT-AT in children with HCV infection and to compare FT-AT analysis with liver histology. A total of 43 serum samples from 38 children with chronic HCV infection were analyzed retrospectively. Histological evaluation was performed according to the METAVIR scoring system. In 16 of the children, 21 serum samples were tested with FT-AT and compared to 21 LB (serum/LB pairs) in nontransplanted and liver-transplanted children. FT-AT was also measured in 22 infected children without LB and in 50 healthy controls. FT-AT values in controls were comparable to those of healthy adults, validating the adult FT-AT parameters in children. In most infected children (74%), the FT-AT score was <or = A1-F1. Concordance between FT-AT and METAVIR scores was found in 10 pairs and discordance in 11. FT-AT/METAVIR concordance was better in non-transplanted (8/13 pairs, 62%) than in transplanted (2/8 pairs, 25%) children. A prospective evaluation of FT-AT in non-transplanted children with chronic HCV infection would be worthwhile in future.

摘要

FibroTest-ActiTest(FT-AT)已在慢性丙型肝炎病毒(HCV)感染的成人中得到验证,可作为肝活检(LB)的非侵入性替代方法,但关于其在儿童中的应用数据较少。本研究的目的是评估FT-AT在HCV感染儿童中的应用,并将FT-AT分析与肝组织学进行比较。回顾性分析了38例慢性HCV感染儿童的43份血清样本。根据METAVIR评分系统进行组织学评估。在16名儿童中,对21份血清样本进行了FT-AT检测,并与非移植和肝移植儿童的21份肝活检样本(血清/肝活检样本对)进行比较。还对22名未进行肝活检的感染儿童和50名健康对照进行了FT-AT检测。对照组的FT-AT值与健康成人相当,验证了儿童中的成人FT-AT参数。在大多数感染儿童(74%)中,FT-AT评分≤A1-F1。在10对样本中发现FT-AT与METAVIR评分一致,11对样本不一致。非移植儿童(8/13对,62%)的FT-AT/METAVIR一致性优于移植儿童(2/8对,25%)。未来对非移植慢性HCV感染儿童进行FT-AT的前瞻性评估将是值得的。

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