Department of Pediatrics, Faculty of Medicine, Cairo University, Egypt.
Eur J Gastroenterol Hepatol. 2010 Aug;22(8):946-51. doi: 10.1097/MEG.0b013e328336ec84.
Hepatitis C virus (HCV) is a major cause of chronic hepatitis and hepatic fibrosis. Liver biopsy, because of its limitations and risks, might be considered an imperfect gold standard for assessing the severity of chronic liver diseases. In this study, we aimed to prospectively validate FibroTest (FT) and ActiTest (AT) as noninvasive serum biochemical markers for assessment of the degree of hepatic fibrosis and necroinflammatory activity respectively, in pediatric patients with chronic HCV infection and compare them to liver biopsy.
Fifty patients, aged 2 to 18 years, with chronic HCV infection were prospectively enrolled. Two assessments were carried out, within 24-h duration, one of a liver biopsy specimen and the other FT and AT measured in serum sample.
A highly significant linear trend and correlation were found between FT-related fibrosis and fibrosis stage by METAVIR scoring on histopathological examination. A highly significant correlation was also found between AT and necroinflammatory histological activity using METAVIR as well. The FT area under the receiver operating characteristic curve (AUROC) is 0.97, SE=0.02 which can diagnose patients with mild stage of fibrosis, thus discriminating them from those with no (or minimal) fibrosis. The AT can successfully discriminate between patients with moderate activity and those with mild activity with AUROC=0.93, SE=0.06.
FT and AT are potential noninvasive methods for assessment of hepatic fibrosis and necroinflammatory activity in pediatric patients with chronic HCV infection in comparison with liver biopsy.
丙型肝炎病毒（HCV）是慢性肝炎和肝纤维化的主要病因。由于其局限性和风险，肝活检可能被认为是评估慢性肝病严重程度的不完美金标准。在这项研究中，我们旨在前瞻性验证 FibroTest（FT）和 ActiTest（AT）作为非侵入性血清生化标志物，分别评估小儿慢性 HCV 感染患者的肝纤维化程度和坏死性炎症活动程度，并将其与肝活检进行比较。
50 名年龄在 2 至 18 岁之间的慢性 HCV 感染患者被前瞻性纳入研究。在 24 小时内进行了两次评估，一次是肝活检标本，另一次是血清样本中的 FT 和 AT 测量。
FT 相关纤维化与 METAVIR 组织病理学评分的纤维化分期之间存在高度显著的线性趋势和相关性。AT 与 METAVIR 所示坏死性炎症组织学活动之间也存在高度显著相关性。FT 的接收器工作特征曲线（AUROC）下面积为 0.97，SE=0.02，可诊断轻度纤维化患者，从而将其与无（或最小）纤维化患者区分开来。AT 可以成功地区分中度活动和轻度活动患者，AUROC=0.93，SE=0.06。
FT 和 AT 是评估小儿慢性 HCV 感染患者肝纤维化和坏死性炎症活动的潜在非侵入性方法，与肝活检相比。
