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Original Research

Med Arch. 2012; 66(4): 226-230


Indirect Serum Fibrosis Markers in Hepatitis C Virus (HCV) Infection

Karolina Paunovic, Miomir Stojanovic, Zorica Dimitrijevic, Goran Paunovic, Vidojko Djordjevic, Ljiljana Konstantinovic, Svetislav Kostic.




Abstract

Assessment of liver fibrosis is important for making treatment decisions, as well as for predicting prognosis and therapeutic outcome in patients on chronic hemodialysis (HD) treatment and infected with hepatitis C virus (HCV). The aim of the present investigation was to evaluate changes in standard laboratory tests (AST, ALT, γGT, cholesterol and platelet count) and indirect serum fibrosis markers: AST-to-platelet ratio index (APRI), FIB-4 and Forns index, in chronically HCV-infected patients on maintenance HD with and without antiviral treatment. Patients and methods: A total of 38 patients on chronic HD program more than 3 months and with chronic hepatitis C, were included in the study. According to local legislature 14 patients receive antiviral therapy (24 or 48 weeks, according to HCV genotype) adjusted for patients on HD: eight of them achieved sustained virological response (SVR) and six did not. Results: All treated patients were HCV genotype 1. Baseline blood samples for standard laboratory tests and indirect serum fibrosis markers were collected on the day of antiviral treatment initiation, as well as at the end of follow-up treatment, 36 month later. At the beginning of antiviral treatment there were no significant differences in APRI, FIB-4, Forns and its components be-tween patients who will achieve SVR and those who did not. A significant decrease of AST, ALT, γGT and APRI, and moderate decrease FIB-4 and Forns index was found at the end of follow-up in patients with SVR. In non-sustained responders group those three indexes and its components remained unchanged. Using cut-of values for APRI and FIB-4 (APRI

Key words: HCV infection, Serum fibrosis markers, Antiviral treatment, APRI, FIB-4, Forns, Hemodialysis.






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