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Title: Utility and limitations of Hepascore and transient elastography to detect advanced hepatic fibrosis in HFE hemochromatosis.
Austin Authors: Ong, Sim Yee;Khoo, Tiffany;Nicoll, Amanda J;Gurrin, Lyle;Worland, Thomas ;Pateria, Puraskar;Ramm, Louise E;Testro, Adam G ;Anderson, Gregory J;Skoien, Richard;Powell, Lawrie W;Ramm, Grant A;Olynyk, John K;Delatycki, Martin B 
Affiliation: Victorian Clinical Genetics Services, Parkville, VIC, Australia
Department of Gastroenterology, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
Bruce Lefroy Centre, Murdoch Children's Research Institute, Melbourne, VIC, Australia
The University of Melbourne, Melbourne, VIC, Australia
Department of Gastroenterology, Eastern Health, Box Hill, Victoria, Australia
Department of Gastroenterology, Fiona Stanley Hospital, Murdoch, WA, Australia
Monash University, Melbourne, VIC, Australia
Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Carlton, VIC, Australia
Hepatic Fibrosis Group, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
Gastroenterology and Hepatology
Iron Metabolism Laboratory, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
Faculty of Medicine, The University of Queensland, Brisbane, Australia
Issue Date: 19-Jul-2021
Date: 2021-07-19
Publication information: Scientific Reports 2021; 11(1): 14654
Abstract: Aspartate aminotransferase-to-platelet ratio index (APRI) and Fibrosis-4 Index (Fib4) have been validated against liver biopsy for detecting advanced hepatic fibrosis in HFE hemochromatosis. We determined the diagnostic utility for advanced hepatic fibrosis of Hepascore and transient elastography compared with APRI and Fib4 in 134 newly diagnosed HFE hemochromatosis subjects with serum ferritin levels > 300 µg/L using area under the receiver operator characteristic curve (AUROC) analysis and APRI- (> 0.44) or Fib4- (> 1.1) cut-offs for AHF, or a combination of both. Compared with APRI, Hepascore demonstrated an AUROC for advanced fibrosis of 0.69 (95% CI 0.56-0.83; sensitivity = 69%, specificity = 65%; P = 0.01) at a cut-off of 0.22. Using a combination of APRI and Fib4, the AUROC for Hepascore for advanced fibrosis was 0.70 (95% CI 0.54-0.86, P = 0.02). Hepascore was not diagnostic for detection of advanced fibrosis using the Fib4 cut-off. Elastography was not diagnostic using either APRI or Fib4 cut-offs. Hepascore and elastography detected significantly fewer true positive or true negative cases of advanced fibrosis compared with APRI and Fib4, except in subjects with serum ferritin levels > 1000 µg/L. In comparison with APRI or Fib4, Hepascore or elastography may underdiagnose advanced fibrosis in HFE Hemochromatosis, except in individuals with serum ferritin levels > 1000 µg/L.
DOI: 10.1038/s41598-021-94083-x
Journal: Scientific Reports
PubMed URL: 34282177
Type: Journal Article
Appears in Collections:Journal articles

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