Diagnostic value of multiple biomarker panel for prediction of significant fibrosis in chronic hepatitis C

ObjectivesWhether new biomarkers contribute significantly to the existing, simple noninvasive test (comprising of routine laboratory parameters such as the AST to platelet ratio index (APRI)) for predicting liver fibrosis remains unknown.MethodsWe measured 7 biomarkers in 91 patients with chronic hepatitis C (CHC): haptoglobin, apolipoprotein A1, α2-macroglobulin, hyaluronic acid, type III procollagenic peptide, matrix metalloproteinase-2, and tissue inhibitor of metalloproteinase-1.ResultsThe “multibiomarker” score (based on regression coefficients of significant biomarkers) is an independent predictive factor for significant fibrosis [APRI-adjusted odds ratio, 2.41 (95% CI, 1.28 to 4.55)]. However, the incorporation of the multibiomarker score into the APRI resulted in only a small diagnostic improvement [0.83 (95% CI, 0.74 to 0.92) vs. 0.79 (0.69 to 0.89); p = 0.19].ConclusionsFor assessing significant fibrosis in individual CHC patients, the 7 contemporary biomarkers that we studied add only modestly to the readily available, simple noninvasive index.

► We measure 7 new biomarkers for noninvasive assessment in 91 patients with chronic hepatitis C.
► Multiple biomarker score based on their regression coefficients is an independent predictive factor for significant fibrosis.
► The incorporation of the multiple biomarker score into AST to platelet ratio index results in only a small improvement of about 4%.
► New biomarkers add only modestly to the readily available, simple noninvasive index.