A discriminant score based on four routine laboratory blood tests for accurate diagnosis of severe fibrosis and/or liver cirrhosis in Egyptian patients with chronic hepatitis C

Liver biopsy is still recommended in most patients with chronic hepatitis C (CHC). Due to its limitations and risks, the use of non-invasive blood biomarkers has been suggested for predicting liver cirrhosis in these patients. Here, we analyzed a panel of routine blood biochemical and hematological markers of 455 Egyptians (272 males and 183 females aged 26-67 years; mean age of 47.25 years) with clinically confirmed CHC. The multivariate discriminant analysis (MDA) selected a function based on absolute values of the four routine biomarkers; score = [albumin (g/L) × 0.3 + platelet count (109/L) × 0.05] − [alkaline phosphatase (IU/L) × 0.014 + AST/ALT ratio × 6 + 14]. The MDA function correctly classified 98% of the cirrhotic patients at a discriminant cut-off score = 0 (i.e. less than 0 indicated liver cirrhosis and greater than 0 indicated CHC without cirrhosis) with high degrees of specificity (97%), positive predictive value (99%) and negative predictive value (92%). The MDA of the absolute values of a combination of four routine tests can efficiently indicate liver cirrhosis in CHC patients. Based on individual patient MDA score value, each patient can be simply and efficiently classified into a cirrhotic or a non-cirrhotic liver patient.