Blood Tests to Diagnose Fibrosis or Cirrhosis in Patients With Chronic Hepatitis C Virus Infection
Authors: Paul Calès, Victor de Ledinghen, Jérôme Guéchot
Journal: Annals of Internal Medicine (2013)

Letters3 September 2013Blood Tests to Diagnose Fibrosis or Cirrhosis in Patients With Chronic Hepatitis C Virus InfectionPaul Calès, MD, Victor de Ledinghen, MD, and Jérôme Guéchot, PharmD, PhDPaul Calès, MDFrom CHU and LUNAM University, Angers, France; CHU and Segalen University, Bordeaux, France; and Saint-Antoine Hospital, APHP, Paris, France., Victor de Ledinghen, MDFrom CHU and LUNAM University, Angers, France; CHU and Segalen University, Bordeaux, France; and Saint-Antoine Hospital, APHP, Paris, France., and Jérôme Guéchot, PharmD, PhDFrom CHU and LUNAM University, Angers, France; CHU and Segalen University, Bordeaux, France; and Saint-Antoine Hospital, APHP, Paris, France.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-159-5-201309030-00020 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:We thank Chou and Wasson for their impressive review (1) and would like to comment on some aspects. They introduce the selected studies as those comparing the diagnostic accuracy of blood tests with that of liver biopsy, although most of the studies evaluated diagnostic accuracy using the latter as a reference standard. This precision is important because biopsy is an imperfect gold standard. Because the main judgment criterion was based on the area under the receiver-operating characteristic curve (AUROC), its interpretation should have taken into account the misclassification rate of liver biopsy as already shown (2).Table ...References1. Chou R and Wasson N. Blood tests to diagnose fibrosis or cirrhosis in patients with chronic hepatitis C virus infection: a systematic review. Ann Intern Med. 2013;158:807-20 LinkGoogle Scholar2. Mehta SH, Lau B, Afdhal NH, and Thomas DL. Exceeding the limits of liver histology markers. J Hepatol. 2009;50:36-41. [PMID: 19012989] CrossrefMedlineGoogle Scholar3. Boursier J, Bacq Y, Halfon P, Leroy V, de Ledinghen V, de Muret A, et al. Improved diagnostic accuracy of blood tests for severe fibrosis and cirrhosis in chronic hepatitis C. Eur J Gastroenterol Hepatol. 2009;21:28-38. [PMID: 19060630] CrossrefMedlineGoogle Scholar4. Vergniol J, Foucher J, Terrebonne E, Bernard PH, le Bail B, Merrouche W, et al. Noninvasive tests for fibrosis and liver stiffness predict 5-year outcomes of patients with chronic hepatitis C. Gastroenterology. 2011;140:1970-9, 1979.e1-3. [PMID: 21376047] CrossrefMedlineGoogle Scholar5. Boursier J, Bertrais S, Oberti F, Gallois Y, Fouchard-Hubert I, Rousselet MC, et al. Comparison of accuracy of fibrosis degree classifications by liver biopsy and non-invasive tests in chronic hepatitis C. BMC Gastroenterol. 2011;11:132. [PMID: 22129438] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Paul Calès, MD; Victor de Ledinghen, MD; Jérôme Guéchot, PharmD, PhDAffiliations: From CHU and LUNAM University, Angers, France; CHU and Segalen University, Bordeaux, France; and Saint-Antoine Hospital, APHP, Paris, France.Disclosures: Dr. Calès: Patents (money to institution): Angers University; Royalties (money to institution): Angers University. All other authors have no disclosures. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoBlood Tests to Diagnose Fibrosis or Cirrhosis in Patients With Chronic Hepatitis C Virus Infection Roger Chou and Ngoc Wasson Blood Tests to Diagnose Fibrosis or Cirrhosis in Patients With Chronic Hepatitis C Virus Infection Roger Chou and Ngoc Wasson Blood Tests to Diagnose Fibrosis or Cirrhosis in Patients With Chronic Hepatitis C Virus Infection Thierry Poynard , Vlad Ratziu , and Mona Munteanu Metrics 3 September 2013Volume 159, Issue 5Page: 371-372KeywordsAlanineAminotransferasesBiopsyChronic hepatitis CCirrhosisCoenzymesFibrosisHematologic testsLiverLiver diseasesLiver fibrosisReproducibility ePublished: 3 September 2013 Issue Published: 3 September 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...