Page 39 - The Flying Publisher Guide to Hepatitis C Treatment

Patients’ monitoring during and after treatment | 39

Table 2.6 – Composite biochemical scores
Test Markers Interpretation
FibroTest™ alpha-2-macroglobulin, Result is provided as a score of 0
(Imbert-Bismut 2001) apolipoprotein A1, to 1, proportional to the severity
haptoglobin, GGT, of the fibrosis, with conversion
to the METAVIR system (from F0
bilirubin to F4).
HepaScore™ alpha 2 -macroglobulin A HepaScore <0.55 is considered
(Adams 2005) GGT*, bilirubin, “negative” and indicates a
hyaluronic acid, age, METAVIR score of F0 or F1.
gender A HepaScore ≥0.55 is considered
“positive” and indicates a
METAVIR score of F2 to F4.
FibroMeter™ alpha2–macroglobulin, FibroMeter™ has two main
(Cales 2005) hyaluronic acid, diagnostic targets (fibrosis stage
platelets, prothrombin and area of fibrosis), being
index, AST, urea, age, adapted for special explicit
gender causes†.
* GGT: γ-glutamyltranspeptidase
† chronic viral hepatitis B or C, alcoholic liver disease and non-alcoholic fatty
liver disease
FibroTest™ (Biopredictive, Paris, France) identifies about 70% of
patients with histological signs of moderate to severe fibrosis
and about 90% of patients with histological signs of cirrhosis,
using the manufacturers’ recommended cutoff values. The
FibroTest™ together with FibroScan™ have excellent utility for
the identification of HCV-related cirrhosis, but lesser accuracy
for earlier stages (Shaheen 2007).
All these tests are based on routine biochemistry blood assays
and can be influenced by intercurrent conditions. At the same
time, these scores may fluctuate or revert to lower classes after
initial worsening and a dynamic overview is more valuable than
a single determination.
In Europe, the typical approach is to perform a blood test such as
one of the commercially available assays, followed by transient
elastography. If both tests have concordant results on the
disease stage, no biopsy is needed; if there is discordance, biopsy
is performed. New fibrosis indexes combining the biochemical