Comparison of simple tests for the non-invasive diagnosis of clinically silent cirrhosis in chronic hepatitis C

G. Borroni, R. Ceriani, M. Cazzaniga, M. Tommasini, M. Roncalli, C. Maltempo, C. Felline, F. Salerno

Research output: Contribution to journalArticle


Background: Biopsy is the gold standard for assessing cirrhosis in patients with chronic hepatitis C virus infection, but it is expensive and at risk of complications. Alternative non-invasive methods have been developed but their usefulness remains uncertain. Aim: To compare the accuracy of five non-invasive scores in detecting cirrhosis. Methods: We reviewed the charts and liver biopsies of 228 consecutive, treatment-naïve, hepatitis C virus-positive patients, 13.2% of whom with histological diagnosis of cirrhosis. The five alternative scores were age-platelet index, cirrhosis discriminant score, aspartate transaminases to platelet ratio index, Pohl's index, and aspartate transaminases/alanine transaminases ratio. Results: The specificities of the scores were good (87-100%), but not so their sensitivities (17-67%). Accordingly positive likelihood ratios were generally good but negative likelihood ratios were suboptimal. Combinations of the scores independently related to cirrhosis only slightly change this diagnostic accuracy. Using double cut-offs to exclude/diagnoses cirrhosis, cirrhosis discriminant score classified 21% of patients without misdiagnoses and aspartate transaminases to platelet ratio index classified 85% of case with 9% of misdiagnoses. Conclusions: The five scores showed variable sensitivities and specificities in detecting liver cirrhosis, both individually and in combination. The use of double cut-off points may make the cirrhosis discriminant score and aspartate transaminases to platelet ratio index useful to reduce the number of patients submitted to liver biopsy.

Original languageEnglish
Pages (from-to)797-804
Number of pages8
JournalAlimentary Pharmacology and Therapeutics
Issue number5
Publication statusPublished - Sep 2006

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Fingerprint Dive into the research topics of 'Comparison of simple tests for the non-invasive diagnosis of clinically silent cirrhosis in chronic hepatitis C'. Together they form a unique fingerprint.

  • Cite this