Diagnostic Performance of Fibrotest/Actitest for Staging Significant Liver Fibrosis in Thai Chronic Hepatitis C Patients

Background: Chronic hepatitis C viral (HCV) infection remains a major critical challenge in Thailand.Clinical management requires diagnostic significant liver fibrosis. Fibrotest/Actitest is a novel non-invasive testing for alternative liver biopsy. There are limited studies of the testing in Thailand. Objective: To demonstrate the diagnostic performance to predict significant fibrosis (METAVIR stage >F2) using Fibrotest/Actitest compared to liver biopsy in HCV patients. Materials and Methods: The present study prospectively enrolled 100 HCV patients, who underwent liver biopsy. Fibrotest/Actitest was done in the same day. Liver histology was evaluated using the METAVIR scoring system. Diagnostic stat was calculated and evaluated for the best cut-off values of patients with METAVIR fibrosis F>2. Results: The AUROC for Fibrotest/Actitest was 0.74 (0.64 to 0.83) and the best cut-off was >0.44 for prediction significant fibrosis (F>2) in Thai Chronic hepatitis C viral infection patients with sensitivity, specificity, PPV, and NPV as 75.4% (63.1 to 85.2), 71.4 (53.7 to 85.4), 83.1 (71.0 to 91.6) and 61 (44.5 to 75.8), respectively. This cut-off was more accuracy than the international cut-off (>0.49) and improved sensitivity, PPV and NPV for prediction significant fibrosis in Thai chronic HCV infection. Conclusion: Fibrotest/Actitest addresses a critical need for management of chronic HCV infection. Cut-off >0.44 was a predictor of the significant fibrosis (F2) and acceptable diagnostic performance. Keywords: Chronic hepatitis C virus, Fibrotest/Actitest, Liver biopsy, METAVIR fibrosis