부산대학교 도서관

Aim We sought to evaluate the performance of transient elastography ( TE) for the assessment of liver fibrosis in chronic hepatitis C ( CHC) patients with beta-thalassemia. Methods Seventy-six CHC patients with beta-thalassemia underwent TE, liver biopsy, T2-weighted magnetic resonance imaging ( MRI) for the assessment of liver iron content ( LIC) and laboratory evaluation. The accuracy of TE and its correlation with the other variables was assessed. Results TE values increased proportional to fibrosis stage ( r = 0.404, P < 0.001), but was independent of T2-weighted MRI-LIC ( r = 0.064, P = 0.581). In multivariate analysis, fibrosis stage was still associated with the log-transformed TE score(standardized β = 0.42 for F4 stage of METAVIR, P = 0.001). No correlation was noted between LIC and TE score (standardized β = 0.064, P = 0.512). The area under the receiver operating characteristic curve for prediction of cirrhosis was 80% (95% confidence interval, 59-100%). A cut-off TE score of 11 had a sensitivity of 78% and specificity of 88.1% for diagnosing cirrhosis. The best cut-off values for ' TE-FIB-4 cirrhosis score' comprising TE and FIB-4 and ' TE-APRI cirrhosis score' combining TE with aspartate aminotransferase-to-platelet ratio index ( APRI) both had 87.5% sensitivity and 91.04% specificity for the diagnosis of cirrhosis. Conclusion Regardless of LIC, TE alone or when combined with FIB-4 or APRI, is a diagnostic tool with moderate to high accuracy to evaluate liver fibrosis in CHC patients with beta-thalassemia. However, because splenectomy in a proportion of our subjects might have affected the platelet count, the scores utilizing APRI and FIB-4 should be interpreted cautiously. [ABSTRACT FROM AUTHOR]