Comparison of test performance profile for blood tests of liver fibrosis in chronic hepatitis C

J Hepatol. 2007 Mar;46(3):395-402. doi: 10.1016/j.jhep.2006.09.020. Epub 2006 Nov 7.


Background/aims: We evaluated the test performance profile (TPP) of blood tests of liver fibrosis.

Methods: Three hundred and fifty-six patients with C chronic hepatitis were included in two centers. Metavir staging of liver specimens by two independent pathologists and the following tests were evaluated: Fibrotest (FT), APRI, FibroMeter (FM), and Hepascore (HS).

Results: Metavir stages were: F0: 4%, F1: 55%, F2: 26%, F3: 11%, and F4: 4%. The AUROCs were not significantly different, respectively, FT, FM, APRI, HS: >or=F2: 0.79, 0.78, 0.76, >or=0.76; F3: 0.81, 0.85, 0.81, 0.81; and F4: 0.86, 0.94, 0.92, 0.89. The TPP relies on the paired comparison of blood-test misclassification based on liver specimen, e.g. FT vs FM, respectively: F0+1: 18 vs 28% (p=0.0003), >or=F2: 43 vs 31% (p=0.004). There was no center effect.

Conclusions: In those populations, the four blood tests had a similar performance for significant fibrosis (F>or=2), lying in the lower range of published results which is attributable to a low >or=F2 prevalence, and for >or=F3 and F4. However, FM and FT had performance profiles significantly different as a function of fibrosis stages or diagnostic target (fibrosis cut-off). This has to be considered during the interpretation process. Moreover, the performance should be reported with different diagnostic targets.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adult
  • Algorithms
  • Aspartate Aminotransferases / blood
  • Biopsy
  • Blood Platelets / enzymology
  • Disease Progression
  • Female
  • Hematologic Tests / methods*
  • Hepatitis C, Chronic / blood*
  • Hepatitis C, Chronic / complications*
  • Humans
  • Liver / pathology
  • Liver Cirrhosis / blood
  • Liver Cirrhosis / diagnosis*
  • Liver Cirrhosis / etiology*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Retrospective Studies


  • Aspartate Aminotransferases