P-102 PERFORMANCE OF NONINVASIVE METHODS TO GRADUATE FIBROSIS AND INFLAMMATION IN A GROUP OF PATIENTS WITH AUTOIMMUNE HEPATITIS

No Liver biopsy is considered the gold standard to define fibrosis stage and inflammation degree in Autoimmune Hepatitis (AIH). Noninvasive methods have been utilized for these purposes, However, the respective accuracies in different populations have not been clarified. AIMS: Investigate the performance of TE and APRI and of serum IgG and γ-glob levels in defining liver fibrosis and inflammation degree, respectively, in a group of patients with AIH. Prospective study involving patients with AIH who underwent liver biopsy (classified by Metavir and Ishak) and TE (FibroScan, Echosens 502), with a maximum interval of 6 months between the two procedures. Laboratory parameters for APRI, IgG and γ-glob were obtained within a maximum interval of 3 months from the biopsy. The performances were compared with liver biopsies using ROC curves. 63 patients with AIH were included (88% female; mean age 43 ± 18 years), platelets levels: 214.524 ±72.121/µL. Medians: IgG:1530, APRI: 0.4 and TE: 8.8 kPA. Liver fragments had ≥ 8 complete portal spaces. Thirty-four patients (54%) had advanced fibrosis (F≥3 METAVIR) and 67% had inflammation A≤1 by METAVIR and A<6 by ISHAK. Correlations of IgG and γ-glob with inflammation were poor (R=0.21; P=0.20 and R=0.29; P=0.09, respectively). Regarding fibrosis, the best correlation was with TE (R=0.61; P<0.001), AUROC value of 0.84 (95% IC:0.73-0.92; P<0.0001) and moderate correlation was observed with APRI (R=0.44; P<0.001), AUROC value of 0.78 (95% IC: 0.66-0.88; P<0.001). The best cutoff of TE to define advanced fibrosis was 7.9 kPA (sensitivity:84%; specificity=74%). Regarding APRI, the best cutoff for advanced fibrosis was 0.24 (sensitivity: 97%; specificity=50%). Compared to APRI, TE showed the best performance in defining advanced fibrosis, with good accuracy. APRI had a moderate correlation with fibrosis. None IgG nor γ-glob showed good correlations with inflammation. Further studies are needed to confirm these findings.

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Journal
Annals of Hepatology
Published
2024-12-01
DOI
https://doi.org/10.1016/j.aohep.2024.101716
Primary Topic
Liver Diseases and Immunity
Type
article
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article

P-102 PERFORMANCE OF NONINVASIVE METHODS TO GRADUATE FIBROSIS AND INFLAMMATION IN A GROUP OF PATIENTS WITH AUTOIMMUNE HEPATITIS

Nathalia Carraro, Adriane Feijó Evangelista, Alberto R. Ferraz, Leonardo da Veiga et al.
Annals of Hepatology
Liver Diseases and Immunity
article

P-102 PERFORMANCE OF NONINVASIVE METHODS TO GRADUATE FIBROSIS AND INFLAMMATION IN A GROUP OF PATIENTS WITH AUTOIMMUNE HEPATITIS

Nathalia Carraro, Adriane Feijó Evangelista, Alberto R. Ferraz, Leonardo da Veiga, Ana Carolina Cardoso, Vivian Rotman, João Marcello de Araújo Neto, Renata de Mello Perez, R. Matos, Maria Chiara Chindamo, Debora Canoilas, Daniella Moutta
article en

Abstract

No Liver biopsy is considered the gold standard to define fibrosis stage and inflammation degree in Autoimmune Hepatitis (AIH). Noninvasive methods have been utilized for these purposes, However, the respective accuracies in different populations have not been clarified. AIMS: Investigate the performance of TE and APRI and of serum IgG and γ-glob levels in defining liver fibrosis and inflammation degree, respectively, in a group of patients with AIH. Prospective study involving patients with AIH who underwent liver biopsy (classified by Metavir and Ishak) and TE (FibroScan, Echosens 502), with a maximum interval of 6 months between the two procedures. Laboratory parameters for APRI, IgG and γ-glob were obtained within a maximum interval of 3 months from the biopsy. The performances were compared with liver biopsies using ROC curves. 63 patients with AIH were included (88% female; mean age 43 ± 18 years), platelets levels: 214.524 ±72.121/µL. Medians: IgG:1530, APRI: 0.4 and TE: 8.8 kPA. Liver fragments had ≥ 8 complete portal spaces. Thirty-four patients (54%) had advanced fibrosis (F≥3 METAVIR) and 67% had inflammation A≤1 by METAVIR and A<6 by ISHAK. Correlations of IgG and γ-glob with inflammation were poor (R=0.21; P=0.20 and R=0.29; P=0.09, respectively). Regarding fibrosis, the best correlation was with TE (R=0.61; P<0.001), AUROC value of 0.84 (95% IC:0.73-0.92; P<0.0001) and moderate correlation was observed with APRI (R=0.44; P<0.001), AUROC value of 0.78 (95% IC: 0.66-0.88; P<0.001). The best cutoff of TE to define advanced fibrosis was 7.9 kPA (sensitivity:84%; specificity=74%). Regarding APRI, the best cutoff for advanced fibrosis was 0.24 (sensitivity: 97%; specificity=50%). Compared to APRI, TE showed the best performance in defining advanced fibrosis, with good accuracy. APRI had a moderate correlation with fibrosis. None IgG nor γ-glob showed good correlations with inflammation. Further studies are needed to confirm these findings.

Annals of HepatologyVol. 29
Universidade Federal do Rio de Janeiro (BR), Universidade Federal do Estado do Rio de Janeiro (BR)
Good health and well-being
Openalex Percentile: Top 65%
Liver Diseases and Immunity
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