Abstracts of the 2023 Annual Meeting of the ALEH
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Introduction and ObjectivesLiver 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.
Patients / Materials and MethodsProspective 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.
Results and Discussion63 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%).
ConclusionsCompared 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.
