STUDY OF CONCORDANCE BETWEEN THE DEGREE OF LIVER FIBROSIS ESTIMATED THROUGH APRI AND FIB-4 BIOCHEMICAL SCORES, AND ELASTORESONANCE IN PATIENTS WITH AUTOIMMUNE HEPATITIS

Introduction and Objectives

Autoimmune hepatitis is a chronic and progressive necroinflammatory disease with a fluctuating course of activity and affects more frequently the female sex. The etiopathogenesis is still unknown and may be the result of an interaction between factors: genetic, immunological, autoantigens; Therefore, the interaction of genetic predisposition with an environmental trigger and the disorder in immunoregulation would result in chronic inflammation of the hepatocytes and with it the development of hepatic fibrosis. Diagnostic tests for the evaluation of liver fibrosis include liver biopsy and non-invasive elastographic methods, such as transition elastography and elastoresonance, as well as serum biomarkers, composed of different variables that help predict the degree of liver fibrosis.

Objective

Compare the concordance between the results obtained for the diagnosis of liver fibrosis by the APRI and FIB-4 score, with the elastoresonance, in patients with HAI.

Material and methods

Elastoresonance, APRI and FIB-4 were performed in 6 patients to assess the concordance between different degrees of fibrosis.

Results

A total of 6 patients with a recent diagnosis of HAI were included in the study. The mean age was 50.33 years and 100% were women. 66.66% of the patients presented an advanced degree of fibrosis (F2-F3-F4) due to elastoresonance. The values ​​for the APRI index were: 3 patients (50%) had an advanced degree of fibrosis, 1 patient had a low degree of fibrosis (6%) and 2 patients (33.33%) had intermediate. The findings for the FIB-4 values ​​were exactly the same. The agreement of elastoresonance in the different degrees of fibrosis against the APRI and FIB-4 score was 100%.

Discussion

Non-invasive methods to measure the degree of liver fibrosis in patients with chronic liver disease have shown to be useful, and in this study, it transcends that the correlation with the degree of fibrosis obtained by elastoresonance with the APRI and FIB-4 scores is 100%, this could avoid reaching the liver biopsy, which although it is the gold standard in measuring the degree of liver fibrosis, is an invasive and expensive method, which involves risks for the patient (puncture of other internal organs, infection and adverse reaction to contrast material).

Conclusions

In patients classified with advanced fibrosis, the concordance between the estimates obtained using the elastoMR and those derived from the APRI and FIB-4 scores are high. However, a limitation of this study is the size of the sample.

The authors declare that there is no conflict of interest.