Liver fibrosis may occur in teens with chronic HCV infection

Adolescents with chronic hepatitis C virus (HCV) infection are prone to develop significant fibrosis, including cirrhosis, reveals a study. Serum biomarkers aspartate transaminase-to-platelet ratio index (APRI) and Fibrosis-4 index (FIB-4) are positively associated with liver stiffness measurement (LSM).

Thirty-five adolescent patients (mean age, 14.2±1.8 years; 63 percent male) were recruited in this study. Of these, 29 (83 percent) were infected vertically, 21 (60 percent) were treatment-naïve, 30 (86 percent) were infected with genotype 1, and five (14 percent) were infected with genotype 4 HCV.

The authors evaluated liver fibrosis using transient elastography (TE) and measured serum biomarkers APRI and FIB-4. In addition, they assessed the diagnostic performance of APRI and FIB-4 by calculating area under the receiver operating characteristics (AUROC) curve using LSM results as reference.

Transient elastography results showed no or mild fibrosis (F0/1 in METAVIR scale) in 31 patients (89 percent). Four patients (11 percent) had significant fibrosis (F≥2), including three (9 percent) with cirrhosis (F4).

The median APRI and FIB-4 were 0.32 and 0.32, respectively. LSM correlated with both APRI (r, 0.61, 95 percent confidence interval [CI], 0.35–0.79; p=0.0001) and FIB-4 (r, 0.60, 95 percent CI, 0.32–0.78; p=0.0002). The AUROC for APRI and FIB-4 for the diagnosis of significant fibrosis was 0.855 (95 percent CI, 0.695–951).

Moreover, significant fibrosis was predicted by an APRI cutoff >0.374 (sensitivity: 100 percent; specificity: 67.7 percent) and a FIB-4 cutoff >0.402 (sensitivity: 75.0 percent; specificity: 90.3 percent).