Utility and limitations of hepascore and transient elastography to detect advanced hepatic fibrosis in HFE hemochromatosis

Authors

Sim Y. Ong
Tiffany Khoo
Amanda J. Nicoll
Lyle Gurrin
Thomas Worland
Puraskar Pateria
Louise E. Ramm
Adam Testro
Gregory J. Anderson
Richard Skoien
Lawrie W. Powell
Grant A. Ramm
John K. Olynyk, Edith Cowan UniversityFollow
Martin B. Delatycki

Document Type

Journal Article

Publication Title

Scientific Reports

Volume

11

Issue

1

Publisher

Nature

School

School of Medical and Health Sciences

RAS ID

36260

Funders

National Health and Medical Research Council

Grant Number

NHMRC Number : APP1048740, APP1061332

Comments

Ong, S. Y., Khoo, T., Nicoll, A. J., Gurrin, L., Worland, T., Pateria, P., ... Delatycki, M. B. (2021). Utility and limitations of hepascore and transient elastography to detect advanced hepatic fibrosis in HFE hemochromatosis. Scientific Reports, 11, article 14654. https://doi.org/10.1038/s41598-021-94083-x

Abstract

Aspartate aminotransferase-to-platelet ratio index (APRI) and Fibrosis-4 Index (Fib4) have been validated against liver biopsy for detecting advanced hepatic fibrosis in HFE hemochromatosis. We determined the diagnostic utility for advanced hepatic fibrosis of Hepascore and transient elastography compared with APRI and Fib4 in 134 newly diagnosed HFE hemochromatosis subjects with serum ferritin levels > 300 µg/L using area under the receiver operator characteristic curve (AUROC) analysis and APRI- ( > 0.44) or Fib4- ( > 1.1) cut-offs for AHF, or a combination of both. Compared with APRI, Hepascore demonstrated an AUROC for advanced fibrosis of 0.69 (95% CI 0.56–0.83; sensitivity = 69%, specificity = 65%; P = 0.01) at a cut-off of 0.22. Using a combination of APRI and Fib4, the AUROC for Hepascore for advanced fibrosis was 0.70 (95% CI 0.54–0.86, P = 0.02). Hepascore was not diagnostic for detection of advanced fibrosis using the Fib4 cut-off. Elastography was not diagnostic using either APRI or Fib4 cut-offs. Hepascore and elastography detected significantly fewer true positive or true negative cases of advanced fibrosis compared with APRI and Fib4, except in subjects with serum ferritin levels > 1000 µg/L. In comparison with APRI or Fib4, Hepascore or elastography may underdiagnose advanced fibrosis in HFE Hemochromatosis, except in individuals with serum ferritin levels > 1000 µg/L.

DOI

10.1038/s41598-021-94083-x

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