ft in prognostic of hbv fibrotest: predictive value in hbv
TRANSCRIPT
FibroTest: FibroTest: predictivepredictive value in value in HBVHBV
1.1. Diagnosis and clinical optionsDiagnosis and clinical options
2.2. FibroTest: a 4-years prognostic studyFibroTest: a 4-years prognostic study
In this PresentationIn this Presentation
Diagnosis and clinical optionsDiagnosis and clinical options
Results interpretable no risk of false positive/negative
Not interpretable Risk of false
positive/negative*
Repeat Test or perform
elastography/ biopsyNo biopsy mandatory
Treatment TreatmentOr follow-up**
Follow-up** with FibroTest
Treatment Or follow-up
95% 5%
(For liver injuries Assessment)
Diagnosis and clinical optionsDiagnosis and clinical options
Positive serologyPositive serology
Poynard et al, Comp Hepatol 2004
5 years prognostic value5 years prognostic value
FibroTest
Ngo et al, Hepatology AASLD 2007 Ngo et al, Hepatology AASLD 2007 - Patients and Methods- Patients and Methods
Aim To prospectively assess the 4-year prognostic value of FibroTest-ActiTest staging compared to biopsy and to HBV-DNA for predicting cirrhosis decompensation and survival.
Patients and method
Prospective hospital-based cohort of chronic hepatitis B patients (n=504) (consecutive Ag HBs positive patients with baseline FibroTest-ActiTest HBV DNA measurements)
Mean age 42 yrs,71% males, 30% asian AgHBe+ 18%
HBV-related complications (main end-point): liver-related death liver transplantation liver failure (ascites, jaundice, hepatic encephalopathy) variceal bleeding, hepatocellular carcinoma
Ngo et al, Hepatology AASLD 2007 Ngo et al, Hepatology AASLD 2007 - Results- Results
• 4-year survival without HBV related complications according for FibroTest severity groups
0.00
0.25
0.50
0.75
1.00
0 10 20 30 40 50 60 70 80Follow-up (months)
Sur
viva
l with
out H
BV
com
plic
atio
ns
-- Minimal fibrosis-- Moderate fibrosis-- severe fibrosis
Surv
ival
with
out c
ompl
icati
ons
months
Baseline FT value n HBV
complications
Survival without HBV
complications
0.00-0.31 263 2 98.9 (97.5-1.00)
0.32-0.58 127 4 91.7 (82.9-1.00)
0.59-1.00 114 26 72.2 (62.9-81.6)
All 504 32 97.9 (94.9-1.00)
• 4-year survival without HBV related death according for FibroTest severity groups
0.00
0.25
0.50
0.75
1.00
0 10 20 30 40 50 60 70 80Follow-up (months)
Sur
viva
l with
out H
BV
rela
ted
deat
h
-- Minimal fibrosis-- Moderate fibrosis-- severe fibrosis
Surv
ival
with
out c
ompl
icati
ons
months
Baseline FT value n HBV related
death
Survival without HBV
complications
0.00-0.31 263 0 100
0.32-0.58 127 0 100
0.59-1.00 114 15 84.2 (76.8-91.6)
All 504 15 86.9 (80.2-93.5)
Ngo et al, Hepatology AASLD 2007 Ngo et al, Hepatology AASLD 2007 - Results- Results
• Better AUROCs for FibroTest versus HBV-DNA for 4-years survival without HBV complications or death
AUROC: 4 years without complications
FTAUROC (95%CI)
HBV-DNAAUROC (95%CI) p
0.89 (0.82-0.94) 0.57 (0.40-0.70) <0.001
AUROC: 4 years without death
FTAUROC (95%CI)
HBV-DNAAUROC (95%CI) p
0.95 (0.91-0.97) 0.55 (0.38-0.68) <0.001
Ngo et al, Hepatology AASLD 2007 Ngo et al, Hepatology AASLD 2007 - Results- Results
0.00
0.25
0.50
0.75
1.00
0.00 0.25 0.50 0.75 1.00
1-Specificity
Sensi
tivity
Sens
ivity
Specificity
-- FibroTest-- HBV DNA
0.00
0.25
0.50
0.75
1.00
0.00 0.25 0.50 0.75 1.00
1-Specificity
Sensi
tivity
Sens
ivity
Specificity
-- FibroTest-- HBV DNA
• Similar AUROCs for FibroTest and Biopsy of 4-year survival without HBV complications and death
FTAUROC (95%CI)
Liver biopsyAUROC (95%CI)
p
0.99 (0.90-0.99) 0.97 (0.93-0.99) 0.32
Ngo et al, Hepatology AASLD 2007 Ngo et al, Hepatology AASLD 2007 - Results- Results
Ngo et al, Hepatology AASLD 2007 Ngo et al, Hepatology AASLD 2007
ConclusionsConclusions
FibroTest’s prognostic value Possible combinations of FT
4-year prognostic value similar to that of liver
biopsy better to that of HBV-DNA
With baseline viral load To improve prediction for
DeathComplications