ActiTest accuracy for the assessment of histological activity grades in patients with chronic hepatitis C, an overview using Obuchowski measure
T. Poynard a 
, M. Munteanu b, Y. Ngo b, L. Castera c, P. Halfon d, V. Ratziu a, F. Imbert-Bismut a, D. Thabut a, M. Bourliere e, P. Cacoub f, D. Messous a, V. de Ledinghen c
Bienvenue sur EM-consulte, la référence des professionnels de santé.
Article gratuit.
Connectez-vous pour en bénéficier!
Summary
Background
ActiTest (AT) is a biomarker of liver necro-inflammatory histological activity validated in patients with chronic hepatitis C (HCV).
Aim
The aim was to assess the accuracy of AT in comparison with alanine aminotransferase (ALT) the standard of care.
Methods
Methods used an integrated database of individual data and the new recommended Obuchowski measures. An updated “classical” meta-analysis of AT validation studies was also performed. The main end points were the area under the ROC curves (AUROCs) for the diagnosis of each histological activity grade defined using METAVIR scoring system. To avoid repeated tests and the spectrum effect of activity grades prevalence, the comparison of AT and ALT accuracies used the Obuchowski method.
Results
For the individual analysis, a total of 1250 patients were included and for the meta-analysis six studies (2017 patients) were included. The overall accuracy of AT for the diagnosis of any activity grade (Obuchowski measure=0.850) was significantly higher than the accuracy of ALT (Obuchowski measure=0.837; P =0.009). The updated standard meta-analysis confirmed the accuracy of AT (p <0.0001) both in independent AUROC=0.79 (95% CI, 0.73–0.85) and in non independent studies AUROC=0.74 (95% CI, 0.67–0.81).
Conclusions
The accuracy of AT for grading the necro-inflammatory activity of patients with HCV was significantly higher than ALT serum activity alone, the standard biomarker.
Plan
Vol 34 - N° 6-7
P. 388-396 - août 2010 Retour au numéro
Article précédent
- The cholangiographic features of severe forms of ABCB4/MDR3 deficiency-associated cholangiopathy in adults
- R. Poupon, L. Arrive, O. Rosmorduc
- Long-term quality-of-life assessment of gastrointestinal symptoms before and after laparoscopic Nissen fundoplication
- F. Borie, A. Glaise, E. Pianta, M. Veyrac, B. Millat
Bienvenue sur EM-consulte,
la référence des professionnels de santé.
Plus de 500 000 articles médicaux,
paramédicaux et scientifiques vous attendent.
Déjà abonné à cette revue ?