Modeling hepatic fibrosis in African American and Caucasian American patients with chronic hepatitis C virus infection

Robert J. Fontana, David E. Kleiner, Richard Bilonick, Norah Terrault, Nezam Afdhal, Steven H. Belle, Lennox J Jeffers, Darmendra Ramcharran, Marc G. Ghany, Jay H. Hoofnagle

Research output: Contribution to journalArticle

45 Citations (Scopus)

Abstract

Assessment of histological stage is an integral part of disease management in patients infected with the hepatitis C virus (HCV). The aim of this study was to develop a model incorporating objective clinical and laboratory parameters to estimate the probability of severe fibrosis (i.e., Ishak fibrosis ≥ 3) in previously untreated African American (AA) and Caucasian American (CA) patients with HCV genotype 1. The Ishak fibrosis scores of 205 CA and 194 AA patients enrolled in the Viral Resistance to Antiviral Therapy of Chronic Hepatitis C study (Virahep-C) were modeled using simple and multiple logistic regression. The model was then validated in an independent cohort of 461 previously untreated patients with HCV. The distribution of fibrosis scores was similar in the AA and CA patients as was the proportion of patients with severe fibrosis (35% vs. 39%, P = .47). After accounting for the number of portal areas in the biopsy, patient age, serum aspartate aminotransferase, alkaline phosphatase, and platelet count were independently associated with severe fibrosis in the overall cohort, and the relationship with fibrosis was similar in both the AA and CA subgroups. The area under the receiver operating characteristic curve (AUROC) of the Virahep-C model (0.837) was significantly better than in other published models (P = .0003). The AUROC of the Virahep-C model was 0.851 in the validation population. In conclusion, a model consisting of widely available clinical and laboratory features predicted severe hepatic fibrosis equally well in AA and CA patients with HCV genotype 1 and was superior to other published models. The excellent performance of the Virahep-C model in an external validation cohort suggests the findings are replicable and potentially generalizable.

Original languageEnglish
Pages (from-to)925-935
Number of pages11
JournalHepatology
Volume44
Issue number4
DOIs
StatePublished - Oct 1 2006

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Chronic Hepatitis C
Virus Diseases
Hepacivirus
African Americans
Fibrosis
Liver
ROC Curve
Genotype
Disease Management
Aspartate Aminotransferases
Platelet Count
Antiviral Agents
Alkaline Phosphatase
Logistic Models
Biopsy
Serum
Population

ASJC Scopus subject areas

  • Hepatology

Cite this

Fontana, R. J., Kleiner, D. E., Bilonick, R., Terrault, N., Afdhal, N., Belle, S. H., ... Hoofnagle, J. H. (2006). Modeling hepatic fibrosis in African American and Caucasian American patients with chronic hepatitis C virus infection. Hepatology, 44(4), 925-935. https://doi.org/10.1002/hep.21335

Modeling hepatic fibrosis in African American and Caucasian American patients with chronic hepatitis C virus infection. / Fontana, Robert J.; Kleiner, David E.; Bilonick, Richard; Terrault, Norah; Afdhal, Nezam; Belle, Steven H.; Jeffers, Lennox J; Ramcharran, Darmendra; Ghany, Marc G.; Hoofnagle, Jay H.

In: Hepatology, Vol. 44, No. 4, 01.10.2006, p. 925-935.

Research output: Contribution to journalArticle

Fontana, RJ, Kleiner, DE, Bilonick, R, Terrault, N, Afdhal, N, Belle, SH, Jeffers, LJ, Ramcharran, D, Ghany, MG & Hoofnagle, JH 2006, 'Modeling hepatic fibrosis in African American and Caucasian American patients with chronic hepatitis C virus infection', Hepatology, vol. 44, no. 4, pp. 925-935. https://doi.org/10.1002/hep.21335
Fontana, Robert J. ; Kleiner, David E. ; Bilonick, Richard ; Terrault, Norah ; Afdhal, Nezam ; Belle, Steven H. ; Jeffers, Lennox J ; Ramcharran, Darmendra ; Ghany, Marc G. ; Hoofnagle, Jay H. / Modeling hepatic fibrosis in African American and Caucasian American patients with chronic hepatitis C virus infection. In: Hepatology. 2006 ; Vol. 44, No. 4. pp. 925-935.
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