الفهرس 
1. Changes in the hepatic architecture (A) associated with advanced hepatic fibrosis (B). Following chronic liver injuryOnly 14 pages are availabe for public view
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Abstract
The aim of our study is to evaluate the usefulness of seven indirect markers of liver fibrosis as compared to liver biopsy as a gold standard.
The study included 100 patients with chronic hepatitis C infection intended to receive antiviral treatment (pegylated interferon and ribavirin). The patients were chosen from patients attending the interferon clinic of cairo fatemic hospital.
All Patients were subjected to the following:
1. Careful medical history taking.
2. Thorough clinical examination.
3. Laboratory evaluation including:
-Complete blood count
-Liver biochemical profile including: serum bilirubin (total and direct), ALT, AST, GGT, Serum albumin, coagulation profile.
- Kidney function tests (serum urea and creatinine).
- Viral markers including HCV antibodies and HBV antibodies (HBsAg, HBcAb).
- Quantitative HCV RNA by PCR.
- Antinuclear antibodies (ANA) and antimitochondrial Antibodies (AMA).
- Antischistosomal antibodies tested for patients with previous history of contact with canal water.
4.Abdominal ultrasonography.
5.Liver biopsy and histological examination.
6. Calculation of the seven indirect serum markers:
Age /platelet index
AST/ALT ratio
The Aspartate Aminotransferase to Platelet Ratio Index
Model 3
Bonacini’s discriminant score
Forn’s fibrosis index
FIB-4
7.Statistical analysis of the results.
In the studied group:
1. We found no statistical significant difference between male and female, cases with and without past history of diabetes, hypertension and previous operations, smokers and non smokers as regards the rate of significant fibrosis, bridging fibrosis and cirrhosis P>0.05. Except in cirrhosis, cases with past history of operation showed significantly higher rate P<0.05.
2. Cases with significant fibrosis showed significantly lower platelet count and higher ALT level when compared to cases with non significant fibrosis.
3. Cases with significant fibrosis showed higher age / platelet ratio than to those with non significant fibrosis, with sensitivity 68.75% and specificity 59.62%. And showed no statistical significant difference regarding bridging fibrosis and cirrhosis.
4. Comparison between cases with significant fibrosis, bridging fibrosis and cirrhosis with AAR showed that there was no statistical significant difference P>0.05.
5. Comparison between cases with significant fibrosis, bridging fibrosis and cirrhosis with APRI showed no statistical significant difference P>0.05.
6. Cases with significant fibrosis showed higher Bonacini’s discriminant score when compared to non significant fibrosis P<0.05. And there was no statistical significant difference regarding cases with bridging fibrosis (P=0.48) or cirrhosis (P=0.83).
7. Comparison between cases with significant fibrosis, bridging fibrosis and cirrhosis with Model 3 showed that there was no statistical significant difference P>0.05.
8. Cases with significant fibrosis showed higher Forn’s fibrosis index when compared to non significant fibrosis P<0.05, with no statistical significant difference between cases with and without bridging fibrosis and cirrhosis.
9. Cases with significant fibrosis showed higher FIB-4 index when compared to non significant fibrosis P<0.05, with no statistical significant difference between cases with and without bridging fibrosis and cirrhosis.
10. Age/platelet ratio was able to classify higher number of significant fibrosis than Bonacini, Forn’s and FIB-4 (66%, 63%, 63% and 63%) respectively.
11. When age/platelet index, Bonacini’s dicriminant score, Forn’s fibrosis index and FIB-4 index were analyzed together, Bonacini, Forn’s and FIB-4 became non significant but age/platelet index remained significant, age/platelet >2.02 was associated with more than 3 fold increase in odds of significant fibrosis.