Prevalence of liver fibrosis and risk factors in a general population using non-invasive biomarkers (FibroTest)

Thierry Poynard; Pascal Lebray; Patrick Ingiliz; Anne Varaut; Brigitte Varsat; Yen Ngo; Pascal Norha; Mona Munteanu; Fabienne Drane; Djamila Messous; Françoise Imbert Bismut; Jean Pierre Carrau; Julien Massard; Vlad Ratziu; Jean Pierre Giordanella

doi:10.1186/1471-230X-10-40

Table 3 Predictive values of oriented screening strategies

From: Prevalence of liver fibrosis and risk factors in a general population using non-invasive biomarkers (FibroTest)

Strategy	Number subjects	Presumed fibrosis	Confirmed fibrosis
Prevalence fibrosis ¹	7463	209 (2.8%)	50 (0.7-1.4%)
Metabolic factors oriented
Predictive value
At least one metabolic factor	3990	163 (4.1%)	40 (1.0%)
None	3473	46 (1.3%)	10 (0.3%)
Odds ratio	7463	3.2 (2.3-4.5)	3.4 (1.7-7.5)
Area under ROC curve	4854	0.69(0.64-0.73)	0.71 (0.59-0.80)
Alcohol-oriented per self-
*reported consumption*
Predictive value
>10 g female/20 g male	1686	52 (3.1%)	15 (0.9%)
<= 10 g female/<= 20 g male	5770	157 (2.7%)	35 (0.6%)
Odds Ratio	7456	1.1 (0.8-1.6)	1.5 (0.8-2.8)
Area under ROC curve	7456	0.55(0.51-0.59)	0.52 (0.43-0.60)
*CDT oriented*
Predictive value
CDT>1.6	348	45 (12.9%)	22 (6.3%)
CDT<= 1.6	749	29 (3.9%)	8 (1.1%)
Odds Ratio	1097	3.7 (2.2-6.2)	6.1 (2.6-15.4)
Area under ROC curve	1097	0.72(0.64-0.78)	0.75 (0.67-0.86)
Hepatitis Virus-oriented ²
Predictive value
HBsAg or HCV antibody	36	5 (13.9%)	3 (8.3%)
HBsAg and HCV negative or not done at baseline	7427	204 (2.7%)	47 (0.6%)
Odds ratio	7463	5.9 (1.9-15.6)	15.3 (3.4-50.9)
Transaminases- oriented
Predictive value
ALT >= 50 IU/L	513	53 (10.3%)	17 (3.3%)
ALT < 50 IU/L	6950	156 (2.2%)	33 (0.5%)
Odds ratio	7463	5.0 (3.6-7.0)	7.2 (3.8-13.4)
Area under ROC curve	7463	0.72(0.68-0.75)	0.78 (0.72-0.83)
*Age-oriented*
Predictive value
Age > 60 years	2960	156 (5.3%)	42 (1.4%)
Age <= 60 years	4503	53 (1.2%)	8 (0.2%)
Odds ratio	7463	4.7 (3.4-6.5)	8.3 (3.8-19.5)
Area under ROC curve	7463	0.75(0.72-0.78)	0.79 (0.71-0.84)
*Gender-oriented*
Male	4113	189 (4.6%)	47 (1.1%)
Female	3350	20 (0.6%)	3 (0.1%)
Odds ratio	7463	8.0 (5.0-13.1)	12.0 (4.0-54.1)

¹ Upper estimated prevalence assuming that the prevalence of advanced fibrosis would be the same in the population of patients not reinvestigated. Lower prevalence assuming that no advanced fibrosis was present among patients not reinvestigated.
² This strategy was the standard in the screening centers. Two cases with positive HBsAg detected during reinvestigations of advanced fibrosis were not taken into account. There was one coinfection HCV-HBV.

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