Clinical and experimental hepatology · 2026
Are there any non-invasive methods to predict liver fibrosis in children infected by hepatitis C virus rather than liver biopsy?
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Nagi Salma Abdel Megeed, Turky Asmaa Zaky, El Gammal Shaymaa Sabry Ahmed, Elfiky Muhammad Abdelbaeth Hassan, Hafez Mohamed Zaeim, El-Refaey Mohamed E, Emara Ashraf A E, Awad Ahmad Mohamed, AboElenin Mabrouk, Ahmed Hesham Abdelrahman, Abdelraheem Fatma Mahmoud, Hablas Mohamad Ghazy Attia, Awad Khaled Hassaan, El-Lebedy Ismael Akm, Ghoneem Reda Rizk, Abdelmoaty Gamila Saed Khamis, Ghallab Shireen Rashad, Hassan Marwa Fekry, Abouzouna Zeinab Sabri
Аннотация
AIM OF THE STUDY: Since biopsy is an invasive procedure that is not suitable for routine monitoring, and hepatitis C virus (HCV) infection in children can lead to progressive liver damage, liver fibrosis, and its sequela, cirrhosis, aspartate aminotransferase (AST)-to-platelet ratio (APRI) and the fibrosis score (FIB-4) are increasingly substituting biopsy in the evaluation of liver fibrosis. APRI and FIB-4 are promising non-invasive markers for the safe and effective assessment of liver fibrosis. Thus, this study aimed to ascertain whether APRI and FIB-4 scores may be used to identify the stage of liver fibrosis among children diagnosed with HCV.
MATERIAL AND METHODS: From July 2024 to August 2025, a total of 120 children diagnosed with HCV were enrolled in a retrospective study conducted at the Department of Pediatric Hepatology, Gastroenterology, and Nutrition, National Liver Institute, Menoufia University. The study population was divided into two groups: 22 patients were classified as the > F2 group, while 98 patients were assigned to the ≤ F2 group.
RESULTS: There were no significant differences in hemoglobin (HB), white blood cells (WBCs), total bilirubin (TBIL), direct bilirubin (DBIL), alanine aminotransferase (ALT), AST, International Normalized Ratio (INR), and alanine aminotransferase/aspartate aminotransferase ratio (AAR) between the two groups under investigation. The ≤ F2 group showed significantly higher platelet (PLT), alkaline phosphatase (ALKP) and γ-glutamyl transferase (GGT) in comparison to the > F2 group. More importantly, the > F2 group had considerably higher APRI, levels of serum albumin and FIB-4 than the ≤ F2 group.
CONCLUSIONS: In patients with persistent HCV infection, both the FIB-4 and APRI scores demonstrated high diagnostic accuracy in predicting the phases of liver fibrosis. The FIB-4 proved to be a useful non-invasive method for fibrosis assessment because of its exceptional performance, demonstrating high specificity, sensitivity, and overall accuracy.
MATERIAL AND METHODS: From July 2024 to August 2025, a total of 120 children diagnosed with HCV were enrolled in a retrospective study conducted at the Department of Pediatric Hepatology, Gastroenterology, and Nutrition, National Liver Institute, Menoufia University. The study population was divided into two groups: 22 patients were classified as the > F2 group, while 98 patients were assigned to the ≤ F2 group.
RESULTS: There were no significant differences in hemoglobin (HB), white blood cells (WBCs), total bilirubin (TBIL), direct bilirubin (DBIL), alanine aminotransferase (ALT), AST, International Normalized Ratio (INR), and alanine aminotransferase/aspartate aminotransferase ratio (AAR) between the two groups under investigation. The ≤ F2 group showed significantly higher platelet (PLT), alkaline phosphatase (ALKP) and γ-glutamyl transferase (GGT) in comparison to the > F2 group. More importantly, the > F2 group had considerably higher APRI, levels of serum albumin and FIB-4 than the ≤ F2 group.
CONCLUSIONS: In patients with persistent HCV infection, both the FIB-4 and APRI scores demonstrated high diagnostic accuracy in predicting the phases of liver fibrosis. The FIB-4 proved to be a useful non-invasive method for fibrosis assessment because of its exceptional performance, demonstrating high specificity, sensitivity, and overall accuracy.