Diagnostic value of combined serum biomarkers for the evaluation of liver fibrosis in chronic hepatitis C infection: A multicenter, noninterventional, observational study

Background/Aims: The hepatitis C virus (HCV) infection is important cause of chronic hepatitis. Liver biopsy is considered the gold standard for assessment of fibrosis but this procedure is an invasive procedure. We aimed to evaluate the diagnostic efficiency of non-invasive serum biomarkers, separately and in combinations, on liver fibrosis in treatment-naive chronic hepatitis C (CHC) patients. Materials and Methods: Two hundred and sixteen treatment-naive CHC patients were enrolled from 32 locations across Turkey in this open-labelled, non-interventional prospective observational study. FibroTest®, aspartate aminotransferase-to-platelet ratio index(APRI), aspartate aminotransferase and alanine aminotransferase ratio (AAR), fibrosis index based on four factors (FIB-4), Age-platelet(AP) index and Forns index were measured and compared with Metavir scores got from liver biopsies. Results: Data from 182 patients with baseline liver biopsy were suitable for analysis. One hundred and twenty patients (65.9%) had F0-F1 fibrosis and 62 patients (34.1%) had F2-F4 fibrosis. APRI 0.732 area under the curve(AUC) indicated advanced fibrosis with 69% sensitivity and 77% specificity. FIB-4 0.732 AUC and FibroTest 0.715 AUC indicated advanced fibrosis with 69% and 78.4% sensitivity, and 75% and 71.4% specificity, respectively. The combined use of tests also led to an increase in AUC and specificity. Combinations of FibroTest with APRI and/or FIB-4, and FIB-4 with APRI were optimal for the evaluation of liver fibrosis. Conclusion: Fibrotest, FIB-4, APRI, AP index and Forns index exhibit good diagnostic performance for determining liver fibrosis in CHC patients, and the use of at least two tests together will increase their diagnostic value still further. © Copyright 2018 by The Turkish Society of Gastroenterology

Determination of potential allergenic fungal flora and its clinical reflection in suburban elementary schools in Izmir

WOS: 000280640500058PubMed ID: 19731058In this research, in order to determine mean fungus counts, indoor and outdoor air samples were taken in five elementary school buildings located in the city center of Seferihisar, Izmir (45 km from Izmir) within a 1-year period between March and April 2004, and between January and February 2005 representing similar climatic characteristics. Five samples, three from three classes where 5-8, 10-12, and 12-15 age group students attended, one from the corridors, and one from outside the buildings in all the schools, were taken for each period. Within the period of the study, in indoor and outdoor air samples, 7,122 microfungus colonies were counted. Sixty-four species were identified that belong to 17 genera as a result of the identification of isolates obtained. Skin prick tests were applied to 55 out of a total of 117 teachers by the clinicians. According to these test results, 24 teachers were sensitive to at least one agent. Results revealed that, in terms of mold counts, the difference between the schools and the difference between the times (periods) were statistically significant (p < 0.05)