Introduction: Identifying patients with cirrhosis is complicated, but the availability of Transient Elastography by FibroScan for non-invasive assessment of fibrosis appears to have resolved this issue. The objective of our study was to use a Fibroscan database to identify patients with cirrhosis in our primarily African American Hepatitis C patients and to track outcome especially of patients with Hepatitis C (HCV).
Methods: The electronic medical records of 79 out of the 332 individuals (24%) with a Fibroscan between 2014 and 2016 and a score of \u3e12.5 kPa laboratory values recorded, and etiology and outcomes evaluated. AST to Platelet Ratio Index (APRI) and Fibrosis-4 (FIB-4) scores were calculated. An APRI score \u3e0.7 and FIB-4 score \u3e3.25 was used for predicting advanced fibrosis.
Results: Cirrhotic patients were 92% AA, 52% male, and the majority had Hepatitis C (92%). In patients who had FibroScan-defined cirrhosis, neither their APRI nor FIB-4 scores were as reliable as FibroScan for identifying cirrhosis. The lack of accuracy for APRI and FIB-4 was due to low serum-based scores in patients with early onset cirrhosis.
Outcomes for patients with HCV who were treated or not treated were tracked using improvement in FibroScan scores, and development of decompensated cirrhosis. For patients who had a subsequent FibroScan performed after HCV eradication (SVR), there was a statistically significant improvement in fibrosis, as compared to the non-treated patients (p
Conclusions: FibroScan is useful for evaluating for cirrhosis in a predominantly African American population, including regression of fibrosis after HCV eradication
