13C-aminopyrine breath test accurately predicts long-term outcome of chronic hepatitis C.

Alba Rocco, Germana de Nucci, Giovanna Valente, Debora Compare, Agesilao D'Arienzo, Lucia Cimino, Francesco Perri, Gerardo Nardone

Department of Clinical and Experimental Medicine, Gastroenterology Unit, University of Naples Federico II, Naples, Italy.

Journal of hepatology 2012 Apr

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Although numerous non-invasive tests are currently available to explore liver function and disease activity in patients with HCV-related chronic diseases, none of these indicate the likelihood of disease progression in the individual patient. We aimed at assessing the prognostic ability of (13)C(2)-aminopyrine breath test ((13)C-ABT) in the prediction of liver fibrosis progression in patients with HCV chronic hepatitis who prospectively entered a long-term follow-up. Fifty patients with HCV-related chronic disease who underwent paired liver biopsy (at baseline and after a mean period of 86 months) were included in the study. (13)C-ABT was carried out at baseline and every 3 years. Histological progression was defined as increase of at least 2 fibrosis units according to Ishak score. Fourteen patients progressed of at least 2 fibrosis units during the follow-up. These patients were more frequently infected with a HCV-1b genotype and had, at baseline, a significantly older age, higher BMI, AST levels, and AST to platelet ratio index (APRI). (13)C-ABT was altered in 57% of cases at baseline and in 100% of the cases at 3-year follow-up. In the univariate analysis, age (p=0.005), BMI (p=0.006), platelet count (p=0.03), AST (p=0.012) and ALT (p=0.04) levels, APRI (p=0.03), and baseline (13)C-ABT results (p<0.0001) were all independently associated with progression of liver fibrosis. By Cox's multiple regression analysis, the (13)C-ABT was the only covariate that significantly predicted liver fibrosis progression (HR 6.7; 95% CI 2.3-20.1; p<0.001). (13)C-ABT accurately predicts the risk of disease progression in patients with HCV-related chronic hepatitis. Copyright Â© 2012 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Citation

Alba Rocco, Germana de Nucci, Giovanna Valente, Debora Compare, Agesilao D'Arienzo, Lucia Cimino, Francesco Perri, Gerardo Nardone. 13C-aminopyrine breath test accurately predicts long-term outcome of chronic hepatitis C. Journal of hepatology. 2012 Apr;56(4):782-7