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CAN WE REPLACE TRANSIENT ELASTOGRAPHY I.E. FIBRO SCAN WITH CHEAP BIOMARKERS? A CROSS SECTIONAL STUDY AT LAHORE GENERAL HOSPITAL, LAHORE

Azhar Hussain, Zubair, Muhammad Saad Tabassum

Objective: To assess the validity ofSerum Aminotransferase Levels i.e. ALT & AST,Albumin and Bilirubinas fibrosis biomarker, we compared their serum levels with fibro scan for the fibrosis staging and predicting its progression in Pakistani population. Methods: The prospective cross sectional study was conducted in medicine unit 1 and hepatitis clinic of Lahore General Hospital, Lahore starting from11Feb 2017–29Dec2018. We studied 1376 HCV infected patients which were got CBC, LFTs, ELISA, PCR and fibro scan done to perfectly diagnose ongoing hepatitis C infection. In order to differentiate HCV fibrosis progression, we compared the effectiveness of readily available serum aminotransferase Levels i.e. ALT & AST, Albumin and Bilirubin with fibro scan. Results: Area Under the Curve for F0-F3 was less than 0.6 except ALT indicating thatneither of Albumin, Bilirbin, ALT or ASTcan be used as diagnostic biomarker for predicting F0-F3.But,An ALT for F4 stage, the sensitivity was 57.3, specificity 50.0 with AUC=0.698.AST>40 had sensitivity of 82.6 and specificity of 79.0 for F4 stage with AUC=0.707. Bilirubin >0.95 had sensitivity of 45% and specificity of 79.0 for F4 stage with AUC=0.651. Albumin can neither be used as diagnostic biomarker for all the stages of fibrosis (F0-F4). Conclusion: An AST, ALT and Bilirubin can predict cirrhosis in patients with chronic hepatitis C infection. In these patients, a liver biopsy and fibro scan may not be necessary in these patients. Keywords: Hepatitis C, Blood Platelets, Fibro scan score.

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