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PRO-C3: a new and more precise collagen marker for liver fibrosis in patients with chronic hepatitis C

Journal article
Authors J. F. Hansen
M. J. Nielsen
Kristina Nyström
D. J. Leeming
Martin Lagging
Gunnar Norkrans
P. B. Christensen
M. Karsdal
Published in Scandinavian Journal of Gastroenterology
Volume 53
Issue 1
Pages 83-87
ISSN 0036-5521
Publication year 2018
Published at Institute of Biomedicine, Department of Infectious Medicine
Pages 83-87
Language en
Keywords Chronic hepatitis C, liver fibrosis, non-invasive methods, viral hepatitis, diagnostic tests, simple noninvasive index, infection, cirrhosis, predict, Gastroenterology & Hepatology, long er, 1988, biometrics, v44, p837
Subject categories Infectious Medicine


Objective: Detecting significant fibrosis and cirrhosis remains important in treatment and follow-up of patients with chronic hepatitis C Infection (CHC). The aim of this study was to assess the ability of PRO-C3 to identify significant fibrosis (Ishak score3) and cirrhosis (Ishak score5) both as a single test and as a part of algorithms.Materials and methods: PRO-C3 was assessed in baseline samples from the NORDynamIC trial. 270 patients were stratified into groups according to baseline biopsy. Baseline APRI, FIB-4 and GUCI scores were available for comparison in 232 patients.Results: PRO-C3 increased with Ishak scores (p=.001). Area under the curve (AUC) for significant fibrosis was 0.75 (95% CI 0.68-0.81) and 0.76 (95% CI 0.68-0.84) for cirrhosis. FIB-4, APRI and GUCI had similar AUCs. In a PRO-C3 algorithm including age, platelet count, body mass index (BMI) and international normalised ratio (INR), the diagnostic efficacy improved to 0.85 (CI 0.80-0.89) and 0.90 (IQR 0.84-0.96) for significant fibrosis and cirrhosis, respectively.Conclusions: In our study, PRO-C3 was an independent predictor of fibrosis stage, and may play an important role in managing CHC patients.

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