Spotlight Series on Hepatitis C

2014 HIV/Hepatitis C Coinfection Update

February 7, 2014


Turning the Tide: Staging

Turning the Tide: Staging

Improvements in liver monitoring continue to lag behind. Cox pointed out that a number of less-invasive blood tests -- FibroTest, SHASTA, FIB-4, Forns and APRI, for instance -- have been shown to have some value. "In this very inexpensive test, the AST to platelet ratio index is actually pretty good at predicting liver disease when compared to liver biopsy -- which again, isn't perfect," Cox said.

A newer, more advanced, completely non-invasive method -- transient elastography (a.k.a. FibroScan), approved in the U.S. in 2013 -- appears quite useful for picking up high-level liver disease and relatively useful for spotting lower-level disease, Cox said. However, the test -- which gauges liver stiffness by passing ultrasound waves through the organ -- is less effective the more overweight a patient is, and with an average price tag in the $120,000 range, Cox suggested that the technology remained an option that many facilities were unable to afford.

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