الفهرس 
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Abstract
Hepatitis C virus (HCV) infection is one of the main causes of chronic liver disease worldwide. The number of chronically infected persons worldwide may exceed 200 million, with Egypt having the highest prevalence worldwide, 15% of the population had positive results of antibodies tests to HCV whereas 10 % were found to have HCV viraemia.
Histological examination of the liver is an integral part of the evaluation of patients with chronic hepatitis C. Knowledge of the stage of liver fibrosis is essential for prognostication and decisions on antiviral treatment.
For the past 50 years liver biopsy has been considered to be the gold standard for staging of liver fibrosis. This technique allows physicians to obtain diagnostic information not only on fibrosis, but also on many other liver injuring processes. However, many studies clearly highlight several crucial drawbacks of liver biopsy, including risks, complication, high cost, sampling errors and inaccuracy due to inter- and intra-observer discrepancies.
To overcome the previously mentioned complications posed by liver biopsy, alternative non-invasive methods for quantifying and staging liver fibrosis have been developed. These methods range from serum biomarker assays to advanced imaging techniques.
This retrospective cohort study included 100 consecutive adult patients with CHC who had undergone percutaneous liver biopsy at the Tropical Medicine and Gastroenterology department, Sohag University Hospital. History, clinical information and laboratory work up about these patients were obtained from medical records of the department.
The APRI was accurate in predicting both significant fibrosis and cirrhosis. Using one single cut-off, a prediction of absence or presence of cirrhosis could be made in 80.8% of patients, while a prediction of absence or presence of significant fibrosis could be made in 69.9% of patients. The FIB-4 was more accurate in predicting both significant fibrosis and cirrhosis. Using one single cut-off, a prediction of absence or presence of cirrhosis could be made in 81% of patients, while a prediction of absence or presence of significant fibrosis could be made in 71% of patients.
In conclusion, we showed that the FIB-4 and the APRI scores can predict significant fibrosis and cirrhosis in treatment-naive CHC patients with a very high degree of accuracy. The FIB-4 and the APRI can be determined in the clinic or at the bedside. Using one simple formula, significant fibrosis and cirrhosis can be predicted accurately in treatment-naive CHC patients, potentially avoiding the need for liver biopsies in these patients.
Further prospective studies are needed to validate the FIB-4 and the APRI in a larger number of CHC patients in other institutes, in particular, community-based practices where the prevalence of significant fibrosis and cirrhosis may be lower, and in patients who had received antiviral therapy previously.