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dc.contributor.authorPapaluca, T
dc.contributor.authorCraigie, A
dc.contributor.authorMcDonald, L
dc.contributor.authorEdwards, A
dc.contributor.authorMacIsaac, M
dc.contributor.authorHolmes, JA
dc.contributor.authorJarman, M
dc.contributor.authorLee, T
dc.contributor.authorHuang, H
dc.contributor.authorChan, A
dc.contributor.authorLai, M
dc.contributor.authorSundararajan, V
dc.contributor.authorDoyle, JS
dc.contributor.authorHellard, M
dc.contributor.authorStoove, M
dc.contributor.authorHowell, J
dc.contributor.authorDesmond, P
dc.contributor.authorIser, D
dc.contributor.authorThompson, AJ
dc.date.accessioned2020-12-09T22:34:14Z
dc.date.available2020-12-09T22:34:14Z
dc.date.issued2020-11-18
dc.identifierpii: PONE-D-20-24228
dc.identifier.citationPapaluca, T., Craigie, A., McDonald, L., Edwards, A., MacIsaac, M., Holmes, J. A., Jarman, M., Lee, T., Huang, H., Chan, A., Lai, M., Sundararajan, V., Doyle, J. S., Hellard, M., Stoove, M., Howell, J., Desmond, P., Iser, D. & Thompson, A. J. (2020). Non-invasive fibrosis algorithms are clinically useful for excluding cirrhosis in prisoners living with hepatitis C. PLOS ONE, 15 (11), https://doi.org/10.1371/journal.pone.0242101.
dc.identifier.issn1932-6203
dc.identifier.urihttp://hdl.handle.net/11343/253004
dc.description.abstractBACKGROUND AND AIMS: Prison-based HCV treatment rates remain low due to multiple barriers, including accessing transient elastography for cirrhosis determination. The AST-to-platelet ratio index (APRI) and FIB-4 scores have excellent negative predictive value (NPV) in hospital cohorts to exclude cirrhosis. We investigated their performance in a large cohort of prisoners with HCV infection. METHODS: This was a retrospective cohort study of participants assessed by a prison-based hepatitis program. The sensitivity, specificity, NPV and positive predictive value (PPV) of APRI and FIB-4 for cirrhosis were then analysed, with transient elastography as the reference standard. The utility of age thresholds as a trigger for transient elastography was also explored. RESULTS: Data from 1007 prisoners were included. The median age was 41, 89% were male, and 12% had cirrhosis. An APRI cut-off of 1.0 and FIB-4 cut-off of 1.45 had NPVs for cirrhosis of 96.1% and 96.6%, respectively, and if used to triage prisoners for transient elastography, could reduce the need for this investigation by 71%. The PPVs of APRI and FIB-4 for cirrhosis at these cut-offs were low. Age ≤35 years alone had a NPV for cirrhosis of 96.5%. In those >35 years, the APRI cut-off of 1.0 alone had a high NPV >95%. CONCLUSION: APRI and FIB-4 scores can reliably exclude cirrhosis in prisoners and reduce requirement for transient elastography. This finding will simplify the cascade of care for prisoners living with hepatitis C.
dc.languageEnglish
dc.publisherPUBLIC LIBRARY SCIENCE
dc.rights.urihttps://creativecommons.org/licenses/by/4.0
dc.titleNon-invasive fibrosis algorithms are clinically useful for excluding cirrhosis in prisoners living with hepatitis C
dc.typeJournal Article
dc.identifier.doi10.1371/journal.pone.0242101
melbourne.affiliation.departmentMedicine (St Vincent's)
melbourne.affiliation.departmentInfectious Diseases
melbourne.affiliation.facultyMedicine, Dentistry & Health Sciences
melbourne.source.titlePLoS One
melbourne.source.volume15
melbourne.source.issue11
melbourne.source.pagese0242101-
melbourne.identifier.nhmrc1142976
dc.rights.licenseCC BY
melbourne.elementsid1480244
melbourne.openaccess.pmchttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC7673506
melbourne.contributor.authorHellard, Margaret
melbourne.contributor.authorDesmond, Paul
melbourne.contributor.authorSundararajan, Vijaya
melbourne.contributor.authorThompson, Alexander
melbourne.contributor.authorHowell, Jessica
melbourne.contributor.authorHolmes, Jacinta
melbourne.contributor.authorDOYLE, JOSEPH
melbourne.contributor.authorPapaluca, Timothy
dc.identifier.eissn1932-6203
melbourne.identifier.fundernameidNHMRC, 1142976
melbourne.accessrightsOpen Access


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