ÿþ<!DOCTYPE HTML PUBLIC "-//W3C//DTD HTML 4.01 Transitional//EN" "http://www.w3.org/TR/html4/loose.dtd"> <html> <head> <meta http-equiv="Content-Type" content="text/html; charset=iso-8859-1"> <title>EASL 2010 - Poster Presentations</title> <link rel="stylesheet" type="text/css" href="style.css"> </head> <body> <table width="750" align="center" border="0" cellspacing="0" cellpadding="0" class="MainTable"> <tr> <td><img src="http://www2.kenes.com/liver-congress/PublishingImages/top_ei.jpg" width="760" height="129" /></td> </tr> <tr> <td class="content"><h1>Poster Presentations</h1> <P><b>Session Title:</b> Category 8b. ALCOHOLIC DRUG-INDUCED AND FATTY LIVER DISEASE: b. DILI AND ACLOHOLIC LIVER DISEASE<br><b>Presentation Date:</b> Apr 17, 2010</P><h2 align='left'><B>INTERPRETABILITY AND REFERENCE VALUES OF LIVER INJURY BIOMARKERS FIBROTEST AND ACTITEST (FT-AT). A GLOBAL ANALYSIS OF 354,143 CONSECUTIVE ASSESSMENTS</B></h2> <p align='left'><b>T. Poynard</b><sup>1</sup>*, M. Munteanu<sup>2</sup>, O. Deckmyn<sup>2</sup>, Y. Ngo<sup>2</sup>, F. Drane<sup>2</sup>, D. Messous<sup>1</sup>, V. Ratziu<sup>1</sup>, J.M. Castille<sup>2</sup>, C. Housset<sup>1</sup>, F. Imbert-Bismut<sup>1</sup>, FibroFRANCE<br> <em><sup>1</sup>UPMC APHP Paris Liver Center, <sup>2</sup>Biopredictive, Paris, France. *thierry@poynard.com</em></p><br> <p align='justify'>FT-AT are biomarkers combining six serum components, validated for the diagnosis of fibrosis stage and necroinflammatory activity grade, in four most frequent fibrotic liver diseases.<br><b>The aim</b> was to estimate the prevalence of biochemical profiles at risk of false positives/negatives (RFPN) and to identify factors associated with their occurrences.<br> <b><b>Methods: </b></b> Consecutive assessments were performed in 4 populations: 954 blood donors (P1), 7,494 healthy volunteers (P2), 345,695 subjects with suspected liver disease (P3), including 24,872 in a reference center (P4) with recorded clinical data. References values (98% percentiles) were estimated in P1 and P2; usual patients´ values in P3. RFPN were defined as a FT with a component with an abnormal value (1% percentile) and for which the switch by the usual median value lead to a FT variation of at least 0.30 (equivalent to more than one METAVIR stage). Analytical procedures of Laboratories with RFPN>5% were reviewed. P4 RFPN charts were revised by experts. <br> <b><b>Results: </b></b> In P1 mean FT=0.11 (98% percentiles 0.01-0.41), AT=0.08 (0.01-0.40); in P2 FT=0.17 (0.02-0.52), AT=0.11 (0.02-0.52). Prevalence of RFPN was 0% in P1 and P2, 0.97% in P3 (Haptoglobin FP 0.46%; ApoA1 FN 0.21%; A2M FP 0.12% and FN 0.12%, others < 0.05%), and 1.97% in P4. In HIV infection RFPN was 1.77% (46/2602). On the basis of logistic regression, the main factors associated (P< 0.0001) with RFPN were age (Haptoglobin FP, A2M FP and FN, and ApoA1 FN), laboratory activity (< 10.000 tests associated with A2M FP and ApoA1 FN), and HIV co-infection (associated with FP haptoglobin). Because of traceability in P3 laboratories with RFPFN >5% analytical procedures for A2M and ApoA1 were improved, resulting in a significant decrease in RFPN from 18.31% to 2.01% (P< 0.0001). Traceability among P4 lead us to identify rare causes of RFPN such as cardiac ascites and extreme malnutrition for A2M FN, or macrophage activation syndrome for A2M FP. <br> <b><b>Conclusion: </b> </b>The global interpretability rate of FT-AT was 99.3%, including 98.2% in HIV infected patients. Traceability has permitted to reduce the risk of analytical errors and to identify new clinical causes of errors.<br></p> <br><a href='Session-P03-8b.htm'>Back</a><br> <p>&nbsp;</p> <p>&nbsp;</p></td> </tr> </table> </body> </html>