Patient selection: adults (age >= 18 years) with chronic viral hepatitis C
Parameters associated with significant inflammation (active hepatitis)
(1) spider nevi
(2) ferritin > 200 µg/L
(3) albumin <= 3.5 g/dL
(4) hepatomegaly
(5) splenomegaly
(6) WBC count <= 4,000 per µL
(7) ALT > 120 IU/L (3 times the upper limit of normal reference range)
(8) bilirubin > 20 µmol/L
Predictive model for significant inflammation:
(1) ferritin >= 200 µg/L
(2) presence of spider nevi and/or albumin <= 3.5 g/dL
The probability of significant inflammation is high if 2 of the criteria are present. The risk is very low if no criteria are present.
Parameters associated with significant fibrosis:
(1) age >= 40 years of age
(2) spider nevi
(3) history of decompensation
(4) hepatomegaly
(5) splenomegaly
(6) WBC count <= 4,000 per µL
(7) platelet count <= 150,000 per µL
(8) INR > 1.2
(9) albumin <= 3.5 g/dL
Predictive model for significant fibrosis:
(1) spider nevi
(2) platelet count <= 150,000 per µL
(3) splenomegaly and/or albumin <= 3.5 g/dL
The probability of significant fibrosis is high if 2 or 3 of the criteria are present. The risk is low if no criteria are present.
Parameters associated with cirrhosis:
(1) ALT > 120 IU/L
(2) spider nevi
(3) history of decompensation
(4) hepatomegaly
(5) splenomegaly
(6) total bilirubin > 20 µmol/L
(7) platelet count <= 150,000 per µL
(8) INR > 1.2
(9) albumin <= 3.5 g/dL
