Liver function test identifies difficult to diagnose patients with HCV

Intelligent liver function testing successfully identified patients with hepatitis C who were previously undiagnosed, many of whom did not fit traditional at-risk profiles, according to a presentation at the International Liver Conference.

Intelligent liver function testing (iLFT) involves applying an algorithm to blood results, a fibrosis score and clinical data including an HCV immunoglobulin g test to generate a likely diagnosis and management plan from 32 possible outcomes such as HCV.

“[Liver function testing] has the potential to aid, identify and offer treatment to hard-to-reach HCV positive patients, thus allowing us to reach both the WHO and Scotland’s HCV eradication deadlines,” Callum R. Livingstone, medical student at the University of Dundee, said during his presentation.

The researchers considered older patients without over risk factors among those difficult to diagnose with HCV.

In the retrospective cohort analysis study based in Scotland, Livingstone and colleagues investigated whether iLFT could successfully identify HCV positive patients. The researchers studied patients who exhibited an impaired liver function response above 30 in an alanine aminotransferase test between August 2018 and 2020.

During the two years, 6,791 patients underwent iLFT, which yielded HCV antibody-positive diagnoses in 49 individuals. Among the patients with an HCV diagnosis, 20 had no detectable HCV RNA. Out of these 29 patients, 26 completed their recommended treatment.

Overall, the mean age of patients with HCV antibodies was 51 years. These patients usually lived in an affluent area and did not inject drugs. The 24 patients with sustained viral responses were older (mean of 53 years) and were also less likely to have a history of drug use.

“iLFT is non-clinician biased and identifies patients who do not have overt risk factors: those who do not inject drugs, are of an older age and live in more affluent areas,” Livingstone said.