Original Article Value of Egy-Score in diagnosis of significant, advanced hepatic fibrosis and cirrhosis compared to aspartate aminotransferase-to-platelet ratio index, FIB-4 and Forns’ index in chronic hepatitis C virus Mohamed Alboraie, 1 Marwa Khairy, 2 Marwa Elsharkawy, 3 Noha Asem, 4 Aisha Elsharkawy 2 and Gamal Esmat 2 1 Internal Medicine Department, Faculty of Medicine, Al-Azhar University and Egyptian Liver Fibrosis Study Group, 2 Endemic Medicine Department and Hepatology Unit, 3 Clinical and Chemical Pathology Department, and 4 Public Health and Community Medicine Department, Faculty of Medicine, Cairo University, Cairo, Egypt Aim: Serum markers and developed scores are of rising importance in non-invasive diagnosis of hepatic fibrosis. Aspartate aminotransferase-to-platelet ratio index (APRI), FIB-4 and Forns’ index are validated scores used for diagnosis of liver fibrosis. The Egy-Score is a newly developed score for detection of hepatic fibrosis with promising results. We aimed to assess the accuracy of the Egy-Score in the diagnosis of significant fibrosis, advanced fibrosis and cirrhosis compared to APRI, FIB-4 and Forns’ in chronic hepatitis C virus (HCV) patients. Methods: A retrospective study including 100 chronic hepatitis C naïve Egyptian patients was performed. Patients were classified according to stages of fibrosis into three groups: significant fibrosis (≥ F2), advanced fibrosis (≥ F3) and cirrhosis (F4). Egy-Score, APRI, FIB-4 and Forns’ index were calculated. Regression analysis and receiver–operator curves were plotted to assess the sensitivity, specificity and predic- tive values for the significant scores with the best cut-off for diagnosis. Results: An Egy-Score of 3.28 or more was superior to APRI, FIB-4 and Forns’ index for detecting advanced fibrosis with a sensitivity of 91% and specificity of 78%. An Egy-Score of 3.67 or more was superior to APRI, FIB-4 and Forns’ index for detecting cirrhosis with a sensitivity of 82% and specificity of 87%. Forns’ index was superior to Egy-Score, FIB-4 and APRI for detecting significant fibrosis. Conclusion: The Egy-Score is a promising, accurate, easily calculated, cost-effective score in the prediction of hepatic fibrosis in chronic HCV patients with superiority over APRI, FIB-4 and Forns’ index in advanced hepatic fibrosis and cirrhosis. Key words: aspartate aminotransferase-to-platelet ratio index, chronic hepatitis C virus, Egy-Score, FIB-4, Forns’, hepatic fibrosis INTRODUCTION H EPATITIS C VIRUS (HCV) infection is one of the main causes of chronic liver disease worldwide, 1 with the number of chronically infected persons possibly exceeding 200 million persons. 2 HCV is con- sidered a major cause of chronic hepatitis, liver cirrho- sis, hepatocellular carcinoma and liver transplantation. 3 Advanced fibrosis and cirrhosis have been shown to be major independent predictors of non-response to chronic HCV treatment. 4 Liver biopsy is recommended to measure stages of hepatic fibrosis, but its value is being questioned because of its potential risks and the concern of sam- pling error. 5 Alternative non-invasive methods for pre- diction of fibrosis are studied to establish information on the extent of fibrosis by focusing on non-invasive blood marker panels. 6 Correspondence: Dr Marwa Khairy, Endemic Medicine Department and Hepatology Unit, Kasr El-Aini Faculty of Medicine, Cairo University, 15 street 305 New Maadi, Cairo, Egypt. Email: marwakhairy79@hotmail.com Conflict of interest: The authors have no conflict of interest. Received 8 April 2014; revision 24 June 2014; accepted 25 June 2014. Hepatology Research 2014 doi: 10.1111/hepr.12385 © 2014 The Japan Society of Hepatology 1