Assessment of Noninvasive Methods for Prediction of Fibrosis in Patients with Chronic Hepatitis B

Abstract

Noninvasive markers of liver fibrosis have been most extensively studied. The aim of this study was to evaluate and compare the diagnostic accuracies of some of these simple fibrosis tests, aspartate aminotrasferase platelet ratio (APRI), age platelet (AP) index, FIB-4 score and aspartate aminotrasferase (AST)/alanin aminotrasferase (ALT) ratio (AAR) in patients with chronic hepatitis B (CHB). Eighty male and 34 female patients were included into the study. Liver biopsy of CHB patients were evaluated histologically and significant fibrosis was defined with Scheurer fibrosis score 2 or more. All these test results were compared with liver histology. Significant fibrosis was detected in 34 patients. Older age, high serum AST and gama-glutamil transferase levels and low platelet count were found as a predictive risk factors for signficant fibrosis (p< 0.05). Only older age was found independent risk factor by multivariate analysis (p< 0.001). In patients with significant fibrosis, high levels of mean FIB-4 score, AP index and APRI were detected (p< 0.05). Area under receiver operating characteristic (ROC) curve of FIB-4 score, AP index, APRI and AAR for predicting significant fibrosis were 0.827, 0.788, 0.729 and 0.580, respectively. Existance or exclusion of significant fibrosis was reliably predicted by FIB-4 score, AP index, APRI and AAR in 75%, 77%, 33% and 67% of the patients, respectively. In conclusion, FIB-4 score and AP index were found to be the most suitable scores for predicting existance or exclusion of significant fibrosis in CHB patients. Age was found to be a significant factor indicating the presence of fibrosis, therefore it was thought that, scores using age as a component, might be more succesfull for predicting fibrosis.

Keywords

• Hepatitis B
• Chronic
• Biopsy
• Fibrosis
• Diagnosis