Non-invasive tests in prediction of liver fibrosis in chronic hepatitis B and comparison with post-antiviral treatment results

Clin Res Hepatol Gastroenterol. 2013 Apr;37(2):152-8. doi: 10.1016/j.clinre.2012.07.003. Epub 2013 Feb 4.

Abstract

Background and aim: The aim of this study was to assess and compare the performance of a series of non-invasive tests to detect fibrosis in patients with chronic hepatitis B (CHB).

Patients and methods: Seventy-six patients with CHB, whose blood samples were collected and biopsies were done on the same day, were included in this study. Pre-treatment calculations of aspartate aminotransferase to platelet ratio index (APRI), Forn's index, FIB-4, S-index, Shanghai Liver Fibrosis Group's index (SLFG) and Hepascore(®) were done and relations with mild and advanced fibrosis and cirrhosis were assessed. Post-treatment values of APRI, Forn's index, FIB-4, S-index with oral antiviral agents were also investigated.

Results: APRI, S-index, SLFG, FIB-4, Forn's index and Hepascore(®) had 0.669, 0.669, 0.739, 0.741, 0.753, 0.780; retrospectively Area Under the Receiver Operating Characteristic Curve (AUROC) for significant fibrosis. APRI, Forn's index, S-index, FIB-4, SLFG, and Hepascore(®) had 0.681, 0.714, 0.715, 0.738, 0.747, 0.777 retrospectively AUROC for advanced fibrosis. APRI, SLFG, FIB-4, Forn's index, S-index, and Hepascore(®) had 0.741, 0.742, 0.768, 0.779, 0.792, 0.824 retrospectively AUROC for cirrhosis. APRI, Forn's index, FIB-4 and S-index were significantly lower in post-treatment group compared with pre-treatment group (P-values: <0.05, 0.001, 0.003, 0.018; respectively).

Conclusion: Hepascore(®) showed the best performance to predict significant fibrosis. Our study also suggests that the use of non-invasive test to predict fibrosis in patients with CHB may reduce the need for liver biopsy and may help to monitor the efficacy of treatment.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Alanine Transaminase / blood
  • Antiviral Agents / therapeutic use*
  • Aspartate Aminotransferases / blood
  • Biomarkers / blood
  • Biopsy, Fine-Needle
  • Cross-Sectional Studies
  • Female
  • Hematologic Tests*
  • Hemoglobins / analysis
  • Hepatitis B, Chronic / complications*
  • Hepatitis B, Chronic / drug therapy*
  • Humans
  • Liver / pathology
  • Liver Cirrhosis / blood
  • Liver Cirrhosis / diagnosis*
  • Liver Function Tests
  • Male
  • Middle Aged
  • Platelet Count
  • Predictive Value of Tests
  • ROC Curve
  • Sensitivity and Specificity
  • Serum Albumin / analysis
  • Severity of Illness Index
  • Ultrasonography, Interventional
  • gamma-Glutamyltransferase / blood

Substances

  • Antiviral Agents
  • Biomarkers
  • Hemoglobins
  • Serum Albumin
  • gamma-Glutamyltransferase
  • Aspartate Aminotransferases
  • Alanine Transaminase