Prediction of significant fibrosis in HBeAg‐positive patients with chronic hepatitis B by a noninvasive model†

Zeng, Minghui; Lu, Lungen; Mao, Yimin; Qiu, Dekai; Li, Jiqiang; Wan, Mo-Bin; Chen, Cheng-Wei; Wang, Jiyao; Cai, Xiong; Gao, Chunfang; Zhou, Xingtao

doi:10.1002/hep.20960

Cited by 156 publications

(165 citation statements)

References 33 publications

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“…Using a cutoff score of <3.0 ruled out fibrosis while a score of >8.7 predicted significant fibrosis with high accuracy (74).…”

Section: Other Testsmentioning

confidence: 99%

Fibrosis assessment in patients with chronic hepatitis B virus (HBV) infection

Parikh¹,

Ryan²,

Tsochatzis³

2017

Ann. Transl. Med.

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Chronic hepatitis B virus (HBV) infection is a major cause of liver morbidity and mortality worldwide.While a proportion of the 250 million individuals chronically infected with HBV will not come to significant harm or require therapy, many others risk developing complications of the end-stage liver disease such as decompensated cirrhosis and hepatocellular carcinoma (HCC), without intervention. Due to the complex natural history of HBV infection, patients require an expert assessment to interpret biochemistry, viral serology and appropriately stage the disease, and to initiate monitoring and/or therapy where indicated. The detection and quantification of liver fibrosis is a key factor for disease management and prognostication for an individual with HBV. The reliance on invasive liver biopsy to stage disease is diminishing with the advent of robust non-invasive blood-and imagingbased algorithms which can reliably stage disease in many cases. These tests are now incorporated into International guidelines for HBV management and relied upon daily to inform clinical judgement. Both blood-and imagingbased approaches have advantages over liver biopsy, including minimal risks, lower cost, better patient acceptance and speed of results, while disadvantages include lower diagnostic accuracy in intermediate disease stages and variability with co-existing hepatic inflammation or steatosis. This review outlines the methods of fibrosis assessment in chronic HBV infection and focuses on the most commonly used blood-and imaging-based noninvasive tests, reviewing their diagnostic performance and applicability to patient care.

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“…Using a cutoff score of <3.0 ruled out fibrosis while a score of >8.7 predicted significant fibrosis with high accuracy (74).…”

Section: Other Testsmentioning

confidence: 99%

Fibrosis assessment in patients with chronic hepatitis B virus (HBV) infection

Parikh¹,

Ryan²,

Tsochatzis³

2017

Ann. Transl. Med.

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“…Individual serum markers of liver fibrosis are useful for the diagnosis or exclusion of liver cirrhosis, but have limited accuracy for the diagnosis of significant fibrosis [23]. Recently, some fibrosis scores which have been calculated from statistical models were described [8][9][10][14][15][16][17]. Some of the fibrosis scores include serum indices comprised of routine laboratory parameters, and other fibrosis scores require measurement of additional fibrosis markers.…”

Section: Discussionmentioning

confidence: 99%

“…To overcome the limitations of a liver biopsy, a variety of serum markers ranging from routine laboratory tests to more complex indices have been proposed [8][9][10][11][12][13][14][15][16][17], but no single test is sufficient to provide an accurate assessment on hepatic fibrosis for every clinical situation. Assessment of liver fibrosis with multiple serum markers used in combination is sensitive, specific, and reproducible, suggesting that multiple serum markers may be used in conjunction with liver biopsy to assess a range of chronic liver diseases.…”

Section: Introductionmentioning

confidence: 99%

“…Assessment of liver fibrosis with multiple serum markers used in combination is sensitive, specific, and reproducible, suggesting that multiple serum markers may be used in conjunction with liver biopsy to assess a range of chronic liver diseases. Recently, algorithms and indices using clinical and biochemical measurements have been advanced as methods for detecting liver fibrosis in chronic hepatitis C [9,12,14,15,18], and current noninvasive scores give reliable information on liver fibrosis in one-third of patients with chronic hepatitis C, especially when used in combination; however, there are insufficient reports in patients with chronic hepatitis B [13,17,19].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Non-Invasive Index for Predicting Significant Liver Fibrosis: Comparison of Diagnostic Performances in Patients with Chronic Hepatitis B and C

Cheong

Seo

et al. 2010

Dig Dis Sci

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Background/Aims The majority of non-invasive markers of liver fibrosis have been developed in patients with chronic hepatitis C. We aimed to develop a formula for predicting significant fibrosis in patients with chronic viral hepatitis and to compare the usefulness of published models derived from the data obtained from patients with chronic hepatitis C. Methods Serum markers and the METAVIR stage of fibrosis in liver biopsy specimens were compared prospectively in patients with chronic hepatitis B and C (estimation set, 367; validation set, 159). Results In the estimation set, multiple forward stepwise logistic regression analysis identified c-glutamyl transpeptidase, haptoglobin, a2-macroglobulin, matrix metalloproteinase-2, and tissue inhibitor of metalloproteinase-1 as independent predictors of significant fibrosis. A formula termed the SF index was constructed with the aforementioned five variables. The areas under the receiver operating characteristic curves of the SF index for predicting significant fibrosis were 0.828, 0.776, and 0.827 in the estimation, validation, and total sets, respectively. Using cut-off scores of 2.2 and 3.3, significant fibrosis was predicted with considerable accuracy. The diagnostic performances of the SF index and the Zeng index derived from chronic hepatitis B patients were much better than indices derived from chronic hepatitis C patients, such as the APRI, Forns index, and FIB-4. Conclusions We developed a novel formula for predicting significant fibrosis in patients with chronic viral hepatitis. Serum indices from studies in patients with chronic hepatitis C were less accurate in patients with chronic hepatitis B for predicting significant fibrosis.

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“…Considering recent research in which ECM markers or acute-phase proteins have widely been adopted as important components of fibrosis assessment in HBV related liver disease [23][24][25][26], it may seem surprising that both ECM markers and acute-phase proteins did not additionally contribute to the diagnosis of cirrhosis. Before such biomarkers are accepted, their superiority to routine laboratory data should be meticulously appraised.…”

Section: Discussionmentioning

confidence: 99%