The liver fibrosis index is superior to the APRI and FIB-4 for predicting liver fibrosis in chronic hepatitis B patients in China

Abstract

BackgroundThe purpose of this study was to prospectively investigate the value of real-time ultrasound elastography (RTE) for the diagnosis of liver fibrosis (LF) in patients with chronic hepatitis B (CHB), to correlate the elastography findings with the histologic stage of LF and to compare RTE findings with those from noninvasive tests of LF calculated using laboratory blood parameters.MethodsLiver biopsies, laboratory blood testing, and RTE were performed in 91 patients with CHB. The LF index (LFI) was calculated using a multiple linear regression equation involving 11 parameters, which represented the degree of LF. The higher the LFI is, the greater the degree of LF.ResultsThe mean aspartate aminotransferase-to-platelet ratio index (APRI) and the mean fibrosis index based on four factors (FIB-4) were significantly different for the 5 stages of LF, respectively. The APRI (r = 0.43, P = 0.006), FIB-4 (r = 0.51, P = 0.012) and LFI (r = 0.562, P = 0.004) were correlated with the stages of LF. For discriminating stage F0 from F1, only the LFI had significant power (P = 0.026) for predicting stage F1. For discriminating stage F4 from F3, only the LFI had statistically significant power (P = 0.024) in predicting stage F4. The areas under the receiver operating characteristic curves (AUCs) of the LFI for diagnosing significant, advanced LF and liver cirrhosis were significantly higher than those of the APRI and FIB-4, and the LFI had better sensitivity and specificity.ConclusionsThe LFI calculated by RTE is reliable for the assessment of LF in patients with CHB and has better discrimination power than the APRI and FIB-4.

Body mass index (BMI) and alpha-fetoprotein (AFP) level correlate with the severity of HCV-induced fibrosis in a cohort of Egyptian patients with chronic HCV

“…However, there was a slight increase in the percentage of males especially in the severe group, in accordance with studies [30,51,52]. This issue remains controversial, as laboratory analysis showed no significant difference between the studied groups, in accordance with several studies [59][60][61], while other studies contradict our observations [62][63][64][65]. It is possible, though, that the overrepresentation of male subjects relates to HCV infection in general [52] and is not associated with a certain complication or its severity.…”

Hepatitis B Virus: From Diagnosis to Treatment

“…The WHO recommends AST to platelet ratio index (APRI) calculated according to the formula: APRI = [AST/AST ULN (upper limit of normal) × 100/platelet count (10 9 /l] to estimate the stage Diagnosis and treatment of hepatitis B virus 4 395 of liver fibrosis (WHO 2017b). TE is another noninvasive method; however, due to its limitations such as high cost, inaccurate results with elevated ALT levels, restriction with liver necro-inflammation, and obesity, the WHO recommends the APRI index as a relatively accurate method for predicting advanced liver fibrosis (EASL 2017; WHO 2017b; Huang et al 2019). It has been recommended that 40 IU/ml as ULN value should be used in the APRI formula (WHO 2017b).…”

Review of Serum Biomarkers and Models Derived from Them in HBV-Related Liver Diseases

“…Moreover, Huang et al [88] also found that APRI and FIB-4 had a worse predictive ability for identifying significant, advanced LF and cirrhosis than real-time ultrasound elastography in CHB patients in China, with lower sensitivity and accuracy.…”