Assessment of liver fibrosis in Egyptian chronic hepatitis B patients A comparative study including 5 noninvasive indexes

作者：Tag Adeen Mohammed; Omar Maha Zeinelabedin; Abd Elsalam Fatma Mohamed; Hasaneen Ali; Mohamed Mohamed Ahmed; Elfeky Hala Mohamed; Said Ebada Mohamed; Abdul Aziz Badawy; Osman Amira Hefney; Ahmed Enas Sebaey; Osman Ghada Sidky; Abdul Samie Taghreed

来源：Medicine, 2018, 97(6): e9781.

DOI：10.1097/MD.0000000000009781

• AAR
• APRI
• chronic hepatitis B
• Fib-4
• noninvasive indexes
• RPR
• S-index

Fibrosis assessment in chronic hepatitis B (CHB) is essential for prediction of long-term prognosis and proper treatment decision. This study was conducted to assess predictability of 5 simple noninvasive fibrosis indexes in comparison to liver biopsy in CHB patients.
A total of 200 CHB adult Egyptian patients were consecutively included in this study, all were subjected to liver biopsy with staging of fibrosis using METAVIR scoring system. Fibrosis indexes including S-index, red cell distribution width to platelets ratio index (RPR), fibrosis-4 index (Fib-4), AST to platelets ratio index (APRI), and AST/ALT ratio index (AAR) were compared to biopsy result and their predictabilities for the different fibrosis stages were assessed using area under receiver operating characteristic curve (AUROC) analysis.
S-index showed the highest AUROCs for predicting fibrosis among the studied indexes. AUROCs of S-index, RPR, Fib-4, APRI, and AAR were: 0.81, 0.67, 0.70, 0.68, and 0.60 for prediction of significant fibrosis (F2-F4), 0.90, 0.66, 0.68, 0.67, and 0.57 for advanced fibrosis (F3-F4), and 0.96, 0.62, 0.61, 0.57, and 0.53 for cirrhosis (F4), respectively. The optimal S-index cutoff for ruling in significant fibrosis was >= 0.3 with 94% specificity, 87% PPV, and 68% accuracy, while that for ruling out significant fibrosis was <0.1 with 96% sensitivity, 91% NPV, and 67% accuracy. Accuracy of S-index was higher for predicting cirrhosis (91%) than that for predicting advanced fibrosis (79%) and significant fibrosis (68%).
S-index has the highest predictability for all fibrosis stages among the studied fibrosis indexes in HBeAg-negative CHB patients, with higher accuracy in cirrhosis than in the earlier fibrosis stages.

• 出版日期2018-2