Development of a fibrosis index including hepatitis B virus basal core promoter A1762T mutation for pretherapeutic evaluation

作者：Yeh Christopher Sung Huan^*; Hsu Chao Wei; Liang Kung Hao; Chen Yi Cheng; Lin Chih Lang; Chien Rong Nan; Hu Tsung Hui; Lin Wey Ran; Lai Ming Wei; Chu Yu De; Yeh Chau Ting^*

来源：Journal of Gastroenterology and Hepatology, 2018, 33(8): 1530-1537.

DOI：10.1111/jgh.14120

• age-stratified analysis
• basal core promoter
• genotype
• hepatitis B virus
• liver fibrosis

Background and AimCommonly used non-invasive fibrosis scores usually included serum transaminase levels in the equations, including Aspartate transaminase to Platelet Ratio Index (APRI) and fibrosis-4 (FIB-4). Transaminases fluctuated significantly in chronic hepatitis B patients with exacerbations, leading to unsteady score values. As such, here, we aim to develop a transaminase-free score suitable for pretherapeutic evaluation of fibrosis stages.
MethodsFirstly, 1082 treatment-naive chronic hepatitis B patients were enrolled and divided into modeling (n=541) and verification (n=541) cohorts. Secondly, 265 patients having received liver biopsy, with known Ishak fibrosis stages, were included for independent correlation.
ResultsCross-sectional analysis of 1082 patients revealed age-dependent variation of association between virological factors and cirrhosis. A fibrosis score including Anti-hepatitis B e antibody, Basal core promoter (BCP) A1762T mutation, and Platelet count Index (named ABPI) was derived from the modeling cohort. ABPI performed better than APRI and FIB-4 in the verification cohort for identifying cirrhotic patients (comparison of area under the receiver operating characteristic curves: ABPI vs APRI and FIB-4=0.785 vs 0.563 [P<0.001] and 0.700 [P=0.026], respectively). The performance of ABPI was even better in young (<40years old) hepatitis B patients (area under the receiver operating characteristic curves: 0.856 vs 0.402 [P<0.001] and 0.599 [P=0.009], respectively). Finally, in the independent cohort of 265 patients with known Ishak fibrosis stages, it was found that ABPI effectively distinguished between Ishak fibrosis stages 3 and >3 and between 4 and >4 (P<0.001 for each).
ConclusionsWe developed a transaminase-free fibrosis score (ABPI) utilizing basal core promoter A1762T data, which outperformed APRI and FIB-4.

• 出版日期2018-8
• 单位长春大学