Gamal, S., Nasser, M., Mohamed, S., Sally, A., Reham, S., Nabiel, M. (2018). Noninvasive markers for staging fibrosis in chronic hepatitis B patients. Medical Journal of Viral Hepatitis, 2.2(2), 17-23. doi: 10.21608/mjvh.2018.55737
Shiha Gamal; Mousa Nasser; Salah Mohamed; Abed Sally; Soliman Reham; Mikhail Nabiel. "Noninvasive markers for staging fibrosis in chronic hepatitis B patients". Medical Journal of Viral Hepatitis, 2.2, 2, 2018, 17-23. doi: 10.21608/mjvh.2018.55737
Gamal, S., Nasser, M., Mohamed, S., Sally, A., Reham, S., Nabiel, M. (2018). 'Noninvasive markers for staging fibrosis in chronic hepatitis B patients', Medical Journal of Viral Hepatitis, 2.2(2), pp. 17-23. doi: 10.21608/mjvh.2018.55737
Gamal, S., Nasser, M., Mohamed, S., Sally, A., Reham, S., Nabiel, M. Noninvasive markers for staging fibrosis in chronic hepatitis B patients. Medical Journal of Viral Hepatitis, 2018; 2.2(2): 17-23. doi: 10.21608/mjvh.2018.55737
Noninvasive markers for staging fibrosis in chronic hepatitis B patients
1Internal Medicine dept., Mansoura Univ., Egypt, Egyptian Liver Research Institute and Hospital (ELRIH), Sherbin, El-Mansoura, Egypt.
2Tropical Medicine dept., Mansoura Univ., Egypt.
3Tropical Medicine dept., Port Said, Univ., Egypt. & Egyptian Liver Research Institute and Hospital (ELRIH), Sherbin, Mansoura
4Egyptian Liver Research Institute and Hospital (ELRIH), Sherbin, El-Mansoura, Biostatistics dept., South Egypt Cancer Institute, Assiut Univ., Egypt
Abstract
Background: Noninvasive evaluation of liver fibrosis in chronic hepatitis B (CHB) is a growing research field. We planed to study and assess the act of some non-invasive forms in Egyptian patients with chronic hepatitis B. Patients and Methods: The present study involved 109 patients who had chronic hepatitis B infection. The scoring models involved; AST to ALT ratio (AAR), age-platelet index (API), AST-toplatelet- ratio-index (APRI) and Fibrosis-4 (FIB-4), transient elastography (TE) as non invasive indicators for staging fibrosis in chronic hepatitis B patients were measured in all patients. Agreement between the results of serum biomarker and those of transient elastography was assessed by Kappa (ê) index. The optimal cutoff points used for these tests were settled on by maximizing Kappa index. The performance of serum markers was judged by receiver operator characteristic (ROC) curves. The work of each manner for differentiating significant fibrosis, advanced fibrosis, and cirrhosis was weighted against. Results: API, APRI and FIB4 showed statistically significant differences (p-value <0.0001) in distinguishing significant fibrosis, advanced fibrosis, and cirrhosis, while AAR showed statistically insignificant differences (p-value >0.05) in that differentiation. The cutoff values of AAR, API, APRI and FIB4 showed a successive increase in values when the stage of fibrosis progressed from significant fibrosis to advanced fibrosis to cirrhosis. The AUROC in distinguishing significant fibrosis and advanced fibrosis was highest in APRI and higher in FIB4 than API while in distinguishing cirrhosis it was highest in API and higher in APRI than FIB4. Conclusion: API, APRI and FIB-4 could reliably distinguish significant fibrosis, advanced fibrosis and cirrhosis while AAR is not a reliable predictor to distinguish significant fibrosis or advanced fibrosis.
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