Comparison of invasive and non-invasive methods for assessment of liver fibrosis in patients with chronic hepatitis B and hepatitis C virus infections

Author:

Majzoobi Mohammad Mahdi12ORCID,Heidari Behnoosh3ORCID,Keramat Fariba12,Poorolajal Jalal4ORCID,Ghasemi Basir Hamid Reza5ORCID,Soltanian Ali Reza6ORCID,Eini Peyman12ORCID

Affiliation:

1. Brucellosis Research Center, Hamadan University of Medical Sciences, Hamadan, Iran

2. Department of Infectious Diseases, Sina Hospital, Hamadan University of Medical Sciences, Hamadan, Iran

3. Infectious Diseases Specialist, Homozgan University of Medical Sciences, Bandar Abbas, Iran

4. Research Center for Health Sciences and Department of Epidemiology, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran

5. Department of Pathology, Sina Hospital, Hamadan University of Medical Sciences, Hamadan, Iran

6. Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran

Abstract

Introduction: Different methods are employed to determine the severity of chronic viral hepatitis and liver fibrosis Objectives: This study was conducted to compare invasive and non-invasive tests for assessment of liver fibrosis in the patients with chronic hepatitis B and C. Patients and Methods: In this study, the results of liver biopsy based on the METAVIR scoring system were compared with biomarkers, including fibrosis-4 (FIB-4) and aspartate aminotransferase-to-platelet ratio index (APRI) for identifying liver fibrosis. Results: Out of 194 patients, 63 and 131 patients had hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, respectively. There was a significant difference between patients with METAVIR stages 0-1 and patients with METAVIR stages 2-3, based on the FIB-4, aspartate aminotransferase (AST) to platelet ratio index (APRI) and the mean prothrombin time (PT), international normalized ratio (INR), platelet (PLT), alanine transaminase (ALT) and AST. A correlation was found between the FIB-4 and APRI indices and the METAVIR score of patients with hepatitis. The FIB-4 index, with a cut-off value <1.1 for detecting liver fibrosis in patients with HBV infection, showed sensitivity of 83.3%, specificity of 64.7%. Further, a positive predictive value (PPV) of 35.7%, and a negative predictive value (NPV) of 94.3% was detected. On the other hand, the APRI index, with a cut-off value <0.73, showed 59% sensitivity, 76.5% specificity, PPV of 33.3% and NPV of 86.7%. The FIB-4 index, with a cut-off value <1.47 for detecting liver fibrosis in patients with HCV infection, showed 73.7% sensitivity, 73.2% specificity, PPV of 31.8%, and NPV of 94.3%. Additionally, the APRI index, with a cut-off value <1.7, showed 42.1% sensitivity, 97.3% specificity, PPV of 72.7% and NPV of 90.8%. Conclusion: According to the results, in patients with chronic hepatitis, the severity of liver fibrosis increased with an increase in the APRI and FIB-4 indices. Therefore, these two indices can replace biopsy under certain circumstances.

Publisher

Maad Rayan Publishing Company

Subject

Immunology and Microbiology (miscellaneous),Hematology,Immunology,Endocrinology, Diabetes and Metabolism

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