Evaluation of APRI and FIB-4 scoring systems for non-invasive assessment of hepatic fibrosis in chronic hepatitis B patients

• Published in: Journal of hepatology 2016-04, Vol.64 (4), p.773-780
• Main Authors: Kim, W. Ray, Berg, Thomas, Asselah, Tarik, Flisiak, Robert, Fung, Scott, Gordon, Stuart C, Janssen, Harry L.A, Lampertico, Pietro, Lau, Daryl, Bornstein, Jeffrey D, Aguilar Schall, Raul E, Dinh, Phillip, Yee, Leland J, Martins, Eduardo B, Lim, Seng Gee, Loomba, Rohit, Petersen, Jörg, Buti, Maria, Marcellin, Patrick
• Format: Article
• Language: English
• Subjects: Adult; APRI; Aspartate Aminotransferases - blood; Biopsy; Chronic hepatitis B; Female; FIB-4; Fibrosis; Gastroenterology and Hepatology; Hepatitis B, Chronic - complications; Humans; Liver - pathology; Liver Cirrhosis - blood; Liver Cirrhosis - diagnosis; Male; Platelet Count; Severity of Illness Index
• ISSN: 0168-8278; 1600-0641
• DOI: 10.1016/j.jhep.2015.11.012

Background & Aims While the gold standard in the assessment of liver fibrosis remains liver biopsy, non-invasive methods have been increasingly used for chronic hepatitis B (CHB). This study aimed to evaluate the performance of two commonly used non-invasive scoring systems (aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis index based on four factors (FIB-4)) to predict fibrosis stage in CHB patients. Methods Demographic, histologic and clinical laboratory data from two trials investigating tenofovir disoproxil fumarate in CHB were analyzed. Predicted fibrosis stage, based on established scales and cut-off values for APRI and FIB-4 scores, was compared with Ishak scores obtained from liver biopsy at baseline and at 240 week follow-up. Results In the 575 patients with a baseline liver biopsy, APRI and FIB-4 scores correlated with Ishak stage ( p