Albumin–Bilirubin Score Differentiates Liver Fibrosis Stage and Hepatocellular Carcinoma Incidence in Chronic Hepatitis B Virus Infection: A Retrospective Cohort Study

Fujita, Koji; Nomura, Takako; Morishita, Asahiro; Oura, Kyoko; Yoneyama, Hirohito; Kobara, Hideki; Tsutsui, Kunihiko; Himoto, Takashi; Masaki, Tsutomu

doi:10.4269/ajtmh.19-0129

Cited by 17 publications

(18 citation statements)

References 30 publications

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“…Currently, application of ALBI score is limited in cirrhosis patients, similar to the Child Pugh score. However, our previous studies have clari ed that the ALBI score has the potential to differentially diagnose brosis stage 4 from stage 1 to 3 in HCV infection, HBV infection, and PBC [34][35][36]. In AIH, ALBI score was able to diagnose brosis stage 4 regardless of the in ammatory severity of the hepatitis at any stage of the disease.…”

Section: Discussionmentioning

confidence: 94%

Prognosis of Probable Autoimmune Hepatitis Patients in a Retrospective Cohort Study

Fujita

Oura

Tadokoro

et al. 2020

Preprint

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Background: Autoimmune hepatitis (AIH) is an idiopathic inflammatory liver disease with genetic susceptibility and unknown environmental triggers, which results in failures of physiologic immunotolerance and destruction of the liver tissues. The gold standard for diagnosis is the International Autoimmune Hepatitis Group (IAIHG) scoring system: the disease is classified as definite or probable according to the scores. However, conventional research on probable AIH has focused on the Caucasian population and there is little data pertaining to the Asian population. Therefore, this study aimed to assess and compare the prognosis of Japanese patients with probable and definite AIH. Methods: Patients with probable and definite AIH diagnosed based on IAIHG scores between 1987 and 2018 were enrolled in this retrospective study. Results: Seventy-two patients with definite AIH and 49 patients with probable AIH were evaluated in the study. Univariate analysis revealed age, fibrosis stage 4, and the fibrosis-4 index were prognostic factors for overall survival. Multivariate analysis indicated that age and liver cirrhosis significantly affected the overall survival. When the cut off albumin-bilirubin score was set appropriately, cirrhosis was differentially diagnosed using albumin-bilirubin score with 100% sensitivity and 70.5% specificity. Classification of probable or definite disease did not alter overall survival with statistical significance. Conclusions: Our findings suggest that probable AIH should be managed as definite AIH is managed in Japanese population. The albumin-bilirubin score helps identify liver cirrhosis and is a prognostic biomarker for overall survival.

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Section: Discussionmentioning

confidence: 94%

Prognosis of Probable Autoimmune Hepatitis Patients in a Retrospective Cohort Study

Fujita

Oura

Tadokoro

et al. 2020

Preprint

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“…A previous study found that the albumin-bilirubin (ALBI) score can be used for liver fibrosis staging in Japanese chronic hepatitis B patients and can help distinguish cirrhotic from noncirrhotic status. 21 The author found that ALBI scores significantly differed between stage 3 and stage 2 fibrosis and between stage 4 and stage 3 fibrosis. The higher the ALB levels, the lower is the liver fibrosis stage.…”

Section: Discussionmentioning

confidence: 97%

Hepatitis B core‐related antigen serum levels are associated with significant liver fibrosis in treatment‐naive chronic HBV infection patients

Liu

et al. 2022

Journal of Viral Hepatitis

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Several hepatitis B virus (HBV) serum markers have been identified as risk factors for liver fibrosis in patients with chronic HBV infection, and several noninvasive fibrosis tests based on serum indexes are now used to identify the severity of liver fibrosis. We aimed to identify the relationship between hepatitis B core‐related antigen (HBcrAg) serum levels and liver fibrosis in treatment‐naive chronic HBV infection patients. A total of 246 treatment‐naive chronic HBV infection patients were enrolled in this study. All of the patients underwent liver biopsies at baseline. Using the METAVIR fibrosis stages, there were 15, 140, 50, 26 and 15 patients in the F0, F1, F2, F3 and F4 stages (METAVIR scoring system), respectively. The biochemical, serological and virological parameters were measured using standard laboratory procedures. The HBcrAg serum levels of the patients were examined via ELISA. HBcrAg serum levels of F2, F3 and F4 stage patients were significantly higher than those of nonsignificant liver fibrosis patients (METAVIR F0‐F1), but there were no significant differences among F2, F3 and F4 stage patients. Serum HBcrAg (OR, 2.18; 95% confidence interval [CI], 1.51–3.16), albumin (ALB) (OR, 0.60; 95% CI, 0.41–0.87), prothrombin activity (PTA) (OR, 0.58; 95% CI, 0.40–0.83) and platelet (PLT) counts (OR, 0.38; 95% CI, 0.25–0.57) were associated with significant liver fibrosis (METAVIR F2‐F4). The serum HBcrAg value enabled the correct identification of patients with significant fibrosis, with an area under the receiver operating characteristic curve of 0.81 (95% CI, 0.75–0.88). The APRI, FIB‐4 index and ALBI score can identify significant liver fibrosis with an area under the ROC curve of 0.74 (95% CI, 0.66–0.81), 0.73 (95% CI, 0.65–0.80) and 0.63 (95% CI, 0.55–0.72), respectively. Compared with these three indexes, the accuracy rate of diagnosis of significant fibrosis based on HBcrAg was higher than that of the FIB‐4 index (p = 0.0479) and ALBI score (p = 0.0030). HBcrAg, ALB, PTA serum levels and PLT counts were associated with significant liver fibrosis in treatment‐naive chronic HBV infection patients. HBcrAg serum levels enabled the correct identification of patients with significant fibrosis (METAVIR F2–F4), and HBcrAg was more effective than the FIB‐4 index and ALBI score.

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“…and Lu et al [35] . ALB has been con rmed as an independent indicator of advanced liver brosis in patients with NAFLD [36] , and it can also signi cantly contribute to the index for staging liver brosis in patients with viral hepatitis [37,38] . A/G was used as biomarkers in many cases such as tumor prognosis [39][40][41] and chronic diseases [42][43][44] , but only one study involved A/G into the brosis markers [45] .…”

Section: Fibrosis-related Clinical Factorsmentioning

confidence: 99%

Radiomics Analysis of Contrast-enhanced CT for Staging Liver Fibrosis: An Update for Image Biomarker

Wang

Tang

Mao

et al. 2021

Preprint

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BackgroundTo establish and validate a radiomics-based model for staging liver fibrosis at contrast-enhanced CT images.Materials and MethodsThis retrospective study developed two radiomics-based models (R-score: radiomics signature; R-fibrosis: integrate radiomic and serum variables) in a training cohort of 332 patients (median age, 59 years; interquartile range, 51-67 years; 256 men) with biopsy-proven liver fibrosis who underwent contrast-enhanced CT between January 2017 and December 2020. Radiomic features were extracted from non-contrast, arterial and portal phase CT images and selected by using the least absolute shrinkage and selection operator (LASSO) logistic regression to differentiate stage F3-F4 from stage F0-F2. Optimal cutoffs to diagnose significant fibrosis (stage F2-F4), advanced fibrosis (stage F3-F4) and cirrhosis (stage F4) were determined by receiver operating characteristic curve analysis. Diagnostic performance was evaluated by area under the curve, Obuchowski index, calibrations and decision curve analysis. An internal validation was conducted in 111 randomly assigned patients (median age, 58 years; interquartile range, 49-66 years; 89 men).ResultsIn the validation cohort, R-score and R-fibrosis (Obuchowski index, 0.843 and 0.846, respectively) significantly outperformed aspartate transaminase-to-platelet ratio (APRI) (Obuchowski index, 0.651; P < .001) and fibrosis-4 index (FIB-4) (Obuchowski index, 0.676; P < .001) for staging liver fibrosis. By using the cutoffs, R-fibrosis and R-score had a sensitivity range of 70%-87%, specificity range of 71%-97%, and accuracy range of 82%-86% in diagnosing significant fibrosis, advanced fibrosis and cirrhosis.ConclusionRadiomic analysis of contrast-enhanced CT images can reach great diagnostic performance of liver fibrosis.

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Albumin–Bilirubin Score Differentiates Liver Fibrosis Stage and Hepatocellular Carcinoma Incidence in Chronic Hepatitis B Virus Infection: A Retrospective Cohort Study

Cited by 17 publications

References 30 publications

Prognosis of Probable Autoimmune Hepatitis Patients in a Retrospective Cohort Study

Prognosis of Probable Autoimmune Hepatitis Patients in a Retrospective Cohort Study

Hepatitis B core‐related antigen serum levels are associated with significant liver fibrosis in treatment‐naive chronic HBV infection patients

Radiomics Analysis of Contrast-enhanced CT for Staging Liver Fibrosis: An Update for Image Biomarker

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