Albumin–bilirubin score indicates liver fibrosis staging and prognosis in patients with chronic hepatitis C

Abstract

Aim Albumin–bilirubin (ALBI) grade was investigated to predict prognosis of patients with cirrhosis. It was defined using the ALBI score calculated based on serum total bilirubin and albumin, which represent liver function. The diagnostic accuracy for liver fibrosis staging in patients with chronic hepatitis using the ALBI score has not been investigated well. This study aimed to evaluate the diagnostic abilities of the ALBI score for liver fibrosis staging in chronic hepatitis and cirrhosis in Japanese patients with hepatitis C virus (HCV) infection. Methods Japanese patients with HCV infection who underwent liver biopsy examinations were enrolled in a retrospective study. Fibrosis staging and activity grading were assessed using the modified METAVIR score. The ALBI score was calculated according to the following equation: Log10 total bilirubin (μmol/L) × 0.66 + albumin (g/L) × (−0.085). Results A total of 382 patients were enrolled in this study. The ALBI score differentiated fibrosis stage 4 from 3 and stage 3 from 2 (P < 0.05). When an ALBI score of −2.125 was adopted as a cut‐off value, the sensitivity and specificity were 73.2% and 87.1%, respectively, with a positive likelihood ratio of 5.67 to differentiate stage 4 from stages 1–3. Kaplan–Meier analysis showed that smaller ALBI scores at baseline correlated with better hepatocellular carcinoma (HCC)‐free and overall survival (P < 0.05). Conclusions The ALBI score indicates liver fibrosis staging in Japanese patients with HCV infection. Furthermore, smaller ALBI scores predict better HCC‐free survival and overall survival. The ALBI score has the potential to expand its application from cirrhosis to chronic hepatitis.

Prognosis of Probable Autoimmune Hepatitis Patients in a Retrospective Cohort Study

“…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.…”

Clinicopathologic Features of Patients With Primary Hepatocellular Carcinoma Surviving Without Recurrence More Than 10 Years After Primary Hepatic Resection

“…We previously reported that ALBI combined with the TNM classification predicts recurrence-free survival of patients after hepatectomy [33]. Furthermore, lower ALBI correlates with longer HCC-free survival of patients with chronic HCV hepatitis [34].…”

Favorable outcome of retreatment by direct‐acting antivirals for hepatitis C patients with daclatasvir plus asunaprevir combination therapy failure

“…The ALBI score was originally proposed as an indicator for hepatic functional reserve in patients with HCC. 16 However, the ALBI score was recently reported to indicate liver fibrosis and prognosis in patients with chronic hepatitis C. 26 We calculated it for evaluating hepatic functional reserve. It has been reported that improvement of the synthetic ability of the liver and increased albumin were observed in HCV-infected patients who obtained an SVR with DCV + ASV.…”

“…The ALBI score was originally proposed as an indicator for hepatic functional reserve in patients with HCC . However, the ALBI score was recently reported to indicate liver fibrosis and prognosis in patients with chronic hepatitis C . We calculated it for evaluating hepatic functional reserve.…”