Development and validation of a novel score for fibrosis staging in patients with chronic hepatitis B

Wu, Daxian; Rao, Qiong; Chen, Wenqian; Ji, Feiyang; Xie, Zhongyang; Huang, Kaizhou; Chen, Ermei; Zhao, Yalei; Ouyang, Xiaoxi; Zhang, Sainan; Jiang, Zhengyi; Zhang, Lingjian; Xu, Linjie; Gao, Hainv; Li, Lanjuan

doi:10.1111/liv.13756

Cited by 12 publications

(9 citation statements)

References 44 publications

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“…GPR is a new noninvasive marker for liver fibrosis in patients with chronic HBV infection despite the diagnostic value of GPR being atypical [10,11,[41][42][43]. Our findings demonstrated the good performance of GPR in predicting significant fibrosis, advanced fibrosis and cirrhosis, with AUROCs of 0.75, 0.74, and 0.80.…”

Section: Discussionmentioning

confidence: 63%

INR-to-platelet ratio (INPR) as a novel noninvasive index for predicting liver fibrosis in chronic hepatitis B

Ding¹,

Zheng²,

Huang³

et al. 2021

Int. J. Med. Sci.

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Objective: We aimed to investigate whether a novel noninvasive index, i.e., the international normalized ratio-to-platelet ratio (INPR), was a variable in determining liver fibrosis stage in patients with chronic hepatitis B (CHB). Methods: A total of 543 treatment-naïve CHB patients were retrospectively enrolled. Liver histology was assessed according to the Metavir scoring scheme. All common demographic and clinical parameters were analyzed. Results: Based on routine clinical parameters (age, sex, HBeAg status, HBV DNA, hematological parameters, coagulation index, and liver biochemical indicators), a novel index, i.e., the INR-to-platelet ratio (INPR), was developed to magnify the unfavorable effects of liver fibrosis on INR and platelets. The AUCs of INPR for predicting significant fibrosis, advanced fibrosis, and cirrhosis were 0.74, 0.76 and 0.86, respectively. Compared with APRI, FIB-4, and GPR, the INPR had comparable predictive efficacy for significant fibrosis and better predictive performance for advanced fibrosis and cirrhosis. Conclusion: INPR could be an accurate, easily calculated and inexpensive index to assess liver fibrosis in patients with CHB. Further studies are needed to verify this indicator and compare it with other noninvasive methods for predicting liver fibrosis in CHB patients.

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Section: Discussionmentioning

confidence: 63%

INR-to-platelet ratio (INPR) as a novel noninvasive index for predicting liver fibrosis in chronic hepatitis B

Ding¹,

Zheng²,

Huang³

et al. 2021

Int. J. Med. Sci.

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“…A study of 2343 CHB patients revealed that serum ChE was closely correlated with liver fibrosis, and the GCPR model including ChE presented better diagnostic performance than GPR in differentiating significant fibrosis and cirrhosis ( 26 ). Wu et al ( 27 ) also reported that serum ChE was an independent indicator of advanced fibrosis in CHB patients. Of note, serum ChE activity can be affected by several factors, such as obesity, diabetes, uremia, hyperthyroidism, and lipid metabolism disorder ( 24 ).…”

Section: Discussionmentioning

confidence: 93%

Development and Validation of a Non-invasive Model to Predict Liver Histological Lesions in Chronic Hepatitis B Patients With Persistently Normal Alanine Aminotransferase and Detectable Viremia

Wang

et al. 2022

Front. Med.

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BackgroundA critical and controversial issue is whether antiviral therapy should be recommended in chronic hepatitis B virus (HBV) infection patients with persistently normal alanine aminotransferase (PNALT) and detectable HBV DNA. The study aimed to develop a non-invasive model for predicting significant liver histological changes (SLHC), which is the histological indication for antiviral therapy in chronic hepatitis B (CHB) patients with PNALT and detectable HBV DNA.Methods398 chronic HBV infection patients with PNALT and detectable HBV DNA who underwent liver biopsy were divided into the estimation set (n = 256) and validation set (n = 142). A multivariate logistic regression model was developed to predict SLHC in the estimation set, and the diagnostic performance was further validated in the validation set.Results132 patients (33.2%) with PNALT and detectable HBV DNA had SLHC. Aspartate aminotransferase (AST), cholinesterase (ChE), and liver stiffness measurement (LSM) were identified as the independent predictors of SLHC. The AUROC of the SLHC index, which combined AST, ChE, and LSM, was 0.824 and 0.816 in the estimation and validation set, respectively, for the prediction of SLHC. Applying the SLHC index ≤ 0.15, the presence of SLHC could be excluded with high negative predictive value in the estimation set (93.2%) and in the validation set (90.2%). Applying the SLHC index ≥ 0.55, the presence of SLHC could be considered with high positive predictive value in the estimation set (79.2%) and in the validation set (76.5%).ConclusionThe SLHC index provides a high accuracy in predicting liver histological indication for antiviral therapy in CHB patients with PNALT and detectable HBV DNA.

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“…It was reported that thyroid function was a good index of hepatic function, and that levels of thyroid hormones could be used as indicators to evaluate severity of liver injury in CHB patients. [14][15][16][17][18] Several studies have suggested a potential relationship between thyroid function and inflammatory activity in liver disease.…”

Section: Discussionmentioning

confidence: 99%

“…During liver injury, thyroid dysfunction will occur. [14][15][16][17][18] However, the patterns of thyroid hormone abnormalities vary markedly among patients. Bano et al 13 found that higher TSH levels were a risk factor for fibrosis in patients with nonalcoholic fatty liver disease.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, thyroid function could be used to evaluate the severity of liver injury in CHB patients and as a prognostic indicator for patients with liver cirrhosis. [14][15][16][17][18] These studies suggested a potential relationship between thyroid function and inflammatory activity during liver disease. To date, no studies have addressed the relationship between thyroid function and liver inflammatory activity, especially based on METAVIR inflammatory scores.…”

Section: Introductionmentioning

confidence: 99%

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Predictors of inflammatory activity in treatment-naive hepatitis B e-antigen-negative patients with chronic hepatitis B infection

Wang²,

Jiang³

et al. 2020

J Int Med Res

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Objective Liver inflammatory activity staging is critical to guide the treatment of chronic hepatitis B virus (CHB) infection. Here, we aimed to identify practical clinical biomarkers of moderate inflammatory activity in hepatitis B e-antigen (HBeAg)-negative CHB patients. Methods Treatment-naïve HBeAg-negative CHB patients who underwent liver biopsy at our hospital from 1 January 2013 to 31 December 2016 were enrolled. Markers of inflammatory activity were analyzed using binary logistic regression. The area under the receiver operator characteristic curve (AUROCC) was used to assess diagnostic accuracy. Results A total of 106 HBeAg-negative treatment-naive CHB patients were enrolled. According to their METAVIR inflammatory scores, 30.2% of patients were in stage ≥A2. Total triiodothyronine (TT3) and hepatitis B virus (HBV) DNA levels were predictors of moderate inflammatory activity (A ≥ 2). The AUROCCs of TT3 and HBV DNA levels were 0.651 and 0.797, respectively. The optimal cut-off values for TT3 and HBV DNA were 1.755 nmol/L and 4.61 log10 IU/mL, respectively. Conclusions A sizable proportion of treatment-naive HBeAg-negative CHB patients required antiviral treatment (30.2%) after undergoing liver biopsy. TT3 and HBV DNA helps identify patients with moderate inflammatory activity (A ≥ 2), potentially reducing the need for liver biopsies and helping guide treatment of CHB patients.

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Development and validation of a novel score for fibrosis staging in patients with chronic hepatitis B

Abstract: FT4 may be an indicator for fibrosis staging in chronic hepatitis B patients. FibroStage is a better model than aspartate transaminase-to-platelet ratio index, fibrosis-4, FibroIndex, Forn, and Lok for the comprehensively diagnosis of significant and advanced fibrosis and cirrhosis.

Cited by 12 publications

References 44 publications

INR-to-platelet ratio (INPR) as a novel noninvasive index for predicting liver fibrosis in chronic hepatitis B

INR-to-platelet ratio (INPR) as a novel noninvasive index for predicting liver fibrosis in chronic hepatitis B

Development and Validation of a Non-invasive Model to Predict Liver Histological Lesions in Chronic Hepatitis B Patients With Persistently Normal Alanine Aminotransferase and Detectable Viremia

Predictors of inflammatory activity in treatment-naive hepatitis B e-antigen-negative patients with chronic hepatitis B infection

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