Abstract:To evaluate the performance of aspartate transaminase-to-platelet ratio index (APRI) and fibrosis index based on four factors (FIB-4) to predict significant fibrosis and cirrhosis in hepatitis B virus e antigen (HBeAg)-negative chronic hepatitis B (CHB) patients with alanine transaminase (ALT) ≤ twice the upper limit of normal (2 ULN).Histologic and laboratory data of 236 HBeAg-negative CHB patients with ALT ≤ 2 ULN were analyzed. Predicted fibrosis stage, based on established scales and cut-offs for APRI and … Show more
“…The optimal cut‐off values of these noninvasive models discriminating different fibrosis stages were determined by Youden Index and presented in Table , along with corresponding sensitivities, specificities, PPVs and NPVs. Comparing most of the optimal cut‐off values derived from our data with those published before, differences existed.…”
Section: Resultsmentioning
confidence: 54%
“…Some of these noninvasive models have been validated in CHB cohorts, for instance, Desalegn and colleagues did validation on APRI in a CHB cohort in sub‐Saharan Africa, reporting the AUROCs for diagnosing SF and cirrhosis being 0.79 and 0.86 . Nevertheless, comparing with CHC cohorts, data of validation in CHB cohorts were insufficient and diagnostic accuracies of these noninvasive models varied among studies, let alone some of the models, such as fibrosis cirrhosis index (FCI), fibrosis index (FI), Doha score and Virahep‐C model, have not been validated in CHB patients yet. Hence, to comprehensively evaluate diagnostic accuracies of these noninvasive models, more studies on validation in CHB patients, especially those in large cohorts, were imperative.…”
In Chinese HBV-infected patients, Virahep-C models and GPR had high accuracies in diagnosing liver fibrosis and cirrhosis, while the most discussed models like APRI and FIB-4 did not outstand. Assessment should take into account the HBeAg sero-status, since these noninvasive models were more appropriate for HBeAg-positive patients than HBeAg-negative ones.
“…The optimal cut‐off values of these noninvasive models discriminating different fibrosis stages were determined by Youden Index and presented in Table , along with corresponding sensitivities, specificities, PPVs and NPVs. Comparing most of the optimal cut‐off values derived from our data with those published before, differences existed.…”
Section: Resultsmentioning
confidence: 54%
“…Some of these noninvasive models have been validated in CHB cohorts, for instance, Desalegn and colleagues did validation on APRI in a CHB cohort in sub‐Saharan Africa, reporting the AUROCs for diagnosing SF and cirrhosis being 0.79 and 0.86 . Nevertheless, comparing with CHC cohorts, data of validation in CHB cohorts were insufficient and diagnostic accuracies of these noninvasive models varied among studies, let alone some of the models, such as fibrosis cirrhosis index (FCI), fibrosis index (FI), Doha score and Virahep‐C model, have not been validated in CHB patients yet. Hence, to comprehensively evaluate diagnostic accuracies of these noninvasive models, more studies on validation in CHB patients, especially those in large cohorts, were imperative.…”
In Chinese HBV-infected patients, Virahep-C models and GPR had high accuracies in diagnosing liver fibrosis and cirrhosis, while the most discussed models like APRI and FIB-4 did not outstand. Assessment should take into account the HBeAg sero-status, since these noninvasive models were more appropriate for HBeAg-positive patients than HBeAg-negative ones.
“…11 A recent retrospective study that analysed HBeAg-negative HBV patients with ALT levels ≤2 of the upper limit of normal highlighted that conventional scores like FIB-4 and APRI might underestimate the proportion of significant fibrosis and cirrhosis, if the cut-off values are not adjusted to the specific characteristics of the patients (eg HBeAg-negative, normal/mildly elevated ALT). 12 Although most of these algorithms are more effective in detecting significant fibrosis than tests that are based on individual measurements, they do not necessarily increase diagnostic accuracy for cirrhosis. 2 The incorporation of serum GP73 as a biomarker might have the potential to overcome this limitation.…”
Section: See Article On Page 1612mentioning
confidence: 99%
“…Nonetheless, APRI and FIB‐4 scores have significant pitfalls in clinical practice for the assessment of fibrosis, as demonstrated by a study that focused on patients with more advanced disease (97% fibrosis stage ≥2, and 24% had cirrhosis) and a substantial proportion of patients with ALT above twice the upper limit of normal . A recent retrospective study that analysed HBeAg‐negative HBV patients with ALT levels ≤2 of the upper limit of normal highlighted that conventional scores like FIB‐4 and APRI might underestimate the proportion of significant fibrosis and cirrhosis, if the cut‐off values are not adjusted to the specific characteristics of the patients (eg HBeAg‐negative, normal/mildly elevated ALT) …”
“…Entretanto, sua utilização e confiabilidade para predizer fibrose nos pacientes infectados por HBV é assunto amplamente discutido na literatura científica. Alguns autores opõem-se à utilizado do APRI nesses casos107,108 ; enquanto outros defendem a sua utilização[109][110][111][112][113][114][115][116] . Com os dados obtidos neste trabalho não foi possível aderir à um posicionamento ou outro em relação à utilização do APRI para predizer fibrose hepática, uma vez que dados de exames de imagem, como ultrassonografias não foram coletados.…”
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