Non-Invasive Index for Predicting Significant Liver Fibrosis: Comparison of Diagnostic Performances in Patients with Chronic Hepatitis B and C

Abstract

Background/Aims The majority of non-invasive markers of liver fibrosis have been developed in patients with chronic hepatitis C. We aimed to develop a formula for predicting significant fibrosis in patients with chronic viral hepatitis and to compare the usefulness of published models derived from the data obtained from patients with chronic hepatitis C. Methods Serum markers and the METAVIR stage of fibrosis in liver biopsy specimens were compared prospectively in patients with chronic hepatitis B and C (estimation set, 367; validation set, 159). Results In the estimation set, multiple forward stepwise logistic regression analysis identified c-glutamyl transpeptidase, haptoglobin, a2-macroglobulin, matrix metalloproteinase-2, and tissue inhibitor of metalloproteinase-1 as independent predictors of significant fibrosis. A formula termed the SF index was constructed with the aforementioned five variables. The areas under the receiver operating characteristic curves of the SF index for predicting significant fibrosis were 0.828, 0.776, and 0.827 in the estimation, validation, and total sets, respectively. Using cut-off scores of 2.2 and 3.3, significant fibrosis was predicted with considerable accuracy. The diagnostic performances of the SF index and the Zeng index derived from chronic hepatitis B patients were much better than indices derived from chronic hepatitis C patients, such as the APRI, Forns index, and FIB-4. Conclusions We developed a novel formula for predicting significant fibrosis in patients with chronic viral hepatitis. Serum indices from studies in patients with chronic hepatitis C were less accurate in patients with chronic hepatitis B for predicting significant fibrosis.

Comparison of diagnostic accuracy of aspartate aminotransferase to platelet ratio index and fibrosis‐4 index for detecting liver fibrosis in adult patients with chronic hepatitis B virus infection: A systemic review and meta‐analysis

“…Sixty‐eight full‐text articles were eligible for evaluation and 29 studies were excluded for the similar studies from one center (n = 8), failure to use biopsy (n = 5), data incomplete (n = 8), or small sample size (n = 8). Finally, 39 studies were selected for evaluation and meta‐analysis . All studies included in this review were from Europe and Asia (Fig.…”

“…Twenty‐six studies used the Metavir score, six used the Ishak score, five used the Scheuer score, and one used the Batts and Ludwig score. Thirty‐three studies included HBV‐monoinfected patients (n = 8,789); three studies included HBV‐infected patients with other factors, including alcohol consumption (n = 512); and one study included patients with HCC (n = 76) . According to the QUADAS score, the methodological quality of the included studies was satisfactory (Table ).…”

Significance of Oral Glucose Tolerance Tests in Non-alcoholic Fatty Liver Disease Patients with a Fasting Plasma Glucose Level of <126 mg/dL and HbA1c Level of ≤6.4% in Japan

“…We previously estimated the aspartate aminotransferase platelet ratio index (APRI), calculated as the AST [ULN]/platelet count [10 3 /mL] ×100, from a database (37). Unfortunately, our results did not show the APRI to be a predictor of DM, as most of our patients had either no or mild liver fibrosis.…”

“…Recent studies have demonstrated that non-invasive serum markers can be used to predict the onset of DM (35)(36)(37). We previously estimated the aspartate aminotransferase platelet ratio index (APRI), calculated as the AST [ULN]/platelet count [10 3 /mL] ×100, from a database (37).…”

Associations among serum concentrations of interleukin-18, matrix metalloproteinase-2 (MMP-2), tissue inhibitor of metalloproteinase-1 (TIMP-1) and METAVIR fibrosis score in patients with chronic hepatitis

“…MMPs and TIMPs play an important role in hepatic fibrosis. [1][2][3] In particular, serum MMP-2 concentration has been reported to correlate with the degree of periportal necrosis and fibrosis presented and the total histological activity score [4][5][6] while serum TIMP-1 has been reported to correlate with liver fibrosis in a cohort of HIV-HCV co-infected patients, 6,7 in HCV infection, [8][9][10] in alcoholic liver disease, 11 in HBV infection 12 and in parasitic infestation. 13 What all these studies would seem to indicate is that whatever might be the cause of liver damage, the mechanism of fibrogenesis would appear to be the same.…”