Validation and comparison of simple noninvasive models for the prediction of liver fibrosis in chronic hepatitis C

Amorim, Thabata Glenda Fenili; Staub, Guilherme Jönck; Lazzarotto, César; Silva, André Pacheco; Manes, Jóice; Ferronato, Maria da Graça; Shiozawa, Maria Beatriz Cacese; Narciso-Schiavon, Janaína Luz; Dantas-Corrêa, Esther Buzaglo; Schiavon, Leonardo de Lucca

doi:10.1016/s1665-2681(19)31410-3

Cited by 43 publications

(7 citation statements)

References 36 publications

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“…This was in agreement with many authors. [28][29][30][31][32] The viral load correlated positively with the hepatic fibrosis severity and AFP, whereas RBP4 correlated positively with the platelet count, and negatively with fibrosis stage, viral load, AFP, and the five non-invasive fibrosis indices (APRI, CDS, Fib-4, GUCI, Lok index). PLR correlated negatively with fibrosis stage and the five non-invasive fibrosis indices.…”

Section: Discussionmentioning

confidence: 99%

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<p>The Utility of Retinol-Binding Protein 4 in Predicting Liver Fibrosis in Chronic Hepatitis C Patients in Response to Direct-Acting Antivirals</p>

Fayed¹,

Mahmoud²,

Ali³

2020

CEG

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Background: Hepatic fibrosis grading is crucial for chronic hepatitis C (CHC) patients in monitoring liver disease progression and antiviral treatment indication. Retinol-binding protein 4 (RBP4), an adipokine secreted by adipocytes and hepatocytes, has variable levels in health and disease. Purpose: To comparatively evaluate RBP4 serum levels in predicting liver fibrosis in CHC versus fibroscan, noninvasive fibrosis, and inflammatory indices. Patients and Methods: Cohort study included 50 naive non-obese CHC patients and 20 age-, sex-and body mass index-matched healthy subjects. Fibroscan, RBP4, and noninvasive fibrosis as APRI, CDS, FIB-4, GUCI, Lok index indices based on serological markers, and inflammatory indices as platelet to lymphocyte ratio (PLR) and liver regeneration markers as; alpha-fetoprotein (AFP) and APRI, were evaluated in response to direct-acting antivirals (DAAs). Results: RBP4 was significantly lower in patients than in controls (P=0.0001) and progressively decreased with the increase in fibrosis grade (F0-F=41.42±3.08), (F2=39.32±1.43), (F3-F4= 35.31±0.5), (P=0.0001). Liver function, stiffness, and RBP4 significantly improved after treatment (P=0.0001). RBP4 negatively correlated with viral load (r=−0.78, p=0.0001), fibroscan fibrosis grade (r=−0.52, p=0.0001), AFP (r=−0.63, p=0.0001), and positively correlated with platelet (r=0.424, p=0.0001), and white cell count (r=0.298, p=0.002). RBP4 at a cutoff value <40.55 ng/mL might predict significant fibrosis (90.48% sensitivity, 62.5% specificity, AUROC=0.811, 95% CI=67.5-90.0) and at a cutoff value <35.9 ng/mL could predict advanced fibrosis (100% sensitivity, 100% specificity, AUROC =1.0, 95% CI=0.929-1). Conclusion: RBP4 showed excellent accuracy, sensitivity, specificity, PPV, and NPV. RBP4 has a superior diagnostic performance in predicting advanced fibrosis grads in CHC patients and hence can replace expensive invasive procedures.

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Section: Discussionmentioning

confidence: 99%

“…This was in line with the finding of other authors. [29][30][31][32][33][34][35] RBP4 is the most superior, likewise fibroscan, with an outstanding performance in predicting significant and advanced fibrosis, followed by Fib-4 score, GUCI, APRI, LOK index, CDC, and PLR. This is in line with other authors.…”

Section: Discussionmentioning

confidence: 99%

<p>The Utility of Retinol-Binding Protein 4 in Predicting Liver Fibrosis in Chronic Hepatitis C Patients in Response to Direct-Acting Antivirals</p>

Fayed¹,

Mahmoud²,

Ali³

2020

CEG

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“…[11,12] The APRI and FIB-4 scores have been reported to identify hepatitis C-related fibrosis in many studies, thus alleviating the need for the invasive liver biopsy. [10,13,14] Sonderup et al [15] emphasised the importance of these scores in the assessment of liver fibrosis in the context of hepatitis C in sub-Saharan Africa, as they are cheap, available, easy to interpret and can be done in an outpatient setting. However, these scores have not been reported on in HCV-infected individuals in SA or sub-Saharan Africa.…”

Section: Researchmentioning

confidence: 99%

“…Similar results have been reported by others. [13,14] Implementing these scores in clinical practice can reduce the need for invasive liver biopsies. Interestingly, the same fibrosis scores have been found to have limitations when used in hepatitis B patients.…”

Section: Researchmentioning

confidence: 99%

Hepatitis C infection at a tertiary hospital in South Africa: Clinical presentation, non-invasive assessment of liver fibrosis, and response to therapy

et al. 2020

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“…[6] However, APRI, FIB-4, and FIB-5 scoring systems seem to be insufficient in some studies to differentiate early stage fibrosis from advanced fibrosis due to their low sensitivity and positive predictive values. [7] Our study was designed to evaluate how effective the APRI, FIB-4, and FIB-5 scoring systems are in predicting liver fibrosis in CHB patients who underwent liver biopsy for treatment decision.…”

Section: Introductionmentioning

confidence: 99%

How effective are APRI, FIB-4, FIB-5 scores in predicting liver fibrosis in chronic hepatitis B patients?

et al. 2022

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Liver fibrosis is the most important factor in the prognosis and treatment plan of patients with chronic hepatitis B (CHB). Aspartate aminotransferase (AST)-to-platelet ratio index (APRI), fibrosis index based on 4 factors (FIB-4), and fibrosis index based on 5 factors (FIB-5) scores are noninvasive fibrosis markers, and previous comparative studies have shown that they are as effective as liver biopsy in detecting liver fibrosis in different liver diseases. The aim of our study is to investigate whether existing scoring systems are effective in demonstrating fibrosis in CHB patients and to compare the APRI, FIB 4, and FIB 5 scores in differentiating early and advanced fibrosis in 123 patients who underwent liver biopsy for CHB infection. APRI, FIB-4, and FIB-5 scores of patients who underwent liver biopsy due to CHB were calculated by means of calculators and recorded to be compared with liver biopsies in terms of fibrosis scoring. One hundred twenty-three patients who underwent liver biopsy due to chronic hepatitis B were included in the study. APRI (area under the receiver-operating characteristic [ROC] curve 0.728), FIB-4 (area under the ROC curve 0.693) and FIB-5 (area under the ROC curve 0.643) scores were evaluated as significant predictors of advanced fibrosis. The scoring system with the highest positive and negative predictive value was evaluated as FIB-4. APRI, FIB-4, and FIB-5 scoring systems are appropriate scoring systems in the assessment of advanced fibrosis in patients with CHB. Our study is the first to compare APRI, FIB-4, and FIB-5 values in CHB patients, and more comprehensive studies are needed.Abbreviations: APRI = aspartate aminotransferase (AST)-to-platelet ratio index, CHB = chronic hepatitis B, FIB-4 = fibrosis index based on 4 factors, FIB-5 = fibrosis index based on 5 factors, NSF = non-significant fibrosis, ROC = receiver-operating characteristic, SF = significant fibrosis.

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Validation and comparison of simple noninvasive models for the prediction of liver fibrosis in chronic hepatitis C

Cited by 43 publications

References 36 publications

<p>The Utility of Retinol-Binding Protein 4 in Predicting Liver Fibrosis in Chronic Hepatitis C Patients in Response to Direct-Acting Antivirals</p>

<p>The Utility of Retinol-Binding Protein 4 in Predicting Liver Fibrosis in Chronic Hepatitis C Patients in Response to Direct-Acting Antivirals</p>

Hepatitis C infection at a tertiary hospital in South Africa: Clinical presentation, non-invasive assessment of liver fibrosis, and response to therapy

How effective are APRI, FIB-4, FIB-5 scores in predicting liver fibrosis in chronic hepatitis B patients?

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