Staff Members - Benha University
Assessment of liver fibrosis in Egyptian chronic hepatitis B patients
Medicine • 2018
Publication Information
Authors
Mohammed Tag-Adeen, MD, PhDa,∗, Maha Zeinelabedin Omar, MD, PhDb,Fatma Mohamed Abd-Elsalam, MD, PhDb, Ali Hasaneen, MD, PhDc, Mohamed Ahmed Mohamed, MD, PhDc,Hala Mohamed Elfeky, MD, PhDb, Ebada Mohamed Said, MD, PhDb, Badawy Abdul-Aziz, MD, PhDb,Am
Keywords
AAR, APRI, chronic hepatitis B, Fib-4, noninvasive indexes, RPR, S-index
Journal
Medicine
Publisher
Not Available
Volume
6
Issue
1
Pages
97:6 (e9781)
publication.type
International
Paper Link
Not Available
Supplementary Materials
Not Available
Abstract
Fibrosis assessment in chronic hepatitis B (CHB) is essential for prediction of long-term prognosis and proper treatment decision.
This study was conducted to assess predictability of 5 simple noninvasive fibrosis indexes in comparison to liver biopsy in CHB
patients.
A total of 200 CHB adult Egyptian patients were consecutively included in this study, all were subjected to liver biopsy with staging
of fibrosis using METAVIR scoring system. Fibrosis indexes including S-index, red cell distribution width to platelets ratio index (RPR),
fibrosis-4 index (Fib-4), AST to platelets ratio index (APRI), and AST/ALT ratio index (AAR) were compared to biopsy result and their
predictabilities for the different fibrosis stages were assessed using area under receiver operating characteristic curve (AUROC)
analysis.
S-index showed the highest AUROCs for predicting fibrosis among the studied indexes. AUROCs of S-index, RPR, Fib-4, APRI,
and AAR were: 0.81, 0.67, 0.70, 0.68, and 0.60 for prediction of significant fibrosis (F2–F4), 0.90, 0.66, 0.68, 0.67, and 0.57 for
advanced fibrosis (F3–F4), and 0.96, 0.62, 0.61, 0.57, and 0.53 for cirrhosis (F4), respectively. The optimal S-index cutoff for ruling in
significant fibrosis was ≥0.3 with 94% specificity, 87% PPV, and 68% accuracy, while that for ruling out significant fibrosis was
This study was conducted to assess predictability of 5 simple noninvasive fibrosis indexes in comparison to liver biopsy in CHB
patients.
A total of 200 CHB adult Egyptian patients were consecutively included in this study, all were subjected to liver biopsy with staging
of fibrosis using METAVIR scoring system. Fibrosis indexes including S-index, red cell distribution width to platelets ratio index (RPR),
fibrosis-4 index (Fib-4), AST to platelets ratio index (APRI), and AST/ALT ratio index (AAR) were compared to biopsy result and their
predictabilities for the different fibrosis stages were assessed using area under receiver operating characteristic curve (AUROC)
analysis.
S-index showed the highest AUROCs for predicting fibrosis among the studied indexes. AUROCs of S-index, RPR, Fib-4, APRI,
and AAR were: 0.81, 0.67, 0.70, 0.68, and 0.60 for prediction of significant fibrosis (F2–F4), 0.90, 0.66, 0.68, 0.67, and 0.57 for
advanced fibrosis (F3–F4), and 0.96, 0.62, 0.61, 0.57, and 0.53 for cirrhosis (F4), respectively. The optimal S-index cutoff for ruling in
significant fibrosis was ≥0.3 with 94% specificity, 87% PPV, and 68% accuracy, while that for ruling out significant fibrosis was