Performance of noninvasive tools for identification of minimal liver fibrosis in patients with hepatitis B virus infection.

Abstract

BACKGROUND:

Various noninvasive liver fibrosis assessment tools are available. Here, we evaluated the performance of the asparagine aminotransferase-to-platelet ratio index (APRI), the fibrosis-4 index (FIB-4), transient elastography (TE), and the globulin-platelet (GP) ratio for identifying liver fibrosis in patients with hepatitis B virus (HBV) infection.

METHODS:

A total of 146 patients were assessed using TE, FIB-4, APRI, the GP ratio, and liver biopsy. Three patient grouping methods were applied: any fibrosis (AF; F0 vs. F1/2/3/4); moderate fibrosis (MF; F0/1 vs. F2/3/4); and severe fibrosis (SF; F0/1/2 vs. F3/4). Receiver operating characteristic (ROC) curve analysis, univariate analyses, and multivariate logistic regression were conducted.

RESULTS:

Regardless of patient-grouping method, the area under the curve (AUC) of TE and the GP ratio were similar. Using the AF grouping method, the GP ratio showed superior performance compared with APRI and FIB-4: the AUCs for the GP ratio, TE, APRI, and FIB-4 were 0.76, 0.75, 0.70, and 0.66, respectively. Using the MF grouping method, the GP ratio also showed superior performance compared with APRI and FIB-4: the AUCs for the GP ratio, TE, APRI, and FIB-4 were 0.66, 0.68, 0.57, and 0.53, respectively. Using the SF grouping method, the AUCs for the GP ratio, TE, APRI, and FIB-4 were not significantly different.

CONCLUSION:

Compared with FIB-4 and APRI, the GP ratio had higher accuracy for identifying liver fibrosis, especially early-stage fibrosis, in patients with HBV infection.

• Authors: Hong Zhang, XinXing Shi, Lin Wang, Yilan Zeng, Xintong Kang, Liang Huang
• Journal: Journal of clinical laboratory analysis (J Clin Lab Anal) Vol. 35 Issue 9 Pg. e23960 (Sep 2021) ISSN: 1098-2825 [Electronic] United States
• PMID: 34403524 (Publication Type: Journal Article)
• Copyright: © 2021 The Authors. Journal of Clinical Laboratory Analysis published by Wiley Periodicals LLC.

Chemical References

• Globulins
• Aspartate Aminotransferases

Topics

• Adult
• Aspartate Aminotransferases (metabolism)
• Blood Platelets (pathology)
• China (epidemiology)
• Elasticity Imaging Techniques (methods)
• Female
• Globulins (metabolism)
• Hepatitis B (complications, virology)
• Hepatitis B virus (isolation & purification)
• Humans
• Liver Cirrhosis (diagnosis, epidemiology, virology)
• Male
• ROC Curve
• Severity of Illness Index