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FIBS-enabled Noninvasive Metabolic Profiling
Published on: February 3, 2014
Profile and value of FIB-4 in patients with dual chronic hepatitis C and B
Chun-Jen Liu1,2,3, Tai-Chung Tseng1,3, Wan-Ting Yang3
1Division of Gastroenterology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Insights
The FIB-4 index can identify patients with chronic hepatitis B and C coinfection at risk of liver cirrhosis and HCC. This simple biomarker is valuable even for patients undergoing antiviral therapy.
Area of Science:
- Hepatology
- Virology
- Biomarker Research
Background:
- Chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infection pose risks for adverse liver outcomes.
- Coinfection with HBV and HCV may exacerbate these risks.
- The predictive role of the Fibrosis-4 (FIB-4) index in coinfected patients remains unclear.
Purpose of the Study:
- To investigate the association between the FIB-4 index and the development of liver cirrhosis and hepatocellular carcinoma (HCC) in patients with chronic HBV/HCV coinfection.
- To evaluate the FIB-4 index's utility in predicting clinical outcomes in coinfected individuals, including those receiving treatment.
Main Methods:
- Retrospective study of 152 non-cirrhotic patients with chronic HBV and HCV coinfection.
- Patients were divided into treated (n=56) and untreated (n=96) groups.
- The association between baseline FIB-4 index and the incidence of liver cirrhosis and HCC was analyzed over a median follow-up of 9.88 years.
Main Results:
- The treated group showed a higher rate of hepatitis B surface antigen seroclearance compared to the untreated group.
- The incidence of liver cirrhosis and HCC was significantly lower in the treated group than in the untreated group.
- A higher baseline FIB-4 index correlated with an increased risk of liver cirrhosis and HCC, particularly in the treated group.
Conclusions:
- The FIB-4 index is a valuable tool for identifying Taiwanese patients with chronic HCV/HBV coinfection who are at risk of adverse liver events.
- Its predictive utility extends to patients receiving pegylated interferon/ribavirin therapy.
- FIB-4 index levels decreased in patients who achieved sustained virological response after treatment.
Background And Aims:
Patients with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection are at risk of developing adverse outcomes. Coinfection with both viruses may further increase the risk. Currently, little is known about the role of fibrosis-4 (FIB-4) index, a simple liver fibrosis stage biomarker, in predicting the clinical outcomes.
Methods:
We retrospectively enrolled 152 non-cirrhotic patients with dual chronic HCV and HBV infection: 56 patients received pegylated interferon/ribavirin therapy, while 96 patients remained untreated. The association between the FIB-4 index and the incidence of liver cirrhosis and hepatocellular carcinoma (HCC) was explored.
Results:
After a 9.88-year follow-up, the incidence of hepatitis B surface antigen seroclearance was 4.97 (95% confidence interval: 3.13-7.89) per 100 person-years in the treated group and was 1.77 (1.10-2.85) in the untreated group. Of the treated group, only three and six patients developed HCC and liver cirrhosis, respectively, while 17 and 23 patients developed HCC and liver cirrhosis, respectively, in untreated group. Baseline FIB-4 index correlated with the development of liver cirrhosis in multivariable analysis of all subjects. High baseline FIB-4 index (per 1 point increase) in the treated groups was associated with a higher risk of developing liver cirrhosis (P = 0.001) and HCC (P = 0.038) in univariable analysis. FIB-4 index decreased only in the treated group who achieved sustained virological response (n = 34, FIB-4 index decreasing from 1.84 to 1.55).
Conclusions:
In Taiwanese patients coinfected with HCV and HBV, FIB-4 index helps identify patients at risk of developing adverse events, even in patients receiving pegylated interferon/ribavirin therapy.
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