Using AST-platelet ratio index and fibrosis 4 index for detecting chronic hepatitis C in a large-scale community
Yuan-Hung Kuo1,2, Kwong-Ming Kee1, Nien-Tzu Hsu1,3
1Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
Insights
Aspartate transaminase-platelet ratio index (APRI) and Fibrosis 4 (FIB-4) scores effectively identify individuals with higher risks of Hepatitis C virus (HCV) infection and hepatocellular carcinoma (HCC) during community screenings.
Area of Science:
- Hepatology
- Public Health
- Non-invasive Diagnostics
Background:
- Liver fibrosis assessment is crucial for managing liver diseases.
- Non-invasive markers like APRI and FIB-4 offer alternatives to liver biopsy.
- Community screenings provide opportunities for early detection of liver conditions.
Purpose of the Study:
- To evaluate the utility of APRI and FIB-4 in detecting chronic viral hepatitis in community settings.
- To assess the correlation between APRI/FIB-4 scores and hepatitis status, including Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV).
- To determine the association of these non-invasive markers with the risk of hepatocellular carcinoma (HCC).
Main Methods:
- A large-scale community-based health screening was conducted in Tainan city from 2004 to 2013.
- APRI and FIB-4 scores were calculated for 180,359 participants aged 40 and older.
- Statistical analysis was performed to correlate scores with hepatitis status (HBV, HCV) and HCC development.
Main Results:
- Prevalence of chronic HCV increased significantly with higher APRI and FIB-4 cut-offs.
- APRI (≥0.7) and FIB-4 (≥3.5) showed strong correlations with HCV infection and HCC development at the township level.
- No significant correlation was found between APRI/FIB-4 scores and HBV infection.
Conclusions:
- Community screenings utilizing APRI and FIB-4 can effectively identify individuals at higher risk for underlying HCV infection.
- These non-invasive markers are valuable tools for predicting the risk of incident HCC in community settings.
- APRI and FIB-4 demonstrate potential for targeted screening and management of liver disease in the general population.
Background:
Aspartate transaminase-platelet ratio index (APRI) and fibrosis 4 (FIB-4) are two non-invasive indexes to predict liver fibrosis in liver disease. This study was to use APRI and FIB-4 to detect chronic virus hepatitis in community screenings.
Methods:
From 2004 to 2013, a series of community-based health screenings for residents aged 40 and older were held in Tainan city. APRI and FIB-4 of each participant were calculated and their association further analyzed with hepatitis status.
Results:
We enrolled 180359 participants including 18726 (10.4%) hepatitis B virus (HBV), 13428 (7.4%) hepatitis C virus (HCV), 1337 (0.7%) HBV plus HCV and 146868 (81.5%) Non-HBV Non-HCV. The prevalence of chronic HCV increased with the elevation of APRI cut-offs or FIB-4 cut-offs (13.9%, 28.1%, 38.8%, 45.2%, to 49.9% in APRI≥0.3, 0.5, 0.7, 0.9,1.1, p<0.001 for the linear trend; or 15.8%, 26.4%, 34.4% to 39.7% in FIB-4≥1.75, 2.75, 3.5, 4.25, p<0.001). At the township level, APRI≥ 0.7 and FIB-4≥ 3.5 were highly correlated with HCV infection (r = 0.95, p<0.001 in APRI and r = 0.809, p<0.001 in FIB-4) and hepatocellular carcinoma (HCC) development (r = 0.894, p<0.001 in APRI and r = 0.804, p<0.001 in FIB-4), but not correlated with HBV infection.
Conclusions:
Community screenings derived APRI or FIB-4 can identify patient subsets with increased of underlying HCV infection and risk of incident HCC.
Related Concept Videos
01:25Ultrasound II: Endoscopic Ultrasound and FibroScan
Endoscopic Ultrasound (EUS):
01:22Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test