Prognostic Value of Inflammatory Indicators in Chronic Hepatitis B Patients With Significant Liver Fibrosis: A Multicenter Study in China

Area of Science:

• Hepatology
• Biomarkers
• Diagnostic Tools

Background:

• Accurate diagnosis of significant liver fibrosis is crucial for managing chronic hepatitis B (CHB).
• Existing methods may have limitations in predicting fibrosis severity.
• Inflammatory indicators show potential but require further validation.

Purpose of the Study:

• To evaluate the predictive value of inflammatory indicators for significant liver fibrosis in CHB patients.
• To develop and validate a nomogram for predicting significant liver fibrosis.
• To improve diagnostic accuracy and guide treatment decisions.

Main Methods:

• A retrospective study involving 563 CHB patients across three cohorts (development, internal validation, independent validation).
• Analysis of biochemical and serological inflammatory indicators, including Alanine aminotransferase (ALT), aspartate aminotransferase (AST), prothrombin time activity percentage (PTA), and liver stiffness measurement (LSM).
• Multivariate logistic regression analysis to identify key predictive factors and construct a nomogram.

Main Results:

• Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were significantly associated with significant liver fibrosis but had limited predictive power alone.
• The developed nomogram, incorporating ALT, AST, PTA, and LSM, demonstrated excellent predictive performance.
• Areas under the receiver operating characteristic curve (AUROC) were 0.860 (development), 0.877 (internal validation), and 0.811 (independent validation).

Conclusions:

• A novel nomogram integrating ALT, AST, PTA, and LSM provides a robust tool for predicting significant liver fibrosis in CHB patients.
• This nomogram offers improved diagnostic accuracy compared to individual indicators.
• The findings support the use of this nomogram for optimizing patient management and prognosis in CHB.