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How effective are APRI, FIB-4, FIB-5 scores in predicting liver fibrosis in chronic hepatitis B patients?
Ferdane Pirincci Sapmaz1, Galip Büyükturan1, Yusuf Serdar Sakin1
1Gastroenterology Department, Gülhane Education and Training Hospital, Ankara, Turkey.
Insights
Noninvasive markers like APRI, FIB-4, and FIB-5 effectively assess liver fibrosis in chronic hepatitis B (CHB) patients. FIB-4 demonstrated the highest predictive value for advanced fibrosis.
Area of Science:
- Hepatology
- Biomarkers
- Diagnostic Tools
Background:
- Liver fibrosis significantly impacts prognosis and treatment in chronic hepatitis B (CHB).
- Noninvasive fibrosis markers, including APRI, FIB-4, and FIB-5, are increasingly utilized as alternatives to liver biopsy.
- Previous studies indicate their efficacy across various liver diseases.
Purpose of the Study:
- To evaluate the effectiveness of APRI, FIB-4, and FIB-5 scores in assessing liver fibrosis in CHB patients.
- To compare the performance of these scoring systems in differentiating early from advanced fibrosis.
- To determine the most accurate noninvasive marker for fibrosis staging in CHB.
Main Methods:
- A study involving 123 CHB patients who underwent liver biopsy.
- Calculation of APRI, FIB-4, and FIB-5 scores using validated calculators.
- Comparison of calculated scores against liver biopsy results for fibrosis staging.
Main Results:
- APRI, FIB-4, and FIB-5 were identified as significant predictors of advanced fibrosis.
- APRI achieved an area under the ROC curve of 0.728, FIB-4 of 0.693, and FIB-5 of 0.643.
- FIB-4 exhibited the highest positive and negative predictive values, indicating superior performance in fibrosis assessment.
Conclusions:
- APRI, FIB-4, and FIB-5 are appropriate tools for assessing advanced fibrosis in CHB patients.
- FIB-4 appears to be the most reliable among the evaluated noninvasive markers for this population.
- This study is the first to directly compare these three markers in CHB patients, highlighting the need for further comprehensive research.
Abstract:
Liver fibrosis is the most important factor in the prognosis and treatment plan of patients with chronic hepatitis B (CHB). Aspartate aminotransferase (AST)-to-platelet ratio index (APRI), fibrosis index based on 4 factors (FIB-4), and fibrosis index based on 5 factors (FIB-5) scores are noninvasive fibrosis markers, and previous comparative studies have shown that they are as effective as liver biopsy in detecting liver fibrosis in different liver diseases. The aim of our study is to investigate whether existing scoring systems are effective in demonstrating fibrosis in CHB patients and to compare the APRI, FIB 4, and FIB 5 scores in differentiating early and advanced fibrosis in 123 patients who underwent liver biopsy for CHB infection. APRI, FIB-4, and FIB-5 scores of patients who underwent liver biopsy due to CHB were calculated by means of calculators and recorded to be compared with liver biopsies in terms of fibrosis scoring. One hundred twenty-three patients who underwent liver biopsy due to chronic hepatitis B were included in the study. APRI (area under the receiver-operating characteristic [ROC] curve 0.728), FIB-4 (area under the ROC curve 0.693) and FIB-5 (area under the ROC curve 0.643) scores were evaluated as significant predictors of advanced fibrosis. The scoring system with the highest positive and negative predictive value was evaluated as FIB-4. APRI, FIB-4, and FIB-5 scoring systems are appropriate scoring systems in the assessment of advanced fibrosis in patients with CHB. Our study is the first to compare APRI, FIB-4, and FIB-5 values in CHB patients, and more comprehensive studies are needed.
