Reduced Predictive Performance of the FIB-4 Index in Chronic Hepatitis B Patients With Concurrent Metabolic...

Area of Science:

• Hepatology
• Non-invasive diagnostics
• Liver fibrosis assessment

Background:

• The combined prevalence of chronic hepatitis B (CHB) and metabolic dysfunction-associated liver disease (MASLD) is increasing.
• Non-invasive markers for liver fibrosis assessment in CHB patients with concurrent MASLD are underexplored.

Purpose of the Study:

• To evaluate the diagnostic performance of the FIB-4 index for liver fibrosis prediction in CHB patients.
• To assess the utility of FIB-4 in the specific subgroup of patients with coexisting CHB and MASLD.

Main Methods:

• Prospective study including 109 CHB and 64 CHB-MASLD patients.
• Liver stiffness measurement via elastography and FIB-4 index calculation.
• Statistical analysis including ROC curves to determine diagnostic accuracy.

Main Results:

• FIB-4 demonstrated robust performance in predicting fibrosis in the general CHB group (AUC=0.86).
• In the CHB-MASLD subgroup, FIB-4 showed significantly reduced diagnostic accuracy (AUC=0.61, p=0.12).
• CHB-MASLD patients exhibited higher BMI, dysglycemia, and dyslipidemia compared to CHB-alone patients.

Conclusions:

• The FIB-4 index is a reliable non-invasive marker for fibrosis in CHB patients, irrespective of BMI.
• The diagnostic utility of FIB-4 is compromised in patients with concurrent CHB and MASLD.
• Development of novel, accurate non-invasive tools is crucial for managing CHB-MASLD patients.