Noninvasive markers for staging fibrosis in chronic hepatitis B patients
Gamal, S., Nasser, M., Mohamed, S., Sally, A., Reham, S., Nabiel, M. (2018). Noninvasive markers for staging fibrosis in chronic hepatitis B patients. EKB Journal Management System, 2.2(2), 17-23. doi: 10.21608/mjvh.2018.55737
Shiha Gamal; Mousa Nasser; Salah Mohamed; Abed Sally; Soliman Reham; Mikhail Nabiel. "Noninvasive markers for staging fibrosis in chronic hepatitis B patients". EKB Journal Management System, 2.2, 2, 2018, 17-23. doi: 10.21608/mjvh.2018.55737
Gamal, S., Nasser, M., Mohamed, S., Sally, A., Reham, S., Nabiel, M. (2018). 'Noninvasive markers for staging fibrosis in chronic hepatitis B patients', EKB Journal Management System, 2.2(2), pp. 17-23. doi: 10.21608/mjvh.2018.55737
Gamal, S., Nasser, M., Mohamed, S., Sally, A., Reham, S., Nabiel, M. Noninvasive markers for staging fibrosis in chronic hepatitis B patients. EKB Journal Management System, 2018; 2.2(2): 17-23. doi: 10.21608/mjvh.2018.55737

Noninvasive markers for staging fibrosis in chronic hepatitis B patients

Medical Journal of Viral Hepatitis
Article 4, Volume 2.2, Issue 2, March 2018, Page 17-23  XML PDF (151.19 K)
Document Type: Original article
DOI: 10.21608/mjvh.2018.55737
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Authors
Shiha Gamal1; Mousa Nasser2; Salah Mohamed2; Abed Sally2; Soliman Reham3; Mikhail Nabiel4
1Internal Medicine dept., Mansoura Univ., Egypt, Egyptian Liver Research Institute and Hospital (ELRIH), Sherbin, El-Mansoura, Egypt.
2Tropical Medicine dept., Mansoura Univ., Egypt.
3Tropical Medicine dept., Port Said, Univ., Egypt. & Egyptian Liver Research Institute and Hospital (ELRIH), Sherbin, Mansoura
4Egyptian Liver Research Institute and Hospital (ELRIH), Sherbin, El-Mansoura, Biostatistics dept., South Egypt Cancer Institute, Assiut Univ., Egypt
Abstract
Background: Noninvasive evaluation of liver fibrosis in chronic
hepatitis B (CHB) is a growing research field. We planed to
study and assess the act of some non-invasive forms in
Egyptian patients with chronic hepatitis B. Patients and
Methods: The present study involved 109 patients who had
chronic hepatitis B infection. The scoring models involved;
AST to ALT ratio (AAR), age-platelet index (API), AST-toplatelet-
ratio-index (APRI) and Fibrosis-4 (FIB-4), transient
elastography (TE) as non invasive indicators for staging fibrosis
in chronic hepatitis B patients were measured in all patients.
Agreement between the results of serum biomarker and those
of transient elastography was assessed by Kappa (ê) index.
The optimal cutoff points used for these tests were settled on
by maximizing Kappa index. The performance of serum markers
was judged by receiver operator characteristic (ROC) curves.
The work of each manner for differentiating significant fibrosis,
advanced fibrosis, and cirrhosis was weighted against. Results:
API, APRI and FIB4 showed statistically significant differences
(p-value <0.0001) in distinguishing significant fibrosis, advanced
fibrosis, and cirrhosis, while AAR showed statistically insignificant
differences (p-value >0.05) in that differentiation. The cutoff values
of AAR, API, APRI and FIB4 showed a successive increase in
values when the stage of fibrosis progressed from significant
fibrosis to advanced fibrosis to cirrhosis. The AUROC in distinguishing
significant fibrosis and advanced fibrosis was highest
in APRI and higher in FIB4 than API while in distinguishing
cirrhosis it was highest in API and higher in APRI than FIB4.
Conclusion: API, APRI and FIB-4 could reliably distinguish
significant fibrosis, advanced fibrosis and cirrhosis while AAR is
not a reliable predictor to distinguish significant fibrosis or
advanced fibrosis.
Keywords
Noninvasive markers; Chronic hepatitis B; Transient elastography; Liver fibrosis
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