Non-invasive method for assessment of liver fibrosis in clinically diagnosed chronic hepatitis B viruscarriers / 中华传染病杂志

ABSTRACT

Objective To verify the value of routine laboratory markers for assessment of liver fibrosis status in chronic hepatitis B virus (HBV) carriers.Methods A total of 196 patients who were clinically diagnosed with chronic HBV carriers with liver biopsy and routine laboratory test were included in this study. The data of complete blood count, aspartate aminofransferase/alanine aminotransferase (AST/ALT),aspartate aminotransferase to platelet ratio index (APRI) and ageplatelet index (API) were collected and calculated.Patients were divided into group S0 (n=112) and group S1- S3 (n =84) based on liver fibrosis stages.Measurement data were analyzed by Wilcoxon rank sum test and enumeration data were analyzed by chi square test.Results All 196 enrolled HBV carriers were HBV DNA positive,with 156 (79.6％) HBeAg-positive.Age,ALT,AST,AST/ALT,APRI and API were all significantly higher in group S1- S3 than those in group S0 (statistic value=7.705,6.33,7.095,4.977,11.059,8.936,respectively; all P＜0.05).However,PLT level was lower in the former group compared to that in the latter group (statistic value=10.196,P＜0.05 ).The area under receiver operating characteristic curve (AUROC) of APRI and API were 0.827and 0.829,respectively.The highest sensitivity and negative prediction value (NPV) were 70.46 ％and 71.43 ％ respectively when using API.The best specificity and positive prediction value (PPV)was 92.94％ and 92.86％,respectively when using APRI.When APRI≥0.30 was used as the cut-off of liver fibrosis,97.62 ％ of 119 patients were diagnosed with liver fibrosis; when API≥4.0 was used as the cut-off of liver fibrosis, 96.43％ of 112 patients were diagnosed with liver fibrosis.Conclusion APRI and API are two simple and feasible non-invasive biochemical markers that can be used to determine liver fibrosis status in chronic HBV carriers.