Salih, R., Elyasin, H., Al-Akayshee, R. (2021). Evaluation of Noninvasive Biomarkers in Staging of Hepatitis B-Related Fibrosis. Alustath, 21(2), 171-176. doi: 10.52573/ipmj.2021.174627
Rasha Fawzi Salih; Hedef Elyasin; Raghad Jawad Al-Akayshee. "Evaluation of Noninvasive Biomarkers in Staging of Hepatitis B-Related Fibrosis". Alustath, 21, 2, 2021, 171-176. doi: 10.52573/ipmj.2021.174627
Salih, R., Elyasin, H., Al-Akayshee, R. (2021). 'Evaluation of Noninvasive Biomarkers in Staging of Hepatitis B-Related Fibrosis', Alustath, 21(2), pp. 171-176. doi: 10.52573/ipmj.2021.174627
Salih, R., Elyasin, H., Al-Akayshee, R. Evaluation of Noninvasive Biomarkers in Staging of Hepatitis B-Related Fibrosis. Alustath, 2021; 21(2): 171-176. doi: 10.52573/ipmj.2021.174627

Evaluation of Noninvasive Biomarkers in Staging of Hepatitis B-Related Fibrosis

Iraqi Postgraduate Medical Journal
Article 8, Volume 21, Issue 2, April 2022, Pages 171-176    PDF (315.97 K)
Document Type: Research Paper
DOI: 10.52573/ipmj.2021.174627
Authors
Rasha Fawzi Salih1; Hedef Elyasin2; Raghad Jawad Al-Akayshee3
1Al-karkh Maternity Hospital, Baghdad \Iraq
2College of Medicine\Baghdad University \Iraq.
3Gastroenterology and Hepatology Teaching Hospital, Medical City, Baghdad\Iraq.
Abstract
BACKGROUND:
Infection with hepatitis B virus (HBV) is a public health problem worldwide; it is the main cause of fibrosis, cirrhosis and hepatocellular carcinoma (HCC).  Early detection of significant fibrosis is essential for reaching antiviral therapy decisions. Considering the limitations of liver biopsy, noninvasive methods to identify significant fibrosis in chronically HBV infected patients are needed in clinical practice.
OBJECTIVE:
To evaluate the performance of aspartate aminotransferase (AST) to platelet ratio index (APRI) and fibrosis index based on four factors (FIB-4) as simple noninvasive markers for staging of liver fibrosis in chronic hepatitis B in comparison with liver biopsy and to compare between the diagnostic performance of APRI and FIB-4 in staging of liver fibrosis.
PATIENTS AND METHODS:
A combined retrospective (38 case) and prospective (2 cases) study of the records of 40 patients with chronic hepatitis B (CHB) who attended the Gastroenterology and Hepatology Teaching Hospital in Baghdad during the period from (January 2016 - July 2019). All patients had a percutaneous liver biopsy for staging of liver fibrosis. The cases were divided into two groups, non significant fibrosis and significant liver fibrosis, according to histopathology stage of fibrosis.
Serum AST, alanine aminotransferase (ALT) levels and platelet counts were obtained from the results of blood samples taken on the same day of liver biopsy. Calculation of APRI and FIB4 indices was done for each pateint of the study .
RESULTS:
 the diagnostic performance of both indices in significant and non significant fibrosis was determined by Area Under Receiver Operating Curve (AUROC) .The value of AUROC for APRI index  was 0.992, ,P=0.0001,  specificity 100%, sensitivity 95.8% at cut-off value  0.41 and the value of AUROC for FIB4 index  was 0.997, P=0.0001, specificity  100%, sensitivity 95.7% at cut value  0.73.
CONCLUSION:
Both indices APRI and FIB-4 show good performance with high sensitivity and specificity as simple noninvasive markers for staging of liver fibrosis in CHB.
 
 
Keywords
CHB; FIB4; APRI; liver fibrosis
References
  1. Hepatitis B - World Health Organization (18 July 2019)
  2. Liang P, Zu J, Yin J, et al. The independent impact of newborn hepatitis B vaccination on reducing HBV prevalence in China, 1992–2006: a mathematical model analysis. J TheorBiol 2015;386:115–21.
  3. Delhaye ,M. , Louis, H. , Degraef ,C. , et al. Relationship between hepatocyte proliferative activity and liver functional reserve in human cirrhosis. Hepatology1996;23:1003-11.
  4. Caillot F, Derambure C, Bioulac-Sage P, et al. Transient and etiology-related transcription regulation in cirrhosis prior to hepatocellular carcinoma occurrence.World J Gastroenterol 2009;15:300-9. 
  5. Regev A, Berho M, Jeffers LJ, et al. Sampling error and intraobserver variation in liver biopsy in patients with chronic HCV infection. Am J Gastroenterol 2002;97:2614–18.
  6. Munteanu I. Daniela, Radulescu A. Mihaela, Arama Victoria, Mihailescu I. Raluca,NegruAnca, Arama S.Ş. Diagnostic performances of APRI and FIB-4 score for the evaluation of liver fibrosis in patients with chronic hepatitis C.Therapeutics, Pharmacology and Clinical Toxicology, Vol XVII,  Number 3,  September 2013: 110 - 11.
  7. Wai CT., GreensonJK., Fontana RJ., et al. A simple noninvasive index can predict both significant fibrosis and cirrhosis in patients with chronic hepatitis C. Hepatology 2003;38:518–26.
  8. Sterling RK. , Lissen E, Clumeck N. , et al. Development of a simple noninvasive index to predict significant fibrosis in patients with HIV/HCV coinfection. Hepatology 2006;43:1317–25.
  9. METAVIR Score Uses and Results By Charles Daniel . Updated December 18, 2018.
10. Baclig, Michael O et al. “Hepatic steatosis in chronic hepatitis B: a study of metabolic and genetic factors.” International journal of molecular epidemiology and genetics2018; 9: 13-19.

11. Noam Peleg ,et al. Liver steatosis is a strong predictor of mortality and cancer in chronic hepatitis B regardless of viral load. JHEP Reports 2019; 1: 9-16.

12. I Bar-Yishay, Y Shaul, AShlomai. Hepatocyte metabolic signalling pathways and regulation of hepatitis B virus expression Liver Int, 2011;31: 282-90.

13. Li Q, Lu C, Li W, Huang Y, Chen L. Evaluation of eLIFT for Non-invasive Assessment of Liver fibrosis and Cirrhosis in Patients with Chronic Hepatitis B Virus Infection. Sci Rep. 2017;7:5429.

14. Ayed HB, Koubaa M, Yaich S, et al. APRI Score as a Predictor of Significant Liver Fibrosis in Chronic Hepatitis B. Open Forum Infect Dis. 2017;4(Suppl1):S196. Published 2017 Oct 4.

15. Raghad J. Al-Akayshee, Abdulwahhab S. Abdullah . Use of Simple Routine Markers for Non-invasive Assessment of Liver Fibrosis in Iraqi Patients with Chronic Viral Hepatitis. Iraqi Journal of gastroenterology. 2015; 9.

16. Sheth SG, Flamm SL, Gordon FD, et al. AST/ALTratio predicts cirrhosis in patients with chronic hepatitisC virus infection, Am J Gastroenterol .1998;93:44–48.

17. Oscar Mitchell ,David M Feldman, Marla Diakow, Samuel H Siga. The pathophysiology of thrombocytopenia in chronic liver disease. Hepatic Medicine: Evidence and Research,13 April 2016.

Statistics
Article View: 71
PDF Download: 48


Journal Management System. Powered by ejournalplus.com