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Validation of FIB-4 and comparison with other simple noninvasive indices for predicting liver fibrosis and cirrhosis in hepatitis B virus-infected patients

Authors
 Beom Kyung Kim  ;  Do Young Kim  ;  Jun Yong Park  ;  Sang Hoon Ahn  ;  Chae Yoon Chon  ;  Ja Kyung Kim  ;  Yong Han Paik  ;  Kwan Sik Lee  ;  Young Nyun Park  ;  Kwang Hyub Han 
Citation
 LIVER INTERNATIONAL, Vol.30(4) : 546-553, 2010 
Journal Title
 LIVER INTERNATIONAL 
ISSN
 1478-3223 
Issue Date
2010
MeSH
Adult ; Alanine Transaminase/blood ; Aspartate Aminotransferases/blood ; Biomarkers/blood* ; Biopsy, Needle ; Cohort Studies ; Diagnosis, Differential ; Disease Progression ; Female ; Hepatitis B, Chronic/diagnosis ; Hepatitis B, Chronic/pathology* ; Humans ; Immunohistochemistry ; Liver Cirrhosis/diagnosis ; Liver Cirrhosis/pathology* ; Liver Cirrhosis/virology ; Male ; Platelet Count ; Predictive Value of Tests ; RNA, Viral/blood ; ROC Curve ; Reproducibility of Results ; Severity of Illness Index ; Viral Load
Keywords
chronic hepatitis B ; cirrhosis ; FIB‐4 index ; liver biopsy ; prediction
Abstract
BACKGROUNDS: To optimize management and predict long-term clinical courses in patients with chronic hepatitis B (CHB), noninvasive tests to determine the degree of hepatic fibrosis have been developed. AIMS: This study aimed to validate a simple, noninvasive FIB-4 index, which was first derived from an HCV-HIV-co-infected population, in patients with CHB and to compare it with other noninvasive tests for predicting cirrhosis. METHODS: From 2006-2008, a total of 668 consecutive CHB patients who underwent liver biopsies were enrolled. The fibrosis stage was assessed according to the Batts and Ludwig system by a single pathologist blinded to patients' data. RESULTS: For prediction of significant (F > or = 2) and severe (F > or = 3) fibrosis, and cirrhosis (F = 4), the area under the receiver-operating characteristic curves were 0.865, 0.910 and 0.926 respectively. In predicting cirrhosis, it demonstrated diagnostic values comparable to the age-spleen platelet ratio index (0.937, P=0.414) and age-platelet index (0.928, P=0.888), and better outcomes than spleen-platelet ratio index (0.882, P=0.007), aspartate aminotransferase (AST)-platelet ratio index (0.731, P<0.001) and AST-alanine aminotransferase ratio index (0.730, P<0.001). FIB-4 cut-offs of 1.6 and 3.6 provided 93.2% negative predictive value and 90.8% positive predictive value for detection of cirrhosis respectively. Based on these results, liver biopsy could be avoided in 70.5% of the study population. These cut-offs were validated internally using bootstrap resampling methods, showing good agreement. CONCLUSIONS: FIB-4 is a simple, accurate and inexpensive method of predicting cirrhosis, with outcomes comparable to other noninvasive tests and may reduce the need for liver biopsy in the majority of CHB patients
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/j.1478-3231.2009.02192.x/abstract
DOI
10.1111/j.1478-3231.2009.02192.x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Kim, Beom Kyung(김범경) ORCID logo https://orcid.org/0000-0002-5363-2496
Kim, Ja Kyung(김자경) ORCID logo https://orcid.org/0000-0001-5025-6846
Park, Young Nyun(박영년) ORCID logo https://orcid.org/0000-0003-0357-7967
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Paik, Yong Han(백용한)
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Lee, Kwan Sik(이관식) ORCID logo https://orcid.org/0000-0002-3672-1198
Chon, Chae Yoon(전재윤)
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/101889
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