Abstract
BackgroundAt present, most assessments of liver fibrosis staging mainly focus on non-invasive diagnostic methods. This study aims to construct a noninvasive model to predict liver histology for antiviral therapy in chronic hepatitis B (CHB) with alanine aminotransferase (ALT) < 2 times upper limit of normal (ULN).MethodsWe retrospectively analyzed 577 patients with CHB who received liver biopsy and whose ALT was less than 2 ULN. Then they were randomly divided into a training group and a validation group. Through logistic regression analysis, a novel predictive model was constructed in the training group to predict significant changes in liver histology [necro-inflammatory activity grade (G) ≥ 2 or fibrosis stage (S) ≥ 2] and then validated in the validation group.ResultsIf liver biopsy showed moderate or severe inflammation or significant fibrosis, antiviral treatment was recommended. Aspartate aminotransferase (AST), anti-hepatitis B virus core antibody (anti-HBC) and glutamine transpeptidase (GGT) were identified as independent predictors for antiviral therapy, with area under the ROC curve (AUROC) of 0.649, 0.647 and 0.616, respectively. Our novel model index, which combined AST, anti- HBC and GGT with AUROC of 0.700 and 0.742 in training set and validation set.ConclusionsThis study established a noninvasive model to predict liver histology for antiviral treatment decision in patients with CHB with ALT < 2 ULN, which can reduce the clinical needs of liver biopsy.
Highlights
At present, most assessments of liver fibrosis staging mainly focus on non-invasive diagnostic methods
We aimed to constructed a noninvasive model based on serum markers to accurately identify moderate and severe inflammation or significant fibrosis related to CHB, which is helpful to the decision-making of antiviral treatment in patients with chronic hepatitis B with Alanine aminotransferase (ALT) < 2 upper limit of normal (ULN) and to reduce the need for liver biopsy as much as possible
A total of 181 cases (52.2%) in the training set and 134 cases (58.2%) in the verification set were identified as obvious fibrosis, and they were identified as requiring antiviral treatment
Summary
Most assessments of liver fibrosis staging mainly focus on non-invasive diagnostic methods. Hepatitis B virus (HBV) infection is still a major public health problem in the world. It is one of the most serious and common health problems, affecting more than 2 billion people [1]. The inevitable progression of HBV infection to persistent or intermittent liver inflammation and fibrosis greatly increases the risk of progression to cirrhosis, Hepatocellular carcinoma (HCC) and end-stage liver disease [2]. The main purpose of chronic hepatitis B virus (CHB) treatment is to inhibit HBV replication, reduce the occurrence of liver decompensation and prevent the progress of disease as soon as possible [1].
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
