Abstract
.The albumin–bilirubin (ALBI) score was originally established to stratify prognosis in patients with cirrhosis. The diagnostic accuracy of ALBI score in liver fibrosis staging in patients with chronic hepatitis B remains to be investigated. The present retrospective study, therefore, aimed to evaluate the ability of this score to stage liver fibrosis in these patients. Briefly, consecutive patients with hepatitis B virus (HBV) infection who underwent liver biopsy examinations in Kagawa University Hospital were enrolled. Liver fibrosis stage was assessed using a modified Meta-Analysis of Histological Data in Viral Hepatitis score. Albumin–bilirubin scores were calculated according to the following equation: (log10 total bilirubin [T-Bil] × 0.66) + (albumin [Alb] × −0.085). A total of 91 patients were enrolled in this study. Albumin–bilirubin score was able to differentiate stage 4 from stage 3 fibrosis (P < 0.05). When an ALBI score of −2.190 was adopted as the cutoff value for differentiating stage 4 from stages 1–3, the sensitivity, specificity, and positive likelihood ratio were 85.7%, 74.0%, and 3.300, respectively. Kaplan–Meier analysis showed that baseline ALBI scores < −2.190 correlated with better hepatocellular carcinoma (HCC)–free survival (P < 0.05). In conclusion, ALBI score can be used for liver fibrosis staging in Japanese chronic hepatitis B patients and can help distinguish cirrhotic from non-cirrhotic status. Furthermore, ALBI score was useful as a prognosis biomarker in our patients, with smaller ALBI scores predicting better HCC-free survival. Because calculating ALBI score is easy using serum T-Bil and Alb alone, ALBI score will help clinicians with decision-making in management of HBV-infected patients.
Highlights
Hepatitis B virus (HBV) infection is a major public health problem worldwide
ALBI scores significantly differed between fibrosis stages, indicating that the ALBI score can be used for fibrosis staging
Smaller ALBI scores correlated with better hepatocellular carcinoma (HCC)-free survival, suggesting that the ALBI score may be useful in predicting patient prognosis
Summary
Hepatitis B virus (HBV) infection is a major public health problem worldwide. When defined as hepatitis B surface (HBs) antigen positivity, HBV infection is estimated to affect 257 million living people, resulting in 887,000 deaths in 2015.1 If left untreated, chronic hepatitis B progresses to liver cirrhosis in up to 40% of patients.[2,3] According to an observational study, approximately 30% of cirrhotic patients develop hepatocellular carcinoma (HCC) in 10 years.[4]. Measuring serum direct biomarkers, such as Wisteria floribunda agglutinin-positive Mac-2 binding protein (WFA-M2BP) and Enhanced Liver Fibrosis score, and performing liver biopsy examination for patients with HBV infection would mean great economic burden in limited healthcare budgets.[7,8] Simpler and less-expensive methods to evaluate liver fibrosis stage is to be established
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