Abstract
Background: We compared the diagnostic validity of three non-invasive tests of fibrosis: age to platelet index, aspartate transaminase to platelet ratio index and aspartate transaminase to alanine transaminase ratio to histology fibrosis stage among Africans chronically infected with the hepatitis B virus. Methods: Ninety treatment-naive chronic hepatitis B patients were subjected to liver biopsy. Excluded from the study were patients with HCV and HIV co-infection, and significant alcohol consumption. Staging was performed using the Metavir system, whereas AST, ALT, and platelet count were determined using manual methods, within 4 weeks of liver biopsy. Results of fibrosis score and markers of fibrosis were compared using EPI Info 2005 version 3.3.2. Results: The mean age of the study population was 31.8 ± 8.9 years. Fibrosis stages and AAR, API and APRI scores were positively correlated, respective correlation coefficients being 0.48, 0.48 and 0.22 ( p %lt; 0.0001). Their positive predictive values were 52% (AAR), 63% (API) and 54% (APRI), with sensitivities of 60, 11 and 96%, respectively. The diagnostic accuracy of AAR for cirrhosis was 100%. Conclusions: Non-invasive fibrosis markers are not as sensitive for diagnosing significant fibrosis in chronic hepatitis B compared to hepatitis C patients and might have a limited utility for use in hepatitis B endemic populations.
Published Version
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