Abstract
Recently, the easy Liver Fibrosis Test (eLIFT), a sum of points attributed to age, gender, gamma-glutamyl transpeptidase, aspartate transaminase, platelets, and prothrombin time, was developed for diagnosing advanced fibrosis and cirrhosis in chronic liver disease. We aimed to evaluate the performance of eLIFT to predict liver fibrosis and cirrhosis in patients with chronic hepatitis B (CHB). Histologic and laboratory data of 747 CHB patients were analyzed. The performance of eLIFT for diagnosing liver fibrosis and cirrhosis was compared with that of aspartate transaminase to platelet ratio index (APRI) and fibrosis index based on the 4 factors (FIB-4). To predict advanced fibrosis, the AUROC of eLIFT was comparable with that of APRI (0.66 vs 0.71, p = 0.095) and FIB-4 (0.66 vs 0.67, p = 0.612). To predict severe fibrosis, the AUROC of eLIFT was lower than that of APRI (0.65 vs 0.83, p < 0.001) and FIB-4 (0.65 vs 0.82, p < 0.001). To predict cirrhosis, the AUROC of eLIFT was also lower than that of APRI (0.64 vs 0.85, p = 0.001) and FIB-4 (0.64 vs 0.76, p = 0.033). The eLIFT is not a good non-invasive test for the diagnosis of liver fibrosis and cirrhosis in CHB patients.
Highlights
Chronic hepatitis B virus (HBV) infection is very common: worldwide, 240 million have chronic HBV infection1
We evaluated the diagnostic performance of easy Liver Fibrosis Test (eLIFT) for advanced fibrosis, severe fibrosis, and cirrhosis, and compared with that of aspartate transaminase to platelet ratio index (APRI) and FIB-4 in 747 chronic hepatitis B (CHB) patients
The early management of CHB patients had been recommended by all international guidelines1, 7, 11
Summary
Chronic hepatitis B virus (HBV) infection is very common: worldwide, 240 million have chronic HBV infection. Chronic hepatitis B (CHB) can lead to a progressive accumulation of liver fibrosis which progressively evolves to cirrhosis, hepatocellular carcinoma (HCC), liver failure, and death. Liver biopsy is the reference procedure for liver fibrosis evaluation; limitations of this procedure include invasive nature, cost, and risk of serious complications These limitations of liver biopsy make it unsuitable as first-line test to screen liver fibrosis in CHB patients. In January 2017, Boursier et al developed a novel algorithm-the easy Liver Fibrosis Test (eLIFT), a sum of points attributed to age, gender, gamma-glutamyl transpeptidase (GGT), aspartate transaminase (AST), platelet count, and prothrombin time, for the diagnosis of advanced fibrosis and cirrhosis in the training set of 2503 patients with chronic liver disease (CLD). We evaluated the diagnostic performance of eLIFT for advanced fibrosis, severe fibrosis, and cirrhosis, and compared with that of APRI and FIB-4 in 747 CHB patients
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