Sa1305 Assessment of Liver Fibrosis in Patients With Chronic Hepatitis B -Diagnostic Accuracy of Four Noninvasive Tests

Abstract

Background: Liver biopsy remains the gold standard to assess liver fibrosis in chronic hepatitis B (CHB). However, the use of noninvasive methods has emerged in recent years, namely tests based on serum fibrosis markers. The aim of our study was to evaluate the accuracy to predict liver fibrosis in CHB patients using four noninvasive tests: APRI [aspartate aminotransferase/platelet ratio index], AAR [aspartate aminotransferase/alanine aminotransferase ratio], FibroQ (fibro-quotient) and FIB-4. Methods: Forty CHB patients who underwent liver biopsy were included in the study. The patients were divided into two groups according to their METAVIR fibrosis scores (F0-1, no/minimal fibrosis; F2-4, significant fibrosis). Diagnostic accuracy for each test was measured using the area under the receiver operating curve (AUC), followed by calculation of sensitivity, specificity, positive predictive value (PPV) and negative predictive values (NPV). Results: The FIB-4 score had the best diagnostic accuracy for significant fibrosis (AUC 0,81, 95% CI 0,661-0,963), followed by APRI (AUC 0,80, 95% CI 0,645-0,954), and FibroQ (AUC 0,72, 95% CI 0,504-0,929). AAR did not have a good accuracy for liver fibrosis (AUC 0,48, 95% CI 0,263-0,698). The optimal cutoff value for FIB-4 was 1 (sensitivity 67%, specificity 77%, PPV 46%, NPV 89%), 0,5 for APRI (sensitivity 78%, specificity 68%, PPV 41%, NPV 91%) and 1,7 for FibroQ (sensitivity 67%, specificity 74%, PPV 43%, NPV 88%). Conclusion: FIB-4, APRI and FibroQ are accessible and useful tools to assess liver fibrosis in patients with CHB.