Abstract
BackgroundAspartate transaminase-platelet ratio index (APRI) and fibrosis 4 (FIB-4) are two non-invasive indexes to predict liver fibrosis in liver disease. This study was to use APRI and FIB-4 to detect chronic virus hepatitis in community screenings.MethodsFrom 2004 to 2013, a series of community-based health screenings for residents aged 40 and older were held in Tainan city. APRI and FIB-4 of each participant were calculated and their association further analyzed with hepatitis status.ResultsWe enrolled 180359 participants including 18726 (10.4%) hepatitis B virus (HBV), 13428 (7.4%) hepatitis C virus (HCV), 1337 (0.7%) HBV plus HCV and 146868 (81.5%) Non-HBV Non-HCV. The prevalence of chronic HCV increased with the elevation of APRI cut-offs or FIB-4 cut-offs (13.9%, 28.1%, 38.8%, 45.2%, to 49.9% in APRI≥0.3, 0.5, 0.7, 0.9,1.1, p<0.001 for the linear trend; or 15.8%, 26.4%, 34.4% to 39.7% in FIB-4≥1.75, 2.75, 3.5, 4.25, p<0.001). At the township level, APRI≥ 0.7 and FIB-4≥ 3.5 were highly correlated with HCV infection (r = 0.95, p<0.001 in APRI and r = 0.809, p<0.001 in FIB-4) and hepatocellular carcinoma (HCC) development (r = 0.894, p<0.001 in APRI and r = 0.804, p<0.001 in FIB-4), but not correlated with HBV infection.ConclusionsCommunity screenings derived APRI or FIB-4 can identify patient subsets with increased of underlying HCV infection and risk of incident HCC.
Highlights
The prevalence of chronic hepatitis C virus (HCV) increased with the elevation of Aspartate transaminase-platelet ratio index (APRI) cut-offs or fibrosis 4 (FIB-4) cut-offs (13.9%, 28.1%, 38.8%, 45.2%, to 49.9% in APRI 0.3, 0.5, 0.7, 0.9,1.1, p
There are more than 350 million persons infected with chronic hepatitis B virus (HBV) [1]
Since the tests used to calculate APRI and FIB-4 are usually included in general health screenings in Taiwan, we aimed to describe differences in the prevalence of HCV and HBV infection based on increasing thresholds of APRI and FIB-4 performed in population-based screening
Summary
There are more than 350 million persons infected with chronic hepatitis B virus (HBV) [1] It is endemic in Taiwan, where HBV infection is usually acquired perinatally or in early childhood [2]. With the offer of HBV vaccine for the newborn in Taiwan since 1984, the annual incidence of HBV infection is decreasing [3]. Those subjects with chronic hepatitis B (CHB) infection are still at an increased risk of developing progressive liver disease like liver cirrhosis (LC), or hepatocellular carcinoma (HCC), and liver-related motality [4]. This study was to use APRI and FIB-4 to detect chronic virus hepatitis in community screenings
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