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 22 April 2018

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Predictive model for identifying Hep B without significant liver fibrosis

Application of this non-invasive model could provide useful information on the stage of disease, guide future management decisions, and potentially decrease the need for liver biopsy in some patients with chronic Hep B, finds this month's American Journal of Gastroenterology.

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Histological assessment of liver fibrosis is important in the management of chronic Hepatitis B infection but poorly accepted by patients because of its invasiveness.

Dr Chan and colleagues from Hong Kong developed a noninvasive model to assess liver fibrosis in patients with chronic Hepatitis B using clinical and routine laboratory data.

The researchers conducted a retrospective study on 235 treatment-naïve viremic patients with chronic Hepatitis B.

The research team performed univariate analysis of data from the training cohort (n = 150) followed by multivariate logistic regression to identify independent predictors of significant fibrosis and generate predictive models.

The models were validated by the investigators with the remaining patients or validation cohort (n = 85) and by receiver operating characteristics analysis.

The model comprising 3 routine laboratory tests was accurate in predicting absence of significant fibrosis
American Journal of Gastroenterology

The investigative team identified body mass index, platelet count, serum albumin, and total bilirubin levels as independent predictors of bridging fibrosis or cirrhosis.

Receiver operating characteristics analysis was performed using the predictive probabilities derived from the regression models.

The researchers found that the area under the receiver operating characteristics curve of the best model was 0.80 for the training cohort, 0.77 for the validation cohort, and 0.79 for the entire cohort.

Using the low cut-off probability of 0.15, the investigators could exclude significant fibrosis in 83 patients of the total patient population.

Dr Chan concludes, “Our noninvasive model comprising body mass index and 3 routine laboratory tests was accurate in predicting absence of significant fibrosis.

“Application of this model could provide useful additional information on the stage of disease, guide future management decisions, and potentially decrease the need for liver biopsy in some patients with chronic Hepatitis B.”

American Journal of Gastroenterology 2005: 100(3): 616
11 March 2005

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